牙科全麻技术前后患儿口腔相关生活质量的对比研究

目的:观察分析全身麻醉下儿童口腔治疗前后患儿口腔相关生活质量的改变.方法:收集接受全身麻醉下牙齿治疗3～6岁的患儿59例资料,由患儿家长全麻前和术后1个月分别填写儿童口腔健康生活量表,本量表包括患儿自身影响部分和家庭影响部分.通过分析软件SPSS 19.0进行数据分析.结果:全麻后口腔健康生活量表总分降低51％ (P＜0.001),其中患儿影响部分降低50％ (P ＜0.001),家庭影响部分降低53％ (P ＜0.001),效应量分别为1.4和4.0.结论:对于年幼不合作且多数牙齿龋损的患儿,全身麻醉下牙齿治疗可显著提高患儿及其家庭的口腔相关生活质量.     

北京市海淀区3岁儿童龋病患病状况及龋病活跃性检测的研究

目的 通过了解北京市2所大学附属幼教机构学龄前儿童的口腔健康状况、龋病活跃性,了解儿童患龋情况与龋病活跃性之间的关系,探讨龋病活跃性检测筛查龋易感儿童及反映龋活跃性检测试剂的灵敏性和特异性,评价其对患龋预测的有效性和可行性.方法 对3岁年龄组儿童进行连续1年的口腔检查和龋活跃性检测,分析儿童患龋情况的变化与龋病活跃性之间的关系.结果 3岁儿童的患龋率为44.80%,龋均dft为2.04,龋面均dfs为2.79,儿童龋活跃性检测结果的各个分值与儿童患龋程度呈高度正相关关系(P<0.001).1年后随访,龋高危组儿童的新龋发生率显著高于龋低危组,经统计学检验其差异具有显著性意义(P<0.001).Cariostat法进行龋活跃性检测的敏感度可达95.1%,特异度达50.2%.结论 龋活跃性检测能够准确的反映儿童龋患现状,预测儿童患龋的趋势,为儿童制定个性化的预防保健计划.     

动机性访谈技术在儿童口腔全麻术后疗效评估

目的:对比两种不同的口腔健康管理方式在改善DGA患儿术后效果的差异,并进一步研究其可能存在的影响因素。方法：将130名进行DGA治疗的患儿作为研究对象,分为试验组和对照组,记录患儿DGA术前、术后1、3、6月龋活跃性、龋齿数及口腔卫生习惯,采用SPSS 17.0软件进行统计分析。结果：与术前相比,1月、3月、6月复查的患龋风险及患龋率均下降,但试验组下降更明显,且差异具有统计学意义。术后6月随访时,龋态风险和患龋人数相关,差异具有统计学意义。风险因素显示仅睡前吃甜食饮料、牙线使用情况与DGA术后龋病复发有明显相关,差异具有统计学意义。结论：动机性访谈技术与传统常规口腔宣教相比,在降低DGA术后龋风险及患龋率方面有明显的优势,值得在临床中进一步推广。     

儿童固定矫治中龋病活跃性变化的观察

目的　观察儿童固定矫治中龋病活跃性的变化。方法　以龋病活跃性检测法对进行方丝弓固定矫正器治疗的 30例恒牙列儿童 ,分别在戴用固定矫正器之前 ,戴固定矫正器后 1周 ,1、3和6个月时 ,检测龋病活跃性度数。结果　矫治前龋病活跃性度数与矫治后 1、3、6个月的差异均有显著性 ;矫治后 1周龋病活跃性度数与矫治后 3、6个月差异亦有显著性。结论　戴用固定矫正器的儿童龋病活跃性度数增加 ,龋病敏感度增强     

低龄儿童乳牙龋病流行病学及龋活跃性分析

目的:调查3～6岁儿童乳牙龋病的流行情况,研究龋活跃性与患龋严重程度的关系。方法:纳入南京市6所幼儿园1 375名3～6岁儿童进行口腔检查和龋活跃性试验。结果:3～6岁儿童平均患龋率和龋均分别为50.48%和2.13,龋齿充填率6.93%,其中5岁年龄组患龋率和龋均分别为61.42%和2.92。龋活跃性各分值之间的患龋率及龋均差异显著(P<0.01)。龋活跃性与患龋率及龋均呈高度正相关(P<0.01)。结论:3～6岁年龄段儿童的患龋情况严重,且治疗率十分低,应加强口腔健康教育,开展多种防龋措施。龋活跃性检测结果能够真实反映患龋现状,有助于筛选龋易感者。     

