口腔种植患者的口腔护理行为调查分析

目的：了解口腔种植患者的口腔护理行为,为口腔种植患者的口腔护理健康教育提供依据。方法：对在福建省级机关医院口腔科完成口腔种植义齿修复半年以上的患者进行问卷调查。结果：3.2%患者每天刷牙3次;34.8%患者刷牙时间大于3分钟;50.2%左右患者经常使用牙线和牙缝刷;30.3%患者经常使用冲牙器;仅6.7%患者做到戒烟;49.4%患者不按医嘱定期复查;65.2%患者未能进行牙周洁治。结论：口腔种植患者在口腔专业维护方面存在偏差,应加强健康教育,同时应特别注意文化程度较低的人群。     

Oral complications associated with cancer therapy An M. D. Anderson Cancer Center experience

Abstract. Oral complications associated with cancer therapy may not be inevitable. The intensity and duration can be prevented or alleviated by correcting existing oral-dental pathology and maintaining meticulous oral care. Microbial (bacterial, fungal and viral) assessment not only allows appropriate documentation of mucositis versus mucosal infection but directs therapeutic treatment.     

Effects of an oral health program on the occurrence of oral candidosis in a long-term care facility

OBJECTIVES: The aim was to evaluate the effectiveness of a preventive oral health program on the prevalence of oral candidosis in 237 frail or dependent residents in a long-term care facility. Half of the residents were included in an experimental group which benefited from a preventive oral hygiene program including instruction of the carers and implementation of a recall program for professional oral hygiene care. METHODS: Intraoral examinations and yeast cultures from the oral mucosa and the fitting denture surface were carried out at baseline and 18 months later. The outgrowth of yeast was estimated on Oricult-N dip slides using the scale: no growth; 1-20 colonies; 21-100 colonies; >100 colonies. RESULTS: At baseline (n = 237) and at 18 months (n = 159) the experimental and the control groups were similar with regard to the residents' distribution by age, sex, dental and prosthetic status and prevalence of denture stomatitis. The 78 residents lost had the same baseline characteristics as the survivors, except for being older. In the experimental group the severity of the inflammation of the palate decreased (P = 0.005) as well as the prevalence of glossitis (P = 0.005). At baseline high yeast scores from the mucosa (>20) were observed in about 50% of the residents in the experimental as well as the control group. At 18 months this figure was 23.4% for the experimental and 48.7% for the control group (P = 0.001). There was also a reduction of the number of residents with positive cultures and the denture yeast scores at 18 months in the experimental group (P = 0.05). CONCLUSIONS: This study has shown that the preventive program was effective in reducing the colonization of the oral mucosa and dentures by Candida and thereby improving the health of the oral mucosa.     

武汉市东西湖区5岁儿童口腔健康行为调查

目的:了解东西湖区5岁儿童的基本口腔健康行为及其家长的儿童口腔卫生知识水平,为东西湖区儿童口腔卫生保健工作提供信息支持。方法:按照第三次全国口腔健康流行病学调查方案设计的5岁儿童家长问卷,对东西湖区8所幼儿园529名5岁儿童家长进行问卷调查,了解儿童饮食行为,口腔卫生行为、利用口腔医疗行为,家长口腔保健知识知晓情况。结果:30%的儿童经常有睡前进食甜食的习惯。5%的儿童在3岁前开始刷牙,每日刷牙2次者仅占10%。有5%的儿童使用含氟牙膏刷牙。在过去1年中,90%的儿童没看过牙医。结论:东西湖区5岁儿童口腔健康行为低于全国平均水平,儿童口腔健康行为尚不完善,有必要加强父母的口腔健康教育,建立正确的儿童口腔健康行为。     

Is prosthodontic treatment age‐dependent in patients 60 years and older in Public Dental Services?

