280例口腔修复科患者牙科畏惧症的初步探讨

２８０例口腔修复科患者牙科畏惧症的初步探讨苏州口腔医院口腔修复科洪炯牙科畏惧症（ＤｅｎｔａｌＦｅａｒ，ＤＦ或ＤｅｎｔａｌＡｎｘｉｅｔｙ，ＤＡ）是指对牙科所持有的忧虑、紧张或害伯的心理状态，以及在行为上表现为敏感性增高，耐受力降低，甚至躲避治疗的现象。...     

口腔健康教育对泰州市城区小学生口腔卫生知识和口腔健康行为改变的影响

目的了解口腔健康教育对小学生口腔卫生知识和行为习惯的影响,为开展口腔疾病预防和制定学校口腔卫生工作政策提供依据。方法采用随机整群抽样方法,抽取泰州市海陵区6所小学2～3年级4 000名学生进行3个月的口腔健康教育,并在教育前后分别进行问卷调查,比较口腔卫生知识和行为习惯的变化。结果口腔健康教育后小学生的口腔健康基本知识、对窝沟封闭的认识、口腔健康行为的改变等17项内容均高于教育前,差异均有统计学意义(P<0.01)。结论泰州市小学生口腔健康教育应有计划、长期进行。     

口腔门诊患者健康知识和行为调查及健康教育推广

目的通过对口腔门诊患者进行口腔健康知识、健康行为以及就医行为的调查,评价健康教育的效果,为更好地开展口腔健康教育提供参考。方法随机选取就诊和候诊患者249例,在口腔健康教育前进行问卷调查,收回问卷后,现场进行口腔健康教育,并于患者就诊后3个月进行电话回访。结果健康教育前,有87例（34.9%）知道牙齿与人的咀嚼、发音以及维护正常的面容有直接关系;能定期接受口腔检查和洁牙的分别为18例（7.2%）和77例（30.9%）;能按医嘱复诊的78例（31.3%）。通过健康教育后,愿意接受回访的患者237例,回访率95.2%。回访结果显示,经过健康教育后,自愿定期进行口腔检查和使用牙线的分别为116例和94例,占回访人数48.9%和39.7%;愿意定期洁牙的119例,占回访人数50.2%;此外,牙周疾病患者按医嘱复诊的达171例（72.2%）,能按医嘱复诊的人数比接受健康教育前明显提高（χ2=81.007,P〈0.001）。结论口腔健康教育可使人们掌握更多正确的口腔健康知识,提高自我保健能力,主动采取有利于口腔健康的行为。     

口腔健康教育前后小学生口腔健康知识行为变化调查

目的　探讨口腔健康教育对儿童口腔健康知识和行为的影响。方法　自行设计调查表 ,采用重复测量的方法 ,调查口腔健康教育前后儿童口腔健康知识和行为情况。结果　口腔健康教育可显著提高儿童口腔健康知识 ,对口腔健康行为有一定的作用 ,口腔健康行为的改变与父母职业有关。结论　口腔健康教育对儿童口腔健康知识和口腔健康行为有积极作用 ,应在小学生中开展常规的口腔卫生教育课     

深圳市成人牙科畏惧症患者的口腔健康相关生活质量研究

目的：研究牙科畏惧症（DF）患者的口腔健康相关生活质量。方法：选择在深圳市第五人民医院口腔科门诊就诊的358名18～75岁初诊患者,应用口腔焦虑量表（CDAS）和口腔健康影响程度量表（OHIP-14中文版）、人口统计学一般项目表进行调查。结果：DF患者的OHIP-14的分值中位数为21.25,明显高于一般就诊患者（中位数11.20）。且在生理性疼痛、心理不适和心理障碍等领域影响最大。CDAS与OHIP-14分值间的相关系数为0.255。结论：在牙科畏惧症患者中,牙科畏惧程度与口腔健康影响程度之间存在相关性,焦虑程度越高的患者口腔健康相关生活质量越差。对牙科畏惧症患者进行有效的心理干预可以提高其相关生活质量。     

儿童牙科的行为管理

在儿童牙科中,行为管理技术的运用是医护人员在临床操作中极其重要的一部分.行为管理技术的应用,其重要目的之一是为了减轻孩子的焦虑和恐惧,尽可能与患儿很好的交流,使不配合甚至怀有对立情绪的患儿得到顺利治疗.本文回顾了近年国内外有关专著和发表于口腔及心理学杂志上与此专题有关的文献总结归纳各种行为管理技术、家长对各种方法的态度、方法应用的趋势和有待加强开展的方面.     

