103例口腔患儿应用笑气镇静的临床效果

目的:观察笑气吸入法在儿童牙科临床治疗效果.方法:选取有牙科焦虑症,行为表现分级为Venham 2 ～4级患儿103例,经患儿家长同意采取笑气吸入,记录每次镇静治疗时患儿的心率、血氧饱和度、呼吸频率,评定笑气吸入在儿童牙科的镇静效果.结果:93例Venham 2～4级患儿笑气吸入后口腔治疗基本顺利进行,10例Venham 4级患儿不能配合治疗,改为束缚下治疗.结论:笑气吸入法能够减轻或缓解患儿对牙科的恐惧和不安,是一种有效的镇静方法.     

儿童牙病治疗中的心理治疗探讨

目的　探讨心理治疗在儿童配合牙病治疗中的作用。方法　采用VeerkampJ(1993)标准将 876例儿童牙病治疗前牙科畏惧症 (DF)状况进行分级 ,针对不同分级的儿童采用不同的心理治疗。结果　 876例患儿中有 85 3例得到了不同程度的治疗 ,配合率达到 97 2 %。结论　心理治疗是帮助儿童配合牙病治疗的重要手段     

认知行为疗法对学龄前牙科焦虑症患儿就诊合作程度的干预评估

目的：评估认知行为疗法应用于学龄前牙科焦虑症患儿口腔治疗的效果。方法收集3～6岁牙科焦虑症患儿86例，随机分为试验组和对照组。试验组采用认知行为疗法进行行为管理，对照组采用Tell-Show-Do技术进行行为管理。通过比较2组患儿的配合程度和Frankl治疗依从性评分来评估该方法对学龄前牙科焦虑症儿童就诊行为的干预效果。结果试验组中，38例能配合治疗，5例不能配合，对照组中24例配合，19例不配合，试验组配合程度优于对照组（χ2=11.328，P＜0.01）；Frankl治疗依从性评分结果，试验组为（2.61±0.82）分，对照组为（1.93±0.96）分，试验组优于对照组（F=1.956，P＜0.01）。结论应用认知行为疗法对学龄前牙科焦虑症患儿治疗时，首先进行必要的情绪干预，而后再行无痛治疗，可纠正患儿的恐惧心理。     

笑气镇静在儿童牙科焦虑症患者的临床应用

目的:评价笑气吸入对儿童牙科焦虑症患者治疗中的镇静效果。方法:随机选择3～12岁因对牙科恐惧抗拒治疗的患儿138人,给予全程笑气吸入进行治疗的方式,采用自身对照,记录术前术后的镇静情况。观察患儿对治疗的依从性及对治疗的反应。结果:在138例中107位患儿在笑气镇静下顺利完成治疗,31例失败,患儿在术前后治疗依从性和术后反应方面有显著性差异。结论:笑气镇静可以有效提高患儿对牙科治疗的依从性和舒适度。     

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目的    探讨快速脱敏疗法在牙科畏惧症儿童中的应用。方法    选取2008年7—10月到青岛市口腔医院儿童牙科门诊就诊的3～7岁牙科畏惧症患儿100例，随机分为两组（每组各50例），干预组使用快速脱敏疗法，对照组不使用快速脱敏疗法，比较两组儿童在牙科治疗中的配合程度。结果    使用快速脱敏疗法的儿童在诊疗中的配合程度明显高于未使用快速脱敏疗法的儿童，差异具有统计学意义（P < 0.01）。结论    快速脱敏疗法能有效降低牙科畏惧症儿童在牙科治疗中的恐惧程度。     

