影响妊娠妇女孕前口腔检查的多因素综合分析

[摘要] 目的 通过调查问卷综合分析影响妊娠妇女孕前口腔检查的因素。方法 采用系统抽样的方法按照样本纳入标准选取广州市花都区妇幼保健院514例产检妇女作为问卷调查对象。在第三次全国口腔健康流行病学调查问卷的基础上,结合本课题的研究目的 设计问卷。调查问卷的内容包括:人口统计学资料、口腔健康知识的认知、口腔健康态度、孕前进行口腔检查的情况、未进行孕前口腔检查的原因、看牙费用支付途径;通过问卷结果进行分析。结果 514例调查对象中共有121名进行了孕前的口腔检查,占25.5%,孕前是否进行口腔检查与受教育程度和月收入相关(P<0.001),与口腔健康知识的认知和看牙费用是否报销之间明显相关(P<0.001),和口腔健康态度间相关性不明显。383例孕前未进行口腔检查的主要原因依次是牙齿没有问题、没有必要,没有时间及害怕看牙疼痛,仅仅有6.5%认为是因为经济因素。结论 广州市花都区妊娠妇女孕前进行口腔检查的比例偏低,建议将孕前口腔健康检查严格纳入孕前保健的基本项目中并为妊娠妇女提供特殊口腔保险项目。     

孕妇口腔健康教育即时效果评价

目的 评价对孕期妇女开展口腔健康教育、提高其口腔保健知识水平的效果.方法 将152名孕妇按不同文化程度分为两组,同时为其开设孕期口腔健康教育讲座,采取授课前及授课后问卷调查的方式对授课即时效果进行评价,并比较不同文化程度的孕妇口腔健康知识水平.结果 听课前、后孕妇相关口腔保健知识水平的差异有统计学意义(P＜0.01),成绩提高均值达26.71±14.57.不同文化程度的孕妇在听课前口腔保健知识水平差异有统计学意义(P＜0.05),听课后差异无统计学意义(P＞0.05).结论 孕期口腔健康教育讲座能有效地提高孕妇口腔保健知识水平.问卷调查的方式对孕妇在口腔健康教育前后的知识水平进行评价可更好地量化评价指标,使口腔宣教更具针对性,收到良好的效果.     

口腔卫生健康指导对孕期妇女口腔健康的促进作用

目的:观察口腔卫生健康指导对孕期妇女口腔健康的促进作用。方法:从2010—2011年在海珠区妇幼保健院进行产前检查的初孕妇进行初筛后,从中选择780名,经基线检查并对相关口腔疾病治疗后,分为实验组(350名)和对照组(430名),实验组由口腔医师定期进行口腔卫生指导,对照组不进行口腔卫生指导。6个月后口腔检查,评价口腔卫生健康指导对孕期妇女口腔健康的作用。结果:经过口腔卫生健康指导后,实验组口腔卫生状况优于对照组(P<0.05),牙龈炎、龋病发病率均低于对照组(P<0.05)。结论:孕妇口腔卫生健康指导对其口腔健康具有促进作用,建议纳入社区卫生服务范围。     

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目的评价孕期妇女口腔保健宣教措施的临床效果。方法选择2008年3—4月妊娠后第1次来湖北省妇幼保健院做孕期检查且怀孕期不超过3个月的孕妇30人,随机分为试验组(接受口腔保健宣教)和对照组(未接受口腔保健宣教),比较孕妇接受与不接受口腔保健宣教5个月后的牙周与龋病情况。结果接受口腔保健宣教的孕妇较未接受宣教孕妇的牙龈指数、牙石指数差异均有统计学意义(P<0.05),但龋病的新发生率差异无显著性意义(P>0.05)。结论孕期口腔保健宣教措施可有效改善孕妇口腔健康水平。     

妊娠妇女孕前口腔检查的调查状况及影响因素分析

目的调查分析张家港市妊娠妇女孕前口腔检查情况及其影响因素。方法选择张家港市妇幼保健所产前门诊初次孕检的783名妊娠妇女进行问卷调查:人口统计学资料、孕前口腔检查情况、未进行孕前口腔检查的原因等;通过问卷结果进行统计分析。结果 783名妊娠妇女中共有104名进行了孕前口腔健康检查,占13.3%,孕前是否进行口腔健康检查与年龄段、文化程度、月收入水平、有无职业相关(P<0.05),与口腔健康知识的认知明显相关(P<0.001),与口腔健康态度相关性不明显。679名未进行口腔检查的主要原因依次是:"牙齿没问题、没必要"、"没有时间"、"害怕看牙疼痛"。结论张家港市孕前口腔检查率较低,建议加强育龄妇女的口腔卫生宣教,同时把孕前口腔检查严格纳入孕前保健的基本项目中,促进孕妇和胎儿健康。     

