脑源性神经营养因子突变与焦虑

焦虑是人们在现代社会生活中不可避免的一种情绪体验,并已成为一个越来越普遍的问题。焦虑症又称焦虑性神经症,以焦虑、紧张、恐惧等情绪障碍,伴有植物神经系统症状和运动不安等为特征,临床上分为广泛性焦虑症和惊恐发作（又称急性发作）焦虑症。近来的研究表明,脑源性神经营养因子（brain-derived neurotrophic factor,BDNF）的基因突变可引起焦虑相关行为。有望利用此基因研发出治疗焦虑症的有效药物和方法。     

拔除阻生智齿患者牙科焦虑的调查及分析

目的：了解综合医院口腔科拔除阻生智齿患者牙科焦虑的患病情况并进行相关因素分析。方法：采用牙科焦虑一般因素调查表、改良牙科焦虑量表（MDAS）及状态焦虑量表（S-AI）对300例口腔颌面外科门诊的拔除阻生智齿患者进行调查及评定,同时对引起牙科焦虑的相关因素进行分析。结果：拔除阻生智齿患者牙科焦虑的发生率为56.00%,有6项因素对牙科焦虑症的患病率有影响,差异有统计学意义（P〈0.05）,其中5项因素对MDAS得分影响较大。结论：牙科焦虑在拔除阻生智齿的患者中较普遍,有多种因素影响患者牙科焦虑的程度。     

拔除阻生智齿患者牙科焦虑的调查及分析

目的:了解综合医院口腔科拔除阻生智齿患者牙科焦虑的患病情况并进行相关因素分析。方法:采用牙科焦虑一般因素调查表、改良牙科焦虑量表(MDAS)及状态焦虑量表(S-AI)对300例口腔颌面外科门诊的拔除阻生智齿患者进行调查及评定,同时对引起牙科焦虑的相关因素进行分析。结果:拔除阻生智齿患者牙科焦虑的发生率为56.00%,有6项因素对牙科焦虑症的患病率有影响,差异有统计学意义(P<0.05),其中5项因素对MDAS得分影响较大。结论:牙科焦虑在拔除阻生智齿的患者中较普遍,有多种因素影响患者牙科焦虑的程度。     

脑源性神经营养因子突变与焦虑

焦虑是人们在现代社会生活中不可避免的一种情绪体验,并已成为一个越来越普遍的问题.焦虑症又称焦虑性神经症,以焦虑.紧张、恐惧等情绪障碍,伴有植物神经系统症状和运动不安等为特征,临床上分为广泛性焦虑症和惊恐发作(又称急性发作)焦虑症.近来的研究表明.脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)的基因突变可引起焦虑相关行为.有望利用此基因研发出治疗焦虑症的有效药物和方法.     

牙科全瓷修复研究进展

20世纪60年代以前,牙科修复的主要目标是恢复牙齿的生理功能。随着物质文明和精神文明的丰富提高,人们对牙科修复的期望目标不只是停留在恢复生理功能的层面,更期望能达到天然牙的色泽及外观[1],因此,各类美容牙科修复材料的应用不断推陈出新。全瓷材料由于其极佳的表面光泽度,良好的透明性和半透明性,更接近于天然牙齿的色泽和硬度等优点,已日渐受到牙医和患者的青睐。本文就全瓷材料在口腔修复中的临床应用进展状况作一简要概述。1瓷嵌体早在1880年,Rollins就采用型片法进行了陶瓷嵌体修复的初步尝试。瓷嵌体除了具有嵌体的一般优良特性…     

催产素在社交焦虑症治疗中的作用

社交焦虑症是一种比较常见的精神疾病,主要表现在公共场合恐惧、忧虑,与人交流困难、胆怯,从而导致患者社交障碍,严重影响患者的正常生活。近年研究显示,催产素在社会支持上起重要的作用,对于社交焦虑症有一定的治疗作用。本文综述了近年来在利用催产素治疗社交焦虑症方面的研究进展。     

恐惧记忆消散的神经生物学机制研究进展

恐惧消散被认为是一种通过形成新的抑制性学习来拮抗最初的恐惧记忆的复杂过程。目前,通过旨在促进恐惧消散的疗法治疗诸如焦虑症等神经精神疾病已在临床上取得了较好的疗效,因此,如何更有效持久地维持恐惧消散记忆具有重要的意义。围绕与恐惧记忆消散相关的脑区及恐惧记忆消散的分子机制进行阐述,有助于更深入地理解恐惧记忆消散相关的神经生物学机制,为后续研究提供新的方向。     

牙科焦虑的病因及心理干预的研究进展

牙科焦虑对于病人和口腔医生来说是一个严重的问题.牙科焦虑惠者经常逃避治疗,这种严重的牙科焦虑,可能导致疾病的误诊.由于逃避治疗,致使牙齿疾病不断恶化,进而加重焦虑并形成恶性循环.本文将对口腔科门诊患者牙科焦虑的病因及心理干预的研究进展进行综述.     