基于环境听觉管理的舒适化治疗策略在儿童牙科畏惧症中的应用效果研究

摘要：目的    探讨基于环境听觉管理的舒适化治疗策略在儿童牙科畏惧症中的应用效果。方法    选择2021年7—8月于武汉大学口腔医院儿童口腔科就诊需行口腔治疗的3 ~ 10岁牙科畏惧症患儿60例，随机分为试验组和对照组，每组各30例。对照组仅进行行为管理，试验组在行为管理基础上采用环境听觉管理（佩戴无线智能耳机聆听音乐或音乐故事）。采用儿童畏惧调查-牙科分量表（CFSS-DS）和Venham临床焦虑与合作行为级别评定量表（以下简称“Venham量表”）评估两组患儿治疗前后的焦虑畏惧水平和临床合作情况。结果    在治疗后，两组患儿CFSS-DS评分较治疗前均显著下降，且试验组患儿CFSS-DS评分和Venham量表评级均显著低于对照组，差异均有统计学意义（均P < 0.05）。此外，试验组患儿的临床合作率显著高于对照组，差异有统计学意义（P < 0.05）。结论    基于环境听觉管理的舒适化治疗策略能够有效缓解儿童的牙科畏惧症状和焦虑水平，提高就诊的依从性和配合度，有望为开展儿童口腔舒适化治疗提供新的思路和参考。     

Carisolv去腐对155例牙科畏惧症患儿影响的观察

目的　比较Carisolv去腐和传统车针去腐对牙科畏惧症患儿的影响。方法　选择门诊龋齿患儿300例,其中采用Carisolv去腐155例,传统车针去腐145例,比较2组患儿的CFSS-DS评分值、术中行为分级、疼痛情况和去腐时间。结果　2组患儿CFSS-DS评分值治疗前无显著性差异,治疗后有显著性差异;2组患儿术中行为分级、疼痛率和去腐时间均有显著性差异。结论　Carisolv去腐可有效缓解儿童对牙科的畏惧,值得临床推广。     

儿童牙科患儿心理分析及护理配合

儿童牙科患儿心理分析及护理配合中山医大口腔医疗中心谭艾贤牙科治疗通常包括一些复杂而精细的操作，患者的合作程度会影响操作的进行。由于口腔科诊室中特殊的设备和治疗环境，即使是成人患者，对牙科治疗都有不同程度的恐惧心理；在儿童这种恐惧的心理就更明显。加上儿...     

口腔科门诊儿童牙病护理配合体会

目的探讨如何利用有限人力资源做好儿童牙病治疗过程中的护理配合工作,使儿童在相对平稳的心理状态下安全快捷地接受治疗,提高医生的工作效率。方法对386例2~12岁患儿进行相应的心理诱导后,根据其配合程度进行临床分型,针对不同患儿采用不同术中护理配合。结果 2~4岁患儿52.44%属于心理诱导不合作型,需要采用固定法护理配合。5~6岁患儿中51.45%属于基本合作型,50.72%采用四手操作护理配合。7~12岁患儿中53.61%属于合作型,59.04%采用巡回护理配合。结论巡回护理配合更适合7~12岁患儿。2~4岁患儿多需要固定法护理配合。四手操作适合各个年龄段,尤其是5-6岁的学龄前患儿。     

儿童患者在牙病诊治中的心理特点及护理

通过临床随机调查的503例牙病患儿在就诊过程中表现出的心理状态,将患儿分为配合型、依赖型、恐惧型、拒绝型,提出家长的言行举止、患儿年龄大小以及生活环境的不同将影响患儿在就诊中的配合程度。并总结出相应的护理措施:适合儿童就诊的环境布置,候诊患儿的宣传教育,接诊患儿言行举止要热情、亲切、和蔼,诊疗中什对患儿不同心理特征采用诱导、表扬、对比等方法,引导患儿配合治疗。     

Reasons for repeat dental treatment under general anesthesia for the healthy child

