牙科医生对口腔卫生服务体系评价

目的；分析牙科医生的日常工作量和牙医对口腔卫生服务的态度评价，有助于口腔卫生服务体系的制定和评价。方法；根据武汉市卫生部门登记在册的牙科医生，采用整群抽样的方法随机选择250名牙科医生进行开放式问卷调查。结果：所调查的250名样本中，52％为女性，牙科医生平均工作年限为11．6年，平均使用0．8台牙椅，每位牙医平均每天看15个病人。主要工作时间用于充填治疗和拔牙。93％的牙医认为中国口腔卫生服务强调治疗而忽视预防保健。结论：口腔卫生服务应重视口腔预防保健。     

600名牙科患者口腔卫生保健行为的调查和分析

目的 :了解牙科患者的口腔卫生保健行为。方法 :设计问卷对 6 0 0名牙科患者进行口腔卫生保健行为的多项调查。结果 :选择保健牙刷的占 47 7% ,仅 19 3%患者采用竖刷法 ,74 82 %患者每天刷牙 2次及以上 ,每次刷牙时间长于 3min的仅 2 5 2 % ,选择含氟牙膏的为 46 %。x2 分析显示文化程度高者比低者较多选择保健牙刷和每天刷牙 2次及以上 (p <0 0 5 ) ,再次就诊者选择含氟牙膏和接受过口腔健康教育的比例高于初诊者 (p <0 0 5 ) ,40岁以上患者较多选择脱敏牙膏 ,40岁以下患者较多选择含氟牙膏 (p <0 0 1)。结论 :牙科患者的口腔卫生保健行为有待进一步规范和强化     

2390名小学生龋病调查

目的了解小学生龋齿患病情况,更好地开展口腔卫生保健。方法辖区4所小学学生2 390人,由经过培训的牙科医生采用口内直视法进行检查。结果患龋率为37.62%,女生患龋率高于男生。龋齿治疗率仅为4.48%,恒牙龋治疗率高于乳牙龋。结论学生及家长对龋病危害认识不足,口腔卫生保健应从小抓起,要提倡正确的刷牙方法,学校应定期开展普查普治工作,早期发现龋齿,以利及时治疗。     

武汉市东西湖区5岁儿童口腔健康行为调查

目的:了解东西湖区5岁儿童的基本口腔健康行为及其家长的儿童口腔卫生知识水平,为东西湖区儿童口腔卫生保健工作提供信息支持。方法:按照第三次全国口腔健康流行病学调查方案设计的5岁儿童家长问卷,对东西湖区8所幼儿园529名5岁儿童家长进行问卷调查,了解儿童饮食行为,口腔卫生行为、利用口腔医疗行为,家长口腔保健知识知晓情况。结果:30%的儿童经常有睡前进食甜食的习惯。5%的儿童在3岁前开始刷牙,每日刷牙2次者仅占10%。有5%的儿童使用含氟牙膏刷牙。在过去1年中,90%的儿童没看过牙医。结论:东西湖区5岁儿童口腔健康行为低于全国平均水平,儿童口腔健康行为尚不完善,有必要加强父母的口腔健康教育,建立正确的儿童口腔健康行为。     

广东省先天性心脏病儿童口腔健康状况及就医行为初步调查

目的：了解广东省先天性心脏病儿童的口腔卫生现状,为先心病儿童的口腔卫生保健1作提供客观依据。方法：参照第二次全国口腔健康流行病学调查的相关内容及检查标准,选取广东省119名2～16岁先心病儿童调查其龋病、叮视菌斑指数及相关口腔就诊信息。结果：先心病儿童患龋率为72.3％,龋均、龋面均分别为（4．9±5．2）、（10.3±14．8）,可视菌斑指数为（48．1％±26．7％）。5-6岁年龄组龋均高于2。4岁组（P=0．002）。检出588颗龋齿,8颗已行充填治疗,龋齿充填率仅1．4％。14名儿童曾就诊牙医,因口腔问题就诊者占78．6％。结论：广东省先心病儿童口腔卫生状况差,患龋率高,龋患情况严重,但牙科治疗率低,与其父母缺乏口腔预防保健意识有关,提示加强和重视先心病儿童口腔卫生教育的必要性。     

