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目的 评价笑气/氧气吸入镇静技术辅助牙科畏惧症患儿口腔治疗的疗效.方法 选择2009年10月至2011年6月来济南市口腔医院就诊,有紧张恐惧情绪,无法完成常规条件下口腔治疗的患儿64例,随机分为试验组和对照组,每组32例.试验组患儿在应用笑气/氧气吸入镇静技术下进行口腔治疗,对照组患儿仅在心理行为诱导下进行口腔治疗.对比两组患儿临床治疗效果及主观焦虑水平与就诊行为改善程度.结果 两组患儿治疗有效率分别为87.5％和62.5％,差异有统计学意义(P＜0.05).治疗后两组患儿儿童畏惧调查表-牙科分量表(CFSS-DS)平均得分和Venham临床焦虑及合作行为级别评分均降低,试验组下降更明显(P＜0.05).结论 笑气/氧气吸入镇静技术能够有效缓解患儿就诊中的焦虑恐惧情绪、改善其就诊行为表现,提高患儿口腔治疗的合作性.     

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。     

虚拟现实技术在儿童口腔治疗行为管理中的应用

牙科焦虑症表现为患者在口腔诊治时感到紧张、焦虑和害怕。DA在儿童时期的发生率很高，相当一部分患儿因恐惧口腔治疗而拒绝配合医生诊治，导致病情延误，甚至可能成为长久的心理创伤。随着科技的快速发展，虚拟现实技术正逐渐应用于各领域，因其具有沉浸感、想象性和交互性等特征，适用于口腔门诊儿童的非药物性行为管理，从而提升患儿口腔治疗的依从性。文章通过具体临床研究阐述VR技术在儿童口腔治疗行为管理中的应用。     

儿童口腔局部麻醉控制疼痛研究进展

儿童口腔疾病治疗中,患儿的配合度与疼痛控制密切相关,局部麻醉是疼痛控制最常用的方法之一。局部麻醉药物的合理选择、麻醉剂量的准确评估、针对不同类型患儿个性化麻醉方案的制定等为儿童口腔疾病治疗提供了保障。安全有效的局部麻醉既有利于提高治疗质量和远期疗效,又能让患儿获得舒适的就诊体验,有助于其建立积极的口腔保健态度。文章对儿童口腔局部麻醉控制疼痛的研究进展做一综述。     

儿童口腔局部麻醉控制疼痛研究进展

 儿童口腔疾病治疗中，患儿的配合度与疼痛控制密切相关，局部麻醉是疼痛控制最常用的方法之一。局部麻醉药物的合理选择、麻醉剂量的准确评估、针对不同类型患儿个性化麻醉方案的制定等为儿童口腔疾病治疗提供了保障。安全有效的局部麻醉既有利于提高治疗质量和远期疗效，又能让患儿获得舒适的就诊体验，有助于其建立积极的口腔保健态度。文章对儿童口腔局部麻醉控制疼痛的研究进展做一综述。     

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目的    探讨心理行为诱导对牙科畏惧症（dental anxiety, DA）患儿的临床疗效。方法    对2009年2月至2010年7月在济南市口腔医院门诊就诊的398例3～12 岁口腔疾患儿童,采用儿童焦虑调查表-牙科分量表（children’s fear survey schedule-dental subscale, CFSS-DS ）进行分析比较,并将筛选出的316例DA 患儿随机分为试验组和对照组。试验组在进行常规口腔治疗的同时,采用心理行为诱导;对照组仅进行常规口腔治疗。结果      试验组治疗后,DA 程度明显下降（P＜0.01）,男孩DA 程度的下降较女孩更显著（P＜0.05）。结论    心理行为诱导治疗DA患儿效果明显,有利于提高临床治疗效率与治疗质量。     

