广东省3~5岁人群乳牙龋病抽样调查报告(2015—2016年)

目的 了解广东省3~5岁人群乳牙龋病状况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省3、4、5岁城乡常住人口各864人,男女各半,城乡各半.按照第四次全国口腔健康流行病学调查方案牙列检查方法和标准,使用CPI探针检查全口乳牙牙冠龋病情况.计算患龋率、龋均、充填率等.结果 3、4、5岁人群乳牙患龋率分别为58.33%、68.40%、78.47%,龋均分别为3.03、4.34、5.69,龋齿充填率分别为0.92%、1.47%、1.26%.3、4、5岁人群患龋率和龋均在城乡及年龄组间的差异有统计学意义,农村高于城市,随年龄增长,患龋状况加重;患龋率在不同性别间的差异无统计学意义,3岁人群龋均女性高于男性(t=2.04,P=0.042),4岁人群(t=0.15,P=0.882)、5岁人群(t=1.00,P=0.317)龋均在不同性别间的差异无统计学意义;5岁儿童患龋率(x2=23.123,P<0.001)和龋均(t=6.290,P<0.001)高于2005年,龋齿充填率提升不明显(x2=0.481,P=0.488).结论 广东省3~5岁儿童乳牙龋病患病状况较严重,98%以上的龋齿未经治疗,是龋病预防的重点人群,特别是农村儿童.     

北京市5岁儿童乳牙龋病抽样调查报告

目的 了解北京市5岁儿童乳牙龋病状况,为北京市口腔卫生保健工作提供科学依据.方法 采用多阶段分层等容量随机抽样的方法,抽取北京市5岁城乡常住儿童共792名,男女各半,按<第三次全国口腔健康流行病学调查方案>中的方法,检查全口乳牙患龋情况.结果 在792名受检儿童中,北京市5岁儿童乳牙患龋率为58.59%,乳牙龋均为2.57,农村高于城市;龋齿充填率为17.96%,城市高于农村.结论 应进一步加强乳牙龋病的宣传和预防工作,提高儿童家长对乳牙龋病的重视程度,加强高危人群的监测和防治,加大对农村地区的口腔医疗及人力资源配置的扶持力度.     

江苏省3～5岁儿童龋病流行病学抽样调查报告

目的了解江苏省3～5岁儿童龋病流行现状,为江苏省儿童口腔卫生保健工作提供信息支持。方法按照第四次全国口腔健康流行病学调查方案,采用分层多阶段等容量随机抽样的方法,抽取江苏省3～5岁儿童1 337人,其中3岁组441人、4岁组455人、5岁组441人。使用CPI探针检查全口乳牙冠龋情况,计算患龋率、龋均、充填率等。结果 3、4、5岁人群乳牙患龋率分别为47.39%、60.22%和71.43%;龋均分别为2.22、2.94、4.05;龋齿充填率分别为0.72%、1.72%、2.63%。不同年龄组的患龋率和龋均不同(P<0.05),随年龄增长,患龋状况加重。患龋率和龋均在不同性别间的差异无统计学意义。3岁人群患龋率农村高于城市(P<0.01),4岁、5岁人群患龋率在城乡间差异无统计学意义。4岁人群龋均农村大于城市(P<0.05),3岁、5岁人群龋均在城乡间差异无统计学意义。不同样本地区儿童乳牙患龋状况不同。3、4、5岁儿童乳牙显著性龋均指数分别为6.01、7.44、9.03。乳牙患龋率最高的牙位是上颌乳中切牙和下颌乳磨牙。5岁儿童乳牙患龋率和龋均高于2005年,充填率仅有小幅提升。结论江苏省3～5岁儿童乳牙患龋状况严重,应针对高风险人群进行重点防治。     

780名5岁儿童乳牙患龋情况调查分析

目的了解四川省5岁儿童乳牙患龋情况,为制定龋病防治规划提供参考依据。方法根据世界卫生组织《口腔健康调查基本方法》（第4版）,参照第三次全国口腔健康流行病学抽样调查方案,在四川省3个城市、3个农村随机抽样选取调查点,共调查780名5岁儿童的患龋情况,并将调查结果与第二次全国口腔健康流行病学抽样调查结果进行比较。结果四川省5岁儿童乳牙患龋率为58.72%,龋均为2.77,龋齿充填率为2.32%;乳牙患龋率和龋均在男性和女性、城市和农村儿童之间的差异均不具有统计学意义,而乳牙龋齿充填率则存在性别和地区间的差异。与第二次全国口腔健康流行病学抽样调查结果相比,四川省5岁儿童乳牙患龋率和龋均的差异均无统计学意义（P>0.05）,而龋齿充填率有所下降（P<0.05）。结论四川省5岁儿童乳牙龋齿患病率仍然较高,而龋齿充填率相对较低,今后儿童龋病防治工作应加强乳牙保健的口腔卫生宣传教育,提高家长对乳牙龋充填重要性的认识,促进乳牙的治疗。     

