妊娠期口腔保健对预防妊娠期牙龈炎的效果

目的 探讨妊娠期口腔保健对预防妊娠期牙龈炎的效果。方法 选取2022年1月-2022年12月我院选择口腔检查的妊娠期产妇98例,分为两组,对照组选择常规健康教育干预,研究组选择口腔保健干预。结果 与对照组比,研究组牙龈疾病的发生率较低(P＜0.05)；研究组的牙周指标情况更好(P＜0.05)；研究组口腔保健知识的认知率更高(P＜0.05)。结论 妊娠期口腔保健对预防妊娠期牙龈炎的效果更加显著,可以有效降低牙龈疾病的发生率,改善牙周指标,提高对口腔保健知识的整体认知率,值得推广。     

Pregnancy and oral health: a review and recommendations to reduce gaps in practice and research

This article presents a review of the research relevant to oral health during pregnancy and includes nursing practice recommendations for referral of women to a dentist for safe and effective dental care during pregnancy. In recent years, research linking periodontitis to the risk for adverse birth outcomes has resulted in increased interest in the topic of oral health during pregnancy. The achievement of optimal oral health in pregnant women as its own benefit, however, has in the past been hampered by myths surrounding the safety of dental care during pregnancy. Many women also lack access to dental care and dental insurance, which interferes with their ability to receive adequate oral care during pregnancy. Intraoral changes that occur with pregnancy because of hormonal changes, combined with lack of routine exams and delays in treatment for oral disease, place pregnant women at higher risk for dental infections.     

Periodontal disease is associated with lower antioxidant capacity in whole saliva and evidence of increased protein oxidation

The aim of this cohort study was to determine whether periodontitis and gingivitis are associated with impaired salivary antioxidant status and increased oxidative injury. One hundred and twenty-nine patients attending a routine dental check-up were recruited for the study. Periodontal disease status was characterized using the Community Periodontal Index of Treatment Needs (CPITN) system. Total salivary antioxidant capacity and salivary ascorbate, urate and albumin were determined in a sample of whole unstimulated saliva. Protein carbonyl concentrations were determined as an index of oxidative injury. Patients in the lowest tertile of CPITN score exhibited decreased salivary delivery of antioxidants and specifically urate than patients in the upper tertile. Poor periodontal health was associated with increased concentrations of protein carbonyls in saliva. Women had significantly lower total antioxidant status than men, regardless of periodontal health. Periodontal disease is associated with reduced salivary antioxidant status and increased oxidative damage within the oral cavity.     

Legionnaire's disease: a current update.

Legionnaire's disease was first identified and described in January 1977. Even today, it is often regarded as an unusual or exotic disease, when in fact it is a very common form of community and nosocomial acquired pneumonia. The major roles of the acute care nurse, including patient health education; psychosocial needs of the patient; and strategies for disease prevention and control, are discussed.     

TOXEMIA OF PREGNANCY IN THE GUINEA PIG

The clinical and pathological manifestations of a disease occurring in the late stages of pregnancy or following parturition in the guinea pig are described. The similarity of this disease to toxemia of pregnancy in the rabbit is discussed. The disease appears to be of endogenous origin and is in some way associated with a disordered metabolism occurring at about the time of parturition.     

Determination of cortisol in saliva and serum by a luminescence-enhanced enzyme immunoassay

A new luminescence-enhanced enzyme immunoassay (LEIA) has been developed and validated for the direct measurement of cortisol in saliva and serum. It has been demonstrated that this LEIA has a very good analytical and functional sensitivity. There was a good correlation to a commercial RIA. The assessment of diurnal cortisol profiles of healthy persons are discussed. Cortisol monitoring is indicated in diseases with abnormal glucocorticoid production such as Cushing's syndrome and Addison's disease. Because of the diurnal fluctuation of cortisol levels it is necessary to take several samples for an individual cortisol profile or during dynamic tests like the dexamethasone-suppression or ACTH stimulation. Salivary sample collection is an alternative method without the stress of repeated venipuncture. The measurement of cortisol in saliva is advisable in patients with abnormal cortisol-binding-globulin (CBG) levels such as pregnancy, hypothyroidism, nephrotic syndrome or marked adipositas and during the administration of certain drugs, especially oral contraceptives.     