上海牙防服务管理模式的演变与思考

目的　探讨和研究城市实现国家口腔卫生保健目标和牙防服务管理模式。方法　建立行政与专业单位合作的牙防管理模式 ,即社区牙防服务管理五要素 (C - 5M)模式。结果　 5 0年来上海儿童少年的口腔普查普治累计逾 195 5万人 ,1993年以来每年普查普治 5 5万人。各项指标显示 ,较好地完成了 2 0 0 0年国家口腔卫生保健小康地区及上海市的目标任务。结论　牙防C - 5M模式是城市实现口腔卫生保健目标的有效的管理模式 ,为依法规范牙防工作提供了有益的经验     

武汉市牙医对爱滋病的态度、知识及在感染控制中的行为调查分析

目的 :研究武汉市牙医对AIDS的态度、知识及在感染控制中的行为。方法 :对武汉市 5 0 0名牙医进行问卷调查和分析。结果 :收到有效问卷 46 7份。其中 6 3.2 %的牙医表示愿意治疗AIDS/HIV 病人。 6 0 .4%牙医认为血液是传播HIV的最危险的体液 ,且大多数牙医错误地认为唾液是传播HIV的媒介。 318名牙医每天戴手套操作治疗病人 ,但其中仅 12 8(40 .3% )名牙医在治疗完病人后更换手套。结论 :本研究表明牙医所掌握HIV传播的知识水平较低。同时牙医也没有提供足够的防护措施来保护自己和病人     

虹口区1194名居民口腔保健知识问卷调查分析

世界卫生组织提出”2 0 0 0年人人享有口腔卫生保健”的全球战略目标。要实现这个目标 ,就要把牙病防治工作纳入卫生保键轨道 ,加强群众口腔保健教育 ,普及口腔卫生知识 ,提高群众自我保健意识和防病能力 ,人人做到正确刷牙、合理使用保健牙刷和含氟牙膏。我国这方面工作起步晚 ,覆盖面较小 ,经验少。本次调查旨在了解居民口腔卫生知识掌握情况 ,摸索开展社区口腔保健工作的经验。材料与方法我们于 1 997年 5～ 6月调查了上海市虹口区某街道所属 1 1 94名居民 ,其中男性 6 90名 ,女性 5 5 4名。年龄 3～ 6 5岁。文化程度初中以下 (包括初中 …     

德阳市成年人的口腔健康知识、态度及行为调查

目的　调查四川省德阳市城市、农村和城郊成年人的口腔健康知识、态度和行为,分析影响人群牙科卫生 服务使用的因素。方法　采用世界卫生组织基本口腔保健成年人问卷对1 010名德阳市城市、城郊和农村的35~ 44岁成年人进行面对面访谈,评价德阳市成年人的口腔健康知识、态度及行为,分析影响成年人2年内看牙医行为 的因素。结果　约半数成年人过去1年牙齿或口腔有疼痛,多数成年人的口腔健康态度较好,但对氟防龋的认识 不足。城市成年人使用含氟牙膏的比例(61·3%)明显高于城郊及农村(6·9%、16·8%)。从来没有看过牙医的比例 农村及城郊最高61·0%,71·5%,城市只有32·0%。Logistic回归分析表明,影响2年内看牙医行为的因素有地区类 别和上1年有无牙痛。有牙痛成年人看牙医的OR值是无牙痛成年人的2·84倍。结论　德阳市成年人对口腔健 康知识认识不足,态度较好,牙科卫生服务使用较低,口腔健康知识和行为亟待改进。     

乳牙龋病与小儿口腔卫生行为关系的临床分析

随着我国人民生活水平的提高和生活方式的改变 ,乳牙龋病的发生呈上升趋势 ,且乳牙龋坏发病提早、进展较快 ,城市儿童乳牙患龋率达 79 5 5 % ,但牙齿的保健意识尚未普及。本文对临床上高发龋儿童及无龋儿童的口腔卫生行为进行调查分析 ,探讨乳牙龋病与小儿口腔卫生行为的关系 ,以便更好地开展小儿龋病的预防工作。材　料　和　方　法1　研究对象 :　选择在本院就诊的患乳牙龋病、无系统性疾病的儿童 33名 ,男 11名 ,女 2 2名 ,年龄在 3～ 7岁 ,其ｄｍｆｔ≥ 6为高龋组 ;另在幼儿园选择 34名健康无龋儿童 ,男 13名 ,女 2 1名 ,年龄 3～ 7岁为…     