Prosthodontic treatment is a common procedure for the elderly as tooth loss is a reality in old age. Dentists take care of increasingly older patients with physiological age manifesting as cognitive impairment, frailty or multiple chronic diseases or who have side effects of medicines. We evaluated how patients’ age affects prosthodontic treatment choice and whether we could identify the age when a change in practice occurs. In addition, we determined how common the treatment method of fixed prostheses is among patients aged 60 years or over in Public Dental Services (PDS) and how common rehabilitation of dentition with new dentures is compared with repair of existing dentures. Our data cover all patients aged 60 years and older (n = 130 060) treated in Helsinki PDS in 2007–2012. Data were aggregated into seven groups: 60–64, 65–69, 70–74, 75–79, 80–84, 85–89, and 90 years and over. During the 6‐year period, the mean annual number of the population was about 114 000 and the mean annual number of patients treated with prosthodontics 1700. Prosthodontic treatment choices (repair, removable prosthodontics, fixed prostheses, fibre‐reinforced composite fixed prostheses) vary by age; the older the patient, the rarer fixed or fibre‐reinforced composite fixed prostheses and removable prostheses and the more frequent repairs (P < 0·001). Denture repair was virtually the only treatment that patients over 90 years received. Based on our results, the age at which prosthodontic treatment practices in PDS change is around 70 years. Beyond this age, fixed prosthodontic treatment modalities are very rare and repairs are more common.     

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目的    了解山东省12岁年龄组人群恒牙龋病情况,为山东省牙病防治工作提供依据。方法    2005年9 —12月山东省牙病防治指导组根据经济发展情况选择山东省有代表性的市和县,即济南市市中区、威海市环翠区、济宁市兖州市、章丘市、平原县、费县,每个市（县）抽取3个乡镇。采用多阶段分层等容量随机抽样方法选择12岁年龄组的青少年,共781人。采用第三次全国口腔健康流行病学调查龋病调查标准,调查恒牙龋病情况。结果    山东省12岁年龄组人群恒牙患龋率为33.4 %,龋均0.55,龋齿充填率15.9 %,窝沟封闭率3.8 %,含氟牙膏使用率29.9 %。女性患龋率和龋均（38.0 %,0.63）均明显高于男性（28.8 %,0.46）（P < 0.05）,城乡间无明显差别;城市12岁年龄组人群充填率、窝沟封闭率及含氟牙膏使用率高于农村,差异有统计学意义（P < 0.05）;山东省患龋率、龋齿充填率和窝沟封闭率均明显高于全国水平（P < 0.05）,龋均没有明显差别。结论    山东省12岁年龄组人群牙病防治工作10年来取得了一定成效,但牙病的防治措施仍有待进一步加强,尤其是农村地区。     

Oral bacteria and clinical variables in dependent individuals at a special facility

The oral health of dependent residents at special facilities has often been reported as being poor, but it is difficult to relate oral health to general health and define the need for oral health care. Microbiological analyses of the oral flora have been suggested as a suitable method for evaluating oral health in this group of patients. A study was performed at a nursing facility where 33 individuals participated. The aim was to describe their oral flora in relation to other health variables and to classify the residents on different risk levels. An oral examination of the residents was made at the facility, together with a 3‐day food record and an oral microbiological analysis. The analysis classified the residents in different categories according to both acid‐producing bacteria and the flora correlated with a reduction in general health. The categories were based on previous studies conducted at the Department of Microbiology (Faculty of Odontology in Göteborg). The present study revealed that the level for acid‐producing bacteria was high in 12 individuals and the micriobial level according to decreased general health was high in seven individuals. A high level of acid‐producing bacteria was related to functional impairment, which was in turn related to nutritional problems and help with oral hygiene. The microbial level according to the reduction in general health did not significantly correlate with other variables.     

Effectiveness of health care worker training on the oral health of elderly residents of nursing homes

OBJECTIVES: The aim of this study was to evaluate the effect of a staff training programme on mouth care on the oral health of elderly residents of long-term care institutions. METHODS: Seventy-eight residents of five long-stay institutions were enrolled and underwent a baseline oral health assessment. Staff caring for residents in three of the sites received intensive training in mouth care. This comprised lecture and video material complemented by clinical demonstrations. The oral health of residents at all five sites was reassessed at periods of 3 and 9 months. Staff caring for residents in the remaining two institutions were then provided with mouth care training and all patients were reassessed at 18 months. Statistical analyses were undertaken to examine for significant changes in selected oral health parameters after training, within each group. RESULTS: Oral mucosal disease and oral dryness were common at baseline. The staff training was well received. Following staff training, there was a significant reduction in the number of residents left to undertake their own oral care. There were significant improvements in denture hygiene and a reduction in the number of residents wearing dentures overnight. The prevalence of oral mucosal disease dropped, with significant reductions in angular cheilitis and denture stomatitis. CONCLUSION: This education programme was effective in changing oral health care procedures within long-stay institutions for the elderly, with measurable improvements in oral health of the residents.     