Oral health during pregnancy

The purpose of this article is to explore how poor oral health affects pregnancy and to review current recommendations for dental care during pregnancy. While nurses are concerned with numerous aspects of the health of pregnant women, the health of maternal and fetal dentition may be overlooked. However, due to recent findings that periodontal disease may be a risk factor for preterm low birthweight, nurses and other maternal healthcare providers are becoming more aware of oral health during pregnancy. It is important to understand that establishing a healthy oral environment is the most important objective in planning the dental care for the pregnant patient. This objective is achieved by adequate plaque control (brushing and flossing) and professional prophylaxis including coronal scaling, root planing, and polishing. Nurses, nurse practitioners, and nurse-midwives should include assessment of maternal dentition and referral for dental problems as part of their prenatal practice. Patients should be encouraged to schedule elective dental treatment during the second trimester but seek prompt care for acute dental problems. Teaching related to oral health during pregnancy should include the importance of proper nutrition to ensure maternal and fetal oral health, including taking prenatal vitamins and eating foods high in protein, calcium, phosphorus, and vitamins A, C, and D. Potential teratogens that may be encountered during dental care should also be discussed. Nurses can be vital in improving perinatal outcomes and maternal/fetal dental health through screening, referral, and education of their pregnant clients.     

Prioritizing oral health in pregnancy

Pregnant women are particularly susceptible to gum and periodontal disease. The biochemical and hormonal changes of pregnancy enhance the risk. In addition, pregnant women may not experience symptoms until advanced disease stages and therefore unknowingly increase perinatal risk. Associated risks include: premature birth, low birth weight babies, pre-eclampsia, ulcerations of the gingival tissue, pregnancy granuloma, and tooth erosion. These risks increase in women who smoke, experience nutritional deficiencies, or have less frequent visits to the dentist. Many women fail to see the importance of oral care in pregnancy while others experience barriers to care. Health care providers should be educated to recognize the risks of oral health complications during pregnancy. This article provides a review of literature on the correlations between oral health and pregnancy. Implications for practice include: enhanced screening and referral services in preconception and pregnant populations, providing oral health education in clinics, and advocating affordable oral health for all pregnant women.     

Maternal periodontal disease, pregnancy, and neonatal outcomes

The purpose of this article is to review the current literature on the association between maternal periodontal disease and poor pregnancy and neonatal outcomes and outline the role nurses can play in improving the oral health of pregnant women. Maternal periodontal disease is linked to preterm birth, low birthweight, and preterm low birthweight, but treatment of periodontal disease during pregnancy has been shown to be safe and effective. Nurses, nurse practitioners, and nurse-midwives are in a position to educate pregnant women on the benefits of good oral health and identify and refer women who are in need of dental care for treatment.     

Dynamic Aspect of Reactive Oxygen and Nitric Oxide in Oral Cavity

Oral mucosa is a critical protective interface between external and internal environments. Therefore, it must serve as a barrier to a huge number of microbial species present in the environment. Saliva is an important factor that provides for the environment in the oral cavity, and it is indispensable to the host defense reaction in this manner. Oral neutrophils are also important contributors to maintaining the balance between health and disease in this complex environment. These produce reactive oxygen species, nitric oxide, and several antimicrobial peptides, and enzymes. Neutrophils and saliva all contribute to the maintaining the health of the oral cavity in overlapping but independent ways. In addition to production by neutrophils and macrophage, some bacteria can also generate superoxide, hydrogen peroxide, and nitric oxide. Dietary intake of nitrate-enriched vegetables might play important roles in the protection of the oral and stomach against hazardous pathogens via the gastro-intestinal-salivary cycle of nitric oxide (NO) and related metabolites. This review will focus on defense system of the human oral cavity and metabolism of reactive oxygen and NO.     