两种正畸酸蚀粘接法对儿童致龋活跃性的影响

目的:通过比较传统酸蚀后粘接与自酸蚀粘接正畸固定矫治器后龋活跃性的变化,了解矫治过程中不同酸蚀粘接法与龋活跃性的关系及其诱龋活跃性的差异.方法:随机选择30例11～14岁正畸儿童,安装方丝弓固定矫正器,左侧上下牙列采用传统酸蚀粘接法,右侧牙列采用自酸蚀粘接法,通过CAT龋病活跃性检测法比较正畸前及正畸后1周、1个月、3个月和6个月的龋病活跃性度数.结果:矫治前龋活跃性度数与矫治后3个月和6个月具有显著性差异(p＜0.05);与矫治后1周和1个月无显著性差异(p＞0.05).结论:两种粘接法致龋活跃性明显不同,传统法致龋活跃性高于自酸蚀法.     

唇腭裂修复术前后龋病活跃性的临床观察

目的观察唇腭裂修复术前后1年患儿龋病活跃性的变化。方法40例3~6岁的唇腭裂患儿于唇腭裂修复术前、术后6个月、12个月分别采用Cariostat试验检测龋病活跃性。结果唇腭裂修复术前与术后6个月、12个月的龋病活跃性差异有统计学意义(P<0.05);手术后6个月与12个月的龋病活跃性差异也有统计学意义(P<0.05)。结论唇腭裂修复术后患儿的龋病活跃性下降,龋病敏感性降低。     

龋病活跃性试验

本文讨论了龋病活跃性的定义,龋活跃性试验的基本要求及局限性,龋病活跃性试验在口腔预防医学中的意义和作用。对至今已有的龋活跃性试验,即有关宿主敏感性的龋病活跃性试验和有关口腔细菌的龋病活跃性试验及今后发展作了介绍。     

S-ECC患儿经治疗后菌斑微生物群落短期内改建过程分析

目的 从微生物角度探究重度低龄儿童龋（severe early childhood caries,S-ECC）患儿一次完成龋病治疗前、治疗后3个月内菌斑微生物群落构成和多样性的变化及治疗对于远期无龋状态维持的作用。方法S-ECC患儿在全身麻醉下一次完成龋病治疗,采集治疗前（C）、术后7 d(C-7D)、1个月（C-1M）、3个月（C-3M）无龋牙面集合菌斑,并纳入无龋儿童（CF）为对照组,分析治疗前后菌斑微生物群落短期内的动态改建过程。结果 S-ECC组和CF组菌斑群落组成高度相似;组间α多样性指数差异无统计学意义（P>0.05）;从相对丰度值分析,纤毛菌属、聚集杆菌属等在治疗后较术前下降（P<0.05）,C-7D组血链球菌较C组上升并在3个月内逐渐下降;治疗前韦荣菌属、放线菌属、拟普雷沃菌属、二氧化碳嗜纤维菌属、变异链球菌在C组和CF组间存在显著差异（P<0.05）,其中变异链球菌经治疗后的C-7D、C-1M组与CF组未存在显著差异,而C-3M组较CF组出现上升（P<0.01）。结论 S-ECC患儿在接受治疗后菌群结构的迅速改变,并在治疗后1～3个月逐渐开始建...     

静吸复合全麻下婴幼儿龋治疗的效果评估

目的:评估静吸复合全麻下婴幼儿龋治疗的效果。方法:门诊收集60名符合2002年美国儿童牙科学会重症婴幼儿龋标准的1~5岁健康儿童,其中男38人,女22人。最小年龄17个月,最大年龄60个月,龋均10.62。在静吸复合全麻下接受全口牙齿治疗,术后半年及1年复查,统计充填体保存率,继发龋出现率及经治人群的龋病发病率,使用SPSS软件进行统计学分析。结果:1年复查充填体保存率96.93%,继发龋出现率半年复查为0.32%,1年复查为4.36%,具有统计学显著差异(2χ=22.069,P=0.00)。龋病发病率半年复查为6.67%,1年复查为13.33%,虽无统计学差异,但增高趋势明显。结论:全麻下治疗婴幼儿龋疗程短,疗效佳,临床应用前景广阔。应注意取得患儿家长的配合,培养患儿良好的口腔卫生习惯,定期复查,以达到良好的远期效果。     

