潮州市12~15岁青少年恒牙龋病流行特征分析

自20世纪70年代以来,多数工业化国家儿童龋病发生率呈下降趋势,但在一些龋病率很低的国家,儿童患龋率仍呈上升趋势[1].我国第三、四次口腔健康流行病学调查显示,12岁儿童恒牙龋患率由2005年的28.9%上升至2015年的38.5%[2-3].为了解潮州市12~15岁儿童恒牙患龋率及影响因素,笔者于2016年5-12月抽样调查了潮州市9所学校学生口腔健康状况,现将结果报道如下.     

1989年和2002年祁东县二次龋病调查流行病学分析

目的：了解祁东县步云桥镇农村小学生龋病的发病情况、趋势及分布规律。方法：按龋病检查方法和诊断标准进行。结果：所调查的小学生患龋率1989年为8．55％，2002年为22．02％，患龋率有显著性差异，同一次调查男、女学生患龋率差异无显著性。不同年龄患龋率2002年以8岁组为最高，8岁以后的患龋率随年龄增加而减少，以14岁组患龋率最低。1989年各年龄组患龋率相差不显著。结论：儿童患龋率与饮食习惯、食物结构、年龄、刷牙等有关。     

孕产妇的口腔保健

近年来，我国人均患龋病、牙周病、牙体牙髓病等口腔疾病正在逐渐上升。世界卫生组织近年来所公布的资料说明，当前世界上龋病分布的特点为高度工业化国家患龋率较发展中国家高，北美人和欧洲患龋率高达99％，但由于采取了有效的口腔预防控制措施，患龋率已明显下降，患病趋势由高向低发展；而我国生活水平的提高，患龋率却在逐渐上升。这就急切的需要口腔预防措施的干预，     

渭南市区部分小学生龋齿患病调查分析

目的为了解渭南市区小学生龋患现状，掌握龋患特点及规律，指导学生预防龋病，提高小学生的口腔卫生保健能力。方法采用《全国学生龋病牙周病流行病学调查与防治方案》，随机抽取市区3所小学2887名学生进行调查。结果总龋患率14．89％，龋均0．32。其中男生龋患率12．46％，龋均0．29；女生龋患率17．71％，龋均0．36。男女生之间差异有非常显著性（X^2=119．98，P〈0．005）。结论渭南市区小学生龋患率及龋均女生明显高于男生；女生7岁、男生8岁龋患率及龋均值最高，随年龄增加呈逐年下降趋势。     

780名学龄前儿童龋病调查分析

目的了解学龄前儿童龋病发病情况,寻找有效的预防措施。方法按龋病调查标准对9所幼儿园780名学龄前儿童进行龋病情况调查登记。结果大团镇农村学龄前儿童患龋率为61.4%,龋均为4.5,患龋率和龋均随儿童年龄增大而呈上升趋势。结论大团镇学龄前儿童患龋率高。要通过宣传,增强人群口腔保健意识,预防为主,加强干预,防治结合可从根本上改善本地区学龄前儿童龋病状况。     

南部县6711名中小学生龋病调查

龋病是人类高发病之一，严重危害牙齿健康。为了解南部县城镇中小学生龋病情况，我们于1991年对南部县城镇5所中小学7～18岁6711名学生进行了龋病调查。1结果在6711名学生中患龋者1452人．龋齿数为3379颗，患龋率为21.64％，龋均为2.33.其中男生3681人，患龋者768人，龋齿数为1897颗，患龋率为2086％，龋均2．47女生3030人，患龋者684人，龋齿数为1482颗，患龋率为2257％．龋均为2.17.小学生3162人，患龋者1129人，龋齿数为2776颗，患龋率为3571％，龋均为246；其中小学生乳牙息龋率为2878％，龋均为2．68，恒牙患龋率为693％，龋均为156；…     

东阳市小学生恒牙龋病调查结果

目的：了解东阳市小学生恒牙患龋情况，控制龋病的发展，为今后龋病的预防及治疗工作提供参考。方法对东阳市所有小学生的恒牙进行龋病普查分析。结果东阳市2010—2012年小学生恒牙患龋率分别为11.33％、9.25％和13.76％，龋均分别为0.17、0.17和0.19，恒牙患龋率和龋均3年差异均无统计学意义（P＞0.05）。结论东阳市小学生恒牙的患龋率3年内基本保持平稳，低于全国水平。     

