發(fā)布時(shí)間：2018-01-27 12:50

  本文關(guān)鍵詞： 中老年人 氟牙癥 齲病 人群簡化口腔衛(wèi)生指數(shù) 口腔衛(wèi)生習(xí)慣 牙列缺損 修復(fù) 抽樣調(diào)查　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:1通過口腔檢查的方式對(duì)河北省衡水市高氟區(qū)中老年人進(jìn)行氟牙癥、齲病檢查,計(jì)算該人群的社區(qū)氟牙癥指數(shù)(CFI)、齲病指數(shù),探討氟牙癥與齲病之間的相關(guān)關(guān)系,為當(dāng)?shù)乜谇患膊》乐翁峁┮罁?jù)。2通過口腔檢查的方式對(duì)河北省衡水市高氟區(qū)中老年人進(jìn)行口腔衛(wèi)生狀況檢查,并通過問卷調(diào)查的方式對(duì)河北省衡水市高氟區(qū)中老年人的口腔衛(wèi)生習(xí)慣進(jìn)行了解,計(jì)算該人群簡化口腔衛(wèi)生指數(shù),探討人群簡化口腔衛(wèi)生指數(shù)與口腔衛(wèi)生習(xí)慣的相關(guān)關(guān)系,指導(dǎo)當(dāng)?shù)鼐用竦目谇恍l(wèi)生宣教工作。3通過口腔檢查的方式對(duì)河北省衡水市高氟區(qū)中老年人進(jìn)行牙列缺損及修復(fù)情況檢查,計(jì)算該人群的缺牙率、修復(fù)率,探討牙列缺損及其修復(fù)與性別、年齡的相關(guān)關(guān)系,為當(dāng)?shù)乜谇患膊》乐渭靶迯?fù)提供依據(jù)。方法:本次調(diào)查對(duì)象為河北省衡水市高氟區(qū)中老年人,年齡在45-80歲,共103人,其中20人為無牙頜,共計(jì)1922顆恒牙。1檢查人員:由我院口腔科的10名醫(yī)師擔(dān)任調(diào)查員,先對(duì)調(diào)查員進(jìn)行專業(yè)培訓(xùn)學(xué)習(xí),統(tǒng)一標(biāo)準(zhǔn),合格后上崗,采用統(tǒng)一的調(diào)查表對(duì)調(diào)查對(duì)象進(jìn)行詢問和口腔檢查。2檢查工具:統(tǒng)一使用霸州市金盛醫(yī)療器械有限公司生產(chǎn)的一次性平面口鏡和一次性探針。3調(diào)查表:根據(jù)本研究的目的,結(jié)合可能與氟牙癥、齲病、口腔衛(wèi)生狀況、牙列缺損相關(guān)的影響因素制定調(diào)查表,并經(jīng)過預(yù)實(shí)驗(yàn)測(cè)試和修改后定稿。調(diào)查表分為兩部分,一部分為調(diào)查問卷,內(nèi)容包括:受檢者的性別、年齡、文化程度、口腔衛(wèi)生習(xí)慣、家庭主要飲水來源等;另一部分為檢查表,內(nèi)容包括:氟斑牙、齲病、口腔衛(wèi)生狀況、牙列缺損及修復(fù)情況等。4具體檢查內(nèi)容:參照《第三次全國口腔健康流行病學(xué)調(diào)查方案》[1]和世界衛(wèi)生組織《口腔健康調(diào)查基本方法》(第4版)[2]的標(biāo)準(zhǔn),認(rèn)真檢查所有受檢者的氟斑牙程度和具體治療方式、齲失補(bǔ)牙齒、軟垢和牙石、牙列缺損情況及修復(fù)方式和情況并做出詳細(xì)記錄。5診斷標(biāo)準(zhǔn)和記分標(biāo)準(zhǔn)5.1氟牙癥:按Dean分度標(biāo)準(zhǔn)檢查氟牙癥并記分。根據(jù)牙表面光澤度、變色、缺損程度及對(duì)牙面侵犯面積進(jìn)行分度,可分為正常、可疑、很輕度、輕度、中度、重度。5.2齲齒:采用WH0《口腔健康調(diào)查基本方法》(第4版)[2]中的診斷標(biāo)準(zhǔn)對(duì)該人群恒牙進(jìn)行冠齲檢查。并采用《口腔預(yù)防醫(yī)學(xué)》(第6版)[3]齲失補(bǔ)牙數(shù)(DMFT)進(jìn)行記分。5.3口腔衛(wèi)生狀況:采用人群簡化口腔衛(wèi)生指數(shù)來評(píng)價(jià)該人群的口腔衛(wèi)生狀況,包括簡化軟垢指數(shù)(DI-S)和簡化牙石指數(shù)(CI-S)。5.4牙列缺損及修復(fù)情況:根據(jù)《第三次全國口腔健康流行病學(xué)調(diào)查方案》[1]檢查并記錄該人群牙列缺損、牙列缺失及修復(fù)情況。6統(tǒng)計(jì)學(xué)處理:檢查結(jié)束后將結(jié)果錄入Excel工作表,運(yùn)用SPSS 21.0軟件包進(jìn)行統(tǒng)計(jì)分析。6.1按Dean分度標(biāo)準(zhǔn)將所有調(diào)查對(duì)象分成六組,各氟牙癥組與正常組恒牙齲壞率的比較采用χ2檢驗(yàn)進(jìn)行相關(guān)數(shù)據(jù)分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。各氟牙癥組間恒牙齲壞率的比較采用χ2檢驗(yàn)進(jìn)行相關(guān)數(shù)據(jù)分析,P0.003為差異有統(tǒng)計(jì)學(xué)意義。6.2按刷牙次數(shù)分組,兩組DI-S和CI-S比較采用t檢驗(yàn)進(jìn)行相關(guān)數(shù)據(jù)分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。按是否吸煙分組,兩組DI-S和CI-S比較采用t檢驗(yàn)進(jìn)行相關(guān)數(shù)據(jù)分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。6.3不同年齡組、性別組缺牙率及修復(fù)率的比較,采用χ2檢驗(yàn)進(jìn)行相關(guān)數(shù)據(jù)分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1氟牙癥患病情況所調(diào)查的衡水市高氟區(qū)中老年人CFI為1.45,氟牙癥中度流行,氟牙癥的患病率為83.13%,其中,可疑組:24.10%;很輕度組:19.28%;輕度組:14.46%;中度組:16.87%;重度組:8.43%。2齲病患病情況所調(diào)查的衡水市高氟區(qū)中老年人DMFT:948顆,其中DT:493顆,MT:372顆,FT:84顆,恒牙患齲率為96.39%,齲均為11.42。3口腔衛(wèi)生狀況該人群簡化軟垢指數(shù)(DI-S)為6.34,簡化牙石指數(shù)(CI-S)為7.91,該地區(qū)人群口腔衛(wèi)生狀況很差;口腔衛(wèi)生習(xí)慣,每天刷牙次數(shù)2次者:57.83%;≥2次者:42.17%;吸煙習(xí)慣,不吸:51.81%;吸煙:48.19%,口腔衛(wèi)生習(xí)慣差。4牙列缺損及修復(fù)情況在調(diào)查的103例樣本中,發(fā)現(xiàn)缺牙者74例,缺牙率為71.85%,其中已修復(fù)者35例,修復(fù)率為47.30%;牙列缺損者占72.97%;牙列缺失者占27.03%。5不同氟牙癥組恒牙齲壞率的比較按氟牙癥嚴(yán)重程度分組,(1)正常組(2)可疑組(3)很輕度組(4)輕度組(5)中度組(6)重度組,每組恒牙齲壞率:(1)38.48%;(2)26.48%;(3)15.11%;(4)11.86%;(5)50.00%;(6)66.67%。