婴幼儿龋危险因素初探及釉质脱矿与再矿化研究
|
摘要
婴幼儿龋是儿童最普遍的慢性疾病之一,其发生与喂养、饮食、口腔健康行为、家庭社会经济状况等多种因素有关。但各种危险因素与龋病发生率间的相关关系还存在一定争议,本文第一部分的研究目的在于通过流行病学调查探讨婴幼儿龋及重度婴幼儿龋与喂养、饮食、口腔健康行为及家庭情况等因素的相关性。釉质表面酸蚀脱矿是龋病发展的早期阶段,而市售酸性饮料造成的这一问题已日益受到重视。本文的第二部分目的在于使用激光荧光法测定市售饮料对乳牙釉质表面的酸蚀作用,并进行肉眼和扫描电镜观察。氟化物是早期龋的再矿化治疗的传统药物,但过量使用存在一定安全性问题,含高磷高钙的生物玻璃材料由于不含氟化物,使用安全被认为可用于再矿化治疗。本文第三部分目的在于使用激光荧光法评价生物玻璃材料对早期龋再矿化及抑制脱矿的作用。
第一部分南京城区婴幼儿龋及重度婴幼儿龋流行情况及危险因素调查
摘要:【目的】调查南京主城区婴幼儿龋和重度婴幼儿龋的流行情况及危险因素。【方法】使用平面口镜和5号探针对356名3-5岁儿童进行口腔健康检查并对其家长进行问卷调查,记录有关喂养、饮食等方面的信息。数据先行单因素分析,后通过建立多元Logistic回归模型进行筛选。【结果】婴幼儿龋患病率为61.50%,39.6%的儿童诊断为重度婴幼儿龋,婴幼儿龋筛选出的危险因素为:儿童平时的看护人、断奶时间、开始刷牙的年龄、添加辅食年龄、年龄、含奶瓶睡觉及裹饭习惯。重度婴幼儿龋危险因素为:断奶时间、开始刷牙的年龄、儿童平时的看护人、年龄、含奶瓶睡觉及裹饭习惯。【结论】南京地区3-5岁儿童婴幼儿龋及重度婴幼儿龋的患病率较高,相关影响因素复杂,需加强和开展各项早期预防工作。
第二部分市售酸性饮料对于乳牙釉质酸蚀脱矿作用初探
摘要:【目的】使用激光荧光法测定市售饮料对乳牙釉质表面的酸蚀作用,并使用扫描电镜进行观察。【方法】48颗离体乳前牙随机分为4组,分别浸泡于可乐、鲜橙汁、优酸乳和去离子水中25小时,每5小时换液。通过扫描电镜进行釉质表面形态学观察,并使用激光龋齿探测仪进行定量分析。【结果】可乐组和橙汁组样本酸蚀脱矿明显,实验前后激光荧光值差异有统计学意义,可乐酸蚀脱矿能力显著高于橙汁。优酸乳组脱矿不明显,电镜下可见散在钙化物沉积。【结论】市售酸性饮料可造成乳牙釉质酸蚀脱矿,应当控制儿童此类饮料的饮用量或改变饮用方法。
第三部分生物玻璃材料再矿化和抑制脱矿作用研究
摘要:【目的】使用激光荧光法评价奥威尔牙齿脱敏剂对乳牙釉质再矿化及抑制脱矿的作用。【方法】对60颗离体牙随机分为六组,三组进行再矿化实验,使用可乐酸蚀25小时后其中两组分别使用奥威尔凝胶和含氟牙膏处理14次以模拟一周再矿化治疗(2分钟×2次/天×7天),剩余一组置于去离子水中;另外三组进行抑制脱矿实验,先使用奥威尔凝胶、含氟牙膏和去离子水分别处理,再用可乐酸蚀25小时,以激光龋齿探测仪记录各时点的荧光读数。采用t检验和ANOVA方差分析进行统计分析。【结果】奥威尔组和含氟牙膏组再矿化前后荧光读数有显著差别,奥威尔组的读数显著低于含氟牙膏组。与空白对照组相比,奥威尔组和含氟牙膏组酸蚀后的读数均显著较低,且两组之间有统计学差别。【结论】奥威尔凝胶具有再矿化和抑制脱矿作用,其再矿化作用和抑制脱矿作用优于含氟牙膏。
Early Childhood Caries is one of the most common chronic diseases. It is associated with multiple factors such as feeding, dietary, socio-economic status, oral hygiene behavior and so on. But there is some argument among these risk factors. The aim of the Part One of the study is to investigate the prevalence and risk factors of Early Childhood Caries (ECC) and Severe-ECC (SECC) in the city of Nanjing. Dental erosion is closely associated with caries. Beverage can cause erosion and demineralization of the enamel. The Part Two of the study is to evaluate the morphological alteration and erosive effect on deciduous enamel by several kinds of beverages in Nanjing. Fluoride is used in remineralization therapy of enamel erosion and early caries. But its security is controversial. Bioglass which contain Ca2+ is now use as alternatives of fluoride. The Part Three of the study is to evaluate the effect of Oravive on remineralization and anti-demineralization with a laser fluorescence system.
Part One The prevalence and risk factors of ECC and SECC among 3-5-year-olds in Nanjing