广西壮、汉、瑶族学生龋齿流行现状与动态分析

目的 为了监测学生龋病的流行情况，为制订龋病流行预防控制策略提供依据。方法：根据“全国学生体质健康状况调研”实施细则的要求，采用整群抽样调查的方式进行调研。结果：总样本的乳牙龋患病率为27．15％，恒牙龋患率为16．77％。壮、汉、瑶族的12岁组恒龋均分别为0．48，0．24和0．32。学生龋病的流行特点是；乳、恒牙的龋患率皆为城市高于乡村；壮族高于瑶族和汉族；乳龋患率无性别差异，恒龋患率为女生高于男生。与1995年相比，汉族学生龋患率略有下降，壮族稍有上升，瑶族则为大幅度上升。结论：广西学生龋病流行仍属很低水平，但各群体的流行强度不平衡，龋病流行在总体上呈上升态势。     

芜湖市某小学学生龋病流行动态分析

目的了解芜湖市小学生龋病流行动态,为进一步开展口腔预防保健工作提供依据。方法2000~2005年每年对安徽师范大学附属小学全校6个年级学生进行口腔龋病检查并记录,分析小学生的乳牙患龋率及龋均、第一恒磨牙患龋率及龋均、龋病发病率及治疗率的变化情况。结果随时间的推移,除了龋病发病率表现先升后降,其他指标均表现上升趋势(P<0.05);按年级不同,第一恒磨牙患龋率及龋均一直呈上升状态,其他指标均表现先升后降(P<0.05)。结论小学生乳牙、第一恒磨牙的龋病流行状况在上升。儿童龋病的治疗率还很低,应加强口腔卫生保健工作。     

杭州市0～3岁儿童乳牙龋病流行病学调查及相关危险因素分析

目的调查杭州市0~3岁儿童乳牙龋病流行病学情况,并对引起乳牙龋病的相关危险因素进行分析,为临床防治提供参考依据。方法选取2015年10月-2016年7月杭州口腔医院的2 300例儿童为研究对象,年龄0~3岁,采用调查问卷方式对儿童口腔检查结果、患儿一般状况、出生情况、口腔卫生习惯、喂养状况、饮食情况、母亲文化程度等内容进行统计,并进行相关检验分析。结果 0~3岁儿童患龋率、龋均、龋面均分别为33.9%、0.9、1.5;患乳牙龋病率、龋均、龋面均分别为10.7%、0.4、0.7。随着儿童的年龄增长,儿童相应的患龋率、患乳牙龋病率、龋均、龋面均呈增长趋势,0~3岁儿童患龋率、患乳牙龋病、龋均、龋面均之间比较,差异有统计学意义(P0.05);不良喂养方式、母亲接受过高等教育、1年内母亲经口腔检查显示有龋、唾液检查出变链菌水平等是引起乳牙龋病的主要危险因素。结论杭州市0~3岁儿童随着年龄的增长,乳牙龋病发生率呈增长趋势;为减少乳牙龋病发生率,在儿童生活中应纠正儿童生活习惯、喂养方式,注重口腔卫生保护,加强口腔健康宣教。     

广州市中小学生乳牙龋及龋补与恒牙龋的关联

了解广州市中小学生乳牙龋牙数及龋补与恒牙龋的关联性,为预防学生恒牙龋病提供参考.方法 2014年9-12月,对广州市7,9,12和14岁的5 272名中小学生进行口腔检查,记录乳、恒牙患龋及龋补情况,运用负二项回归模型分析乳牙龋牙数和龋补数对恒龋牙数的影响.结果 广州市7,9和12岁学生乳牙患龋率分别为48.24%,45.21%,6.10%.7,9,12和14岁学生恒牙患龋率分别为0.61%,2.85%,10.14%,14.28%.男、女生乳牙患龋率分别为35.04%和34.08%,恒牙龋患率分别为4.88%和8.82%.以恒龋数为结局变量,分析乳龋对恒龋的影响,调整学生年龄、性别和城乡后,负二项回归模型中离散参数的估计值为16.37 (95%CI=9.27~28.90),女生较男生更易患恒牙龋,越年长的学生患恒牙龋的强度越高,且均有统计学意义(x2值分别为41.09,13.32,19.40,P值均<0.01).乳牙龋拟合负二项回归模型显示,调整年龄、性别和城乡后,有乳牙龋补和恒牙龋补的学生与恒牙龋的关联均有统计学意义(β值分别为1.00,2.76,P值均<0.05).将乳牙龋补和恒牙龋补同时纳入模型后,乳牙龋补对恒牙龋有保护效应(β=-1.09,95% CI=-1.72~-0.46,P<0.01),而恒牙龋补和恒牙龋的正关联也仍有统计学意义(β=3.02,95%CI=2.65~3.39,P<0.01).结论 乳牙龋越严重的中小学生恒牙龋也越严重,对乳牙龋进行龋补修复有助于降低恒牙龋牙数.     