PURPOSE: This study investigated reasons a healthy child may need repeat dental treatment under general anesthesia (GA). METHODS: Experimental subjects were 23 healthy children who received dental treatment under GA twice; controls were 23 healthy children requiring a single dental treatment session under GA. Records review determined demographics, intraoperative information, diagnosis, and treatment provided. Parents of 11 subjects and 9 controls competed a questionnaire and were interviewed. RESULTS: Many factors differed between subject and control children. Common characteristics of children requiring repeat care under GA (subjects) were: (1) 100% percent caries involvement of maxillary central incisors at time of initial treatment; (2) majority of central incisors were nonrestorable; (3) still using nursing bottle at the time of GA; (4) child responsible for brushing own teeth; (5) poor cooperation in the medical and dental setting; (6) difficult personality as described by parent; (7) dysfunctional social situation; and (8) lack of follow-up dental care. Stainless steel crowns were the most successful restoration placed. CONCLUSIONS: A number of predictors were found to help identify high-risk children. Best outcomes following dental rehabilitation under GA may result from aggressive treatment of caries, active follow-up, and education of parents.     

儿童口腔急诊风险防控及行为管理策略

口腔急诊科在接收、救治口腔急诊患者方面发挥重要作用。由于儿童在口腔急诊就诊过程中存在配合性较差以及其他的诊疗特殊性,均会增加诊疗难度及风险,并时刻存在于治疗前、中、后的不同阶段。因此,文章主要结合南方医科大学口腔医院·广东省口腔医院口腔急诊的实际情况,并针对口腔急诊中儿童就诊、治疗等各环节,调整、完善风险防控措施,规范行为管理,提高医务人员应急处置能力,组建防控督导队伍,建立风险防控及行为管理常态化监督机制。在保障诊疗质量的同时,提高口腔急诊儿童风险防控能力,并不断优化管理。     

Indiana infant-toddler dental care survey.

The purpose of this project was to survey Indiana dentists concerning dental care for Indiana infants and toddlers. Dental care issues covered were the age for a child's first dental visit, frequency of rampant or nursing caries cases examined, and dental referral sources for infants and toddlers. The survey also helped determine the dentist's perception of parents' attitudes toward services recommended by the dentist. A twelve question survey was mailed to 2006 general and pediatric dentists in the State of Indiana. The results of the survey were: 1. A large percentage of Indiana dental practitioners do not recommend the first dental visit or examine children for their dental visit until the child is more than one year of age. 2. A majority of Indiana dental practitioners see children with nursing caries or rampant caries on a monthly basis. 3. The majority of Indiana dental practitioners refer children with nursing caries to pediatric dentists for treatment. 4. Although the full treatment plan may undergo some modification based on various parental concerns, a majority of practitioners do not experience difficulty in obtaining treatment plan acceptance for nursing or rampant caries cases.     

Dental health and dental care in severely mentally retarded children

Dental health of 103 children with severe mental retardation living in the north of Sweden, has been surveyed and compared with that of a control group of healthy children of normal intelligence. Data has been related to medical diagnosis, medication, type of residence and previous dental care. The children with severe mental retardation had been offered dental care to the same extent as the control children. Lack of cooperation in treatment and treatment under general anaesthesia was common among the SMR-children. The SMR-children who lived in institutions had a lower prevalence of caries than either those SMR-children not living in institutions or the control group. The SMR-children had a considerably higher frequency of inflamed gingival surfaces and pathological gingival pockets than the control children. The highest frequency was found among children with Down's syndrome. Gingival hyperplasias were recorded in 21% of the SMR-children. The study showed that the children with SMR had shared the generally improved dental care resources and that regular dental care had ensured that there was no neglected need for caries treatment. Periodontal health was poor and the need for stronger and appropriate preventive measures against gingivitis and periodontitis was considerable.     