2008年广州市儿童乳牙龋病流行病学调查报告

目的研究广州市5、6、9岁儿童乳牙龋病流行的现状,为广州市儿童口腔卫生保健工作提供参考。方法采用多阶段、分层、等容量、随机抽样的方法,抽取广州市越秀、海珠、白云、花都、增城、从化6个区5、6、9岁城乡常住城市儿童3 240人,农村儿童1 080人,男女各半。调查标准按照《第三次全国口腔健康流行病学调查龋病检查标准》,使用世界卫生组织《口腔健康调查基本方法》第4版推荐的CPI探针,检查全口乳牙,采用SAS6.12软件统计乳牙患龋率、龋均。结果广州市5、6、9岁儿童乳牙患龋率分别为56.11%、60.76%、64.86%,龋均分别为3.04、3.36、3.29。5岁儿童乳牙患龋率城市为48.52%,农村为78.89%;龋均城市为2.28,农村为5.33,乳牙患龋率和龋均城乡比较差异均有统计学意义（P〈0.05）;乳牙患龋率和龋均男女比较差异无统计学意义。结论广州市农村儿童乳牙患龋情况严重,龋齿治疗率非常低,必须采取有效措施,对广州市农村儿童龋病进行控制。     

辽宁省5岁儿童龋病流行病学调查十年对比分析

目的 通过对辽宁省十年间儿童龋病调查的对比分析,了解龋病患病特点及发展趋势,探讨可能的原因及相应的预防措施。方法 按照全国口腔健康流行病学调查的要求,采用WHO口腔健康调查方法分别于1995年和2005年对辽宁省5岁儿童龋病采取了抽样检查。调查结果 采用SPSS13.0软件包进行数据的统计分析。结果 1995年和2005年辽宁省5岁儿童乳牙患龋率分别为89.49%和73.86%;龋均分别为6.77和4.38,经统计学检验,总体上十年间5岁儿童乳牙患龋率和龋均都有显著下降(P<0.01)。除农村地区十年间患龋率无显著性差异外(P>0.05),其它各组乳牙患龋率和龋均十年间均有显著性差异(P<0.05)。龋病充填的构成在十年间呈上升趋势,但变化幅度不大。城乡和男女性别之间5岁儿童恒牙患龋率和龋均则均无显著性差异(P>0.05)。结论 辽宁省5岁儿童患龋率和龋均均明显低于十年前的调查结果 ,但龋齿充填率仍然很低,应加强对学龄前儿童乳牙龋病的防治。     

2005年广东省5岁人群乳牙龋病抽样调查报告

目的 了解广东省5岁人群乳牙龋病状况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省5岁城乡常住人口720人,男女各半.按照<第三次全国口腔健康流行病学调查方案>中临床检查牙列状况的检查方法和标准,使用CPI探针检查全口乳牙牙冠龋病情况.计算出患龋率、龋均.结果 5岁组人群乳牙患龋率为67.78%、龋均为4.10.患龋人中有3.28%的人曾经治疗,龋齿充填率为1.09%.龋均和患龋率在城乡的差异无统计学意义,男性与女性比较差异有统计学意义.结论 5岁儿童乳牙龋齿较严重, 98.81%龋齿未经治疗,是龋病预防的重点人群.与1995年比较,患龋率和龋均有下降.     

2005年云南省5岁人群乳牙龋病抽样调查报告

目的 调查2005年云南省5 岁人群乳牙龋病状况,为云南省口腔卫生保健工作提供信息支持.方法 采用多阶段、分层、等容量、随机抽样的方法,抽取云南省5岁城乡常住人口720人,男女各半.按照<第三次全国口腔健康流行病学调查方案>中检查方法和标准,使用CPI探针检查全口乳牙牙冠龋病情况,统计患龋率、龋均.结果 5岁组人群乳牙患龋率为65.69%、龋均为3.68,龋齿充填率为3.47%.患龋率和龋均在城乡有差异,差异有统计学意义;男性与女性比较差异无统计学意义.结论 与1995 年云南省的调查结果比较, 2005年云南省5 岁儿童乳牙患龋率和龋均有所下降,龋齿较为严重,依然是龋病预防的重点人群.     