中外儿童口腔治疗焦虑行为的对比

目的：比较美国佛罗里达大学口腔医学院（university of florida college of dentistry,UFCD）儿童牙科和中国解放军总医院（301医院）（301 general hospital of PLA China）儿童牙病科就诊儿童的恐惧心理,以改进管理儿童患者就诊行为的方法。方法：选取2006—09—2007—08在UFCD就诊儿童150例,2007—11—2008—03在解放军301医院儿童牙科就诊儿童270例,采用儿童畏惧调查表一牙科分量表（children＇s fear survey schedule—dental subscale,CFSS-DS）调查儿童牙科畏惧情况,所得数据进行统计学分析。结果：CFSS平均得分≥2．5者,UFCD为19．7％,301医院为27．2％;两地区6岁前儿童DF值均明显高于6岁后儿童（P〈0．05）;301医院女性DF值明显低于男性（P〈0．05）,UFCD则无显著差异;与治疗无关的恐惧,UFCD为32％,301医院为39％;两地区家长对治疗恐惧经历均明显影响患儿牙科畏惧症（DF）的发生（P〈0．05）。结论：父母不良的牙科经历是患儿DF发生的主要因素。年龄,性别也一定程度上影响儿童DF发生。     

口腔患者牙科畏惧症多种影响因素的综合分析研究

目的：综合分析人口统计学、社会学和院前行为等因素对患者牙科畏惧症的影响。方法：采用自编牙科畏惧症问卷及其影响因素对200名口腔专科医院门诊患者进行调查和分析。结果：自编的牙科畏惧症问卷具有良好的信度和效度;性别、年龄、社会压力、治疗费用负担等与牙科畏惧症不存在显著影响;医院信任度与牙科畏惧指数呈边缘显著正相关（P=0.055）;控制人口统计学和社会学变量后,院前行为能够显著预测患者牙科畏惧症程度,变异解释率达29%,其中担心就诊和昨晚休息呈显著正相关（P〈0.05）。结论：牙科畏惧症是一个复杂的情绪反应,关注患者院前行为、提高医院综合诊疗水平能有效防治牙科畏惧症。     

口腔疾病患者口腔保健行为调查与健康教育

目的 了解口腔疾病患者口腔保健行为情况,针对性开展口腔健康指导。方法 采用问卷法调查500名口腔科门诊病人,获得有关口腔自我保健行为的调查结果。结果 口腔保健行为中,竖刷法刷牙方式的正确率较低,仅为30.2%,使用过牙线的仅占10.4%;42.4%的人接受过口腔卫生教育。结论 牙病患者自我口腔保健行为正确率偏低,健康教育、保健指导工作有待深入开展。     

儿童乳牙患龋状况及其家庭口腔健康行为的差异

目的研究家庭口腔健康行为对辽宁省城乡儿童乳牙患龋状况的影响。方法采用多阶段、分层、等容量、随机抽样的方法,运用世界卫生组织《口腔健康调查基本方法》诊断标准对辽宁省城乡792名5岁儿童进行乳牙龋病检查,并随机抽取50%受检者的家长进行问卷调查。结果1）辽宁省5岁儿童乳牙患龋率为73.86%,龋均（dmft）为4.38;其中城市儿童乳牙患龋率为64.14%,农村儿童乳牙患龋率为83.59%,城乡之间儿童乳牙患龋率具有统计学差异（P<0.01）。2）口腔健康行为分析表明,农村儿童进食糖果、巧克力、糖水、碳酸饮料、果汁等的频率高于城市。城市儿童开始刷牙时间、频率、用含氟牙膏的比例均高于农村。城市家长普遍学历高,收入多,儿童定期检查和采取预防措施的人数高于农村。结论辽宁省,尤其是农村地区应加强对家庭口腔健康行为的教育。     

Risk factors for impaired oral health among 18‐ to 34‐year‐old Australians

Objectives: The objective of this study was to determine risk factors for a summary measure of oral health impairment among 18‐ to 34‐year‐olds in Australia. Methods: Data were from Australia's National Survey of Adult Oral Health, a representative survey that utilized a three‐stage, stratified, clustered sampling design. Oral health impairment was defined as reported experience of toothache, poor dental appearance, or food avoidance in the last 12 months. Multivariate Poisson regression models were used to evaluate effects of sociodemographic characteristics, self‐perceived oral health, dental service utilization, and clinical oral disease indicators on oral health impairments. Effects were quantified as prevalence ratios (PR). Results: The estimated percent of 18‐ to 34‐year‐olds with oral health impairment was 42.4 [95 percent confidence interval (CI) 37.7‐47.2]. In the multivariate model, oral health impairment was associated with untreated dental decay (PR 1.38, 95 percent CI 1.13‐1.68) and presence of periodontal pockets 4 mm+ (PR 1.29, 95 percent CI 1.03‐1.61). In addition to those clinical indicators, greater prevalence of oral health impairment was associated with trouble paying a $100 dental bill (PR 1.37, 95 percent CI 1.12‐1.68), usually visiting a dentist because of a dental problem (PR 1.46, 95 percent CI 1.15‐1.86), reported cost barriers to dental care (PR 1.46, 95 percent CI 1.16‐1.85), and dental fear (PR 1.43, 95 percent CI 1.18‐1.73). Conclusions: Oral health impairment was highly prevalent in this population. The findings suggest that treatment of dental disease, reduction of financial barriers to dental care, and control of dental fear are needed to reduce oral health impairment among Australian young adults.     