孕妇牙周病与胎膜早破的相关性研究

目的:本研究通过检查比较胎膜早破孕妇与正常孕妇牙周健康状况,分析牙周健康状况与胎膜早破的关系,为胎膜早破的病因提供一定的临床依据。方法:选择早产胎膜早破(PPROM)孕妇18例、足月胎膜早破(PROM)孕妇20例作为实验组,足月正常孕妇(Non-PROM)28例作为对照组。检查牙周状况记录菌斑指数(PLI)、探诊深度(PD)和龈沟出血指数(SBI)。结果:胎膜早破组牙龈炎症明显,牙周状况差,PLI、SBI均高于正常对照组,差异有统计学意义(P<0.05)。各组间探诊深度无明显差别,无统计学意义。结论:牙周病可能是导致胎膜早破的原因之一。孕期及孕前的口腔保健及口腔健康教育,是预防和减少不良妊娠结局发生的有效措施。     

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。     

上海市某医院孕妇口腔保健知识、态度与行为调查分析

目的:了解上海市某医院孕妇口腔保健相关知识、态度、行为(knowledge,attitude,practice,简称KAP)现状,并分析其影响因素。方法:采用问卷调查方法,对2009年1月—2010年6月在上海市某医院定期产前检查的怀孕16～34周的340名妇女进行随机现场问卷调查。应用SPSS13.0软件包对问卷数据进行频度描述、相关分析、多因素线性回归分析、F检验、t检验等。结果:所调查孕妇口腔保健相关KAP水平较低,总合格率为44.62%;孕妇对待口腔保健普遍态度积极;在口腔保健行为方面,仅29.85%的孕妇怀孕前曾进行口腔检查,39.08%的孕妇产后不准备刷牙,或仅仅漱口;孕妇口腔保健知识、态度、行为间有正相关性;知识与态度、知识与行为、态度与行为之间的相关系数分别为0.255、0.328和0.214(P<0.05);孕妇口腔卫生知识、态度、行为水平主要受孕妇文化程度、职业及丈夫职业的影响,其标准偏相关系数分别为1.109、0.975和0.453(P<0.05);孕妇获取口腔保健知识的主要途径依次是大众传媒、医务人员指导和亲戚朋友经验交流。结论:上海市某医院孕妇的口腔保健知识缺乏,口腔保健行为不正确,应加强对孕妇口腔保健知识的宣传教育和口腔保健行为的指导。     

北京市口腔医师对孕期用药的认知和行为调查分析

目的: 了解北京市口腔医师对孕期用药的认知和行为,并分析其影响因素。方法: 以北京市医疗机构在职口腔医师259名为研究对象,进行横断面调查。采用SAS 9.4软件包中的精确计算法计算口腔医师对孕期用药安全的知晓率和相关药物的使用率,采用二元Logistic回归探讨口腔医师孕期用药安全认知的影响因素。结果: 口腔医师对孕期各项用药安全认知正确率为1.93%~57.92%,合计得分超过8分的比例仅达10.42%（满分16分）。此外,口腔医师在孕期开具、使用各项药品比例普遍较低（2.8%~27.09%）。结论: 北京市口腔医师对孕期用药相关知识了解相对不足,需加强医务人员的继续教育,行业内应尽早出台统一的治疗指南。     

牙周病与早产低出生体重儿关系的临床研究

目的比较分娩早产低出生体重儿(PLBW)的孕妇与足月妊娠正常分娩新生儿(NBW)孕妇的牙周状况及牙周病的发生率,探讨牙周病与PLBW的关系。方法随机选取分娩PLBW的孕妇206例为研究组,选取同期分娩NBW的孕妇209例为对照组,检测两组孕妇的牙周状况,记录菌斑指数(PLI)、探诊深度(PD),临床附着丧失(CAL)和出血指数(BI),并计算牙周炎位点率(PD>3 mm,CAL>2 mm)及牙周病的发生率。结果分娩早产低出生体重儿的孕妇牙周炎位点率(3.3%)和牙周病发生率(81.1%)明显高于对照组(1.4%,35.9%),差异有显著性(P<0.01);牙周炎位点率与孕周和新生儿体重均呈负相关系(P<0.05)。结论牙周病可能是PLBW发生的危险因素。     

