成年患者龋齿的初级临床预防方法:一项综合综述。
Methods of Primary Clinical Prevention of Dental Caries in the Adult Patient: An Integrative Review.
作者信息
Veiga Nélio, Figueiredo Ricardo, Correia Patrícia, Lopes Pedro, Couto Patrícia, Fernandes Gustavo Vicentis Oliveira
机构信息
Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal.
Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal.
出版信息
Healthcare (Basel). 2023 Jun 2;11(11):1635. doi: 10.3390/healthcare11111635.
AIM
Preventive approaches to oral health diseases, mainly dental caries, require individual and collective policies. Thus, this review was conducted to identify the primary prevention methods of dental caries in adults to improve oral health at the clinical and community levels.
METHODS
This review followed the PICO strategy with the research question: "What are the methods of primary prevention of dental caries, in adults, for improving and maintaining oral health integrating clinical and community-based strategies?" Electronic screening was carried out by two independent reviewers in five databases (MedLine/PubMed, SciELO, Web of Science, Cochrane Library, and LILACS) to find relevant publications between 2015-2022. We applied eligibility criteria for selection of the articles. The following MeSH terms were used: "Primary Prevention"; "Adult"; "Oral Health"; "Dental Caries"; "Fluorides, Topical"; "Fluoride Varnishes"; "Pit and Fissure Sealants"; "Preventive Dentistry". Although the term "Prevention strategy" is not a MeSH descriptor, several correlated terms appeared and were used in the search engines: "Preventative Care", "Disease Prevention, Primary", and "Prevention, Primary". The tool provided by the JBI organization (Joanna Briggs Institute) was used to assess the quality of the included studies.
RESULTS
Nine studies were included. Overall, it was found that the main primary prevention methods applied in dentistry in adults are the application of pit and fissure sealants, topical application of fluoride performed in the dental clinic, use of fluoridated toothpaste, mouthwash with chlorhexidine at home, use of xylitol, the recommendation for regular appointments with the dentist, and the need to inform patients about the saliva buffer capacity and adoption of a non-cariogenic diet. For that purpose, preventive policies should be taken to prevent dental caries. These include three major challenges: providing the adult population with more knowledge regarding their oral health, empowering patients through adopting healthy lifestyles, and developing new preventive strategies and awareness campaigns aimed at the adult population to promote proper oral health habits.
CONCLUSIONS
A small number of studies were found whose participants were adult patients. There was some consistency regarding primary prevention methods in our studies. However, good quality randomized control studies are still required to define the best intervention strategies for adult caries prevention.
目的
预防口腔健康疾病,主要是龋齿,需要个人和集体政策。因此,进行本综述以确定成人龋齿的一级预防方法,以在临床和社区层面改善口腔健康。
方法
本综述遵循PICO策略,研究问题为:“在成人中,整合临床和社区策略以改善和维持口腔健康的龋齿一级预防方法有哪些?”由两名独立评审员在五个数据库(MedLine/PubMed、SciELO、科学网、考克兰图书馆和LILACS)中进行电子筛选,以查找2015年至2022年期间的相关出版物。我们应用入选标准来选择文章。使用了以下医学主题词:“一级预防”;“成人”;“口腔健康”;“龋齿”;“局部用氟化物”;“氟化物涂剂”;“窝沟封闭剂”;“预防牙医学”。尽管“预防策略”不是医学主题词描述符,但在搜索引擎中出现了几个相关术语并被使用:“预防保健”、“疾病一级预防”和“一级预防”。使用JBI组织(乔安娜·布里格斯研究所)提供的工具来评估纳入研究的质量。
结果
纳入了九项研究。总体而言,发现成人牙科中应用的主要一级预防方法包括窝沟封闭剂的应用、在牙科诊所进行的局部用氟、使用含氟牙膏、在家用洗必泰漱口水、使用木糖醇、建议定期看牙医,以及需要告知患者唾液缓冲能力并采用非致龋饮食。为此,应采取预防政策来预防龋齿。这些包括三个主要挑战:向成年人群提供更多关于其口腔健康的知识、通过采用健康生活方式增强患者能力,以及制定针对成年人群的新预防策略和宣传活动以促进正确的口腔健康习惯。
结论
发现少数研究的参与者为成年患者。我们的研究中关于一级预防方法存在一些一致性。然而,仍需要高质量的随机对照研究来确定成人龋齿预防的最佳干预策略。