Oral health care patterns and the history of miscarriage

Objective: Oral infections can trigger the production of pro‐inflammatory mediators that may be risk factors for miscarriage. We investigated whether oral health care patterns that may promote or alleviate oral inflammation were associated with the history of miscarriage in 328 all‐Caucasian women. Materials and methods: Of 328 women in this cross‐sectional cohort, 74 had history of miscarriage (HMC). Medical, dental and sociodemographic data were collected through clinical examinations, medical record searches and structured questionnaires. Results: The multivariate regression analyses indicated that urgency‐based dental treatment demonstrated a significant association [odds ratio (OR) = 2.54; 95% confidence interval (CI): 1.21–5.37; P = 0.01] and preventive dental treatment demonstrated a marginally significant inverse association (OR = 0.53; CI: 0.26–1.06; P = 0.07) with HMC. Self‐rated poor oral health had a non‐significant positive association with HMC (OR 1.60; CI: 0.88–2.90). Conclusion: Our results provide sufficient evidence for hypothesis generation to test whether other precise measures of oral inflammation are associated with adverse birth outcomes.     

Long‐term effects of using oral care aides at a nursing home for elderly dependent residents—a pilot study

The oral health status of elderly dependent residents is reported to be poor, as well as difficult to describe. Analysis of oral microbial flora has been suggested as a suitable measurement method. Oral care aides have been shown to have a positive influence on oral health care in nursing. The outcome of an intervention with oral care aides was followed during a two‐year period by recording: (a) the proportion of opportunistic microorganisms and bacteria associated with caries (b) whether oral hygiene assistance were given to the residents or not, and (c) individual experiences concerning oral health care among the staff involved. The oral flora and the amount of oral hygiene assistance improved throughout the entire study period, but staff interviews revealed that it took two years for good cooperation and prophylactic routines to be established. An unexpected finding was the positive correlation (p = .0005) between a high proportion of the opportunistic microorganisms and death within one year.     

Oral candidosis in the elderly in long term hospital care

A total of 137 patients in long term hospital care were interviewed and examined to determine the prevalence, nature and most important causes of oral candidosis in the hospitalized elderly. Oral candidal infection as determined by the imprint culture technique was present in 47% of patients with a further 31% being carriers of Candida. The prevalence of chronic atrophic candidosis in denture wearers was 38%, while 26% of all patients had angular cheilitis, 67% of which had an infective etiology. Microbiologic examination strongly indicated the upper denture as the major source of infection in those with dentures despite the existence of a ward policy which should have encouraged good oral and denture hygiene.     

Anhydrotic ectodermal dysplasia (Christ-Siemens-Touraine syndrome). A case report

The ectodermal dysplasias (EDs) are a complex group of diseases clinically characterised by congenital absence of ectodermally derived structures. The present report details the features of a 13 year old schoolboy with the rare anhydrotic ectodermal dysplasia (Christ-Siemens-Touraine syndrome).     

Oral health‐care utilization in adults with disabilities in Belgium

Leroy R, Declerck D. Oral health‐care utilization in adults with disabilities in Belgium.
Eur J Oral Sci 2013; 121: 36–42. © 2012 Eur J Oral Sci Reports on oral health‐service utilization among individuals with disabilities are very sparse. Nevertheless, such data are a prerequisite for the provision of proper care and for the development of optimal reimbursement schemes and may ultimately lead to better access to care. The objective of the present study was to provide data on oral health‐care utilization in Belgian residents with disabilities and to compare these data with the utilization pattern of their peers without special needs. Data from the Permanent Sample of Socially Insured Persons, an anonymous representative sample of Belgian residents, were used. The database contained prospective data on oral and general health‐care utilization and socio‐demographic variables from 1,221 individuals with disabilities and from 131,877 individuals without disabilities, collected from 2002 to 2008. Overall, annual dental‐attendance rates were very low and in those who attended, professional debridements, a cornerstone in preventive oral health care, were infrequently recorded. In adults with disabilities, significantly fewer radiographs, restorations, and endodontic treatments were recorded, whereas significantly more emergency visits were charged. Further research is indicated to evaluate whether this outcome points to high unmet oral‐treatment needs.     