Oral health during pregnancy

Oral health care in pregnancy is often avoided and misunderstood by physicians, dentists, and patients. Evidence-based practice guidelines are still being developed. Research suggests that some prenatal oral conditions may have adverse consequences for the child. Periodontitis is associated with preterm birth and low birth weight, and high levels of cariogenic bacteria in mothers can lead to increased dental caries in the infant. Other oral lesions, such as gingivitis and pregnancy tumors, are benign and require only reassurance and monitoring. Every pregnant woman should be screened for oral risks, counseled on proper oral hygiene, and referred for dental treatment when necessary. Dental procedures such as diagnostic radiography, periodontal treatment, restorations, and extractions are safe and are best performed during the second trimester. Xylitol and chlorhexidine may be used as adjuvant therapy for high-risk mothers in the early postpartum period to reduce transmission of cariogenic bacteria to their infants. Appropriate dental care and prevention during pregnancy may reduce poor prenatal outcomes and decrease infant caries.     

Effective treatment of Chlamydia trachomatis infection during pregnancy to prevent perinatal and infant complications.

Chlamydia trachomatis is the most prevalent cause of sexually transmitted disease in the United States today. Prenatal health care providers must learn to recognize and effectively treat chlamydial infection in order to help prevent serious consequences in the pregnant woman and in the neonate. This article discusses the diagnosis and treatment of chlamydial infection during pregnancy and during the neonatal period. Patient education of women infected during pregnancy should include guidelines for helping parents and care providers monitor the neonate for signs of conjunctivitis and pneumonia.     

Maintaining oral health during pregnancy: perceptions of midwives in Southwest Sydney

Current evidence highlights the importance of maintaining good oral health during pregnancy, unfortunately, many women in Australia do not access dental services at this time. Compounding the situation is the lack of importance placed on the value of good maternal oral health by prenatal care providers. These constraints highlight the potential value of having preventive oral health advice and referral to an appropriate care pathway during the prenatal period. Midwives are in an excellent position to offer such a service, although the specific aspects of the role have not been clearly defined in Australia. As a preliminary step to the development of an oral health service program, initiated by midwives, this study assesses the midwives' perceptions of such an approach. Data were collected for this qualitative study via a focus group with 15 midwives. Thematic analyses of the data showed that despite the high prevalence of poor oral health in the area, most midwives were unaware of its possible ill-effects on maternal and child health. Midwives were also reluctant to discuss oral health with pregnant women because of a lack of appropriate referral pathways to the Public Dental Services. Midwives were receptive to the idea of establishing this new service but highlighted barriers such as the time involved, the competencies required and the need for referral pathways. The findings suggest that a midwifery-initiated oral health service has potential although issues such as training, time constraints and referral pathways must be addressed.     

Improving oral health in women: nurses' call to action

The purpose of this article is to discuss the most significant oral health and related problems experienced by women, and to provide a Nurse's Plan of Action to respond to these largely preventable diseases. Oral health is integral to women's overall health and well-being, with poor oral health being associated with cancer, heart disease, diabetes, depression, and the birth of preterm, low-birthweight babies. Poor nutrition and lifestyle, principally tobacco and heavy alcohol use, can further increase the risk for oral diseases. Disparities are evident in women's reported poor access of regular dental care related to lack of dental insurance and low income. These facts are disturbing because most oral diseases are preventable. The Surgeon General's report on oral health in America (U.S. Department of Health and Human Services, 2000) and, more recently, the "National Call to Action to Promote Oral Health" (U.S. Department of Health and Human Services, 2003) emphasized the need for partnerships of key stakeholders, including nurses, to get involved in oral disease prevention. Nurses are in an ideal position to provide health promotion education and screening across the multitude of settings in which they work regarding oral health and risk factors for oral disease. Nursing interventions aimed at promoting healthy outcomes and preventing disease should include a focus on oral health.     