Abstract:【Objective】The aim of the study is to investigate the prevalence and risk factors of Early Childhood Caries (ECC) and Severe-ECC(SECC) in the city of Nanjing.【Methods】A total of 356 children were examined using a dental mirror and explorer. A parent or caregiver was asked to complete a questionnaire regarding information about their child. According to the definition of ECC and SECC, the samples were divided into group SECC and group Non-SECC or group ECC and CF. For statistical analysis, The chi-square test, Fisher’s exact test and multivariable logistic regression were used.【Results】The total prevalence of ECC was 69.15% and the prevalence of SECC was 39.6%.In the Logistic regression model, the factors associated were age, children’s caregiver, weaning age, feeding at night, prolonging food in the mouth and age beginning to brush teeth and exclusive feeding time. The factors associated with SECC were: age, children’s caregiver, weaning age, feeding at night, prolonging food in the mouth and age beginning to brush teeth.【Conclusion】There is a high prevalence of ECC and SECC in Nanjing. It is necessary to promote early preventive measures.
Part Two Dental erosion of beverages on deciduous enamel
Abstract:【Objective】The aim of the study is to evaluate the morphological alteration and erosive effect on deciduous enamel by several kinds of beverages in Nanjing.【Methods】48 deciduous teeth were randomly divided into four groups, and were soaked in cola drinks, orange juice, yoghurt and deionized water respectively. A laser fluorescence system and scanning electron microscope were used to make a morphological and quantitative record.【Results】There was significant difference in laser fluorescence value in cola drinks and orange juice groups. Erosive capacity ranked from high to low was: cola drinks, orange juice and yoghurt.【Conclusion】Beverages can cause dental erosion of deciduous teeth. It is suggested that beverages consumption by children should be controlled.
Part Three Effect of Oravive Remineralization and anti-demineralization Evaluated In Vitro
Abstract:【Objective】The aim of the study is to evaluate the effect of Oravive on remineralization and anti-demineralization with a laser fluorescence system.【Methods】60 primary teeth were randomly divided into six groups. Three groups were erosion by colar for 25 hours than treated with Oravive, fluoride dentifrice and distilled water. The other three groups were treated with Oravive, fluoride dentifrice and distilled water than erosion 25 hours. A laser fluorescence system was used to make a quantitative record.【Results】Oravive showed a statistically significant effect on remineralization and anti-demineralization. There was significant difference between Oravive and fluoride dentifrice on remineralization and anti-demineralization.【Conclusion】Oravive have remineralization and anti-demineralization effects. Oravive is superior to fluoride dentifrice on remineralization but equivalent to it on anti-demineralization.
