妊娠期妇女牙周炎症状况的多因素分析

目的：调查孕妇的牙周健康认知情况和牙周状况,对妊娠期妇女牙周炎症状况进行多因素分析。方法：选择2012年1～12月在无锡市妇幼保健院就诊孕妇906名,调查方法包括问卷调查和临床牙周检查,应用SPSS 12．0软件进行t检验、x2检验和Logistic回归分析。结果：①受教育程度较低和月收入为中低水平的孕妇牙周健康知识认知情况较差。②无锡市孕妇的牙周疾病患病率为81．2％,其中牙龈炎和牙周炎患病率分别为55．7％和25．5％。选用非药物牙膏（OR值＝1．33）、受教育程度较低（OR值＝1．32）、每天刷牙1次（OR值＝4．62）、刷牙时间＜1 min（OR值＝1．71）、BMI＞25．0（OR值＝1．23）、孕前1年无就诊（OR值＝3．42）、无洁牙习惯（OR值＝2．16）、不知道刷牙3．3．3．规则（OR值＝1．85）、不使用漱口水（OR值＝1．15）,月收入较低（OR值＝1．65）为牙龈炎的危险因素（P＜0．05）;年龄＞30岁（OR值＝2．79）、孕前或孕期患有全身性疾病（OR值＝2．31）、每天刷牙1次（OR值＝1．68）、BMI＞25．0（OR值＝1．19）、孕前1年无就诊（OR值＝4．16）、无洁牙习惯（OR值＝2．31）、不知道刷牙3．3．3．规则（OR值＝1．56）、月收入较低（OR值＝1．41）为牙周炎的危险因素（P＜0．05）。结论：孕妇牙周疾病的发病率受年龄、受教育情况、收入、刷牙次数、刷牙时间、孕前或孕期患有全身性疾病、洁牙等多种因素影响,需要加强孕妇牙周健康知识教育,其中低学历、低收入者为重点教育人群。     

1720名孕妇牙体牙周健康状况的调查分析

目的：调查分析武汉市孕妇牙体牙周健康状况,为孕前孕期妇女口腔疾病防治提供依据。方法：按照世界卫生组织制定的口腔健康调查基本方法,对5160名孕妇通过随机抽样,采用口腔健康数据库管理系统记录1720名孕妇牙体牙周健康状况。结果：孕妇总患龋率为58．6％,龋均为1．54,龋面均为2．43。牙龈炎患病率72．1％,结石检出率为53．6％。随着孕周的增加龋患率没有明显差异,牙龈炎的发生明显加重,有统计学意义。结论：孕期妇女牙体牙周健康状况较差,提示应加强孕妇口腔卫生宣传指导,采取措施积极治疗口腔疾病。     

孕产妇牙周疾病与早产低体重儿相关性分析

目的:研究孕产妇牙周疾病与早产低体重儿的相关性. 方法:采用横断面调查的方法,根据随机原则并按照纳入标准抽取2006-05～2007-02间在湖北省妇幼保健院进行生产的已作婚姻登记的,并且孕前1 年内及孕期未曾患有下生殖泌尿系统性疾病的妇女432 名.调查方法包括问卷和临床检查:调查问卷为被调查人员相关情况的结构式问题调查;牙周检查项目包括软垢指数、龈沟出血指数、牙周袋探诊深度及临床附着丧失水平等,同时记录新生儿体重和分娩时孕周.运用卡方检验及Logistic回归分析的统计学方法对数据进行分析.结果:分娩出早产低体重儿的孕产妇53 名,占12.3%;正常分娩的孕产妇379 名,占87.7%.早产低体重组孕产妇牙龈炎的患病率为86.6%,牙周炎的患病率为64.2%,正常分娩组的分别为73.6%和32.7%.患有牙龈炎孕产妇分娩出早产低体重儿的OR值为1.30, 95%CI为0.53～3.22;患有牙周炎的孕产妇分娩出早产低体重儿的OR值为2.69, 95%CI为1.37～5.27.结论:孕产妇牙周疾病是引起早产低体重儿的主要危险因素之一.     

