影响牙齿酸蚀症风险性的唾液因素研究进展

唾液是牙齿的外环境。唾液的无机成分、有机成分、缓冲能力及流速流量对酸蚀症风险性都有着重要的影响。了解影响酸蚀症风险性的唾液因素,可对唾液针对性地检测,能够及早发现酸蚀症易感人群, 有助于酸蚀症的早期诊断、早期预防。该文就影响酸蚀症风险性的唾液因素研究进展作一综述。     

视神经炎患者激素治疗引起牙酸蚀症1例

牙酸蚀症是指牙齿受到不涉及细菌的化学物质侵蚀使得牙齿硬组织发生进行性破坏的一种疾病。病因包括内在因素和外在因素，内在因素如暴食、厌食、胃肠道疾病、药物等导致的胃食管反流而引起的牙齿酸蚀，外在因素则主要包括饮食、药物、职业因素等。本文介绍了1位患者，因诊断为视神经炎而接受糖皮质激素治疗，从而引起胃食管反流症状，出现全口牙齿尤其是上颌牙列的重度酸蚀破坏。本文主要就视神经炎激素治疗与牙酸蚀症发生的机制进行了探讨。     

控制牙齿酸蚀症的研究进展

牙齿酸蚀症是指在没有细菌参与的情况下,由化学因素引起的牙体硬组织慢性、不可逆性破坏的疾病。此疾病在人群中普遍存在。控制酸蚀症的发生和发展是口腔临床工作的难点,正日益受到研究者的关注。本文就酸蚀症的早期诊断、风险评估及预防策略的研究进展作一综述。     

激光对牙酸蚀症预防作用的研究进展

酸蚀症是在化学作用下,酸侵蚀导致的牙体硬组织丧失,其过程与细菌作用无关。激光治疗可以抑制牙体硬组织的脱矿作用,进而预防酸蚀症的发生。本文就激光对酸蚀症的预防机理及预防效果作综述。     

酸蚀症患牙腭侧瓷贴面修复的临床观察

牙科酸蚀症是由酸溶解引起不可逆的牙体硬组织丧失,可以导致牙齿折断、临床牙冠丧失及咬合功能紊乱。早期诊断、及时阻断酸性物质的破坏,并根据牙体缺损情况进行相应修复是口腔医师的一项挑战。本文报道一例腭侧瓷贴面修复早期酸蚀症导致的牙体缺损,以微创配合粘接修复达到保护和修复余留牙体组织的目的。     

酸蚀症患者的咬合重建修复

目的：探讨咬合距离降低的酸蚀症患者的修复治疗方法。方法：对酸蚀症患者进行咬合重建序列治疗,包括暂时性[牙合]垫式可摘局部义齿、冠延长术、根管治疗术以及固定与可摘局部义齿联合修复。结果：患者的咬合距离抬高、咀嚼和美观功能得到很好的恢复,无牙周炎症和颢下颌关节的异常。结论：对于咬合距离降低的酸蚀症患者进行修复时要注重咬合重建序列治疗。     

徐州市5岁和12岁儿童酸蚀症调查研究

目的了解徐州市儿童酸蚀症的流行情况。方法采用分层整群随机抽样方法,抽取徐州市1 219名5岁儿童和786名12岁儿童进行酸蚀症流行病学调查。通过调查表记录酸蚀症的临床检查结果,调查问卷调查酸蚀症的危险因素。采用Logistic多元回归分析酸蚀症的危险因素。结果徐州市5岁儿童牙齿酸蚀症的患病率为10.91%,12岁儿童牙齿酸蚀症的患病率为22.14%。酸蚀症的等级多为1级和2级,3级以上的酸蚀症极少。酸蚀症危险因素的比值比（OR）分别为：酸性水果,1.120;酸奶,1.062;运动饮料,1.159;碳酸饮料,1.151;果汁,1.187;睡前喝酸性饮料或酸奶,6.102;胃食道返流性疾病,2.311;维生素C,1.565;补铁剂,1.598。结论我国儿童牙齿酸蚀症已广泛存在,今后应加强口腔卫生教育和饮食指导,减少酸性食品和饮料的摄入量和摄入频率,促进口腔健康。     