辽宁省12岁儿童龋病流行病学抽样调查分析

目的:了解辽宁省12岁儿童恒牙患龋状况,为龋病预防提供科学依据。方法:按照第三次全国口腔健康流行病学调查的要求,对辽宁省城乡6个地区36个调查点的792名12岁儿童进行了口腔检查。结果:在792名受检者中,患龋率和龋均分别为30.05%和0.51,农村和城市地区的患龋率分别为28.54%和31.57%,经统计学检验城乡无统计学意义(χ2=0.87,P>0.05),男女患龋率之间有统计学意义(χ2=10.6,P<0.01),显著性龋均指数为1.53。结论:辽宁省12岁儿童龋患明显低于十年前的状况,但患龋率仍达到30.05%,龋齿充填率也较低,龋齿主要集中于第一恒磨牙,仍应加大预防的力度,以降低龋病的发生。     

江苏省5岁、12岁青少年儿童龋病流行现状及影响因素分析

目的了解江苏省5岁、12岁青少年儿童龋病流行现状及相关因素,为江苏省龋病防治提供依据。方法参照WHO《口腔健康调查基本方法》(第4版)和全国第四次口腔健康流行病学调查方案,采用分层,多阶段,等容量随机抽样的方法,抽取江苏省12个调查点共1 419名受检者,其中5岁组441人,12岁组978人。结果 5岁组乳牙患龋率和龋均分别为71.4%、4.05,男女、城乡间患龋率、龋均均无明显统计学意义,充填率2.6%;高氟区、甜饮料的进食频率、睡前吃甜食与乳牙患龋有明显的相关性。12岁组恒牙患龋率和龋均分别为33.8%、0.60,女性高于男性且具有明显的统计学差异,城乡间无明显差异,龋齿充填率15.1%;性别、甜点心的进食频率、最近一次看牙间隔时间与恒牙患龋有明显的相关性。结论江苏省青少年儿童的患龋情况不容乐观,应重点针对高危人群进行防治,控制患龋高危因素,加强口腔健康教育,制定符合江苏省情况的个性化方案。     

Variation in periodontal referral in 2 regions in theUK

This study investigated the periodontal referral patterns of general dental practitioners (GDPs) in Northern Ireland (NI) and North West England (NWE). A questionnaire dealing with periodontal referral was sent to all 520 GDPs registered in NI and to 274 GDPs in NWE. A usable return was made by 355 (68%) in NI and 189 (70%) in NWE. The NI dentists made significantly more periodontal referrals (median 5, range 0-80) in the year preceding the survey than those in NWE (median 2, range 0-50), p<0.001. Distance was the only factor significantly related to the referral rate in both regions with those who practised more than 25 miles from a specialist referring significantly fewer patients in both regions. In NI, there was a trend towards increased periodontal referral by GDPs who had attended more postgraduate courses; however, in NWE, this was not the case. The GDPs in NWE were significantly less likely than those in NI to refer patients with medical conditions. It is concluded that there is considerable variation in periodontal referral both within and between the 2 regions studied. It is further concluded that in many cases, non-disease factors, such as the accessibility of the specialist service, have powerful effects on the decisions made by dentists and patients in these regions (NI and NWE) in relation to periodontal referral. Much of the variance in referral in North West England, as in Northern Ireland, remains unexplained.     