全身麻醉在儿童口腔疾病治疗中的应用

目的：评价全身麻醉在不配合儿童口腔疾病治疗中的临床疗效。方法：收集4—12岁患口腔疾病需治疗病例59例,分别对捆绑强制性多次复诊完成治疗和全麻一次性完成口腔疾病治疗进行临床效果对比评估。结果：全麻下对不配合儿童进行口腔治疗能缩短疗程、提高医疗质量,改善口腔整体卫生水平,减少继发龋、充填物脱落率（P＜0.05）,减轻治疗过程给患儿带来的恐惧、焦虑等负面情绪,有效提高患者的依从性（P<0.05）。结论：对于不配合治疗儿童进行全麻一次性治疗耗时短、疗效高,可降低心理恐惧和焦虑,保护患儿的心理健康,提高患儿的依从性。     

大连开发区3岁儿童乳牙龋病患病状况及相关因素分析

目的:了解大连开发区3岁儿童乳牙龋病患病状况及影响因素.方法:采用多阶段、整群随机抽样方法,抽取15所幼儿园里全部3岁儿童进行口腔健康检查和儿童家长的问卷调查.参照世界卫生组织推荐龋病诊断标准,问卷内容包括儿童的基本信息、口腔卫生习惯、饮食习惯,家长的口腔健康知识及口腔健康态度以及社会经济因素.使用SPSS 16.0对数据进行统计分析,计算乳牙龋患病率和龋均.采用卡方检验,独立样本t检验和单因素方差分析以及Logistic回归分析比较组间差异及龋病的影响因素.结果:共有1220名3岁儿童完成口腔健康检查,其中964名儿童家长(79.8％)完成问卷调查.3岁儿童乳牙龋病患病率为62.8％,龋均3.40,龋面均7.34,男女间差异均无统计学意义(P＞0.05).Logistic回归分析显示儿童摄入甜食和含糖饮料的频率(P＜0.05),父母的最高学历水平(P＜0.05)与儿童是否患龋相关.结论:大连开发区3岁儿童乳牙龋病患病状况较严重,患龋与进食含糖食物和饮料的频率及家长的教育水平有相关性.     

家长态度与儿童口腔卫生习惯形成的关系

目的：从刷牙次数和甜食消费两个方面,分析家长对龋病易感因素的态度与儿童实际龋相关行为的关系,为开展口腔卫生宣教提供依据.方法：用配对法研究儿童家长对儿童龋病易感因素问题的关心程度与儿童实际行为的联系,dmft=0的儿童及其家长作为对照组,dmft≥3的儿童及家长作为试验组.所得数据用SPSS10.0软件包进行Logistic回归,分析家长对儿童刷牙与甜食摄入相关问题所持的态度与儿童实际行为的关联程度.结果：家长对待儿童刷牙的态度与儿童实际刷牙情况有密切关系（P=0.000）,家长对待儿童甜食问题的态度与儿童实际甜食摄入行为有密切联系（P=0.001）.结论：家长对待儿童刷牙和甜食的态度,在一定程度上反映儿童的相关行为.可通过卫生宣教,提高家长在儿童龋病预防中的作用,减少龋病的发生率.     

氟化钠护齿剂在预防学龄前儿童乳牙龋齿中的疗效观察

目的:观察氟化钠护齿剂预防儿童乳牙龋齿的效果,为全面开展学龄前儿童涂氟防龋提供依据。方法:采取随机整群抽样方法,在上海市徐汇区抽取25所公办幼儿园3~4岁小班儿童共1140名作为研究对象,在儿童家长知情同意的情况下,本着自愿原则,将研究对象分为2组。涂氟组762名,每半年涂氟1次,连续2年共涂布4次;对照组378名,不做涂氟处理。对所有入组儿童进行口腔卫生指导,比较2组儿童患龋率、龋均、龋病发病率、新增龋均的情况,采用SAS 9.4软件包进行统计学分析。结果:2年后,对照组的患龋率、龋均、龋病发生率和新增龋均均显著高于涂氟组（P<0.05）。结论:在学龄前儿童中应用氟化钠护齿剂,能有效降低乳牙龋病发生率和新增龋均,值得在学龄前儿童中推广应用。     