学龄前儿童参与治疗在牙科诊疗中的作用研究`

目的　探讨学龄前儿童参与疾病治疗在牙科诊疗中的作用。方法 选取2017年6月~2018年6月来我院口腔门诊首次就诊并需要复诊的3~6岁学龄前儿童90例为研究对象,根据随机数字法分为实验组和对照组,每组各45例。每次就诊对照组给予常规干预,实验组除常规干预措施外,让患儿参与疾病治疗。首诊和复诊治疗结束后采用CFSS-DS量表、Frankl量表和Houpt行为量表对两组患儿牙科畏惧程度、治疗依从性和治疗完成情况进行评定并比较其统计差异。结果 实验组复诊率为93.33%,高于对照组（77.78%）,差异具有统计学意义（?2=4.406,P<0.05）。实施参与疾病治疗的实验组患儿首诊和复诊CFSS-DS评分均低于对照组,Frankl治疗依从性和Houpt治疗完成情况均优于对照组,两组比较均具有统计学差异（P均<0.05）。和首诊比较,复诊后实验组患儿CFSS-DS评分降低,Frankl治疗依从性提高,差异具有统计学意义（P均<0.05）,但Houpt行为量表评定结果没有统计学差异（P>0.05）。结论 实施学龄前儿童参与疾病治疗能缓解患儿牙科畏惧程度,提高就诊率和治疗依从性。     

七氟醚吸入镇静辅助儿童口腔治疗

目的 评价口腔门诊采用七氟醚吸入镇静镇痛技术辅助儿童口腔治疗的临床应用效果.方法 对广州市妇女儿童医疗中心口腔科收治的患有口腔疾病的不配合儿童170 例采用七氟醚吸入镇静镇痛技术辅助口腔治疗,随访并记录,资料统计分析.结果 170 例患儿镇静后均顺利完成手术,术中无挣扎、哭闹,血压、心率及呼吸指标均在正常范围,无严重缺氧、误吸、呕吐等并发症发生.患儿口腔治疗时间为15 ～ 60 min,术后5 ～ 10 min 苏醒.苏醒期58 例（34.12%）患儿发生烦躁哭闹;术后1 例患儿发生呕吐,立即置头部于低、侧位,及时吸清口内呕吐物及呼吸道分泌物,患儿恢复良好;2 例患儿手术当晚出现低热症状,给予物理降温并口服抗生素后好转.170 例患儿术后随访均无异常.结论 口腔门诊采用七氟醚吸入镇静镇痛技术辅助不配合儿童口腔治疗安全、不良反应少、临床效果显著.     

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。     

儿童口腔科患者就诊配合度的影响因素

儿童口腔科最常见的问题是患儿由于牙科焦虑或者行为管理问题不能配合治疗,对口腔诊疗的正常进行造成极大的影响。本文将从医护、患儿、监护人3个方面对可能造成患儿就诊不合作的因素进行综述,以期为临床工作中了解患儿不配合的原因提供参考。     

DGA下龋病治疗对儿童口腔健康及生长发育的近期影响

目的 随访在全身麻醉下行龋病治疗的患儿,分析全麻下龋病治疗对儿童口腔健康及生长发育的近期影响。方法 收集2017年2月—2018年1月在上海交通大学医学院附属第九人民医院儿童口腔科进行全身麻醉下龋病治疗并符合研究标准的全部病例。经患儿家长知情同意,研究者在术前、术后随访时检查患儿口腔情况,记录身高、体重,检测龋活跃性。采用SPSS 25.0软件包对数据进行统计学分析。结果 治疗前患儿平均龋均值为14.02,夜奶喂养及过早人工喂养的患儿龋均值明显偏高。术后3个月时龋病复发率为25.67%,6个月时龋病复发率为50%。治疗后患儿龋活跃性发生明显改变,3次随访结果中,龋活性值在术后3个月时最低。全麻治疗后患儿用餐时间显著缩短,进食次数及摄入甜食的频率明显下降,刷牙时间明显延长。术后BMI处于正常范围的儿童数量显著增加。结论 全身麻醉下龋病治疗可在短期内显著降低患儿的龋活跃性,改善患儿的口腔健康行为和发育情况。但大部分患儿治疗后仍具有较高的龋复发风险。     

Dental health behavior of children with BBTD treated using general anesthesia or sedation, and of their parents in a recall examination