Trends in socioeconomic disparities in oral health in Brazil and Sweden

Celeste RK, Nadanovsky P, Fritzell J. Trends in socioeconomic disparities in oral health in Brazil and Sweden. Community Dent Oral Epidemiol 2011; 39: 204–212. © 2010 John Wiley & Sons A/S Abstract – Objectives: To describe the dynamics of trends in socioeconomic disparities in oral health in Brazil and Sweden among adults, to assess whether trends follow expected patterns according to the inverse equity hypothesis. Methods: In Sweden, we obtained nationally representative data for the years 1968, 1974, 1981, 1991 and 2000, and in Brazil, for 16 state capitals in 1986 and in 2002. Trends in the prevalence of ‘edentulism’ and of ‘teeth in good conditions’ were described in two groups aged 35–44 with lower and higher economic standards, respectively. Results: There was an annual decline in disparities in ‘edentulism’ of 0.4 percentage points (pp) (95% CI = 0.2–0.7) in Brazil and 0.7pp (95% CI = 0.5–0.9) in Sweden, as a result of improvements in both income groups. Concerning ‘teeth in good conditions’, in Brazil, there was improvement only in the higher income group and absolute disparities have increased (0.5pp annually), while in Sweden, there was a nonsignificant decrease (0.3pp annually) with improvements in both groups. Since 1991 in Sweden and in 2002 in Brazil, our measures of socioeconomic disparities in ‘edentulism’ were not statistically significant. Trends did not differ by sex or dental visit. Conclusions: Despite improvements in both income groups and a decrease in disparities in ‘edentulism’, the poorer group in Brazil has seen no improvement in ‘teeth in good conditions’ and disparities have increased. It appears that Brazil and Sweden reflect different stages of trend for ‘teeth in good conditions’ and the same stages for ‘edentulism’, represented by the inverse equity hypothesis.     

Fluorosis in relation to fluoride levels in water in central Nigeria

Abstract– Objectives : This study was conducted to examine the prevalence of dental fluorosis in relation to fluoride levels in water among children aged 12–15 years in the states of Plateau and Bauchi, Nigeria. Methods : Children ( N =203) were examined using WHO criteria. The children were from two schools and permanent residents of the communities in which the schools are located (Tilden Fulani and Kanadap). Intra-examiner reliability for determining fluorosis scores was 80%. Results : Fluoride levels in the water ranged from 0.0–0.4 mg/L. Prevalence of dental fluorosis in the sample was 51%. Forty-one percent had very mild fluorosis, 7% had mild fluorosis and 3% had moderate to severe fluorosis. The lowest DMFT was observed in the school where the fluoride level of the water ranged between 0.0 and 0.4 mg/L, and in the group with very mild fluorosis. Conclusion : Fluoride levels in water for central Nigeria were appropriate for oral health. In the areas where the children were permanent residents, factors other than the fluoride levels of the water contributed to the severity of dental fluorosis.     

Trends in endodontic claims in Italy

According to the scant data available in the literature, endodontic claims are common among dental professional liability cases and the second most common type of claim. This study aimed to describe the characteristics of endodontic claims in Italy and the most frequently disputed errors, and the discussion below includes consideration of ethical and medico‐legal aspects thereof. We retrospectively analysed 120 technical reports written on cases of professional malpractice in endodontics in the last 5 years. The complainant patients were males in 22.5% of the cases, while females made up the remaining 77.5%. In the dentist sample, male operators were more often involved in litigation cases (80%) than female operators. The most frequently claimed technical errors were: lack of a complete filling of root canal/s (71.7%), the perforation of tooth structure (12.7%), extrusion of sealing materials beyond the apex of the tooth (9.6%) and the fracture of an endodontic instrument (5.9%). In 1.7% of cases it was found that the expert did not make any errors performing the endodontic therapy. In only very few cases (2.7%) no therapy was considered necessary, while the most common therapeutic solution involved in endodontic misconduct was tooth extraction (53.0%). In many cases the dentist preferred to extract the endodontically undertreated tooth and substitute it prosthetically rather than trying to re‐treat it. The discrepancy between the total number of cases examined and those that eventually go to court leads us to believe that the majority of endodontic malpractice cases are resolved in out‐of‐court settlements.     

Human Herpesviridae in acute necrotizing ulcerative gingivitis in children in Nigeria