牙酸蚀症指数的研究现状

［摘要］ 近年来,随着国内外牙酸蚀症患病率的增长,此疾病受到研究者的关注,同时,不少针对酸蚀症的评估指数也被提出并应用到临床检查、流行病学调查和实验室研究中。本文就几种当前主要应用于流行病学调查和临床检查的酸蚀症指数作一综述。     

不同釉质酸蚀技术对正畸托槽粘接的影响

牙面的酸蚀是影响正畸粘接力的一个重要因素,如何正确选择和使用酸蚀方法一直是研究的热点。本文就酸蚀剂的不同种类、剂型、浓度、酸蚀时间及酸蚀技术对正畸粘接力的影响作一综述。     

北京某大学学生志愿者牙侵蚀症患病情况及相关因素调查

目的 对北京某大学学生牙侵蚀症（又称牙酸蚀症）患病情况进行初步调研，分析其相关因素。方法对179名北京某大学在校学生志愿者，采用问卷方式调查牙侵蚀症相关因素，并用van Rijkom改良标准进行临床评估。结果该组人群牙侵蚀症患病率为45．8％，均为牙釉质病损。好发牙面为前牙唇面。牙侵蚀症的发生与碳酸饮料、果汁、冲饮饮料和香蕉等酸性饮食因素相关。结论应对我国青年人群牙侵蚀患病情况加以重视，加强口腔卫生教育和饮食指导。     

Tooth brushing behaviour in Asia: understanding the barriers that impact oral health status

There have been significant improvements in oral health in the last 30 years particularly in children. This is true in the developed world, but not to the same extent in many developing countries. Asia has experienced little improvement in oral health. Inadequate oral hygiene habits have been identified as a major risk factor for oral disease. Investigating the profile of tooth brushing habits in countries in Asia will provide a valuable platform for guiding innovations to help in changing behaviour towards oral health care. The possible barriers to optimal oral hygiene habits for communities in Asia will be discussed. This paper will also include recommendations on some of the models that could be implemented to help improve oral hygiene habits in Asia.     

Methodological considerations concerning the development of oral dental erosion indexes: literature survey, validity and reliability

Within the context of preventing non-communicable diseases, the World Health Report (2002) and the WHO Global Oral Health Program (2003) put forward a new strategy of disease prevention and health promotion. Greater emphasis is placed on developing global policies in oral health promotion and oral disease prevention. The Decayed, Missing, Filled Teeth (DMFT) index does not meet new challenges in the field of oral health. Dental erosion seems to be a growing problem, and in some countries, an increase in erosion of teeth is associated with an increase in the consumption of beverages containing acids. Therefore, within a revision of the WHO Oral Health Surveys Basic Methods, new oral disease patterns, e.g. dental erosion, have to be taken into account. Within the last 20 years, many studies on dental erosion have been carried out and published. There has been a rapid growth in the number of indexes quantifying dental erosion process in different age groups. However, these indexes are not comparable. This article discusses quality criteria which an index intended for assessing tooth erosion should possess.     

Salivary tests for caries and erosion risk factors

Apart from a health questionnaire and oral health examination with a clinical history, it is also important to inquire after oral and salivary complaints. Supplementary it is useful to assess dietary habits in patients at risk and to perform a number of simple salivary tests. Interpretation of all data obtained through these investigations, will enable the identification of a number of caries and erosion risk factors. On the basis of these risk factors a preventive treatment plan can be made for the patient. These data provide the possibility to evaluate the success of the preventive treatment plan after a few years and to make adjustments, if necessary.     

