Chang Juhea, Lee Jung-Hyun, Son Ho-Hyun, Kim Hae-Young
Assistant Professor, Clinic for Persons with Disabilities, Seoul National University Dental Hospital, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 110-768, Korea.
Spec Care Dentist. 2014 Jul-Aug;34(4):201-7. doi: 10.1111/scd.12047. Epub 2013 Sep 9.
This study evaluated the caries risk profile of patients with severe intellectual disabilities (IDs) who received dental treatment under general anesthesia. One hundred and two patients with ID [ID group, mean age (SD); 23.8(9.3)] and 100 healthy patients without ID [NID group, mean age (SD); 23.19(3.3)] were included. Medication, disability type, oral hygiene maintenance, and cooperation of the patients were investigated. Dietary habits, plaque index, mutans streptococci counts, fluoride availability, and salivary buffering were scored and analyzed using the Cariogram. The mean chance of avoiding caries (SD) was 28.1(20.4) in the ID group and 54.7(18.4) in the NID group. The ID group had significantly higher numbers of decayed and missing teeth, but fewer filled teeth than the NID group (p < .05). Significant disparities existed in the distributions of all caries-related factors except for mutans streptococci counts between the two groups (p < .05). The low chance to avoid future caries in ID patients was closely associated with insufficient oral hygiene maintenance (p < .05). Fluoride availability was strongly associated with the chance of avoiding caries in the ID group. Dental patients with severe ID exhibited a higher risk of developing caries than normal patients. Among several caries-related factors, insufficient oral hygiene maintenance and low fluoride availability most contributed to the high risk.
本研究评估了在全身麻醉下接受牙科治疗的重度智力残疾(ID)患者的龋病风险状况。纳入了102例ID患者[ID组,平均年龄(标准差);23.8(9.3)岁]和100例无ID的健康患者[NID组,平均年龄(标准差);23.19(3.3)岁]。调查了患者的用药情况、残疾类型、口腔卫生维护情况及合作程度。使用龋病预测软件对饮食习惯、菌斑指数、变形链球菌计数、氟化物可利用性和唾液缓冲能力进行评分和分析。ID组避免患龋的平均概率(标准差)为28.1(20.4),NID组为54.7(18.4)。ID组的龋失牙数量显著多于NID组,但补牙数量少于NID组(p < 0.05)。两组之间除变形链球菌计数外,所有龋病相关因素的分布均存在显著差异(p < 0.05)。ID患者未来患龋概率低与口腔卫生维护不足密切相关(p < 0.05)。氟化物可利用性与ID组避免患龋的概率密切相关。重度ID的牙科患者患龋风险高于正常患者。在几个龋病相关因素中,口腔卫生维护不足和氟化物可利用性低对高风险的影响最大。