對(duì)結(jié)果進(jìn)行分析后發(fā)現(xiàn)第(3)(4)組受檢者恒牙齲壞率差異無統(tǒng)計(jì)學(xué)意義(P0.05);其余組受檢者恒牙齲壞率差異有統(tǒng)計(jì)學(xué)意義(P0.05)。6按每天刷牙次數(shù)分組,不同組DI-S和CI-S值比較(SX±)按每天刷牙次數(shù)分組(1)2次;(2)≥2次,兩組CI-S值(1)9.44±4.297;(2)5.83±1.839兩組CI-S差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組DI-S值(1)7.71±3.975;(2)5.20±2.112兩組DI-S差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。7按是否吸煙分組,不同組DI-S和CI-S比較(SX±)(1)不吸(2)吸煙,兩組CI-S值(1)6.77±3.191;(2)9.15±4.240兩組CI-S差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組DI-S值(1)5.49±2.164;(2)7.25±4.271兩組DI-S差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。8按性別分組,不同性別組受檢者缺牙率及修復(fù)率比較男性組76.19%、50.00%;女性組68.85%、45.24%。不同性別組的缺牙率與修復(fù)率差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。9按年齡分組,不年齡組受檢者缺牙率及修復(fù)率比較45-59歲63.16%、33.33%;60-74歲66.67%、43.33%;75-89歲100%、70%。不同年齡組的缺牙率與修復(fù)率差異均具有統(tǒng)計(jì)學(xué)意義,且年齡高的調(diào)查者缺牙比例高,而修復(fù)比例也高。10修復(fù)體情況在已修復(fù)者的修復(fù)體中全口義齒所占的比例最大(14例,占40.00%),其他依次是活動(dòng)義齒(12例,占34.29%),非正規(guī)固定橋(6例,占17.14%),固定義齒(3例,占8.57%)、種植修復(fù)(0例,占0%)。結(jié)論:1該區(qū)中老年人氟牙癥及齲病患病率高。隨著社會(huì)和經(jīng)濟(jì)的發(fā)展,該區(qū)在政府領(lǐng)導(dǎo)下已采取改水降氟措施,但中老年人氟牙癥已形成,當(dāng)?shù)蒯t(yī)務(wù)工作者應(yīng)加強(qiáng)口腔衛(wèi)生宣教,提高患牙的治療率。2該區(qū)中老年人口腔衛(wèi)生差,當(dāng)?shù)蒯t(yī)務(wù)工作者應(yīng)加強(qiáng)口腔衛(wèi)生宣教,強(qiáng)調(diào)良好口腔衛(wèi)生習(xí)慣的重要性,改善口腔衛(wèi)生狀況。3該區(qū)中老年人缺牙率高而修復(fù)率低,對(duì)修復(fù)缺失牙齒的必要性的宣傳力度有待增強(qiáng),尤其注重對(duì)于種植修復(fù)、固定義齒修復(fù)的優(yōu)點(diǎn),不良修復(fù)體的缺點(diǎn)及危害方面的宣傳,從而提高中老年人口腔保健意識(shí),進(jìn)一步促進(jìn)其選擇正確的,健康的修復(fù)體,提高生活質(zhì)量。
[Abstract]:Objective: 1 through oral examination to the high fluorine District of Hengshui city in Hebei Province in the elderly of dental fluorosis and caries examination, calculation of the population of the community dental fluorosis index (CFI), dental caries index, investigate the relationship between dental fluorosis and dental caries, provide the basis for.2 by oral oral examination. Health inspection of high fluorine District of Hengshui city in Hebei province in the elderly for prevention of local oral diseases, and carried out by way of a questionnaire survey on oral health habits of high fluorine District of Hengshui City, Hebei Province, in the elderly, calculate the crowd simplified oral hygiene index, discuss the relationship between the crowd simplified oral hygiene index and oral health habits of the local residents to guide the work of oral health education by way of.3 oral examination of high fluorine District of Hengshui city in Hebei Province in the elderly of dentition defect and repair inspection, calculation of the crowd missing The rate of tooth, the repair rate of dentition defect and repair the relationship with gender, age, and provide the basis for local disease prevention and repair. Methods: a survey for the high fluorine District of Hengshui City, Hebei Province, in the elderly, at the age of 45-80, a total of 103 people, of which 20 were edentulous. A total of 1922 permanent teeth.1 inspection personnel: 10 doctors in our hospital department of Stomatology as investigators, the investigators conducted professional training, uniform standards, qualified posts, with a questionnaire inquiry and oral examination.2 inspection tool for investigation object: unified Bazhou Jinsheng medical