Ureaplasma urealyticum airway colonization and pulmonary outcome in neonates

Ureaplasma urealyticum genital tract colonization of pregnant women has been associated with an adverse pregnancy outcome, while its consequent perinatal transmission has been implicated in the development of respiratory disease of the neonate. Clinical manifestations or contributions of ureaplasmal airway colonization in newborns mainly include pneumonia, precocious dysplastic changes and chronic lung disease; although systemic disease has also been documented. This review aims to summarize current diagnostic techniques, pathogenetic mechanisms and pathological data in an attempt to establish an optimal therapeutic approach regarding neonatal U. urealyticum respiratory infection. Related morbidity and mortality, along with the high economic impact of neonatal respiratory disease worldwide, renders this topic particularly interesting and promotes further research in this field.     

Ureaplasma urealyticum airway colonization and pulmonary outcome in neonates

Ureaplasma urealyticum genital tract colonization of pregnant women has been associated with an adverse pregnancy outcome, while its consequent perinatal transmission has been implicated in the development of respiratory disease of the neonate. Clinical manifestations or contributions of ureaplasmal airway colonization in newborns mainly include pneumonia, precocious dysplastic changes and chronic lung disease; although systemic disease has also been documented. This review aims to summarize current diagnostic techniques, pathogenetic mechanisms and pathological data in an attempt to establish an optimal therapeutic approach regarding neonatal U. urealyticum respiratory infection. Related morbidity and mortality, along with the high economic impact of neonatal respiratory disease worldwide, renders this topic particularly interesting and promotes further research in this field.     

No more fighting and biting during mouth care: applying the theoretical constructs of threat perception to clinical practice

The purpose of this article is to describe how the neurobiological principles of threat perception and fear response can support clinical approaches to prevent and reduce care-resistant behaviors during mouth care. Nursing home residents who exhibit care-resistant behavior are at risk for poor oral health because daily oral hygiene may not be consistently provided. Poor oral health predisposes these older people to systemic problems such as pneumonia, cerebral vascular accidents, and hyperglycemia. Care-resistant behavior is a fear-evoked response to nurses' unintentionally threatening behavior during mouth care. Nurses can safely and effectively provide mouth care to persons with dementia who resist care by using personalized combinations of 15 threat reduction strategies.     

Designing an oral health module for the Bachelor of Midwifery program at an Australian University

Maternal oral health is important yet many pregnant women are unaware of its significance. Midwives are advised to promote oral health during pregnancy and are supported to do this in Australia through the Midwifery Initiated Oral Health training program. However, limited undergraduate education is being provided to midwifery students in this area. The objective of this paper is to describe how an innovative oral health education module for an undergraduate midwifery course in Australia was designed using a multidisciplinary approach. Midwives experienced in curriculum development and key investigators from the Midwifery Initiated Oral Health program designed the module using existing literature. Constructive alignment, blended learning and scaffolding were used in the design process. The draft module was then reviewed by midwifery academics and their feedback incorporated. The final module involves 4 h of teaching and learning and contains three components incorporated into first year course units. Each component is aligned with existing learning outcomes and incorporates blended learning approaches and tutorials/class activities as well as online quizzes and personal reflection. The module details key information (current evidence; basic anatomy/physiology; common oral conditions; and guidelines during pregnancy) that could better prepare students to promote oral health in clinical practice. This is the first time such an innovative, multidisciplinary approach has been undertaken embedding oral health in an undergraduate midwifery program in Australia.     

Common oral conditions in older persons

Older persons are at risk of chronic diseases of the mouth, including dental infections (e.g., caries, periodontitis), tooth loss, benign mucosal lesions, and oral cancer. Other common oral conditions in this population are xerostomia (dry mouth) and oral candidiasis, which may lead to acute pseudomembranous candidiasis (thrush), erythematous lesions (denture stomatitis), or angular cheilitis. Xerostomia caused by underlying disease or medication use may be treated with over-the-counter saliva substitutes. Primary care physicians can help older patients maintain good oral health by assessing risk, recognizing normal versus abnormal changes of aging, performing a focused oral examination, and referring patients to a dentist, if needed. Patients with chronic, disabling medical conditions (e.g., arthritis, neurologic impairment) may benefit from oral health aids, such as electric toothbrushes, manual toothbrushes with wide-handle grips, and floss-holding devices.