提高我国口腔科治疗效率的途径

牙科钻机和补牙材料的出现,为口腔治疗开拓了新的途径。对龋齿的治疗从简单地拔除到改用修补方法,尽量保留自生牙,恢复其咀嚼功能。以后又发展为镶装假牙,矫正牙列等等,使口腔治疗工作日趋繁忙。为了提高工作效率和治疗质量,多年来,对口腔治疗设备在结构、性能等方面不断进行改进,曾取得显著效果。但在后阶段,虽然采用了许多先进设备如高速气涡轮牙钻、冷光手术     

噬菌体疗法在口腔疾病中的研究进展

在人体内除肠道外,口腔也是细菌和病毒的重要栖息地。细菌是导致各种口腔疾病的重要因素,同时严格以细菌为宿主的噬菌体病毒也普遍存在于口腔中,尽管如此,口腔中的噬菌体研究依然较少。近年来,随着抗生素耐药菌株的不断出现,传统的抗生素治疗方法遇到了重要挑战,由于噬菌体特异性强、不易产生耐药性、治疗副作用小、研发周期短、成本低廉,因此噬菌体疗法成为目前治疗微生物感染的热点之一,在口腔抗感染的研究中也逐渐受到关注。本综述就噬菌体疗法在口腔抗感染中的研究现状做一个简要的综述,以期为中国此方面的研究起到一个抛砖引玉的作用。     

Dental anxiety among middle-aged and elderly women in Sweden. A study of oral state,utilisation of dental services and concomitant factors

The aim of this project was to investigate dental anxiety and its expression in utilisation of dental services, oral health and oral symptoms. In a cross-sectional study of women's health in Göteborg (population 432,000), Sweden, 1016 women aged 38 to 84 years participated. This randomly selected population took part in a series of investigative procedures including medical and dental clinical examinations, interviews and questionnaires. Levels of dental anxiety were measured on the Corah Dental Anxiety Scale (DAS). The average DAS score obtained was 7.2. The study showed that older women were significantly less anxious than younger ones. Severe dental anxiety (DAS 15) was experienced by 3.9% of the participants. This frequency corresponds well with findings by Hällström and Halling in their analysis of data from the first Göteborg study of women's health 24 years ago. High levels of dental anxiety were correlated with longer intervals between dental visits, poorer oral function and aesthetics and a higher frequency of oral symptoms. Headaches were more prevalent in the younger age groups and a correlation with dental anxiety was revealed. Our previous studies have shown that symptoms such as tension headaches are prevalent among dental phobic patients and that they are reported to be reduced by therapy for dental fear. The clinical and radiographical examinations revealed a generally poorer oral status, with a statistically significant higher number of decayed teeth among women with high dental anxiety.     

General health, dental status and perceived dental treatment needs of an elderly population in Istanbul

doi: 10.1111/j.1741‐2358.2010.00363.x
General health, dental status and perceived dental treatment needs of an elderly population in Istanbul Background: Comprehensive data on the oral health status and dental treatment needs of the elderly population in Turkey are deficient. Objectives: This pilot study determined the general and dental health status, perceived medical and dental treatment needs of an elderly population dwelling in residential homes in Istanbul. Method: Subjects at three different residential homes, namely one belonging to the state and two supported by foundations in Istanbul (N=121, female: 63 and male: 58) were involved in this study. A detailed questionnaire was prepared and dental examinations were conducted. Information was collected related to age, education levels, financial status, current physical functional status, general health, mental health, previous dental history, current dental status, oral hygiene practices and denture hygiene of these elderly people. The prevalence of edentulism, the presence and type of dental prostheses, dental and denture status and denture cleanliness were further evaluated. Results: The three most prevalent reported general health problems were associated with genito‐urinary problems (24%) followed by cardiovascular (18%) and respiratory problems (14%) varying significantly between genders, with males suffering more from cardiovascular problems than females (p < 0.05). Females showed significantly higher gastrointestinal and orthopaedic problems than males (p < 0.05). Females were more frequently edentulous than males but denture hygiene was significantly better in females than in males (p < 0.05). Brushing frequency did not significantly increase denture hygiene (p = 0.6). More than one‐third of the subjects had not been to the dentist within the previous 5–10 years, mainly due to lack of demand, followed by the cost of the dental care and fear. More than two‐thirds of denture‐wearing subjects wore their dentures only during eating. Conclusions: There was significant perceived dental treatment and care need for the sample population of elderly studied.     

