預(yù)防口腔醫(yī)學(xué)課件：牙周病的預(yù)防

1、牙周病的預(yù)防主要內(nèi)容ReviewConcept Periodontal DiseasesEpidemiologyEtiology & risk factorsPrevention & Control總結(jié)主要內(nèi)容ReviewConcept Periodontal DiseasesEpidemiologyEtiology & risk factorsPrevention & Control總結(jié)Review - Periodontal DiseasesConceptGingival diseasesChronic marginal gingivitisHyperplastic gingivitisP

2、regnancy gingivitisPuberty gingivitisAcute necrotizing ulcerative gingivitisepulisConceptPeriodontitisCAPJPRPPPPPSystemic diseasesReview - Periodontal DiseasesEpidemiological characteristics地區(qū)時間人群年齡，性別，民族影響因素口腔衛(wèi)生狀況吸煙營養(yǎng)全身健康狀況城鄉(xiāng)受檢人數(shù)牙齦出血牙石牙數(shù)率 （%）牙數(shù)率 （%）城119457.4171.220.5696.3鄉(xiāng)1159310.1783.523.2298.3合計2

3、35388.7777.321.8797.3全國3544歲年齡組牙齦出血和牙石檢出牙數(shù)及檢出率我國成人的牙周病流行狀況城鄉(xiāng)受檢人數(shù)淺牙周袋深牙周袋牙數(shù)率 （%）牙數(shù)率 （%）城119452.4339.10.125.4鄉(xiāng)115932.6842.20.094.5合計235382.5540.60.114.9全國3544歲年齡組深淺牙周袋檢出牙數(shù)及檢出率我國成人的牙周病流行狀況城鄉(xiāng)受檢人數(shù)牙齦出血牙石牙數(shù)率 （%）牙數(shù)率 （%）城116995.66 64.6 15.81 89.9 鄉(xiāng)117166.70 71.4 14.96 87.5 合計234156.1868.0 15.39 88.7 全國6574歲年

4、齡組牙齦出血和牙石檢出牙數(shù)及檢出率我國成人的牙周病流行狀況城鄉(xiāng)受檢人數(shù)淺牙周袋深牙周袋牙數(shù)率 （%）牙數(shù)率 （%）城116992.6252.00.2010.4鄉(xiāng)117162.5050.50.16 9.7合計234152.5651.20.1810.1全國6574歲年齡組深淺牙周袋檢出牙數(shù)及檢出率我國成人的牙周病流行狀況牙周健康率無牙齦出血，無牙周袋和LOA14.5% 3544歲年齡組14.1% 6574歲年齡組我國成人的牙周病流行狀況牙周病流行狀況全球數(shù)據(jù)Albandar, Periodontology 2000, 2002:31-69.In USA, (according to NHANES

5、III)Aged 30 and older with 6 teeth present, 65.5% had no periodontitis (34.5% had periodontitis)3.1% had advanced periodontitis 9.5% had moderate periodontitis21.8% had mild periodontitis The prevalence increased steadily with aging.牙周病流行狀況全球數(shù)據(jù)Sheiham and Netuveli, Periodontology 2000, 2002;104-21.P

6、roportion of European 35-44 years old with shallow periodontal pocket (3.5mm-5.5mm) ranged from 13% to 54%. The mean for East Europe was 45% and for West Europe was 36%.Adults with deep periodontal pockets (5.5mm) was below 10% in many West European countries but some East European countries had bet

7、ween 30% and 40% affected.牙周病流行狀況全球數(shù)據(jù)Baelum and Scheutz, Periodontology 2000, 2002;79-103.In AfricaThe most prominent findings using the CPI is the very high prevalence of calculus in 15-19 year old and the 35-44 year old groups. While shallow pocket depths of 3.5mm-5.5mm are relatively frequent (33

8、% on average), the deep pocket depths (5.5mm) are rather infrequent (16.6% on average).Dental caries rather than periodontal disease is the main reason for extraction.牙周病流行狀況全球數(shù)據(jù)CountryAgeChronic PeriodontitisJapan35-4456%Saudi Arabia35-4436%New Zealand35-4444%牙周病流行狀況全球數(shù)據(jù)Severe forms of periodontiti