Herpesviruses have been implicated in the pathogenesis of human periodontitis. The present study investigated whether herpeasviruses are present in the lesions of acute necrotizing ulcerative gingivitis. Sixty-two Nigerian children, aged 3–14 years, were studied. Twenty-two children had acute necrotizing ulcerative gingivitis and were also malnourished, 20 exhibited no acute necrotizing ulcerative gingivitis but were malnourished, and 20 were free of acute necrotizing ulcerative gingivitis and in a good nutritional state. Polymerase chain reaction methods were used to determine the presence of human cytomegalovirus (HCMV), Epstein-Barr virus type 1 and type 2 (EBV-1, EBV-2), herpes simplex virus (HSV), human herpes virus 6 (HHV-6), human papilloma virus and human immunodeficiency virus type 1 in crevicular fluid specimens collected by paper points. Of the 22 acute necrotizing ulcerative gingivitis patients, 15 (68%) revealed viral infection and 8 (36%) viral coinfection. Thirteen (59%) acute necrotizing ulcerative gingivitis patients demonstrated HCMV, 6 (27%) EBV-1, 5 (23%) HSV and 1 (5%) HHV-6. Only 2 (10%) subjects from each group not affected by acute necrotizing ulcerative gingivitis showed viral presence, and no control subject revealed viral coinfection. These findings suggest that HCMV and possibly other herpesviruses contribute to the onset and/or progression of acute necrotizing ulcerative gingivitis in malnourished Nigerian children.     

Changes in caries prevalence in Japan

In Japan, the mean DMFT at 12 years of age increased from 2.8 in 1957 to 5.9 in 1975. From the 1981 survey (DMFT=5.43), conversely, the mean DMFT decreased and reached 3.64 in 1993. The increase in caries prevalence can, without doubt, be explained by an increment of sugar consumption, since the intake of sugar increased after World War II and exceeded 18.25 kg/year (50 g/day) in 1965 and reached a maximum value (29.3 kg/year) in 1973 in Japan. On the other hand, the reason why the DMFT has decreased since 1981 is not clear. In many industrialized countries, a caries reduction has been achieved with acceptable fluoride exposure, although sugar consumption was still at a high level. However, fluoride usage was still limited during the last 2 decades in Japan. There is no community where fluoridated drinking water has been supplied since 1972. Fluoride tablet use was also discontinued for children in the 1970s. Fluoride mouthrinsing programs were available for only 19r of school children in 1992. Moreover, the market share of fluoridated dentifrices stayed at 10% until 1986 and became 30% only in 1988. An excellent correlation (r=0.91; P 0.01) is observed between the DMFT in 12-year-olds and per capita sugar consumption per year between 1957 and 1987 in Japan.     

Advances in local anesthesia in dentistry

Local pain management is the most critical aspect of patient care in dentistry. The improvements in agents and techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This article provides an update on the most recently introduced local anesthetic agents along with new technologies used to deliver local anesthetics. Safety devices are also discussed, along with an innovative method for reducing the annoying numbness of the lip and tongue following local anesthesia.     

Localization of SOST/sclerostin in cementocytes in vivo and in mineralizing periodontal ligament cells in vitro

Jäger A, Götz W, Lossdörfer S, Rath‐Deschner B. Localization of SOST/sclerostin in cementocytes in vivo and in mineralizing periodontal ligament cells in vitro. J Periodont Res 2009; doi: 10.1111/j.1600‐0765.2009.01227.x. © 2009 John Wiley & Sons A/S Background and Objective: Cementum and bone are rather similar hard tissues, and osteocytes and cementocytes, together with their canalicular network, share many morphological and cell biological characteristics. However, there is no clear evidence that cementocytes have a function in tissue homeostasis of cementum comparable to that of osteocytes in bone. Recent studies have established an important role for the secreted glycoprotein sclerostin, the product of the SOST gene, as an osteocyte‐derived signal to control bone remodelling. In this study, we investigated the expression of sclerostin in cementocytes in vivo as well as the expression of SOST and sclerostin in periodontal ligament cell cultures following induction of mineralization. Material and Method: Immunolocalization of sclerostin was performed in decalcified histological sections of mouse and human teeth and alveolar bone. Additionally, periodontal ligament cells from human donors were cultured in osteogenic conditions, namely in the presence of dexamethasone, ascorbic acid and β‐glycerophosphate, for up to 3 wk. The induction of calcified nodules was visualized by von Kossa stain. SOST mRNA was detected by real‐time PCR, and the presence of sclerostin was verified using immunohistochemistry and western blots. Results: Expression of sclerostin was demonstrated in osteocytes of mouse and human alveolar bone. Distinct immunolocalization in the cementocytes was shown. In periodontal ligament cultures, following mineralization treatment, increasing levels of SOST mRNA as well as of sclerostin protein could be verified. Conclusion: The identification of SOST/sclerostin in cementocytes and mineralizing periodontal ligament cells adds to our understanding of the biology of the periodontium, but the functional meaning of these findings can only be unravelled after additional in vitro and in vivo studies.