中国口腔医师资源结构研究

中国口腔医师数量在近半个世纪里有了明显的增长,但是相对于中国口腔卫生市场需要相差甚远。通过口腔医师的内部结构与区域分布结构的研究,找出口腔医师的结构优势和劣势,提出口腔医师数量的稀缺还可以通过合理的结构分布而得到弥补。     

A review of the effectiveness of oral health promotion activities among elderly people

Objectives: This study aimed to review the effectiveness of oral health promotion studies conducted among elderly people between 1997 and 2007. Methods: Four electronic databases were searched and papers were rated for level of evidence and scientific quality. Key findings of the papers were summarised. Results: Thirteen thousand nine hundred and four papers were retrieved and 17 studies (18 papers) met the criteria for the review: 13 were randomised controlled studies, three were quasi‐experimental studies and one was a pre‐/post‐single group intervention study. According to the Levels of Evidence, 11 studies could be categorised as 1b and six studies could be categorised as 2b. The quality of the evidence of the 17 studies ranged from 12 to 19; 13 of the studies had a score of 15 or above; four of the studies ranged from 12 to 14. Evidence from oral health promotion activities aimed at preventing caries, improving periodontal health and altering oral health behaviours were reviewed. The use of fluoride, antimicrobial agents and health‐care provider education has important roles within oral health promotion activities for elderly people. Studies have tended to be of short‐term duration and rely on surrogate outcome measures of oral health. Conclusion: In the last 10 years, increasing attention has been paid to oral health promotion activities among the elderly population and high quality evidence has emerged. However, there is a need for even higher‐quality research to provide more definitive guidelines on oral health promotion practices for elderly people.     

人类口腔微生物组学研究:现状、挑战及机遇

全球超过一半的人口患有口腔疾病,其医护费用与全球十大常见死亡病因的花费相当,而且口腔感染与早产、动脉粥样硬化、肝硬化、糖尿病、阿尔茨海默病等全身性或慢性疾病显著相关,因此,口腔微生物组一直是人类微生物组计划的主要研究对象之一。与人体其他部位比较,口腔微生物组研究具有取样快捷、宿主反应表征方便、干预手段直接有效等特点;同时,超过65%的口腔细菌类群已可培养,诸多代表性菌株的全基因组信息已破译。因此口腔微生物组在菌群内部调控网络及其与宿主互作机制、局部感染对远隔器官的影响机制、以及基于菌群的慢病早期预警等微生物组研究核心科学问题上具备作为模式研究体系与技术示范对象的重要优势。本文在分析口腔微生物组学国际、国内研究现状的基础上,建议尽快启动中国人口腔微生物组计划(China human oral microbiome project,CHOMP),通过产学研协同攻关,开拓基于口腔菌群的口腔及全身系统性疾病的个体化预防、诊断及治疗策略。     

Climate,environmental and socio-economic change: weighing up the balance in vector-borne disease transmission

Arguably one of the most important effects of climate change is the potential impact on human health. While this is likely to take many forms, the implications for future transmission of vector-borne diseases (VBDs), given their ongoing contribution to global disease burden, are both extremely important and highly uncertain. In part, this is owing not only to data limitations and methodological challenges when integrating climate-driven VBD models and climate change projections, but also, perhaps most crucially, to the multitude of epidemiological, ecological and socio-economic factors that drive VBD transmission, and this complexity has generated considerable debate over the past 10–15 years. In this review, we seek to elucidate current knowledge around this topic, identify key themes and uncertainties, evaluate ongoing challenges and open research questions and, crucially, offer some solutions for the field. Although many of these challenges are ubiquitous across multiple VBDs, more specific issues also arise in different vector–pathogen systems.     

