口腔预防医学精品教学（中山大学）6.2龋病的预防.pptVIP

caries activity test 细菌因素： Number of S. mutans is increased Number of LB is increased pH of plaque is acid (5.5) Number of cariogenic and acid-producing bacteria is increased Caries Early Diagnosis 临床检查 X线片检查 特殊仪器检查 脱矿, 小龋洞和龈炎 几周后 : 发生再矿化，龈炎愈合 常规临床检查 龋病的早期诊断 （一）临床诊断 龋病的预测与早期诊断 光滑面早期龋-龋白斑 窝沟早期龋-变黑、粗糙 邻面早期龋-粗糙、X线 常规临床检查（视觉、触觉） 龋病早期诊断 X线法 仪器检测：激光荧光法；定量光导荧光法；电阻法；光纤透照法；数字成像光纤透照法等。 龋病的早期诊断 X线诊断 特殊仪器检查 龋病的预测与早期诊断 龋病的三级预防 Three Levels of Prevention for Dental Caries 一级预防 Primary Prevention 1. 进行口腔健康教育 2. 控制及消除危险因素 * Pathogenic Factors in Dental Caries Liao Yidong * Keyes’s diagram Microorganism Tooth Food Time * Four factors Bacteria: S. mutans, LB, Act Food: Carbonhydrate Host: teeth, saliva, acitivity and habit Time * Dental caries Microbiology in Cariology Dental Plaque Dental plaque is the prime aetiological agent of the two main oral diseases, dental caries and periodontal disease. http://www.delftoutlook.tudelft.nl/info/indexe0ee.html?hoofdstuk=ArticleArtID=5116 * Major cariologic bacteria Mutans streptococci Lactobacillus sp Actinimyces sp (Newbrun, Cariology, Chapter 3, 1989) * Mutans streptococci Nonmotile Gram-posotive cocci in short or medium chains Windows of infectivity http://www.irishscientist.ie/2001/01images/01p2080102.jpg * Oral lactobacilli Represent about 1% of the oral flora Constitute only a minor fraction (1/10,000) of the plaque flora Are both acidogenic and aciduric http://www.irishscientist.ie/2001/01images/01p2080102.jpg * Oral Actinomyces Gram-positive Nonmotile Ferment glucose and produce lactic acid (Newbrun, Cariology, chapter3, 1989) * A. naeslundii: Gram stain (×1,000) Actinomyces: scanning electron micrograph ((×18,000) (Prescott L et al. Dental infection. In Microbiology. New York: Von Hoffmann Press, 2002) * Location of the oral flora related to caries The different organisms display some selectivity as to which tooth surface they attack * Types of dental caries in ani