上海市5岁本地和外来儿童患龋状况和口腔健康行为的调查

目的分析上海市5岁本地和外来儿童患龋状况和口腔健康行为的差异,为设计口腔卫生服务项目和相关政策制订提供信息支持。方法采用分层等容量随机抽样方法,调查上海市共575名5岁儿童口腔健康状况,并对家长进行相关问卷调查。结果 5岁乳牙患龋率为65.74%,龋均为3.35,本地儿童明显低于外来儿童(P<0.05)。5岁儿童龋失补充填构成比为12.57%,本地和外来儿童有显著差异(P<0.01)。外来儿童睡前进食甜食的比例高于本地儿童(P<0.05)。外来儿童每天刷牙2次及以上的仅占19.44%,明显低于本地儿童(P<0.01)。从没看过牙的外来儿童比例比本地儿童更高(P<0.01)。结论上海外来儿童患龋状况和口腔健康行为均比本地儿童差,未来需加强对外来儿童的口腔保健力度,有针对性地采取防治措施及健康教育,提高儿童口腔健康整体水平。     

Effect of fear on dental utilization behaviors and oral health outcome

OBJECTIVES: This paper assesses the effect of fear on a number of dental utilization behaviors and oral heath outcome in a sample of adult Floridians. METHODS: A telephone survey was conducted in 2004 among 504 adult Floridians. Data collected included sociodemographic factors, specific fear of dental pain (FDP), global FDP, global dental fear, three measures of dental utilization behaviors, and one measure of oral health outcome. Chi-squared tests and logistic regression analyses were conducted to quantify the individual and multivariate associations between fear factors and four behavior and outcome measures. RESULTS: Global FDP was significantly associated with putting off making a dental appointment and approach to dental treatment. Global dental fear showed an independent negative impact on all four behavior and outcome measures; reports regarding specific fear of painful dental events were not significantly associated with four behavior and outcome measures. CONCLUSIONS: Our findings suggest that: (i) dental fear and FDP have independent negative effects on dental utilization behaviors and oral health outcome after controlling for other sociodemographic and general health factors; and (ii) global dental fear encompasses broader components than FDP.     

Determinants of oral health in a group of Danish alcoholics

The purposes of this survey were to describe dental health in a group of alcoholics and to analyze the influence of social background, dental health behavior and alcohol-related variables on dental health among alcoholics. The dental health in a group of consecutively admitted alcoholics ( n =195) was described with respect to number of teeth present, DMFS. DS and the prevalence of dental erosion, removable dentures, edentulousness, and untreated dental decay. No major differences were found with respect to number of teeth and dental caries (DMFS). when compared to reference figures of the general population. As to untreated decay, however. 3-5 x more actual decayed surfaces were found among the alcoholics. In the multivariate analyses, neither DMFS, nor untreated decay were found to be associated with alcohol-related indicators. These variables were, however, related to variables of social background and dental health behavior. As to number of teeth present, an association was found with duration of alcoholism, but this relationship was eliminated, when the analysis was controlled with respect to social situation. In contrast, dental erosion was related to duration of alcoholism irrespective of confounding control of dental health behavior and social situation. Hence, the study indicates that oral health in alcoholics can be explained mainly by social situation and dental health behavior and not by variables associated directly with alcohol consumption. An exception was the presence of dental erosion, which was associated with the exposure to alcohol.     

Active-involvement principle in dental health education

A basic problem in dental health education (DHE) is that the effect usually disappears shortly after the termination of a program. The purpose of the present study was to obtain long-term effect of a DHE-program by emphasizing the active involvement of the participants. The sample comprised an experimental and a control group, each of 68 unskilled workers, aged 18-64. Active participation was obtained by various means: Teaching was carried out in pre-existing peer groups, the participants' own goals and needs were included, the traditional dentist-patient barriers were excluded, the traditional dentist-patient roles were changed, and the sessions were repeated. No dental treatment was included. The control group did not participate in the DHE-programme. Plaque (PII) and gingivitis (GI) were scored before the program, immediately after, and 6 months and 31/2 yr after the last session. In the experimental group PII and GI decreased significantly from 1.30 and 1.42 at baseline to 0.39 and 0.97 6 months after the program, and 0.45 and 0.79 31/2 yr after the termination of the program. It is suggested that the reason for the long-term effect obtained in the present study was the use of the principle of active involvement of the participants in the DHE-program.