Professional Dental Care for Patients with Dementia

Individuals with dementia present a significant challenge to the dental professional. The dental professional must meet the special needs of the patient with dementia with patience and a variety of non-traditional skills, including treatment planning with caregivers and nonverbal communication to reassure disoriented patients. The goals of dental care for the patient with dementia are to restore and maintain oral health and prevent progression of oral disease. Because of the degenerative nature of dementia, the first dental visit for a patient with dementia may represent the patient's best cognitive functioning level. For this reason, the dental treatment plan should aim to restore oral function quickly and to institute an intensive preventive program. Practical guidelines for preventive diagnostic, and restorative care are provided. To illustrate these points, two cases are presented.     

Utilization of dental health services by community-dwelling older adults in Japan who attended a weekly educational programme

Objectives: The purpose of this study was to describe dental health services utilization and identify factors which influenced a group of independently living elderly persons in an urban area of Japan. Subjects: The study sample consisted of 2,990 participants, 83% of the total sample of the Senior Citizen's College, who were 60 years and over. Measurements: Their dental utilization and satisfaction with dental treatment were measured by a questionnaire from 1993 to 1998 Results: The mean age of the subjects was 66.5 years and 52% were male. Sixty percent of the subjects had visited a dentist within the previous year, and 33% of them had received a regular oral health check‐up. The majority of the subjects (63%) were satisfied with their dental treatment. A multiple stepwise logistic regression analysis showed that dental services utilization had a significant positive association with presence of teeth (p<0.001), being male (p<0.01) and satisfaction with financial status (p<0.05). A regular oral health check‐ups had a significant association with presence of teeth (p<0.001), satisfaction with financial status (p<0.05) and aging (p=0.001). Conclusions: Dental health services utilization was related to the presence of teeth and financial status, rather than age or medical conditions, among independently living elderly persons in an urban area of Japan.     

Impact of pain,psychological-distress,SARS-CoV2 fear on adults’ OHRQOL during COVID-19 pandemic

Corona virus disease (COVID-19) has crippled life, families and oral health care delivery. Hence, we assessed the impact of dental pain, fear of COVID-19 and psychological distress during lockdown on the oral health related quality of life of individuals visiting a tertiary dental care center during COVID-19 pandemic. Cross sectional study conducted among patients between 18 and 60 years. Demographics, access to pain killers, dental care (yes/no), duration (</> 15 days) and intensity of pain were self reported. Fear of COVID-19 was assessed using fear of corona virus scale (FCV-19S); psychological distress in the last 30 days and oral health related quality of life was evaluated. Oral examination was performed and dental caries status (DMFT) was assessed using the world health organization method. Univariate and multivariate regression analysis was conducted to evaluate significant predictors and 5% was set as level of significance. 2966 patients visited our dental emergency due to painful decayed tooth between March-June 2020. Mean age was 42.7 years, 53.97% were males and most common cause of painful teeth was upper right third molar (7.7%). 73.4% reported lack of pain medication; 95% reported closure of dental clinics close to home. Almost 79% suffered from dental pain for >15 days. Higher self reported pain (OR 2.1; 95% CI 1.36–14.71), >15 days of suffering from pain (OR 6.8; 95% CI 2.18–23.14), greater fear of COVID-19 (OR 4.14; 95% CI 1.98–16.07) and psychological distress (OR 4.41; 95% CI 1.09–16.76) were associated with poorer OHRQOL of adults during COVID-19 pandemic. Our findings strongly suggest that COVID-19 pandemic negatively impacts the mental and oral health of individuals affecting their overall health.     