Oral health services in PR China as evaluated by dentists and patients

OBJECTIVE: To describe the function of oral health services and the delivery of oral health care in PR China. DESIGN: Cross-sectional surveys. Self-administered questionnaires gathered information on professional practices and attitudes of Chinese dentists. Patients were examined clinically for caries and services rendered. Patients were interviewed about oral health status, reason of dental visits and consumption of services, perceived need for care and self-care practices. Setting: Wuhan City of the Hubei Province of China. SUBJECTS: Random samples of dentists (n = 250) working with child and adult patients in 1998 in Wuhan City. Each dentist had a representative sample of 20 patients attending consecutively for care enrolled in the study. RESULTS: On average, the dentists saw 12 patients per day, with most time devoted to restorative treatment and extraction. The majority of dentists held the opinion that in China little attention is given to preventive care. Forty per cent of the patients were new to the dentists and more than half attended care because of pain or acute symptoms. The reported mean number of decayed, missing, and filled teeth varied from 2.6 for 12-year-old patients to 10.7 for patients aged 65-74. Daily toothbrushing was practised by more than 90% of the patients in all age groups, however, the tradition of regular dental visits was weak. Most patients (51-75 per cent) attended for care due to acute problems or pain. CONCLUSION: The study indicated the need for reorientation of the Chinese oral health services towards prevention.     

Attitudes and values concerning oral health and utilisation of services among the elderly.

Thus, attitudes to oral health and dental utilisation patterns of older adults show great variation and it seems the level of oral health care an individual will seek and accept will depend on their individual: age and their personal experience with dentists, past and present socio-demographic environment, number of remaining teeth, level of education achieved, expectations of family and/or significant others, level of discomfort experienced either with the dental condition or with past dental care, economic ability to pay for care, level of health or functional dependency, level of cognitive impairment, ability to reach dental services which includes distribution of dentists and geographic isolation, the philosophy of the dentists available to care for the individual.     

Drug users: oral health-related attitudes and behaviours

AIM: Explore oral health-related attitudes and behaviours of drug users. DESIGN: Qualitative study using focus groups and semi-structured interviews. SETTING: Facilities for treatment and recovery of drug users in South London. PARTICIPANTS: Twenty-six male and 14 female recovering drug users. RESULTS: Participants described many changes in lifestyle associated with drug use including the physical effects of drugs, dietary habits, organisational and time constraints and unfavourable social conditions, which were not conducive to oral health. There was considerable health consciousness. They associated general health problems and problems with teeth, gums and oral soft tissues to both direct and indirect effects of drug use. Use of dental services was inhibited by low priority for oral health relative to the need to obtain and use drugs, experientially induced fear of dentists, the acceptability of dental services, needle-phobia, ability to self-medicate and organisational factors in their lifestyles. CONCLUSIONS: The lifestyles of drug users may contribute to oral health problems and low use of services. Drug users therefore comprise a group with special dental needs and need greater access to dental care than most people. Much of this care could be provided in general practice where appropriate dental care can contribute to recovery from drug use.     

Preventing and detecting oral cancer. Oral health care providers' readiness to provide health behavior counseling and oral cancer examinations

BACKGROUND: The authors conducted a study to examine oral cancer prevention and early detection practice patterns in a population-based random sample of practicing oral health care professionals in New York state. METHODS: The authors surveyed a population-based, self-weighting, stratified random sample of dentists (n = 1,025) and dental hygienists (n = 1,025) in New York state. They assessed the subjects' readiness to offer tobacco-use cessation and alcohol-abuse counseling and oral cancer examinations. RESULTS: The effective response rates were 55 and 66 percent for dentists and dental hygienists, respectively. In terms of readiness to perform oral cancer examinations for patients aged 40 years and older, the large majority (82 percent of dentists and 72 percent of dental hygienists) were in the maintenance stage of behavior, indicating that oral cancer examinations were a routine part of their practice. In terms of readiness to offer tobacco-use cessation counseling, only 12 percent of dentists and 21 percent of dental hygienists were in the maintenance stage, and only 2 percent of dentists and 4 percent of dental hygienists were in the maintenance stage of offering alcohol-abuse counseling. CONCLUSIONS: Oral cancer examinations seem to have been adopted as a standard of practice by most oral health care providers in New York state, but cancer prevention services, such as counseling regarding cessation of tobacco use and alcohol abuse, are lacking. CLINICAL IMPLICATIONS: Oral health care providers should be trained in oral cancer prevention services such as tobacco-use cessation and alcohol-abuse counseling and encouraged to include these services, along with continued provision of oral cancer examinations, as a standard aspect of care.     

