脑卒中救治后患者拔牙的临床体会

急性脑血管意外（脑卒中）经内科抢救成功后，部分患者在药物治疗和功能康复期间，因机体部分器官功能不全或缺失、生存质量和生活质量低下以及口腔卫生差，牙齿易发生严重龋坏，而失去口腔内科治疗保存患牙的机会。又因反复发生感染，导致血压波动和可能再次诱发脑血管病...     

66例脑血管患者拔牙治疗的临床研究

脑血管疾患已成为威胁人类健康的三大疾病之一［１］［６］。随着我国社会的老龄化和医疗水平及人民生活水平的提高，将会有更多的脑血管病患者要求进行口腔疾患的治疗。我院是北京市老年病研究中心，脑血管病患者较多，经常有患者到口腔科求治。在过去，我们存在两种情况...     

植入心脏起搏器患者口腔治疗前后心电监测对比研究

目的:探讨植入心脏起搏器患者接受口腔治疗的可行性.方法:监测植入心脏起搏器患者进行口腔治疗术前、术中和术后的心电图、心率和血压的变化,用统计分析方法得出规律性的推断结论.结果:心电图无明显改变;心率和血压指标则有不同程度的变化.结论: 植入心脏起搏器患者在接受口腔治疗时会引起其心率、血压发生不同程度的波动,特别是患者接受拔牙术和高速涡轮机口腔治疗时较为突出;但通过患者体内心脏起搏器的调节或自身调节,足以使心脏恢复正常的心率和心律,保证患者的安全和口腔治疗顺利进行.     

口腔癌和癌前病变细胞中氧化应激相关基因差异表达

目的 筛选口腔鳞状细胞癌和癌前病变细胞中与氧化应激相关的差异表达基因,探讨氧化应激损伤与口腔癌发生的相关性及其作用机理.方法 采用核酸微阵列技术,对口腔鳞状细胞癌细胞株Tca8113、KB及口腔癌前病变细胞株DOK细胞的基因表达谱进行比较研究,检测、筛选口腔鳞状细胞癌中与氧化应激相关的差异表达基因.结果 与氧化应激相关的差异表达基因有28条.与氧化应激关系较密切的差异表达基因有9条,如过氧化物酶、超氧化物歧化酶、谷胱甘肽合成酶、谷胱甘肽S-转移酶、硫氧还原酶及硒蛋白等.另外,细胞角蛋白17、细胞角蛋白10及细胞角蛋白7在Tea8113和KB细胞中表达明显增高.结论 氧化应激损伤可能通过某种信号通路引起细胞角蛋白发生变化,从而导致口腔鳞状细胞癌的发生.氧化应激损伤可能与口腔鳞状细胞癌的发生密切相关.     

我国口腔黏膜病学的发展现状与思考

口腔黏膜病是指发生在口腔黏膜与软组织上的类型各异、种类众多的疾病总称.口腔黏膜病学是研究口腔黏膜病的基础理论与临床诊治的学科.由于口腔黏膜病病因复杂,病种较多,临床表现多样化,往往与全身状况关系密切,有些黏膜病是全身疾病的口腔表现,因此,口腔黏膜病的正确诊断和治疗非常重要.     

心因性口腔痛12例报告

在口腔科就诊的患者中常有口腔顽固性持续性疼痛和口腔异常感的病例，临床检查疼痛区无口腔炎症性疾病及肿瘤，末梢及中枢神经通路无器质性病变，而心理因素对疼痛的发生、程度、恶化都起着重要的作用。临床上将这种找不到明确病理生理机制的口腔颌面部疼痛称为心因性口腔痛。本文对此类病例作一回顾性研究，探讨其临床特点和治疗方法。     

社区与门诊老年人牙科焦虑症及其相关因素的研究

目的:调查社区和牙科门诊老年人牙科焦虑症的发生情况及其相关的因素. 方法:使用汉化Coarh's牙科焦虑量表(Dental Anxiety Scale,DAS)评定来自社区和口腔门诊的各700名老年人的牙科焦虑症(DA)情况,通过自行设计的一般情况表,收集可能与老年人DA发生有关的变量,采用多因素Logistic回归方法分析与社区、口腔门诊老年人DA发生有关因素.结果:DA的发生率在社区老人和口腔门诊老人中分别为23.86%、34.10%.Logistic回归分析显示,社区和口腔门诊老年人牙科焦虑症的共同影响因素包括性别、自我健康评价、亲友看牙经历、生活有焦虑;影响社区老年人牙科焦虑症的因素还包括看牙医的频率和既往就诊满意度. 结论:老年人DA的发生在社区和口腔门诊中均普遍存在,但影响因素有所不同. 减少DA对老年人口腔甚至身心健康的不良影响需要多方面共同努力.     