上海市长宁区845例孕妇口腔健康状况调查分析

目的调查上海市长宁区怀孕中期孕妇口腔卫生状况及患病情况。方法对2009年4月—2010年8月来本院产检的845例孕妇进行问卷调查及临床检查。结果孕妇患龋率43.67%,牙龈炎发病率84.38%,牙周炎的发病率8.28%,孕前口腔保健率22.2%。食物软垢和牙结石是引起牙龈炎和牙周炎的主要原因。结论应加强孕前及怀孕期间的口腔健康教育。     

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目的研究孕妇牙周炎与早产儿、小于胎龄儿之间的相关性。方法将2009年1-4月来湖北省妇幼保健院口腔科进行孕期常规口腔检查的3251名妊娠中期孕妇的资料输入数据库,牙周检查项目包括软垢指数、龈沟出血指数、牙周袋探诊深度及临床附着丧失水平等,随访妊娠结局（新生儿体重、分娩时孕周）。运用χ2检验及logistic回归分析数据。结果3251名孕妇中最终符合调查要求2702名,妊娠中期诊断为牙周炎301例,其中重度牙周炎61例;早产儿、小于胎龄儿的发生率,在重度牙周炎孕妇分别为11。5％和9．8％,在牙周健康孕妇分别为6．0％和6．6％,差异均有统计学意义（P〈0．001）;重度牙周炎孕妇终止妊娠的孕周平均为35．2周、新生儿体重平均2478g,而牙周健康孕妇平均为39.3周和3512g,差异均有统计学意义（P〈0．001）;重度牙周炎孕妇发生早产儿和小于胎龄儿的OR值分别为2．45和3.47。结论孕妇重度牙周炎是引起早产儿、小于胎龄儿等不良妊娠的主要危险因素之一。     

控制牙周感染、维护口腔健康是口腔医学发展的重要基础

牙龈炎和牙周炎是最常见的牙周疾病,也是人类较常见的感染性疾病之一.不仅危害牙周健康和口腔健康,而且与全身健康和疾病有着密切关系.有文献报道亚洲人易患牙周炎,中国是牙周病的高发国家,80%～90%的成人患有不同程度的牙周疾患.     

妊娠晚期孕妇牙周炎与体液中白介素-2含量关系研究

目的 研究妊娠晚期牙周炎孕妇龈沟液、唾液、血清中白介素-2（IL-2）含量变化以及三者间的关联。方法 于2011年4—7月在湖北省妇幼保健院接受口腔检查的妊娠33 ~ 38周单胎孕妇中,随机选取20例牙周炎、26例牙龈炎、22例牙周健康孕妇（对照）纳入研究。分别采集其唾液、龈沟液和血清,采用双抗体夹心ELISA检测IL-2质量浓度。结果 牙周炎组分娩时孕周（36.5 周）明显小于牙龈炎组（38.8 周）和对照组（39.3 周）,牙周炎组分娩时新生儿体重（3079.9 g）低于牙龈炎组（3452.5 g）和对照组（3462.4g）,差异均有统计学意义（均P < 0.05）。牙周炎组大专及以上学历、孕前半年行口腔保健的比例明显低于牙龈炎组和对照组（均P < 0.05）。牙周炎组龈沟液、唾液中IL-2质量浓度明显高于牙龈炎组和正常对照组,差异有统计学意义（均P < 0.05）;但3组血清中IL-2质量浓度比较,差异无统计学意义（P > 0.05）。各组孕妇龈沟液、唾液、血清中IL-2质量浓度之间均两两呈线性相关,差异有统计学意义（均P < 0.01）。结论 妊娠合并牙周炎孕妇口腔中IL-2含量较高,并与血清中IL-2质量浓度呈直线相关,在牙周炎合并不良妊娠结局（如早产、低体重儿等）的发病机制中起一定作用。重视口腔卫生是预防不良妊娠结局的方法之一。     

牙周疾病与早产儿及低体重儿相关性的研究进展

妇女在妊娠期间身体和情绪的变化会影响其口腔健康。孕期常见的口腔表现是牙龈炎和牙周炎。牙周疾病与分娩出早产儿(PTB)及低体重儿(LBW)的相关性是近年颇具争议的研究热点。本文就这一方面的研究现状作一综述。     

3117例孕妇口腔科门诊初诊病例统计分析

目的:为了解门诊孕妇口腔疾病病种和分布情况,进一步做好防治工作.方法:对2003年3月至2007年3月3117例孕妇口腔疾病初诊患者按牙体、牙髓、牙周疾病,口腔颌面炎症,口腔黏膜疾病分类统计.结果:牙周疾病所占比例最高为46.68%,其次分别为口腔颌面炎症30.90%,牙体、牙髓疾病21.17%,口腔黏膜疾病1.25%.结论:加强在孕中期牙周疾病和口腔炎症的治疗,重视孕前口腔健康检查,早期发现,早期治疗口腔疾病,消除对孕妇及胎儿健康的影响.     