Anti-plaque agents. Rationale and prospects for prevention of gingivitis and periodontal disease

Oral health surveys have shown that even in countries with established patterns of oral hygiene habits, most individuals have relatively poor gingival health. This is due to a low interest in complying with oral health procedures. A number of factors are apparent when investigating compliance to oral hygiene habits, viz only approximately 50% of the population brushes twice a day or more, brushing time is probably much too short and use of dental floss is not very prevalent. Studies of the effect of motivation on oral hygiene suggest that improvements can be achieved, but these are not maintained unless motivation is continuously reinforced. This suggests that topically applied anti-plaque agents should be used to augment mechanical plaque control. A number of product forms are available to delivery anti-plaque agents i.e., mouthrinses, dentifrices, aqueous gels, and additionally floss, chewing gum and lozenges. Any product form should provide a physically, chemically and microbiologically stable environment for the agent concerned. It should facilitate optimal bioavailability of the agents at the site of action and encourage patient compliance. Anti-plaque agents for topical administration should have the following properties: high intrinsic efficacy against a broad spectrum of oral organisms, toxicological and ecological safety, oral substantivity, no adverse reactions and good chemical stability. A number of classes of anti-plaque agents have been identified such as positively charged organic molecules, metal salts, phenols, enzymes, peroxides, sugar substitutes, fluorides and surface modifying agents. In order to achieve optimal bioavailability, the agent to be dosed should be compatible with the product form used. The 2 major product forms are rinses and dentifrices.(ABSTRACT TRUNCATED AT 250 WORDS)     

Erosion--diagnosis and risk factors

Dental erosion is a multifactorial condition: The interplay of chemical, biological and behavioural factors is crucial and helps explain why some individuals exhibit more erosion than others. The erosive potential of erosive agents like acidic drinks or foodstuffs depends on chemical factors, e.g. pH, titratable acidity, mineral content, clearance on tooth surface and on its calcium-chelation properties. Biological factors such as saliva, acquired pellicle, tooth structure and positioning in relation to soft tissues and tongue are related to the pathogenesis of dental erosion. Furthermore, behavioural factors like eating and drinking habits, regular exercise with dehydration and decrease of salivary flow, excessive oral hygiene and, on the other side, an unhealthy lifestyle, e.g. chronic alcoholism, are predisposing factors for dental erosion. There is some evidence that dental erosion is growing steadily. To prevent further progression, it is important to detect this condition as early as possible. Dentists have to know the clinical appearance and possible signs of progression of erosive lesions and their causes such that adequate preventive and, if necessary, therapeutic measures can be initiated. The clinical examination has to be done systematically, and a comprehensive case history should be undertaken such that all risk factors will be revealed.     

Dental Caries Risk in Relation to Dietary Habits and Dental Services in Two Industrial Populations

Objectives: Environmental hazards contribute to the poor oral health in many occupations. Among the earliest occupations mentioned are those of the baker and confectionery worker. To determine appropriate ways of promoting oral health in places of work, factors affecting caries susceptibility were studied. Methods : Dental caries status, dietary and dental health behaviors, and salivary microbiologic findings in 338 confectionery and 101 shipyard workers were compared. A caries risk index based on salivary findings was used in log-linear models where the effects of sex, diet, use of dental services, and work environment were studied. Results : Caries experience was found to be high in both populations. Dietary habits were the most important factor affecting caries occurrence and susceptibility. Similar dietary behaviors were found in both groups. Conclusions : The confectionery industry did not seem to be an exceptionally hazardous environment for dental health in general. However, the screening of high-risk workers should be organized. Reimbursement of costs had no major effect on use of dental services or caries risk. Oral health promotion should be integrated with existing occupational health services to improve oral health in industrial populations.     

Prevention of early childhood caries

This paper reviews the methods used for the prevention of early childhood caries (ECC). The education of mothers or caregivers to promote healthy dietary habits in infants has been the main strategy used for the prevention of ECC. This review found that education has a modest impact on the development of ECC. While education should be promoted especially in high risk communities and population groups (low-income families and native populations), it should not be the only preventive strategy of ECC. Early screening for signs of caries development, starting from the first year of life, could identify infants and toddlers who are at risk of developing ECC and assist in providing information to parents about how to promote oral health and prevent the development of tooth decay. High risk children include those with early signs of ECC, poor oral hygiene, limited exposure to fluorides, and frequent exposure to sugary snacks and drinks. These children should be targeted with a professional preventive program that includes fluoride varnish application, fluoridated dentifrices, fluoride supplements, sealants, diet counseling, and chlorhexidine. Prevention of ECC also requires addressing the social and economic factors that face many families where ECC is endemic.     