杭州市妊娠期妇女对儿童口腔保健知识的认知状况调查分析

目的了解杭州市妊娠期妇女对幼儿口腔保健知识的掌握程度。方法对杭州市1257位妊娠期妇女展开问卷调查,问卷内容涉及儿童口腔保健知识共13个问题,并对结果与妊娠期妇女的年龄、孕周、年收入、文化程度进行统计学分析。结果调查结果显示绝大多数妊娠期妇女未能得到口腔专业人员的教育和指导,儿童口腔保健知识尚较贫乏。结论应针对妊娠期妇女进行口腔保健教育及行为改进。     

Knowledge and beliefs regarding oral health among pregnant women

BackgroundRacial or ethnic and economic disparities exist in terms of oral diseases among pregnant women and children. The authors hypothesized that women of a racial or ethnic minority have less oral health knowledge than do women not of a racial or ethnic minority. Therefore, the authors conducted a study to assess and compare maternal oral health knowledge and beliefs and to determine if maternal race and ethnicity or other maternal factors contributed to women’s knowledge or beliefs.MethodsThe authors administered a written oral health questionnaire to pregnant women. The authors calculated the participants’ knowledge and belief scores on the basis of correct answers or answers supporting positive oral health behaviors. They conducted multivariable analysis of variance to assess associations between oral health knowledge and belief scores and characteristics.ResultsThe authors enrolled 615 women in the study, and 599 (97.4 percent) completed the questionnaire. Of 599 participants, 573 (95.7 percent) knew that sugar intake is associated with caries. Almost one-half (295 participants [49.2 percent]) did not know that caries and periodontal disease are oral infections. Median (interquartile range) knowledge and belief scores were 6.0 (5.5–7.0) and 6.0 (5.0–7.0), respectively. Hispanic women had median (interquartile range) knowledge and belief scores significantly lower than those of white or African American women (6.0 [4.0–7.0] versus 7.0 [6.0–7.0] versus 7.0 [6.0–7.0], respectively [P < .001]; and 5.0 [4.0–6.0] versus 6.0 [5.0–7.0] versus 6.0 [5.0–7.0], respectively [P < .001]). Multivariable analysis of variance results showed that being of Hispanic ethnicity was associated significantly with a lower knowledge score, and that an education level of eighth grade or less was associated significantly with a lower belief score.ConclusionsPregnant women have some oral health knowledge. Knowledge varied according to maternal race or ethnicity, and beliefs varied according to maternal education. Including oral health education as a part of prenatal care may improve knowledge regarding the importance of oral health among vulnerable pregnant women, thereby improving their oral health and that of their children.Clinical ImplicationsIncluding oral health education as a part of prenatal care should be considered.     

Perspectives of Maryland women regarding oral health during pregnancy and early childhood

Objectives: The objective of this qualitative study was to obtain information on low‐income women's knowledge, beliefs, and practices regarding oral heath during pregnancy and for infant care. Methods: A professional focus group moderator conducted four focus groups (n = 34) among low‐income women in Maryland who were either pregnant or had children aged two and younger. Purposeful sampling and qualitative content analysis were employed. Results: Women were reasonably well informed about oral health practices for themselves and their children; however, important myths and misperceptions were common. Several themes emerged; a central one being that most women had not received oral health information in time to apply it according to recommended practice. Conclusions: The focus groups with low‐income women provided rich and insightful information and implications for future communication strategies to help prevent dental diseases among pregnant women and their infants.     