Dental caries status of preschool children in Hong Kong

OBJECTIVE: To describe the dental caries status of preschool children in Hong Kong and factors which affect their caries status. DESIGN: 658 preschool children aged 4 to 6 years from six randomly selected kindergartens in Hong Kong were surveyed in December 1997. A questionnaire to investigate possible explanatory variables for caries status was completed by their parents. Dental caries was diagnosed according to the criteria recommended by the World Health Organization (1997). RESULT: Caries experience as measured by the mean number of decayed, missing and filled primary teeth (dmft) of the 4-, 5-, and 6-year-old children were found to be 0.9, 1.8, and 3.3 respectively. Overall, 61% of the children had a zero dmft score. Children born in Mainland China had a higher mean dmft score (4.6) than those born in Hong Kong (1.4). Statistically significant correlations were found between the children's dental caries status and their oral health practices as well as their socio-economic background. Parents' education level, dental knowledge and attitudes were also associated with the children's dental caries experience. CONCLUSION: In general, the caries status of Hong Kong Chinese preschool children was similar to that of children in industrialised countries and was better than that of children in the nearby areas. However, special dental programmes should be made available to children from lower socio-economic classes and new immigrants from Mainland China because they are the high risk groups for caries in Hong Kong.     

多维度口腔清洁干预模式对区域学龄前儿童防龋效果的评价

目的:探讨多维度口腔清洁干预模式对区域学龄前儿童(3～6 岁)的防龋效果.方法 :于2016年10月随机抽取上海市静安区12所幼儿园600名3～4 岁儿童,分为对照组和实验组(每组6 所幼儿园300名儿童).对照组进行常规口腔保健教育,实验组采用多维度口腔清洁干预模式进行干预,随访观察2 年,比较2 组儿童的口腔清洁行...     

Influences of diet on caries activities and caries-risk grouping in children,and changes in parenting behavior

BackgroundDental caries incidence in early childhood is known to influenced by the behavior of parent with their children, and clinicians and dental staff are advised to provide parents with effective oral health instructions. The objectives of this study were to identify the influence of diet of 18- and 24-month-old children on caries activities and investigate changes related to the behavior of their parents after receiving health instructions regarding caries risk for 2-year-old children.MethodsThe subjects were 1,206 child-parent pairs. The children participated in 18-, 24-, and 42-month-old health examinations at Kurashiki City Public Health Center in Kurashiki City, Japan. Cariostat, a caries activity test (Dentsply-Sankin Co., Tokyo), was conducted and the children were then classified into 6 caries-risk groups based on the 42-month-old predictive cutoff points. Their parents were given oral health instructions on caries prevention by dental hygienists of the Kurashiki City Public Health Center. In addition, a questionnaire regarding diet was given to identify its influence on caries activities in 18- and 24-month-old caries activities in 18- and 24-month-old children, as well as the influence of changes in parenting behavior.ResultsA significant number of children in the high-risk group received breast feeding or bottle-feeding with liquids other than water at 18 months of age. Also total time for sucrosecontaining food intake was significantly associated with increased caries activity at 18 months of age. After giving oral health instructions to parents of the 18-month-old children dietary habits significantly correlated with the high-risk group at 24 months of age were breast feeding or bottle-feeding with liquid other than water, total intake time of sucrose-containing food, and frequency of sucrose-containing foods intake. Furthermore, parents whose children were in the higher caries-risk group at 18 months of age showed a lower level of change in parenting behavior as compared to those with children in the lower caries-risk group.ConclusionIt is important to assess problematic dietary habits in accordance with caries-risk in young children and change parent behavior through effective oral health instructions.Clinical ImplicationClinicians can identify problematic dietary habits in children based on caries-risk and provide effective oral health instructions to parents, which may influence.     