Time is on the side of change in dentistry

The 2020 environment challenges health professionals and stakeholders to reconsider oral health-care design and business operations to drive meaningful change toward improving the oral health of all. The Three Domain Framework reinforces connections between social and structural determinants of health while promoting new opportunities to demonstrate value-based solutions that connect care providers, individuals, and communities.     

Accessibility to oral health care for people on social assistance: a survey of social service providers from Public Welfare Centers in Flanders

Objectives: The goals of the present study were as follows: (i) to explore the characteristics of the Flemish Public Centers for Social Welfare (PCSW) concerning oral health care; (ii) to explore possible barriers experienced by people on social assistance and oral health-care providers; and (iii) to explore the accessibility of general and oral health care for people on social assistance. Methods: The data of this cross-sectional study were obtained by a survey of social service providers working in a PCSW. For this purpose, a new questionnaire was developed. The survey was validated by means of a pilot study. All 306 PCSWs in Flanders were invited to participate in this survey, of which 192 (62.7%) responded. Results: The findings demonstrate that for people on social assistance, financial limitations and low prioritisation of oral health are the main barriers to good oral health care. The study reveals that such individuals experience greater financial barriers and poorer access to a dentist than to a general medical practitioner. The study also reveals that dentists report financial concerns and administrative burdens as the main barriers in treating this subgroup. The responses of PCSWs demonstrate that local dentists are reluctant to treat this subgroup. Conclusion: Additional efforts are needed to improve the accessibility of oral health care for people on social assistance. Recommended improvements at the organisational level could improve increased education to target the population on the importance of oral health care. Administrative burden and financial concerns of the providers also need to be addressed to decrease their reluctance to work with those on social assistance.Key words: Oral health care for people on social assistance, oral health care for asylum seekers, oral health care for undocumented immigrants     

Dental therapy in the United States: Are developments at the state level a reason for optimism or a cause for concern?

Access to dental care continues to be a challenge for millions of vulnerable Americans. In more than 50 nations worldwide, dental therapists (DTs), mid‐level providers who deliver a limited scope of dental care under the supervision of a dentist, have helped increase access to needed care. Since 2003, when the Alaska Native Tribal Health System introduced DTs as part of the Federally authorized Alaska Community Health Aide Program, a total of 13 states have adopted the role. However, as of April 2020, there are fewer than 150 DTs in practice throughout the country, and educational and licensing requirements as well as scope of practice vary between each state. Such heterogeneity makes the training and recruitment of future DTs a challenge. This article summarizes the current state of the DT workforce in the United States and discusses the possible future of the profession as other states contemplate adopting the model in the face of ongoing oral health disparities.     

Access to dental care in two long-term refugee camps in western Tanzania; programme development and assessment

Objective: To analyse the demographics surrounding and the sustainability of a course in Emergency Dental Care and Health Promotion developed and taught by a team of dentists from the United States to refugee camp health‐care workers in two long‐term refugee camps in Western Tanzania. Methods: Refugee camp dental patient log books from Mtabila and Nyarugusu camps Kigoma, Tanzania were analysed and demographic data collected on each patient visit from the programme inception in November 2007 until August 2009. Data collection included information relevant to 1961 patient visits. Data were entered into SPSS Statistics 17.0 using the Freq application. Outcomes: Patient visit data included demographics involving both the resident camp populations and the surrounding communities. The distribution of patients treated by nationality was: 58% Burundian (Mtabila), 14% Congolese (Nyarugusu), and 28% Tanzanian citizens residing near both camps. Extractions accounted for 95.5% of procedures performed. Recorded incidences of post‐operative complications were 1 > % of patient visits. Patient visits were steady over time and a referral system was implemented for complex cases. Health promotion sessions were held in both camps. Conclusion: This dental programme has been self‐sustaining and is providing some access to care where none existed previously. Programmes such as this may be one solution to the access to dental care problem in long‐term refugee camps.