Nasu Daisuke, Uematsu Ayako, Nakamura Satoshi, Ishiyama Misa, Shirakawa Tetsuo, Hasegawa Tomohiko, Nasu Yasuko, Kaneko Takahiro, Hoshi Jun, Horie Norio
Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University.
Department of Pediatric Dentistry, Nihon University School of Dentistry.
J Oral Sci. 2020;62(1):89-92. doi: 10.2334/josnusd.19-0042.
The oral hygiene and oral status of children with severe disabilities with both nutritional and respiratory complications who were institutionalized at Karugamonoie (KNI), a facility for children with disabilities, were investigated in this study. Their oral hygiene management was solely dependent on caregivers and nurses at the institution. Thirty children (13 females, 17 males; average age, 7.6 years) who had a tracheotomy and feeding tube (gastrostomy, nasogastric, or jejunostomy feeding tube) were included in the study. As for oral characteristics, poor control of tongue movement, anterior open-bite, abnormal strain of facial muscles, dry mouth, and swallowing dysfunction were found in 63.3%, 63.3%, 13.3%, 20.0%, and 100.0%, of the children, respectively. The mean ± standard deviation Decayed, Missing, Filled Teeth score was 0.13 ± 0.57. The Gingival Index (GI) showed that the children had mild (53.3%) to moderate (46.7%) gingivitis. The Simplified Oral Hygiene Index was excellent in 50.0% of the children, good in 23.3%, fair in 20.0%, and poor in 6.7% of the children. These indices were satisfactory in general except for GI management, which may have been hampered by abnormal oral functions and anterior open-bite. In conclusion, oral hygiene management of children with nutritional and respiratory complications at KNI was shown to be of high quality even without on-site intervention by dental specialists.
本研究调查了在Karugamonoie（KNI）一所残疾儿童机构中，患有严重残疾且伴有营养和呼吸并发症的儿童的口腔卫生和口腔状况。该机构中这些儿童的口腔卫生管理完全依赖于护理人员和护士。本研究纳入了30名儿童（13名女性，17名男性；平均年龄7.6岁），他们均进行了气管切开术并带有喂养管（胃造口术、鼻胃管或空肠造口术喂养管）。在口腔特征方面，分别有63.3%、63.3%、13.3%、20.0%和100.0%的儿童存在舌运动控制不佳、前牙开合、面部肌肉异常紧张、口干和吞咽功能障碍。龋失补牙面均数±标准差为0.13±0.57。牙龈指数（GI）显示，这些儿童患有轻度牙龈炎的比例为53.3%，中度牙龈炎的比例为46.7%。简化口腔卫生指数显示，50.0%的儿童为优秀，23.3%为良好，20.0%为中等，6.7%为差。除了GI管理外，这些指标总体上令人满意，GI管理可能因口腔功能异常和前牙开合而受到阻碍。总之，即使没有牙科专家的现场干预，KNI中患有营养和呼吸并发症的儿童的口腔卫生管理也显示出高质量。