老年人义齿修复的心理特点及其护理

老年人牙齿损失数目较多,据调查我国60岁以上的老年人平均缺牙10颗左右,但成功修复的只有50％.究其原因,一方面,大部分老年人患有全身系统性疾病[1],在口腔治疗过程中惧怕因操作产生疼痛诱发心、脑血管疾病的发作,从而不愿进行系统的口腔修复治疗.另一方面,老年患者合并心理障碍的较多,配合度较差[2].在老年人义齿修复过程中,加强心理方面的护理,使其保持良好的心理状态,对于保证治疗的顺利完成具有重要的意义. 1.临床资料: 2010年11月-2011年11月老年患者义齿修复20例.男性11例,女性9例,年龄60-90岁,其中全口义齿患者3例、固定义齿5例、可摘局部义齿11例、种植义齿1例.     

口腔黏膜癌前病变及鳞状细胞癌中VEGF的表达及意义

目的 :探讨VEGF在口腔扁平苔藓、口腔白斑、口腔鳞状细胞癌中的表达及其在口腔鳞癌发生、发展过程中的意义。方法 :应用VEGF多克隆抗体对 10例正常黏膜、2 7例口腔扁平苔藓、2 4例口腔白斑及 30例口腔鳞状细胞癌分别进行免疫组化检测。结果 :VEGF在口腔鳞状细胞癌组织中高表达 ,与口腔扁平苔藓、口腔白斑、正常口腔黏膜组织存在着显著性差异 (P <0 .0 5 ) ;在口腔扁平苔藓和口腔白斑中VEGF有一定的表达 ,且表达强度强于正常口腔黏膜组 (P <0 .0 5 )。结论 :VEGF的过表达与口腔鳞癌的发生、发展有关 ,可以将其作为预测口腔黏膜恶变潜能的重要标志物。     

噬菌体对口腔疾病发生发展和治疗的影响及机制

噬菌体是特异性感染细菌、真菌等微生物的病毒,是人类口腔生态系统中具有特异性的重要组成部分.在口腔微生物群落、牙菌斑和咽峡部微生物群落中均匀分布有多种噬菌体,与细菌群落相互作用,维持着口腔微生态系统的稳定.许多研究显示,噬菌体与口腔疾病的发生发展相关,并且在相关口腔疾病的治疗中发挥重要作用.本文对噬菌体在口腔微生物群落中的分布特点及其在口腔疾病发生发展和治疗的作用和机制进行综述,旨在为相关口腔疾病的发病机制及临床治疗提供新的思路.     

Oral health care for patients with Alzheimer's disease: An update

Alzheimer's disease and related disorders (ADRD) are among the age‐associated chronic conditions that are most challenging to health care systems around the globe, as patients with dementia require full‐time, intensive care for multiple years. Oral health care is negatively impacted by cognitive decline, and consequently poor oral health is common among people with ADRD. Poor oral health status is linked with many undesirable consequences for the well‐being of people with ADRD, from excruciating local pain to life‐threatening conditions, as aspiration pneumonia. In this paper, the authors provide an update on the most current concepts about Alzheimer's disease epidemiology, etiology, and management, current oral health care for patients with Alzheimer's disease, oral health promotion strategies for this population, as well as current research and future direction for improving oral health care for patients with Alzheimer's disease. It concludes that oral health care should be included in the patient's routine health care as early as possible in the progression of Alzheimer's disease for preventing rapid oral health deterioration. Establishing oral hygiene routines and providing dental treatment that is customized to the patients’ individual needs and disease stage are important to achieve good oral health outcomes and prevent quality of life decline.     

高龄人群口腔卫生保健情况调查

目的：了解高龄老人口腔卫生保健状况.方法：对80岁以上老年人口腔卫生知识问卷调查.结果：具有口腔健康行为的人群,其口腔健康状况良好.结论：加强口腔卫生保健知识教育,养成良好口腔行为习惯,对促进老年人口腔健康很重要.     