instrument limited company to produce the disposable plane mirror and the disposable probe.3 questionnaire: according to the purpose of this study, may be combined with dental fluorosis, dental caries, oral hygiene, dental defect related factors affecting the development of the survey, and after the pre test and modify After the final questionnaire is divided into two parts, one part is the questionnaire content including: the subjects of sex, age, education level, oral hygiene habits, family's main source of potable water; the other part is the check list, including: dental fluorosis, dental caries, oral hygiene status, dentition defect and repair.4 check the specific content: according to < third national oral health epidemiological survey program >[1] and WHO "oral health surveys basic methods" (Fourth Edition) [2] standard, carefully check the degree of dental fluorosis in all subjects and the specific treatment methods, DMFT teeth, soft dirt and odontolith, dentition defect and repair and condition and make a detailed record of.5 diagnostic criteria and scoring criteria of 5.1 dental fluorosis: according to the standard of Dean classification of dental fluorosis and examination score. According to the tooth surface gloss, color, and defect degree of tooth surface area index infringement That can be divided into normal, suspicious, very mild, mild, moderate and severe.5.2 caries: the basic method of WH0< oral health survey "(Fourth Edition) on the population of permanent teeth dental caries diagnosis standard of [2]. And the use of oral preventive medicine > > (the Sixth Edition) [3] number DMFT score (DMFT) oral hygiene status score.5.3: the oral health status of population using the simplified oral hygiene index to evaluate the population, including di-s (DI-S) and ci-s (CI-S).5.4 dentition defect and repair: according to the third national oral health epidemiological survey scheme of >[1] check and record the population of dentition defect, loss and restoration of.6 were listed after the end of the tooth: check the results into the Excel table, were analyzed by Dean.6.1 classification criteria, all subjects were divided into six groups using SPSS 21 software, the dental fluorosis and normal group Permanent tooth caries was compared using the 2 test data of P0.05, the difference was statistically significant. The dental fluorosis group between permanent teeth caries was compared using the 2 test data of P0.003, the difference was statistically significant.6.2 group by brushing, two groups of DI-S and CI-S compared with t test data analysis, P0.05 difference was statistically significant. According to whether the smoking group, two groups of DI-S and CI-S were compared with t test data analysis, P0.05.6.3 had significant difference in different age groups, gender group tooth loss rate and repair rate is complex, 2 test was used for data analysis. P0.05 the difference was statistically significant. Results: 1 dental fluorosis prevalence survey of high fluoride area in Hengshui city of CFI in the elderly was 1.45, moderate epidemic fluorosis, dental fluorosis prevalence rate was 83.13%, among them, suspected group: 24.10%; light 搴︾粍:19.28%;杞誨害緇，

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