预防口腔医学课件：牙周病的预防

1、牙周病的预防主要内容ReviewConcept Periodontal DiseasesEpidemiologyEtiology & risk factorsPrevention & Control总结主要内容ReviewConcept Periodontal DiseasesEpidemiologyEtiology & risk factorsPrevention & Control总结Review - Periodontal DiseasesConceptGingival diseasesChronic marginal gingivitisHyperplastic gingivitisP

2、regnancy gingivitisPuberty gingivitisAcute necrotizing ulcerative gingivitisepulisConceptPeriodontitisCAPJPRPPPPPSystemic diseasesReview - Periodontal DiseasesEpidemiological characteristics地区时间人群年龄，性别，民族影响因素口腔卫生状况吸烟营养全身健康状况城乡受检人数牙龈出血牙石牙数率 （%）牙数率 （%）城119457.4171.220.5696.3乡1159310.1783.523.2298.3合计2

3、35388.7777.321.8797.3全国3544岁年龄组牙龈出血和牙石检出牙数及检出率我国成人的牙周病流行状况城乡受检人数浅牙周袋深牙周袋牙数率 （%）牙数率 （%）城119452.4339.10.125.4乡115932.6842.20.094.5合计235382.5540.60.114.9全国3544岁年龄组深浅牙周袋检出牙数及检出率我国成人的牙周病流行状况城乡受检人数牙龈出血牙石牙数率 （%）牙数率 （%）城116995.66 64.6 15.81 89.9 乡117166.70 71.4 14.96 87.5 合计234156.1868.0 15.39 88.7 全国6574岁年

4、龄组牙龈出血和牙石检出牙数及检出率我国成人的牙周病流行状况城乡受检人数浅牙周袋深牙周袋牙数率 （%）牙数率 （%）城116992.6252.00.2010.4乡117162.5050.50.16 9.7合计234152.5651.20.1810.1全国6574岁年龄组深浅牙周袋检出牙数及检出率我国成人的牙周病流行状况牙周健康率无牙龈出血，无牙周袋和LOA14.5% 3544岁年龄组14.1% 6574岁年龄组我国成人的牙周病流行状况牙周病流行状况全球数据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.牙周病流行状况全球数据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.牙周病流行状况全球数据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.牙周病流行状况全球数据CountryAgeChronic PeriodontitisJapan35-4456%Saudi Arabia35-4436%New Zealand35-4444%牙周病流行状况全球数据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局部促进因素全身危险因素行为和生活方式主要内容ReviewConcept Period

10、ontal DiseasesEpidemiologyEtiology & risk factorsPrevention & Control总结牙周炎的三级预防二级预防 Secondary Prevention 一级预防 Primary Prevention三级预防 Tertiary Prevention疾病的自然进程口腔健康教育口腔卫生指导定期口腔检查预防性洁治术定期检查，牙周基础治疗刮治、牙周手术牙周炎/牙龈炎的一级预防自我口腔保健控制牙菌斑一生中不断地、彻底地清除牙菌斑专业口腔保健牙周炎/牙龈炎的一级预防自我口腔保健控制牙菌斑一生中不断地、彻底地清除牙菌斑有效刷牙使用牙线和牙间刷辅助控制牙

11、菌斑的产品牙膏，漱口水等牙周炎/牙龈炎的一级预防自我口腔保健控制牙菌斑一生中不断地、彻底地清除牙菌斑有效刷牙牙周炎/牙龈炎的一级预防你的牙菌斑清除率（%）有多少？牙周炎/牙龈炎的一级预防你的牙菌斑清除率（%）有多少？Index ？刷牙的效果评价方法 Turesky改良的Q-H菌斑指数0=牙面无菌斑1=牙颈部龈缘处有散在的点状菌斑2=牙颈部菌斑宽度不超过1mm3=牙颈部菌斑覆盖宽度超过1mm， 但在牙面1/3以下4=菌斑覆盖面积占牙面1/3与2/3之间5=菌斑覆盖面积占牙面2/3以上刷牙的效果评价方法 Turesky改良的Q-H菌斑指数（PI）记分牙菌斑清除率（%）=刷牙前后PI记分之和的差值/

12、刷牙前PI记分之和 *100%刷牙的效果评价方法刷牙的效果评价方法刷牙的效果评价方法刷牙的效果评价方法刷牙的效果评价结果牙菌斑清除率（%）刷牙的效果如何提升刷牙时间对清除牙菌斑效果的影响 (Weijden et. al. 1993)推荐: 至少2分钟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.忽视刷牙的重点区域面面俱到！2.刷牙的时长不足不到2分钟3.刷牙的方法不当如何提高刷牙的效果可量化、可跟刷的有效刷牙教程设置了刷牙顺序量化了每个牙面需要刷多少时间，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儿童牙菌斑清除效果如何提高刷牙的效果坚信你的理念牙是

13、可以刷干净的！如何提高刷牙的效果实践中学习牙是可以刷干净的！注意事项：1.按照顺序刷面面俱到2.关注重点部位牙颈部和邻面3.花时间在难刷部位舌侧，最后一颗牙的远中面，上后 牙颊侧面4.刷牙时长23分钟牙周炎/牙龈炎的一级预防自我口腔保健控制牙菌斑一生中不断地、彻底地清除牙菌斑有效刷牙使用牙线和牙间刷辅助控制牙菌斑的产品牙膏，漱口水等牙线和牙间刷的使用/index.php/Home/Index/category?cateId=36牙周炎/牙龈炎的一级预防自我口腔保健控制牙菌斑一生中不断地、彻底地清除牙菌斑有效刷牙使用牙线和牙间刷辅助控制牙菌斑的产品牙膏，漱口水等chlorhexidineTriclosanCPC: Cetyl Pyridinium ChlorideSnF2: Stannous Fluoride牙周炎/牙龈炎的一级预防专业口腔保健预防性洁治