9、s frequently affect only a subset of population groups globally (10%-15%).Approximately 30% to 50% of 35-44 age group has chronic periodontitisReview - Periodontal DiseasesEtiology & risk factorsEtiology - PlaqueBacteria - Pg, Pi, Fn, TF, Td, AaRisk factors局部促進(jìn)因素全身危險因素行為和生活方式主要內(nèi)容ReviewConcept Period

10、ontal DiseasesEpidemiologyEtiology & risk factorsPrevention & Control總結(jié)牙周炎的三級預(yù)防二級預(yù)防 Secondary Prevention 一級預(yù)防 Primary Prevention三級預(yù)防 Tertiary Prevention疾病的自然進(jìn)程口腔健康教育口腔衛(wèi)生指導(dǎo)定期口腔檢查預(yù)防性潔治術(shù)定期檢查，牙周基礎(chǔ)治療刮治、牙周手術(shù)牙周炎/牙齦炎的一級預(yù)防自我口腔保健控制牙菌斑一生中不斷地、徹底地清除牙菌斑專業(yè)口腔保健牙周炎/牙齦炎的一級預(yù)防自我口腔保健控制牙菌斑一生中不斷地、徹底地清除牙菌斑有效刷牙使用牙線和牙間刷輔助控制牙

11、菌斑的產(chǎn)品牙膏，漱口水等牙周炎/牙齦炎的一級預(yù)防自我口腔保健控制牙菌斑一生中不斷地、徹底地清除牙菌斑有效刷牙牙周炎/牙齦炎的一級預(yù)防你的牙菌斑清除率（%）有多少？牙周炎/牙齦炎的一級預(yù)防你的牙菌斑清除率（%）有多少？Index ？刷牙的效果評價方法 Turesky改良的Q-H菌斑指數(shù)0=牙面無菌斑1=牙頸部齦緣處有散在的點狀菌斑2=牙頸部菌斑寬度不超過1mm3=牙頸部菌斑覆蓋寬度超過1mm， 但在牙面1/3以下4=菌斑覆蓋面積占牙面1/3與2/3之間5=菌斑覆蓋面積占牙面2/3以上刷牙的效果評價方法 Turesky改良的Q-H菌斑指數(shù)（PI）記分牙菌斑清除率（%）=刷牙前后PI記分之和的差值/

12、刷牙前PI記分之和 *100%刷牙的效果評價方法刷牙的效果評價方法刷牙的效果評價方法刷牙的效果評價方法刷牙的效果評價結(jié)果牙菌斑清除率（%）刷牙的效果如何提升刷牙時間對清除牙菌斑效果的影響 (Weijden et. al. 1993)推薦: 至少2分鐘刷牙的效果如何提升刷牙的效果如何提升刷牙效果不佳的原因：1.忽視刷牙的重點區(qū)域面面俱到！2.刷牙的時長不足不到2分鐘3.刷牙的方法不當(dāng)如何提高刷牙的效果可量化、可跟刷的有效刷牙教程設(shè)置了刷牙順序量化了每個牙面需要刷多少時間，刷多少次用什么方法刷如何提高刷牙的效果成人牙菌斑清除效果如何提高刷牙的效果兒童牙菌斑清除效果如何提高刷牙的效果堅信你的理念牙是

13、可以刷干凈的！如何提高刷牙的效果實踐中學(xué)習(xí)牙是可以刷干凈的！注意事項：1.按照順序刷面面俱到2.關(guān)注重點部位牙頸部和鄰面3.花時間在難刷部位舌側(cè)，最后一顆牙的遠(yuǎn)中面，上后 牙頰側(cè)面4.刷牙時長23分鐘牙周炎/牙齦炎的一級預(yù)防自我口腔保健控制牙菌斑一生中不斷地、徹底地清除牙菌斑有效刷牙使用牙線和牙間刷輔助控制牙菌斑的產(chǎn)品牙膏，漱口水等牙線和牙間刷的使用/index.php/Home/Index/category?cateId=36牙周炎/牙齦炎的一級預(yù)防自我口腔保健控制牙菌斑一生中不斷地、徹底地清除牙菌斑有效刷牙使用牙線和牙間刷輔助控制牙菌斑的產(chǎn)品牙膏，漱口水等chlorhexidineTriclosanCPC: Cetyl Pyridinium ChlorideSnF2: Stannous Fluoride牙周炎/牙齦炎的一級預(yù)防專業(yè)口腔保健預(yù)防性潔治