江苏省中老年人牙周健康状况及影响因素分析

目的了解江苏省35~74岁人群的牙周健康状况及其相关影响因素,为开展中老年人牙周疾病的防治提供信息支持。方法采用分层、多阶段、等容量随机抽样的方法,抽取江苏省35~74岁城乡居民447人,其中35~44岁146人,55~64岁153人,65~74岁148人。按照第四次全国口腔健康流行病学调查检查标准,采用CPI探针检查全口牙的牙龈出血、牙石、牙周袋和附着丧失状况,并进行问卷调查。结果35~44岁、55~64岁、65~74岁人群,牙龈出血人均牙数和检出率分别为11.3(95.2%)、11.3(95.4%)、8.2(87.2%),牙石人均牙数和检出率分别为21.3(100.0%)、21.5(99.4%)、18.0(98.0%),浅牙周袋人均牙数和检出率分别为1.6(38.4%)、3.0(64.1%)、2.3(53.4%),深牙周袋人均牙数和检出率分别为0.1(2.1%)、0.3(13.1%)、0.2(10.1%),牙周附着丧失人均牙数和检出率分别为1.2(32.2%)、6.0(76.5%)、6.4(87.2%),牙周健康检出率分别为2.1%、0.7%、4.1%。单因素分析显示牙周炎与年龄、性别、学历、吸烟有统计学意义(P<0.05),多元Logistic回归分析显示:年龄为牙周炎的独立危险因素(P<0.05)。结论本次调查显示江苏省中老年人牙周健康和口腔卫生状况较差。年龄、性别、学历、吸烟等可能是影响牙周健康状况的相关因素。应加强中老年人口腔预防保健工作,努力改善中老年人口腔健康状况。     

Oral health and oral diseases in pregnancy: a multicentre survey of Italian postpartum women

Background

The aim of this study was to explore the oral hygiene practices and oral health status of Italian postpartum women.

Methods

A self‐administered questionnaire assessed socio‐demographic information, oral hygiene habits and frequency of dental visits. All women received a thorough oral examination within five days after delivery. Logistic regression models were used to estimate odds ratios and 95% confidence intervals for exposures of interest and the presence of ‘severe’ periodontitis.

Results

Seven hundred and fifty women participated in the study; 99.1% brushed their teeth everyday and 59.9% visited the dentist annually. The mean frequency of sites with bleeding on probing was 16.1% and the median clinical attachment level was 2.1 mm. The mean caries experience score (DMFT) was 8. Severe periodontal disease was present in 21.9% of individuals. Patients who reported visiting a dentist only when in pain and women with three dental caries or more were significantly more likely to have periodontitis (OR: 1.6; 95% CI: 1.1–2.2; p < 0.05 and OR: 2.3; 95% CI: 1.5–3.5; p < 0.01, respectively).

Conclusions

Given the possible association between maternal and infant oral health, and between periodontal infection and general health, antenatal care providers should collaborate with dentists to encourage all pregnant women to comply with the oral health professionals' recommendations regarding appropriate dental brushing techniques and the importance of dental visits.     