第一部分南京城区婴幼儿龋及重度婴幼儿龋流行情况及危险因素调查
摘要:【目的】调查南京主城区婴幼儿龋和重度婴幼儿龋的流行情况及危险因素。【方法】使用平面口镜和5号探针对356名3-5岁儿童进行口腔健康检查并对其家长进行问卷调查,记录有关喂养、饮食等方面的信息。数据先行单因素分析,后通过建立多元Logistic回归模型进行筛选。【结果】婴幼儿龋患病率为61.50%,39.6%的儿童诊断为重度婴幼儿龋,婴幼儿龋筛选出的危险因素为:儿童平时的看护人、断奶时间、开始刷牙的年龄、添加辅食年龄、年龄、含奶瓶睡觉及裹饭习惯。重度婴幼儿龋危险因素为:断奶时间、开始刷牙的年龄、儿童平时的看护人、年龄、含奶瓶睡觉及裹饭习惯。【结论】南京地区3-5岁儿童婴幼儿龋及重度婴幼儿龋的患病率较高,相关影响因素复杂,需加强和开展各项早期预防工作。
第二部分市售酸性饮料对于乳牙釉质酸蚀脱矿作用初探
摘要:【目的】使用激光荧光法测定市售饮料对乳牙釉质表面的酸蚀作用,并使用扫描电镜进行观察。【方法】48颗离体乳前牙随机分为4组,分别浸泡于可乐、鲜橙汁、优酸乳和去离子水中25小时,每5小时换液。通过扫描电镜进行釉质表面形态学观察,并使用激光龋齿探测仪进行定量分析。【结果】可乐组和橙汁组样本酸蚀脱矿明显,实验前后激光荧光值差异有统计学意义,可乐酸蚀脱矿能力显著高于橙汁。优酸乳组脱矿不明显,电镜下可见散在钙化物沉积。【结论】市售酸性饮料可造成乳牙釉质酸蚀脱矿,应当控制儿童此类饮料的饮用量或改变饮用方法。
第三部分生物玻璃材料再矿化和抑制脱矿作用研究
摘要:【目的】使用激光荧光法评价奥威尔牙齿脱敏剂对乳牙釉质再矿化及抑制脱矿的作用。【方法】对60颗离体牙随机分为六组,三组进行再矿化实验,使用可乐酸蚀25小时后其中两组分别使用奥威尔凝胶和含氟牙膏处理14次以模拟一周再矿化治疗(2分钟×2次/天×7天),剩余一组置于去离子水中;另外三组进行抑制脱矿实验,先使用奥威尔凝胶、含氟牙膏和去离子水分别处理,再用可乐酸蚀25小时,以激光龋齿探测仪记录各时点的荧光读数。采用t检验和ANOVA方差分析进行统计分析。【结果】奥威尔组和含氟牙膏组再矿化前后荧光读数有显著差别,奥威尔组的读数显著低于含氟牙膏组。与空白对照组相比,奥威尔组和含氟牙膏组酸蚀后的读数均显著较低,且两组之间有统计学差别。【结论】奥威尔凝胶具有再矿化和抑制脱矿作用,其再矿化作用和抑制脱矿作用优于含氟牙膏。
Early Childhood Caries is one of the most common chronic diseases. It is associated with multiple factors such as feeding, dietary, socio-economic status, oral hygiene behavior and so on. But there is some argument among these risk factors. The aim of the Part One of the study is to investigate the prevalence and risk factors of Early Childhood Caries (ECC) and Severe-ECC (SECC) in the city of Nanjing. Dental erosion is closely associated with caries. Beverage can cause erosion and demineralization of the enamel. The Part Two of the study is to evaluate the morphological alteration and erosive effect on deciduous enamel by several kinds of beverages in Nanjing. Fluoride is used in remineralization therapy of enamel erosion and early caries. But its security is controversial. Bioglass which contain Ca2+ is now use as alternatives of fluoride. The Part Three of the study is to evaluate the effect of Oravive on remineralization and anti-demineralization with a laser fluorescence system.