The views of dentists, nurses and nutritionists on the association between diabetes and periodontal disease: a qualitative study in a Latino community

OBJECTIVE: To interview health professionals in a Latino community about the association between diabetes and periodontitis, and provide a basis to develop interventions for them to promote oral health and good glycemic control among patients with diabetes. METHODS: Five dentists, seven nurses and two nutritionists were interviewed about their practices relevant to oral health and diabetes, knowledge about the association, beliefs about Latinos, recommendations on reaching others in their fields, and barriers. The interviews were audiotaped, transcribed, and analyzed qualitatively. RESULTS: Professionals identified policy, community and practice barriers for promoting diabetic control and oral health. CONCLUSIONS: Producing a resource list, cross-educating professionals about diabetes and oral health, training professionals to better serve Latino patients, developing appropriate protocols for each profession regarding the association between diabetes and periodontitis, and educating the community about diabetic control, oral health and disease prevention were identified as potential strategies to improve oral health among Latino persons with diabetes.     

Diabetes and oral health promotion: a survey of disease prevention behaviors

BACKGROUND: Diabetes is a chronic metabolic disease known to affect oral disease progression. The authors surveyed health behaviors essential for preventing dental and periodontal diseases and maintaining oral health is a population of adult patients with type 1 (insulin-dependent) diabetes. The goals of this study were to assess these patients' oral health behaviors, access to dental care and need for improved health education. METHODS: As part of a dental and periodontal examination, 406 subjects with type 1 diabetes completed a questionnaire regarding their oral health attitudes, behaviors and knowledge. The authors also evaluated 203 age-matched nondiabetic control subjects. RESULTS: The authors found that diabetic subjects' tobacco use and oral hygiene behaviors were similar to those of the nondiabetic control subjects. Diabetic subjects, however, more frequently reported the cost of dental care as a reason for avoiding routine visits. Most of these subjects were unaware of the oral health complications of their disease and the need for proper preventive care. CONCLUSIONS: Patients with diabetes appear to lack important knowledge about the oral health complications of their disease. The results of this survey did not indicate improved prevention behaviors among the subjects with diabetes compared with nondiabetic control subjects. CLINICAL IMPLICATIONS: Dentists have an opportunity and the responsibility to promote good oral health behaviors such as regular dental examinations, proper oral hygiene and smoking cessation that may significantly affect the oral health of their diabetic patients.     

健康教育提高老年患者对牙周病认知与行为的影响

目的：了解老年患者对牙周病变及其预防知识的认知情况,探讨实施健康教育对提高老年患者口腔保健知识与行为的影响。方法：采用调查问卷方法了解200例老年患者对牙周病变及其预防知识的认知,在实施健康教育前后评价患者口腔保健知识与行为的变化。结果：教育前多数患者对牙周病认识不足,58%的患者从未进行牙周洁治,对牙周洁治的正确认识率较低,健康教育后患者的口腔保健知识与行为发生了明显改变（p〈0.05）,90%以上的患者养成了良好的口腔保健行为。结论：健康教育提高了老年患者对牙周病的认知,对牙周病的防治起到了促进作用。     

A functional natural dentition for all – and for life? The oral healthcare system needs revision

The cost of dental care adds to the costs of the already overburdened health sector. Do we – as patients and as society –receive oral health care that is both aligned with the actual disease experience and also, critically based on up‐to‐date scientific knowledge about the major oral diseases? In many places, the practice of dentistry reflects a response to disease patterns that once existed and is based on diagnostic and therapeutic approaches that are no longer valid. Instead, a new cadre of dental professionals is needed, one that is capable of meeting the actual health needs of our populations. This cadre should ensure that patients maintain a functioning dentition from cradle to grave based on cost‐effective disease control principles. There is an urgent need to: (i) reconsider the roles of the different oral health cadres involved in the provision of oral health care; (ii) integrate oral health into general healthcare services; and (iii) restructure the training of oral health personnel. We advocate a radical reform of the oral healthcare system involving the training of two new types of professionals integrated with the general healthcare system: The oral healthcare provider – a highly skilled professional specialised in the diagnosis and control of oral diseases and with a profound understanding of oral health as part of general health – and the oral clinical specialist – whose role is the provision of advanced oral rehabilitation, able also to treat people with complex chronic diseases and multiple medications.     