上海妊娠期女性牙周健康状况的多因素分析

目的:了解上海市妊娠期女性的牙周健康状况,探讨妊娠期女性牙周健康的影响因素,为以后进行有针对性的口腔健康教育、制订公共卫生策略提供依据。方法:采用横断面研究, 随机抽取各区县妇幼保健院建卡的妊娠期女性(0~40周)进行调查。调查方法包括问卷调查和临床牙周检查, 牙周检查项目包括可视菌斑指数、探诊出血指数、牙周袋深度、临床附着丧失。采用SPSS18.0软件包对数据进行χ2检验和logistic多因素回归分析。结果:共调查561名妊娠期女性,平均年龄(27.5±4.0)岁,孕周5~40周,平均孕周(18.9±8.1)周。牙周病患病率49.6%,其中牙周炎患病率为6.8%,牙龈炎为42.8%。Logistic回归分析显示,处于妊娠中、晚期的女性比妊娠早期更容易患牙周病;居住在郊区的妊娠期女性比居住在市区者患牙周病的危险性高。结论:上海市妊娠期女性牙周病的患病率与妊娠周期、居住地有关,应该加强对相应高危人群的口腔健康教育。     

Effect of Tobacco Smoke on the Oral Health of US Women of Childbearing Age

Objectives: To determine the oral health status of US women of childbearing age and to analyze the effect of tobacco smoke on their oral health. Methods: Data from the 1999‐2004 National Health and Nutrition Examination Survey were evaluated for women 15‐44 years of age. The association of exposure to tobacco smoke with untreated caries, mean DMFS, gingivitis, and periodontitis were examined in bivariate and regression analyses controlling for potential confounders. Results: The prevalence of untreated caries was 25%, for gingivitis 49%, and for periodontitis 6%. After adjusting for potential confounders, self‐reported current smoking was a strong independent risk indicator for untreated caries, periodontitis, and to a lesser extent for greater DMFS count. Women with detectable cotinine levels below 15 ng/mL presented with an increased risk for gingivitis. Independent factors associated with increased risk for untreated caries were being Black, having less than a high school education, Medicaid or no health insurance, previous live births, and infrequent and episodic dental visits. Characteristics associated with gingivitis were being Mexican‐American, obese, pregnant, and having infrequent dental visits. Older age, no insurance, and the last dental visit for treatment were independently associated with periodontitis. Conclusions: Dental caries and periodontitis were prevalent among certain subgroups of women of reproductive age. Smoking was found to be a significant risk indicator for various negative oral health outcomes. Barriers to accessing to dental care that were manifested by untreated caries among Black women, mothers, and Medicaid beneficiaries must be better understood.     

Pregnant women's oral hygiene knowledge and habits after the second millennium in South-East Hungary

Among the predisposing agents for inflammatory periodontal lesion dental plaque is the most important, but different local and systemic factors may influence the seriousness or progression of periodontitis. Hormonal changes during pregnancy belong to the systemic aggravating factors. The aim of the present study was to assess pregnant women's oral hygiene knowledge and habits, and if these have a relationship with age, residence, educational level and profession/occupation. Questionnaires were used for the data collection. 275 pregnant women, who underwent prenatal care at the Department of Obstetrics and Gynecology in Szeged, volunteered to answer the questions. The results showed that almost all the women brushed their teeth daily, but only about one third of them used special oral hygiene tools, like dental floss. Many of the women claimed to have gingival bleeding when brushing their teeth. More then 70% visited a dentist during pregnancy. There was a significant relationship between educational level and the use of dental floss (p=0.004) and gingival bleeding (p=0.023) Oral hygiene education, dental and periodontal treatment of pregnant women need more emphasis during prenatal care.     

妊娠期牙周疾病对小于胎龄儿影响的调查研究

目的调查孕妇妊娠期牙周疾病发生的相关社会环境因素,分析妊娠中期妇女的牙周状况对分娩小于胎龄儿(small for gestation age,SGA)的影响。方法纳入2015年5月~2018年5月于四川大学华西口腔医院牙周专科就诊的孕妇共215例,于妊娠16~24周进行牙周检查并记录牙周探诊出血指数(bleeding on probing,BOP)、探诊深度(probing depth,PD),附着丧失(clinical attachment loss,CAL)等指标,同时按照牙周疾病的诊断标准进行产前分组(牙周炎组32例,牙龈炎组171例,牙周健康组12例);患者知情同意选择是否接受牙周基础治疗。通过问卷调查表收集患者基本信息及社会经济相关信息。分娩后收集分娩结果,根据分娩结果进行产后分组(SGA和非SGA组)。比较各组间牙周临床指标及问卷调查、分娩结果等情况。结果平均PD(P=0.005,r= 0.192)、BOP%(P=0.003,r= 0.199)与经济收入呈负相关。牙周炎组平均家庭月收入较牙周健康组及牙龈炎组(P<0.05)低;牙周健康组使用牙线者比例较牙龈炎组高(P<0.05);106名孕妇接受了牙周超声龈上洁治及龈下刮治,109例孕妇仅进行口腔卫生宣教。最终23例(10.7%)发生了SGA,SGA发生率在3组间差异无统计学意义(P>0.05)。SGA组PD≥5 mm、PD≥4 mm的百分比高于非SGA组(P<0.05)。SGA发生率在接受牙周基础治疗组与未接受治疗组间差异无统计学意义(P>0.05)。结论孕妇的家庭月收入、牙线使用情况对妊娠期牙周疾病的发生有影响;妊娠期妇女牙周炎的严重程度与SGA的发生有关。     