The Yad Sarah geriatric dental clinic, a different model

Introduction: There are not sufficient dental services for elderly people around the world. Yad Sarah is an Israel‐wide network of volunteers aiding sick, elderly, isolated and housebound people with an array of services aimed at making home care possible. It provides medical and social services to more than 380 000 elderly persons per year and in addition, lends medical equipment free of charge, has day rehabilitation centres, legal aid council for seniors, provides transportation for the disabled, meal deliveries and geriatric dental services. Materials and methods: The latter are equipped with five dental units (one mobile unit) and a dental laboratory. During the 5 years from 2000 to 2004 the dental services provided dental care for 3890 elderly patients with the main clinic located in Jerusalem. Patients pay an average of 70% of the cost price of their dental care, with the difference being subsidised by Yad Sarah. Of the 515 patients who applied for treatment in 2004, 54% possessed natural teeth in both jaws, 28% were fully edentulous, 12% were edentulous in the maxilla and 6% were edentulous in the mandible. Females applied for dental treatment more often than the male population. Older patients (75–101 years old) required oral care at their homes or at old age residences, more frequently than the younger age groups (60–74 years old). Conclusion: Dental treatment was administered by 70 volunteer dental surgeons, two certified dental hygienists and dental hygienist students. The clinical staff was provided with a comprehensive in‐service training in geriatric dentistry during the 3‐year service learning period. A survey in 2004 showed that 83% of the selected patients were satisfied, compared with 14% who were not. The reasons for satisfaction were, mainly, the personal relationship with the attending staff (41%) and the professional ability of the dental team (46%).     

Edentulism and dental caries in Victorian nursing homes

doi: 10.1111/j.1741‐2358.2011.00510.x Edentulism and dental caries in Victorian nursing homes Objectives: The aim of this project was to investigate edentulism and dental caries in nursing home residents in Victoria, Australia. Background: The Australian population is ageing with a growing number of people living in nursing homes. These residents are at increased risk for dental caries, have more teeth present now than at any time in the past 50 years and often have difficulty maintaining adequate oral hygiene. Materials and methods: Clinical dental examinations were conducted at 31 nursing homes in Melbourne and regional Victoria between May 2005 and June 2006. A total of 510 residents were examined out of 1345 eligible participants. Socio‐demographic and medical history was collected via questionnaire. Results: Just over half of the residents were dentate (53.9%), and dentate residents had a mean of 14.4 teeth present and 2.66 untreated decayed teeth. Residents who required total assistance with oral hygiene had more decayed teeth and fewer filled teeth than residents who did not require assistance. Conclusions: Nursing home residents in Victoria are retaining an increasing number of natural teeth and have more tooth surfaces at risk for dental caries. Untreated dental caries was a significant problem for residents, particularly for those who are dependent on others for their daily oral hygiene care.     

Dental Management of the Geriatric Head and Neck Cancer Patient1

The geriatric patient presenting with cancer of the head and neck region constitutes slightly less than half of all oral cancers diagnosed. Cancers of this region are generally treated with surgery, radiation, chemotherapy or combinations of these three. These patients not only present with special problems due to their age but also with challenging ones resulting from treatment of their disease. The dentist plays an important role in evaluating the patient's oral health and providing necessary services prior to any curative treatment. The dental diagnosis and treatment protocol practiced at Memorial Hospital are discussed for each therapeutic modality along with the measures taken for follow up care.     

Emergency Care of Maxillo-Facial Injuries

Maxillo-facial injuries require immediate first-aid treatment such as the establishment of a free airway, control of hemorrhage and treatment of shock. Support of the facial structures and positioning of the patient face-downwards are essential life-saving measures. Anxiety concerning facial appearance has an adverse influence on the patient''s recovery. Early evacuation to an Advanced Treatment Centre for medical and dental care is of prime importance.     

Sources and patterns of referrals of oral cancer: role of general practitioners.

Referrals of patients with oral squamous cell carcinomas to an oral medicine clinic were assessed with regard to the sources, delays, and pattern of referrals from general medical practitioners and general dental practitioners. Slightly more patients were referred by dental practitioners than by medical practitioners, but general medical practitioners were far more likely to see advanced tumours and to request an urgent second opinion or suggest a diagnosis of malignant disease. The greatest delay overall was caused by the patients in seeking advice from their practitioner, particularly those who attended a general medical practitioner. Both groups of practitioners requested a hospital opinion within roughly a month--a reasonable interval. Subsequent delays were minimal. Delays occur mainly because the patients are slow in seeking professional advice and, in general, do not appear to have been reduced over the decade since a previous British study on referral patterns was carried out. This study emphasises the importance of educating patients about oral cancer since it is they who appear to be mainly responsible for the delays in diagnosis. The results also help to dispel the myth that general medical practitioners might be less competent at diagnosis and referral of patients with oral cancer than are dental practitioners, though we are aware of misdiagnoses from both groups.