Survey of medical doctors' attitudes and knowledge of the association between oral health and pregnancy outcomes

Abstract: Objectives: The study was designed to assess the views and knowledge of healthcare providers in general medicine and other specialties on the association between oral health and pregnancy outcomes. Material and Methods: Two hundred and fifty physicians practicing in northern Jordan hospitals and healthcare centers were asked to complete a questionnaire. Completed questionnaires with the answers were returned completed by 197 participants (response rate was 79%). Results: The majority of the physicians (81%) agreed that pregnancy increases the tendency to have gingival inflammation. However, 88% of doctors advised delay dental treatment until after pregnancy. Only half (54%) thought that tooth and gums problem can affect the outcomes of pregnancy. Moreover, approximately 50% agreed with the possible association between oral health and pregnancy outcomes. Altogether, 52% agreed with the statement ‘a tooth for a baby’ and 57% believed that calcium will be drawn by the developing baby. If asked to advise patient to visit dentist during pregnancy, 50% said they would do so. Moreover, the majority (68%) did not advise women planning to become pregnant to include a periodontal evaluation as part of their prenatal care. About 32% felt that periodontal disease can be treated safely during pregnancy with a procedure called scaling and root planning. Reading the information in a book, magazine or pamphlet was useful and reliable information about preterm births and periodontal disease. Physicians do not routinely advise their patient to seek dental care during pregnancy. General practitioners were less informed about oral health practices on pregnant women. Issues on training need to be addressed. A public health campaign is required to educate healthcare providers to encourage pregnant women on the need for a regular dental check‐up during and prior to attempting pregnancy. Conclusion: There is a need to educate healthcare personnel further about oral health and pregnancy outcomes.     

上海市嘉定区家庭医师对妊娠期口腔疾病治疗的调查分析

目的: 调查分析上海市嘉定区家庭医师对妊娠期口腔疾病治疗问题的认识。方法: 采用问卷方式调查嘉定区家庭医师对妊娠期口腔保健知识的掌握度和口腔疾病治疗相关问题的认识,采用SPSS20.0软件包对数据进行统计学分析。结果: 203名家庭医师参与问卷调查,共回收有效问卷192份。受调查者对于妊娠期口腔治疗安全期的知晓率为70.3%,知道口腔疾病可能导致不良妊娠结局的比例为90.1%,告知服务对象孕前进行口腔检查和治疗的比例为90.6%,认为孕期出现口腔疾病需要及时就诊的比例为93.8%。认为孕妇可以接受龋齿充填、冠修复、龈上洁治、根管治疗、龈下刮治和拔牙的比例分别为91.9%、60.4%、51.0%、40.1%和31.8%,认为孕妇可以接受口腔局麻以及牙科X线检查的比例为55.2%和31.8%,家庭医师的年龄、学历和技术职称是影响观点的主要因素（P值均<0.05）。结论: 嘉定区家庭医师对妊娠期口腔保健知识知晓度较高,但对妊娠期口腔疾病治疗相关问题的看法存在差异,认为孕妇可以接受局麻和牙科X线片检查的医师多具备较高学历和高技术职称。     

孕前及孕期妇女口腔干预与早产低出生体重儿的相关性研究

目的:探讨孕前及孕期妇女口腔干预与早产低出生体重儿的相关性。方法:选取2012~2014年孕前门诊和婚姻登记单位拟怀孕的550名妇女为研究对象,采用口腔问卷调查、口腔检查与提出治疗建议,并追踪妊娠结局,进行数据分析。结果:在社会经济状况和保健意识较优的妇女中,孕前及孕期口腔疾病和治疗与否与妊娠结局无明显相关性。结论:针对该人群妊娠进行的口腔干预行为具有较宽泛的安全范围。     

武汉市1009名孕妇牙周状况调查

目的:了解武汉市孕妇的牙周状况及其影响因素。方法:采用横断面研究的方法,按照纳入标准抽取2006-05—12在省妇幼保健院进行孕检或生产的已作婚姻登记的妇女1009名。调查方法包括问卷调查和临床牙周检查。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:受检孕妇的牙龈炎和牙周炎患病率分别为74.8%和37.2%。大于30岁者患牙周炎的危险度比值(oddsratio,OR)为1.6;学历较低者患牙龈炎的OR为1.4;月收入为中或低水平的孕妇患牙周疾病的几率较大,牙龈炎OR分别为1.5和2.1,牙周炎OR分别为1.1和1.7;孕前近1年内没有口腔就诊行为的孕妇,患牙龈炎和牙周炎的OR分别为2.3和2.1;孕前或孕期患有全身性疾病的孕妇,患牙龈炎和牙周炎的OR分别为1.8和2.2;孕期有过吸烟和饮酒行为的孕妇患牙周炎的OR分别为3.8和1.6。结论:牙周疾病较易发生于年龄较大、学历和月收入较低、口腔健康行为较差、孕前或孕期患有全身性疾病及有吸烟或饮酒行为的孕妇,应加强对这部分孕妇的口腔健康教育。