宏基因组学及其在口腔微生物研究中的应用

宏基因组是指环境中所有微生物的遗传物质总和。宏基因组学技术可以最大限度地利用环境中的微生物资源,受到了国内外微生物研究者的重点关注。口腔中寄居着大量的微生物群落,以往对口腔疾病微生物的研究大多局限于单纯的细菌培养技术,然而,由于培养技术的局限性,部分微生物很难或根本不能培养,宏基因组学技术打破了这一局限性,帮助人类发掘更丰富的口腔微生物资源。最近,以宏基因组学测序为基础的研究描绘出了口腔生态系统的图谱,越来越多的实验证明口腔微生物组在各种口腔疾病甚至全身系统性疾病中的重要作用。同时,这也为基于人类微生物组的诊断和治疗开辟了新的途径。本综述旨在说明宏基因组学是研究人类口腔疾病及全身疾病相关微生物的得力工具,而且具有广阔的发展前景,同时也讨论了宏基因组学在应用中有待克服的局限性。     

Inhibitory effect of oral Lactobacillus against oral pathogens

Aims: To determine the inhibitory effect of oral Lactobacillus against putative oral pathogens. Methods and Results: Total 357 strains comprising 10 species of oral Lactobacillus, Lactobacillus fermentum (195), Lactobacillus salivarius (53), Lactobacillus casei (20), Lactobacillus gasseri (18), Lactobacillus rhamnosus (14), Lactobacillus paracasei (12), Lactobacillus mucosae (12), Lactobacillus oris (12), Lactobacillus plantarum (11) and Lactobacillus vaginalis (10) were used as producer strains. Inhibitory effect against a panel of indicators, periodontitis‐ and caries‐related pathogens, was assessed. Most oral Lactobacillus was able to inhibit the growth of both periodontitis‐ and caries‐related pathogens. The strongest inhibitory activity was associated with Lact. paracasei, Lact. plantarum, Lact. rhamnosus, Lact. casei and Lact. salivarius. Lactobacillus SD1–SD6, representing the six species with the strong inhibitory effect, inhibited growth of Streptococcus mutans ATCC 25175 in the biofilm model. Also, it was demonstrated that growth of Strep. mutans was inhibited in a mixture with Lact. paracasei SD1. The inhibition was enhanced in acidic condition and 5% glucose. Conclusions: The results have shown that oral Lactobacillus SD1–SD6 showed a strong inhibitory effect against Strep. mutans and Streptococcus sobrinus, as well as, Gram‐negative periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Significance and Impact of the Study: The results indicated that Lactobacillus may be of benefit as probiotics for the prevention of oral diseases.     

Oral health of the elderly living in residential homes in Slovenia

doi: 10.1111/j.1741‐2358.2011.00497.x
Oral health of the elderly living in residential homes in Slovenia Objectives:  To evaluate oral health status of the elderly, living in eight randomly selected residential homes for senior citizens across the country. Background: The percentage of the elderly is growing worldwide. With ageing, risks of various oral diseases, including dental caries and periodontal disease, are growing. Methods: Altogether 296 elderly people (88 men, 208 women) of average age 79.89 ± 7.4 years were questioned about their medical condition and oral health practice and examined orally. Evaluation of clinical examination was carried out by DMFT, plaque index ( 10 ) and Community Periodontal Index of Treatment Need (CPITN). Results: Of 296 participants, 106 (35.8%) were edentulous, 95 (32.1%) had one to nine teeth and 95 persons (32.1%) had 10 or more teeth. The average number of teeth in an individual was small: 6.76 ± 7.47. The average number of teeth with caries lesions was 3.59 ± 4.70, filled teeth 1.94 ± 3.63 and teeth without caries or fillings 1.19 ± 2.41. The average DMFT value was 30.75. In 69.5% of participants, dental plaque was visible with the naked eye. Of 171 subjects, in whom CPITN index was appraised, 81.9% would need oral hygiene education, 56.7% would need scaling and root planning and 21.6% would need periodontal surgical treatment. Conclusions: The results of this study indicate poor oral health of the elderly living in residential homes situated in different towns in Slovenia. It is of utmost importance to highlight the necessity of improving oral health care of this population.