The aim of the study was to assess the dental status and dental health behavior of children with Baby Bottle tooth Decay treated using general anesthesia or sedation, and the dental health behavior of their parents in a recall examination. The study population consisted of sixty-five children, among whom thirty-four were treated using general anesthesia and thirty-one using sedation. The recall examination included a full dental examination from which the children's dif index could be drawn. Loe's plaque index was used to assess the amount of plaque on the teeth. Sociodemographic information and the dental health behavior of the parents and children were obtained. Plaque index was similar in the general anesthesia and sedation groups. The parents of the general anesthesia group were younger than the parents of the sedation group (35.0 +/- 6.7 and 38.8 +/- 6.2 for the fathers, and 32.4 +/- 5.9 and 34.9 +/- 5.3 for the mother, respectively). More firstborn children were treated using general anesthesia than using sedation. Significantly more siblings were treated in the sedation group. Children treated using sedation had significantly more siblings treated in the same mode. Parents of the children in the general anesthesia group were significantly more involved in brushing their children's teeth than the other group. In the sedation group, more children brush their teeth without parental help. Significantly more children in the general anesthesia group reduced their sweet consumption than in the sedation group. We conclude that preventive behaviors were more frequently adopted among the families of children treated using general anesthesia.     

The reported impact of oral condition on children in the United Kingdom, 2003

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys of the United Kingdom. AIMS: This paper is concerned with how children are reported to have been affected by their oral condition during the 12 month period immediately preceding the survey and how this relates to the children's experience of caries, their dental attendance behaviour and their social class. METHOD: The information was gathered by self-completion questionnaire distributed to the parents of half of the sample who were clinically examined in the dental survey. RESULTS: Some form of impact was reported by the parents of 22% of five-year-olds, 26% of eight-year-olds, 34% of 12-year-olds and 28% of 15-year-olds. The pattern of responses to the eight impact questions was broadly similar across age groups. The most frequently reported type of impact was pain in all age groups. Impacts on oral function, self-confidence, orally related activity and on the child's emotions were experienced by 4-10% of children of all ages. Fewer children (1-2%) were reported to have experienced more far reaching impacts affecting their social functioning, general health and life overall. CONCLUSIONS: Most children were reported not to have experienced any of the problems covered by the questionnaire. Of those who did, most reported a single problem and for most this was pain. Nevertheless there was a group of children for whom oral function, self-confidence, orally related activity, emotions, social functioning, their health or their life in general were reported to have been affected by their oral condition. The nature of dental care which is appropriate for such children needs to be determined.     

Dental treatment under general anesthesia in a group of patients with cerebral palsy and a group of healthy pediatric patients

This is a comparative study between two groups, one of healthy children and the other of children with cerebral palsy, which underwent dental treatment under general anesthesia at Hospital Sant Joan de Déu Barcelona. The purpose of the study was to compare and determine oral pathology, frequency, severity and postoperative complications in pediatric patients with and without an underlying disease which undergo a dental treatment under general anesthesia. Key words:General anesthesia, cerebral palsy, pediatric patients.     

数字化宣教对非住院全麻下儿童牙病治疗复诊率影响

目的分析利用数字化技术进行卫生宣教对非住院全麻下儿童牙病治疗后的复诊情况的影响,为临床护理工作提供帮助。方法分析2015年1月至2015年12月62例非住院全麻下儿童牙病治疗后的复诊情况,比较数字化卫生宣教对不同学历家长和家庭收入情况下的患儿复诊率的影响。结果家长具备较高学历水平的患儿复诊率更高,家长拥有较高收入的患儿复诊率比低收入家庭的复诊率更高,经数字化卫生宣教的患儿复诊率显著高于未宣教患儿。结论利用数字化技术进行卫生宣教能显著提高患儿复诊率,对指导家长树立正确的口腔健康维护观念,提高和维护患儿疗效具有重要帮助。     

Parental perceptions of their preschool-aged children's oral health

BACKGROUND: Parents have an important role in making decisions about their children's oral health. The purpose of the authors' study was to determine parental perceptions of their children's oral health status and factors correlated with these perceptions of health. METHODS: The authors analyzed data for 3,424 children (2-5 years of age) from the Third National Health and Nutrition Examination Survey. They based the dependent variable on a question asked of primary caregivers: "How would you describe the condition of [child's name]'s natural teeth?" Explanatory variables included demographic variables, dental visits, perception of child's general health, need for dental care and presence of tooth caries. RESULTS: Eighty-nine percent of parents rated their child's oral health as excellent, very good or good, and 11 percent rated it as fair or poor (mean = 2.7 on a five-point scale, with 1 being excellent and 5 being poor). Tooth caries, perceived need for dental cleaning and treatment, lower income and poorer general health perceptions were associated with poorer parental ratings. CONCLUSIONS: Actual disease and perceived need are associated significantly with parents' perceptions of their children's oral health. PRACTICE IMPLICATIONS: Understanding parents' perceptions of their children's oral health and factors that motivate these perceptions can help dentistry overcome barriers that parents encounter in accessing dental care for their children.     