Is Trying to Quit Associated With Tooth Loss and Delayed Yearly Dental Visit Among Smokers? Results of the 2014 Behavioral Risk Factor Surveillance System

Background: The rate of periodontitis in the US population has been estimated to be close to 50%. Patients with periodontitis, especially those who smoke, suffer from a high rate of tooth loss. The purpose of this analysis is to evaluate predictors of poor oral health and oral health habits among smokers and determine if trying to quit smoking is associated with better oral health or oral health habits in smokers in the United States. Methods: Data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) were used in the analysis. After limiting the dataset to smokers, the designated exposure was respondent’s report of trying to quit smoking (yes/no). Two logistic regression models were developed. One model identified factors associated with having a most recent dental visit longer than 1 year before the survey. The second model identified factors associated with loss of six or more teeth. Both models were controlled for confounding factors. Results: After controlling for confounding, among smokers in the 2014 BRFSS, trying to quit was associated with significantly lower odds of respondents having their most recent dental visit longer than a year before the survey (odds ratio [OR]: 0.93; 95% confidence interval [CI]: 0.90 to 0.97) and was a significant risk factor for having lost six or more teeth (OR: 1.06; 95% CI: 1.02 to 1.10). Conclusions: Among smokers in the United States, trying to quit is associated with compliance with yearly dental visits and higher odds of lost teeth. Future research should investigate optimal approaches for providing smoking cessation services in the dental setting.     

Oral health in asthmatic children: a dose-response study

In literature there is a lack of consensus regarding the relationship between dental caries risk and asthma in a child population. Despite these divergent views, all studies conclude that asthmatic children are at risk and that special preventive programs are needed. The asthmatic through either its disease status or its pharmacotherapy carries several factors for an increased caries risk. PH values of most inhalant powders are less than 5.5. A decrease of the salivary and plaque pH has been detected in asthmatic children after use of these inhalers. This low pH value associated with a reduced salivary flow rate (caused by beta-adrenergic agonists and by anti-histaminic medication) makes asthmatics more susceptible to caries and erosion. There are only a few studies that take into account that asthma is a disease with a large diversity of severity and duration. This approach could help to clarify some variability in caries risk. The aim of the present study (a dose-response study) was to examine the oral health status of asthmatic children and to compare the oral health condition and oral health habits within different groups of asthmatic children.     

Oral hygiene habits among adolescents in Finland

Abstract The aim of this study was to analyze oral hygiene habits among Finnish adolescents with regard to age, sex, residence, socioeconomic factors, school career and success. A representative sample of 3209 Finnish adolescents, 13–19 years of age, was drawn. The data were collected by mail surveys in February and September 1977. Participation percentages were 88 and 79. The proportions of daily brushers were 89 % in girls and 57 % in boys. Toothpicks were used sporadically by every second adolescent but daily by 3% only. Dental floss was used sporadically by 10% of the adolescents but daily by 1 %only. In this respect girls were more assiduous than boys. Frequency of toothbrushing clearly increased with age. Girls brushed their teeth significantly more often than boys. The influence of socioeconomic factors was consistent in boys but almost nonexistent in girls. Children of white-collar workers reported better oral hygiene habits than children of blue-collar workers and farmers. Urban adolescents reported better habits than rural adolescents. School success correlated positively with toothbrushing frequency in the younger age groups. Dental health education given by a dentist, a teacher, a hygienist or a nurse had poor correlation with the oral hygiene habits of Finnish adolescents. It was concluded that dental health education should be more directed towards boys, especially at ages 13–15. The education should be planned so that the dental health education better reaches youth of rural areas and lower social classes.