Discovery of a patient with strongly suspected bullous pemphigoid in a ward by oral health care providers

To cite this article:
Int J Dent Hygiene 9 , 2011; 159–162
DOI: 10.1111/j.1601‐5037.2010.00448.x
Kanda N, Soga Y, Meguro M, Tanabe A, Yagi Y, Himuro Y, Fujiwara Y, Takashiba S, Kobayashi N. Discovery of a patient with strongly suspected bullous pemphigoid in a ward by oral health care providers. Abstract: Objectives: Oral health care providers may discover systemic diseases incidentally from signs observed in the oral cavity. Here, we report a case in which oral health care providers in a hospital discovered a patient with strongly suspected bullous pemphigoid (BP), which is a relatively rare but important disease, in a ward. Methods: The patient was a 78‐year‐old Japanese woman admitted to our hospital because of severe Alzheimer’s disease. We discovered recurrent ulcers in the oral mucosa and skin when performing oral care in her ward. Biopsy could not be performed safely because of involuntary biting. We performed blood tests for anti‐BP180‐NC16a antibody, which is autoantibody specific for BP. Results: The patient had a very high anti‐BP180‐NC16a antibody titre. We consulted a dermatologist regarding her clinical course and the clinical features of the oral mucosa and skin along with blood test results. BP was very strongly suspected. Discussion: In cases in which oral health care providers suspect their patients may have BP, appropriate examination and provision of information to the doctor are important. Oral health care providers should have knowledge about systemic diseases, the signs of which appear in oral cavity to avoid missing important systemic diseases.     

A survey of oral surgeons’ tobacco-use-related knowledge and intervention behaviors

Objectives: To evaluate whether oral surgeons are aware of tobacco’s role in oral health. Moreover, we wanted to know professionals’ attitudes towards smoker patients and physicians’ involvement in detecting and eradicating this habit in patients. Study Design: We conducted a survey to determine the awareness of the members of the Spanish Society of Oral Surgery about tobacco’s damage on oral health and the role of dentists in the prevention and elimination of the smoking habit. Results: 450 surveys were distributed during the Seventh National Congress of the Spanish Society of Oral Surgery, of which 224 (49.8%) were answered. Seventy-six point eight percent of oral surgeons said that they have a good knowledge of the effects of snuff on oral health. However, only 42.9% admitted they had received specific training regarding how to deal with patients who want to give up smoking. Sixty-three point four percent had explained to smoker patients the risk of this habit for the oral and general health. However, 17% admitted they do not advise their patients to give up smoking for fear of upsetting them, while 15.2% expressed lack of time, and 3.6% think it is not their competence. As to the relationship between oral cancer and smoking, 83% of oral surgeons recognize a direct relationship. In addition, 85.7% of professionals believe that dentists have a primary role in oral cancer prevention. Conclusions: These results indicate that most oral surgeons are concerned about the smoking habit of their patients. However, it is necessary to increase the specific training of dentists by providing tobacco treatment programs as part of their professional responsibility. Oral surgeons recognize the direct relationship between the smoking habit and oral cancer and regard as very important the role of dentists in the prevention of this disease. Key words:Smoking habit, oral surgery, oral cancer.     

Introduction to nutrition and oral health

Nutrition is vital to human growth, development, and life maintenance and, as such, is also important to oral health. Dietary nutrients include carbohydrates, proteins, fats, vitamins, minerals, and water. This article reviews these nutrients, their functions and sources, and how they relate to oral health and disease. Concepts about which the oral health care provider must be aware in order to counsel patients regarding the impact of diet on oral health and toward healthy lifestyle choices are discussed.     

维、汉患者牙周病知识和口腔保健行为的比较

目的：通过对口腔科维吾尔族和汉族患者的牙周病知识水平和口腔保健行为的调查，了解两民族对牙周病认知程度和保健行为的差异及二者之间的关系。方法：以问卷方式调查了161例维吾尔族患者和339例汉族患者牙周病相关知识，并记录其牙周状况。结果：维吾尔族患者对牙周病的病因和早期症状以及防治知识认知率低于汉族患者，差异有统计学意义，维吾尔族患者中能够使用正确的刷牙方法和经历过洁治术的人数少于汉族患者。了解牙周保健知识以及接受过牙周治疗是影响患者牙周保健行为的因素之一。结论：提示维吾尔族患者的牙周病知识水平和牙周保健行为能力低于汉族患者，必须加强健康教育，应该以改变其口腔保健行为作为重点，并充分发挥少数民族护士的作用。