妊娠期牙龈炎的临床指数和风险因素

牙龈炎会增加不良妊娠的风险,导致孕妇早产和流产以及新生儿低体重.牙龈指数和牙周袋深度在整个妊娠期明显增高,探诊出血在妊娠期增高不明显,临床附着丧失在妊娠期的变化迄今尚不确定,菌斑指数在整个妊娠期及产后均波动较小且维持较低水平.孕妇机体内的性激素血浆浓度可达非孕妇水平的10倍,高浓度的性激素可增加地诺前列酮和白细胞介素-6等炎症递质的产生,从而加重妊娠期牙龈炎症.由于孕妇的身体状况特殊,因此妊娠期牙龈炎的治疗难度较一般牙龈炎大.预防措施主要是积极宣传口腔保健知识,让孕妇保持良好的口腔卫生状况,以降低发病率.探究妊娠期牙龈炎的发生发展规律,可为临床医生提供参考,帮助其减轻或消除妊娠期牙龈炎症状,保障孕妇和胎儿的身体健康.     

Role of periodontal therapy in management of common complex systemic diseases and conditions: An update

The goal of this review is to summarize the results of randomized trials reported since 2010 that assessed the effect of periodontal interventions on at least one systemic outcome in human subjects of any age, gender or ethnicity. Oral outcome measures included gingivitis, pocket depth, clinical attachment loss and/or radiographic bone loss and oral hygiene indices. Studies were excluded if the trial was not completed or if treatment was not randomized. The results suggest that nonsurgical periodontal intervention provided to pregnant women is safe and improves periodontal status without preventing adverse pregnancy outcomes. Nonsurgical periodontal intervention was also found to provide modest improvement in glycemic control in individuals with type 2 diabetes mellitus and periodontitis. Also, improving oral care through mechanical or chemical control of dental‐plaque biofilm formation can contribute to the prevention of respiratory infections in differing clinical settings, including hospitals and nursing homes, and in patients with chronic obstructive pulmonary disease. No clinical trials were reported that tested the effect of periodontal interventions on medical outcomes of atherosclerosis, cardiovascular diseases, stroke, rheumatoid arthritis, Alzheimer's disease, chronic kidney disease or malignant neoplasia.     

Clinical changes in periodontium during pregnancy and post-partum

Background and Aim: Pregnancy has been presented to increase susceptibility to gingival inflammation. It is unclear whether pregnancy gingivitis exposes or proceeds to periodontitis. We examined longitudinally the severity of periodontal changes during pregnancy and post-partum, and compared the findings with an age-matched group of non-pregnant women.
Material and Methods: Thirty generally healthy, non-smoking women at an early phase of their pregnancy and 24 non-pregnant women as controls were recruited. The pregnant group was examined three times during pregnancy and twice during post-partum, and the non-pregnant group three times, once per subsequent month. At each visit, visible plaque index (VPI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were measured from six sites per tooth.
Results: In the pregnant group, BOP and PPD increased simultaneously without relation to plaque between the first and second trimesters, and thereafter decreased during subsequent visits. No changes were detected in CAL during the study period. In the non-pregnant group, BOP stayed invariable during the follow-up and correlated with the amount of plaque. Neither periodontal pocket formation nor significant changes in attachment levels were observed.
Conclusion: Based on this study, changes in clinical parameters during pregnancy are reversible, indicating that pregnancy gingivitis does not predispose or proceed to periodontitis.