Er：YAG 激光龋齿去腐对低龄儿童牙科焦虑症影响的初步观察

临床选取3岁±3月、乳磨牙(牙合)面Ⅱ度龋的患儿20例,随机分成试验组（激光组）和对照组（车针组,n ＝10）,在不使用开口器、束缚带的情况下分别用 Er：YAG 激光和车针去腐。观察患儿初诊、复诊时治疗成功率及畏惧程度。结果显示激光组治疗成功率高于车针组（P ＜0．05）,畏惧程度低于车针组（P ＜0．05）。激光治疗可缓解儿童牙科焦虑,有利于提高临床治疗成功率。     

Prevalence of dental anxiety among 5- to 8-year-old Taiwanese children

OBJECTIVES: Many people experience discomfort to a greater or lesser degree about the prospect of dental treatment. Dental treatment can be a terrible experience, especially for children with dental anxiety. This study estimated the prevalence of dental anxiety among 5- to 8-year-old children in Kaohsiung City, Taiwan. METHODS: The Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) was translated into Chinese, and a receiver operating characteristic (ROC) curve was made based on criteria determined from pretest clinical observations of a sample population to set a cutoff score. Then, the parental CFSS-DS was used as a screening tool to survey the dental anxiety levels of 5- to 8-year-old children at kindergartens and elementary schools in Kaohsiung City, Taiwan. Participants were selected by stratified random sampling. The stratification was done by geographic district, age group, and sex. A total of 3,597 valid questionnaires were collected. RESULTS: The Chinese version of the CFSS-DS had an optimal cutoff score of 38/39 (sensitivity was 0.857, specificity was 0.882) with an area under the ROC curve of 0.912. The estimated prevalence of dental anxiety among 5- to 8-year-old children in Kaohsiung City was 20.6 percent. The dental anxiety score was found to decrease as age increased; primary school boys had significantly lower scores. CONCLUSIONS: The prevalence of dental anxiety was found to be high for 5- to 8-year-old Taiwanese children. The study's findings point to the urgent need for preventive health education and intervention programs in Taiwan to promote children's oral health and reduce dental anxiety.     

牙科全麻技术前后患儿口腔相关生活质量的对比研究

目的:观察分析全身麻醉下儿童口腔治疗前后患儿口腔相关生活质量的改变.方法:收集接受全身麻醉下牙齿治疗3～6岁的患儿59例资料,由患儿家长全麻前和术后1个月分别填写儿童口腔健康生活量表,本量表包括患儿自身影响部分和家庭影响部分.通过分析软件SPSS 19.0进行数据分析.结果:全麻后口腔健康生活量表总分降低51％ (P＜0.001),其中患儿影响部分降低50％ (P ＜0.001),家庭影响部分降低53％ (P ＜0.001),效应量分别为1.4和4.0.结论:对于年幼不合作且多数牙齿龋损的患儿,全身麻醉下牙齿治疗可显著提高患儿及其家庭的口腔相关生活质量.     

不同年龄重度婴幼儿龋治疗时机选择分析

目的:探讨急性、非急性期就诊对不同年龄幼儿牙科焦虑的影响,完善针对焦虑儿童的行为管理。方法:选取3～7岁初次就诊,乳磨牙龋坏儿童192人。每年龄组48人,分别分为实验组、对照组。实验组为急性期就诊患儿,对照组为非急性期患儿。CFSS-DS量表评估患儿治疗前、后及复诊畏惧程度;Venham量表评估初、复诊就诊行为变化。数据进行统计学分析。结果:全年龄段实验组患儿治疗前后CFSS-DS量表评分差值比较,有统计学意义(P＜0.05),对照组无统计学意义。全年龄段实验组患儿初、复诊就诊行为Venham量表评分差值比较,有统计学意义(P＜0.05);对照组无统计学意义。结论:恰当治疗可稳定或改善患儿牙科焦虑,随年龄增长急性期就诊患儿焦虑程度改善更显著。