Communicating with each other

Most dentists commit their professional lives to improving oral health by providing preventive and treatment services to their patients. In addition, dentists often participate in community, professional or legal activities that promote oral health. This paper describes five ways that dentists have worked with each other and with others to enhance oral health: (1) Dentists working with each other to promote oral health without the use of organized dentistry. Described as an example is the experience of all the periodontists in one city in the USA in providing community education. (2) Dental associations organizing or facilitating groups of dentists and other dental health professionals to develop and implement programmes that promote oral health. Two community-based educational efforts stimulated by the American Dental Association are described. (3) Dental specialty associations encouraging and facilitating specialists to work with other dentists to enhance their knowledge and skills in prevention, treatment and appropriate referral. The American Academy of Periodontology's efforts to teach communication skills to periodontists and diagnosis and treatment skills to general practitioners is cited as an example. (4) Dentists working with physicians and other non-dental health professionals to promote oral health. Integrating dental education into childbirth preparation classes for expectant parents is one instance of an interdisciplinary approach. (5) An individual dentist taking a leadership role to positively influence legislation to regulate a harmful substance. The efforts of one dentist to restrict the sale and promotion of smokeless tobacco are described. Working with other dentists, health care providers and legislators represent alternative ways that dentists have affected the oral health of individuals.     

Perceptions of oral illness among Chinese immigrants in Montreal: a qualitative study

Providing culturally competent care has been a growing concern for health care professionals in recent years. Being culturally competent means taking into account the culture of patients in order to provide high-quality services. Accordingly, the objective of this study was to better understand how oral illness was perceived by the largest visible minority group in Canada: Chinese immigrants. We conducted qualitative research based on in-depth interviews with twelve Chinese immigrants in Montreal, Canada. The participants had a high level of education and had lived in Canada for thirteen years or less. The interviews were transcribed, and thematic analyses were then performed. Among the participants, traditional beliefs coexisted with scientific dental knowledge. On the one hand, the subjects had a fairly good understanding of dental caries in terms of etiology, process, prevention, and treatment. On the other hand, they held strong traditional beliefs concerning gingival swelling and bleeding, which had an influence on their attitudes toward dental care and professional services. Oral health care professionals should be informed about Chinese immigrants' oral health beliefs and the acculturation process in order to understand their patients better and provide culturally competent care.     

Oral health behavior and attitudes of adults in Lithuania

In Lithuania, the oral health system is currently in transition and systematic data are needed for public oral health care planning. The objectives of this study were (i) to describe the self-assessment of oral health status in Lithuanian adults, the oral hygiene practices, and dental visiting habits; (ii) to assess the attitudes towards teeth and oral health, dental care and oral health services; (iii) to determine whether oral health attitudes and behavior are affected by socio-economic factors; and (iv) to analyse the association between self-care practices and use of oral health services. The study comprised random samples of 35-44-year-olds (n = 381) and 65-74-year-olds (n = 302). Data were collected during 1997 98 by means of self-administered questionnaires and the response rate was 53%. Nearly all persons of ages 35-44 had natural teeth, whereas 14% of 65-74-year-olds were edentulous. Among the dentate persons, 45% of the young adults against 36% of the elderly claimed having poor teeth, and 66% and 55%, respectively, had experience of pain from teeth or mouth during the past year. At ages 35-44, 33% of participants reported toothbrushing at least twice a day and this was the case for 21% of 65-74-year-olds. Dental visits within the past year were indicated by 60% of young adults and 43% of the elderly; 83% of all participants reported that their last visit to the dentist was due to acute oral symptoms. In general, the participants had positive dental knowledge and attitudes; however, 56% were unaware of any effect of fluoride. The bivariate analyses showed that perceived oral health status and oral self-care practices were related to use of dental services. The multivariate analyses of dental visiting habits revealed the effects of gender, urbanization, presence of natural teeth, experience of dental problems, attitudes to dental care and dentists, and education. In conclusion, preventive dental services should be introduced and the establishment of community-based oral health promotion programs is urgently needed for Lithuania.     