Sucrose and dental caries

Sucrose is unequivocally implicated in the cause of dental caries. Biochemical, microbiological, animal and human clinical and epidemiological evidence support a causal relationship. The risk of caries is related both to the amount and the frequency of intake of sucrose. The evidence that sucrose is important is that a) extracellular synthesis of polysaccharides by plaque bacteria is dependent on high concentration of sucrose. Without synthesis of polymers S. mutans cannot colonize the mouth in large numbers. b) studies on animals show a relationship between sucrose content of a food and its cariogenicity, c) there is a direct relationship between the quantity of sucrose consumed and caries in humans, d) the relationship between dietary sucrose and caries in humans approximates an S-shaped curve that rises more steeply when the sucrose-containing products are consumed frequently and when newly erupted teeth are present in young children and adolescents. Following the sharp rise, the curve flattens out. Sucrose is much more cariogenic than starch in humans. Reduction in sucrose consumption levels by half will benefit dental health and is unlikely to have any detrimental effects on health.     

Sugars and dental caries

A dynamic relation exists between sugars and oral health. Diet affects the integrity of the teeth; quantity, pH, and composition of the saliva; and plaque pH. Sugars and other fermentable carbohydrates, after being hydrolyzed by salivary amylase, provide substrate for the actions of oral bacteria, which in turn lower plaque and salivary pH. The resultant action is the beginning of tooth demineralization. Consumed sugars are naturally occurring or are added. Many factors in addition to sugars affect the caries process, including the form of food or fluid, the duration of exposure, nutrient composition, sequence of eating, salivary flow, presence of buffers, and oral hygiene. Studies have confirmed the direct relation between intake of dietary sugars and dental caries across the life span. Since the introduction of fluoride, the incidence of caries worldwide has decreased, despite increases in sugars consumption. Other dietary factors (eg, the presence of buffers in dairy products; the use of sugarless chewing gum, particularly gum containing xylitol; and the consumption of sugars as part of meals rather than between meals) may reduce the risk of caries. The primary public health measures for reducing caries risk, from a nutrition perspective, are the consumption of a balanced diet and adherence to dietary guidelines and the dietary reference intakes; from a dental perspective, the primary public health measures are the use of topical fluorides and consumption of fluoridated water.     

Dynamics of caries activity and caries reduction in group prophylaxis with fluoride gel

AIM: The study aims at following up the dynamics of caries activity (As) and caries reduction (Rs) of first permanent molars (M1) in group prophylaxis with 0.42% fluoride gel in groups with relatively low caries risk. METHODS: A three-year-long study on 213 7-year olds from Plovdiv was carried out. Children were assigned to two groups - an experimental group and a control group. The children in both groups had no clinical caries on M1 (DMFS = 0) and dft < the means for seven-year olds in Plovdiv. The screening procedure excluded children who were undergoing orthodontic treatment. Eight applications of 0.42% fluoride gel each at 3-month intervals were made in the experimental group. RESULTS: In the first two years caries activity was significantly higher in the control group. In the third year, after discontinuing gel application caries activity in the experimental group slightly increased while that in the control group decreased. No statistically significant differences were found. Caries reduction was highest in the first year (73.12%) with slight decline in the 2nd year (71.12%). In the 3rd year caries reduction was only 17.07%. Despite this, Rs of M1 as measured for the whole period at the end of the 3rd year was 61.93%. CONCLUSION: The first permanent molars are susceptible to caries attack even in groups with relatively low caries risk. The results of this study demonstrate the high effectiveness of prophylaxis using fluoride gel.     

氟化泡沫对学龄前儿童龋齿的预防效果及对乳牙患龋情况和龋面变化的影响

目的研究氟化泡沫对学龄前儿童龋齿的预防效果及对乳牙患龋情况、龋面变化的影响。方法选择2016年1-12月共200例3~4岁学龄前儿童,随机均分为两组,对照组给予常规防龋保健指导,观察组在对照组基础上采用氟化泡沫预防龋齿,每6个月干预1次,共干预治疗4次。观察比较两组的新增龋率、龋均、DMFT指数、浅龋再矿化率。结果两组干预前后龋坏率比较差异均无统计学意义(均P>0.05)。观察组新增龋率显著低于对照组,差异有统计学意义(P<0.05)。干预前,两组龋均比较差异无统计学意义(P>0.05)。干预后,观察组龋均显著低于对照组(P<0.05)。干预前,两组DMFT指数比较差异无统计学意义(P>0.05)。干预后,观察组DMFT指数显著低于对照组(P<0.05)。观察组浅龋再矿化率(36.0%,36例)显著高于对照组(23.0%,23例),差异有统计学意义(χ^2=4.06,P<0.05)。观察组应用氟化泡沫干预过程中,发生误吞4例,发生率为4.0%,无其他不良反应发生。对照组无不良反应发生。结论氟化泡沫对学龄前儿童龋齿的预防效果显著,能够有效控制乳牙患龋情况、龋面变化,从而保护乳牙。