A staged intervention dental health promotion programme to reduce early childhood caries

OBJECTIVE: This paper reports the results of a community trial to assess the effects of a multi-stage dental health promotion programme in reducing Early Childhood Caries (ECC). RESEARCH DESIGN: Two health districts (Primary Care Groups) were matched for dental disease levels and socio-demographic factors. One was randomly allocated to be the test Primary Care Group (PCG), the other the control PCG. Children in the test PCG received a series of interventions to support positive dental health behaviour from the age of 8 to 32 months. Interviews were conducted with parents of children aged 21 months and clinical examinations were undertaken on a larger cohort of children aged 3-4 years in test and control PCGs. SETTING: The interventions were gift bags containing a trainer cup, toothpaste containing 1,450 ppm F and toothbrush, and advice given to the children's parents on attendance at designated clinics and medical practices and further paste and brushes posted to the children's homes. Parents were interviewed on the telephone. Examinations took place at Children's Centres and nursery departments attached to primary schools. OUTCOME MEASURES: Severity and prevalence of ECC and general caries and proportion of parents reporting adopting dentally healthy behaviours. RESULTS: In the test PCG the prevalence of ECC in children who had received the interventions was 16.6% compared with 23.5% of children in the control area, a reduction of 29% (p=0.003). The mean dmft (1.17) and prevalence of general caries experience (28.7%) in the test children were also significantly lower than for children in the control PCG (1.72: 39.2%) (p=0.001). Analysis from a community perspective, which included data from all children examined in both areas, showed the prevalence of ECC in the test and control PCGs was 21.3% and 22.8% respectively and the mean dmft 1.47 and 1.72. The proportion with general caries experience remained statistically significant in favour of the test area 33.8% vs 39.9% (p=0.01). Parents in the test PCG were more likely to report cessation of bottle use (33% vs 18%), use of sugar-free drinks (49% vs 24%), commencement of brushing before first birthday (45% vs 27%) and twice daily brushing (52% vs 34%). CONCLUSION: The parents who received this multi-stage intervention were more likely to report adoption of three positive oral health behaviours; using a trainer cup from one year of age, using safe drinks and brushing twice daily with a fluoride toothpaste. The programme failed to reduce the prevalence of ECC in the community but the prevalence of ECC and general caries experience among the children who participated was less than among children in the control PCG.     

Dental caries prevalence among preschool children of Hubli: Dharwad city

The prevalence of dental caries and treatment needs in the age group of 3-5 years was estimated among 1500 children of Hubli-Dharwad city. The attitude of mothers towards their children's oral health and its relation with caries prevalence was noted among 200 subjects. The prevalence of dental caries was 54.1%. The attitude of mothers towards children's oral health made a statistical difference in the mean dmft levels.     

维生素D水平与低龄儿童龋风险的相关性分析

目的探讨维生素D水平与低龄儿童龋(early childhood caries,ECC)发生风险的相关性分析,为ECC儿童的一级预防提供依据。方法收集389名6~48月龄儿童的月龄、喂养方式、口腔健康行为等资料,记录龋、失、补指数(decayed?missing?filled teeth,dmft),分为ECC组(n=146)和无龋组(n=243),采集指尖末梢血检测维生素D体内活性形式--25?羟维生素D[25(OH)D],采集牙菌斑行龋活跃性检验检测龋态(Cariostat)值,Logistic回归分析25(OH)D等龋相关因素与ECC发生风险的相关性。结果25(OH)D缺乏、不足、正常的儿童的患龋率差异无统计学意义(c2=2.320,P=0.313)。dmft与25(OH)D水平之间无相关(dmft=1~3,r<0.001,P>0.05;dmft>3,r=0.009,P>0.05)。而月龄(OR=1.082,95%CI:1.045~1.121,P<0.001)、出生后6个月内母乳喂养(OR=2.789,95%CI:1.581~4.921,P<0.001)、吃夜奶或含乳头睡(OR=4.187,95%CI:1.938~9.048,P<0.001)、1.5~3.0的高Cariostat值(OR=4.173,95%CI:2.014~8.646,P<0.001)是ECC的风险因素。结论25(OH)D水平与6~48月龄儿童龋无相关性,而月龄、出生后6个月内母乳喂养、吃夜奶或含乳头睡、高龋活跃性(Cariostat值1.5~3.0)是ECC的风险因素,提倡母乳喂养的同时,应为幼儿树立良好的喂养习惯及口腔卫生习惯。