Secular trends in dental services provided by dental therapists and dentists in Southwest Alaska

BackgroundThe goal of the study was to identify secular trends in dental service delivery between dental therapists and dentists in the Yukon-Kuskokwim Delta region of Southwest Alaska, the first area of the United States to authorize dental therapy practice.MethodsElectronic health record transactions from the Yukon-Kuskokwim Health Corporation from 2006 through 2015 (n = 27,459) were analyzed. Five types of dental services were identified using Current Dental Terminology procedure codes: diagnostic, preventive, restorative, endodontic, and oral surgery. Main outcomes were percentages of services provided by dental therapists compared with dentists and population-level preventive oral health care.ResultsThe overall number of diagnostic, preventive, and restorative services in the Yukon-Kuskokwim Delta increased. For diagnostic services, there was a 3.5% annual decrease observed for dentists and a 4.1% annual increase for dental therapists (P < .001). Similar trends were observed for restorative services. For preventive services, there was no change for dentists (P = .89) and a 4.8% annual increase for dental therapists (P < .001). Dental therapists were more likely than dentists to provide preventive care at the population level.ConclusionsDental therapists have made substantial contributions to the delivery of dental services in Alaska Native communities, particularly for population-based preventive care.Practical ImplicationsThe study’s findings indicate that there is a role for dental therapy practice in addressing poor access to oral health care in underserved communities.     

成都市外国人口腔卫生服务利用的影响因素研究

目的 调查中国成都市外国人的口腔卫生服务利用情况及其影响因素,为口腔卫生从业者对口腔卫生服务的国际化发展进行探索,为卫生政策制定者制定移民口腔健康政策提供建议。方法 参照世界卫生组织制定的《成人口腔健康问卷》,结合安德森卫生服务利用模型设计问卷。问卷内容包括口腔健康情况、口腔保健意识、口腔健康保障和基本信息4个部分。采用方便抽样方法选择调查对象。调查结果使用SPSS 20.0统计软件分析,采用Binary Logistic回归和分层分析方法进行统计学分析。结果 共有来自75个国家的654名调查对象完成调查,结果显示有102（15.6%）名外国人在成都曾经遇到过口腔问题却没有就诊。Binary Logistic回归分析显示,女性、长时间在成都居住、过去1年内出现过口腔健康问题、有使用牙线习惯、和家人一起居住在成都者遇到口腔问题或定期口腔体检时,更倾向于到本地口腔科就诊。通过ROC曲线分析,居住在成都10.5个月是外国人选择在成都就诊的临界值。结论 卫生政策制定者可以根据不同居住时间的外国人制定不同的口腔急诊或平诊指南,创造出更方便外国人在成都因口腔问题就诊的环境,以促进外国人在成都的口腔卫生服务利用。     

A clinical minimum data set for primary dental care.

OBJECTIVE: To achieve consensus within primary dental care on the contents of a clinical minimum data set to measure oral health status. DESIGN: Using the Delphi process a simple random sample of 30 LDCs and 10 CDS services in England were asked to rank a list of existing clinical indicators in order of their perceived importance as a means of measuring oral health. A nominated panel representing the stakeholder organisations of primary dental care reviewed this ranking and identified a core group of clinical indicators to be included in a clinical minimum data set. RESULTS: An 80 percent response rate to the Delphi process was achieved. Consensus was reached on a core group of 10 indicators, which can provide information on patient's perceptions of pain, function and appearance, and professional measurements of caries, teeth present, periodontal disease, oral sepsis, presence of mucosal pathology and tooth wear. CONCLUSIONS: A representative sample of primary care dentists in England and the key representative organisations of primary dental care achieved consensus on the contents of a clinical minimum data set to record oral health status in primary dental care. This is a first step in standardising the measurement of oral health status across primary care.