南京市儿童牙病病人就医行为的调查分析

目的:了解南京市儿童牙病患儿就诊原因和就医行为,以便有针对性地开展口腔健康教育、儿童心理辅导。方法:对来我院儿童牙科就诊的3～12岁儿童牙病患儿或家长进行问卷调查423例,幼儿园3～6岁儿童家长问卷调查216例。调查内容包括就医原因、末次就诊接受的口腔治疗项目、6岁以下儿童中过去1年内未就医原因。结果:儿童牙病以牙痛和有口腔问题而检查者居多,分别占56.26%和17.26%,并以拔牙、龋病者居多,分别占29.08%和27.42%;定期检查和接受预防措施的较少;78.24%的6岁儿童过去1年内没有看过牙。结论:儿童牙病以龋病及其并发症为主要就诊原因,就医行为以牙病引起急、慢性牙痛和有口腔问题者居多,治疗以龋病治疗和拔牙为主。儿童和家长口腔健康教育有待加强。     

The influence of dental caries on body growth in prepubertal children

Dental decay and dental treatment are suggested to be related to body growth in children. The aim of this study was first to assess the relation between dental caries and body proportions cross-sectionally in a Suriname caries child population and secondly to investigate whether dental treatment had a significant influence on body growth of these children in a randomised controlled trial using different treatment strategies. Three hundred eighty 6-year-old children with untreated dental decay participated in the study. Caries prevalence and presence of dentogenic infections were recorded. All children were randomly assigned to four different treatment groups ranging from full dental treatment to no invasive treatment at all. Body growth was evaluated by children’s height, weight and body mass index. Participants were evaluated after 6 months and 1, 2 and 3 years. Cross-sectionally, negative correlations were observed between anthropometric measures and the number of untreated carious surfaces and caries experience of the children. Next, no significant differences in growth pattern between the treatment groups were observed. Based on these results, it is suggested that caries activity is a negative predictor for body growth in children and dental intervention does not show significant improvement within 3 years.     

Nursing caries: Literature review and report of a case managed under local anaesthesia

Although the prevalence of dental caries in children has fallen in recent years, significant numbers of children are still treated for nursing caries. This form of rampant caries affects the primary dentition and causes rapid destruction of normally resistant surfaces. The treatment of nursing caries is multifactorial, involving the child, parents, dental team and other health care providers to ensure the restorative dental treatment is supported by parental education in caries prevention, oral hygiene and infant nutrition. This paper presents a literature review on the condition, followed by a case report of a child with nursing caries treated in the clinic under local anaesthesia.     

高龄老年患者人工牙种植术的围手术期护理

目的：探讨高龄患者人工牙种植术临床配合与护理要点,提高老年种植牙手术的成功率。方法：根据老年生理改变及心理变化的特点,在术前做好充分准备,术中采取相应的配合和术后正确的口腔护理措施。结果：本组50例老年种植牙患者种植后,经随访3个月～2年,均形成良好的骨结合,无种植体脱落及牙龈炎等并发症。结论：采用微创种植技术,对老年种植患者术前、术中、术后三个阶段实施精心护理,避免了切口感染,促进切口愈合,提高了老年种植牙手术的成功率。     

Temporal Changes in Dental Caries Levels and Patterns in a Native American Preschool Population

Objectives : The purposes of this study were to assess current dental caries experience and levels of mutans streptococci in Apache children in 1993 and to determine how caries levels and patterns were different from 15 years before. Methods : Four-year-old Head Start children ( n =127) were examined for dental caries and sampled for salivary mutans streptococci in 1993. Dental caries information on 113 4-year-old children from the same location was obtained from a chart audit of the 1978–79 Head Start dental examinations. Results : Neither the caries prevalence (95%) nor the prevalence of caries patterns differed between the 1978–79 and 1993 cohorts. However, the level of treatment received in 1993 was greater than that in 1978–79. Children with nursing caries (64%) had a greater severity of fissure caries and a greater prevalence of posterior proximal caries compared with caries-positive children without nursing caries. The mean dmfs and dmft of the children categorized in the high mutans streptococci range were greater than those of children categorized in the moderate range. Conclusion : The caries prevalence found in these preschool Native Americans is among the highest reported for this age group and does not differ from that found at this location 15 years before. It appears that children with nursing caries in this population are at greater risk for posterior caries patterns.