Part One The prevalence and risk factors of ECC and SECC among 3-5-year-olds in Nanjing
Abstract:【Objective】The aim of the study is to investigate the prevalence and risk factors of Early Childhood Caries (ECC) and Severe-ECC(SECC) in the city of Nanjing.【Methods】A total of 356 children were examined using a dental mirror and explorer. A parent or caregiver was asked to complete a questionnaire regarding information about their child. According to the definition of ECC and SECC, the samples were divided into group SECC and group Non-SECC or group ECC and CF. For statistical analysis, The chi-square test, Fisher’s exact test and multivariable logistic regression were used.【Results】The total prevalence of ECC was 69.15% and the prevalence of SECC was 39.6%.In the Logistic regression model, the factors associated were age, children’s caregiver, weaning age, feeding at night, prolonging food in the mouth and age beginning to brush teeth and exclusive feeding time. The factors associated with SECC were: age, children’s caregiver, weaning age, feeding at night, prolonging food in the mouth and age beginning to brush teeth.【Conclusion】There is a high prevalence of ECC and SECC in Nanjing. It is necessary to promote early preventive measures.
Part Two Dental erosion of beverages on deciduous enamel
Abstract:【Objective】The aim of the study is to evaluate the morphological alteration and erosive effect on deciduous enamel by several kinds of beverages in Nanjing.【Methods】48 deciduous teeth were randomly divided into four groups, and were soaked in cola drinks, orange juice, yoghurt and deionized water respectively. A laser fluorescence system and scanning electron microscope were used to make a morphological and quantitative record.【Results】There was significant difference in laser fluorescence value in cola drinks and orange juice groups. Erosive capacity ranked from high to low was: cola drinks, orange juice and yoghurt.【Conclusion】Beverages can cause dental erosion of deciduous teeth. It is suggested that beverages consumption by children should be controlled.
Part Three Effect of Oravive Remineralization and anti-demineralization Evaluated In Vitro
Abstract:【Objective】The aim of the study is to evaluate the effect of Oravive on remineralization and anti-demineralization with a laser fluorescence system.【Methods】60 primary teeth were randomly divided into six groups. Three groups were erosion by colar for 25 hours than treated with Oravive, fluoride dentifrice and distilled water. The other three groups were treated with Oravive, fluoride dentifrice and distilled water than erosion 25 hours. A laser fluorescence system was used to make a quantitative record.【Results】Oravive showed a statistically significant effect on remineralization and anti-demineralization. There was significant difference between Oravive and fluoride dentifrice on remineralization and anti-demineralization.【Conclusion】Oravive have remineralization and anti-demineralization effects. Oravive is superior to fluoride dentifrice on remineralization but equivalent to it on anti-demineralization.
引文
[1] Iida H, Auinger P, Billings RJ, Weitzman M. Association between infant breastfeeding and early childhood caries in the United States. Pediatrics. 2007 Oct; 120(4):e944-52
[2]Fass E. Is bottle-feeding of milk a factor in dental caries? J Dent Child 1962;29:245-251
[3] Lazarchik DA, Frazier KB. Dental erosion and acid reflux disease: an overview [J]. Gen Dent. 2009 Mar-Apr; 57(2):151-6
[4]陈亚刚,李雪,胡德渝,等.徐州市5岁和12岁儿童酸蚀症调查研究[J]华西口腔医学杂志. 2009,27(5):565-567
[5]楚金普,周学东.牙齿硬组织脱矿与再矿化的研究方法[J]国外医学口腔医学分册2006,1(33):3-5
[6] Huys mans MC, Longbottom C. J Dent Res, 2004, 83 (Spec Iss C): C48-C52
[7]White DJ. J Clin Dent, 1991, 3(1):6-14
[8]Zero DT, Rahbek I, Fu J, et al. Caries Res, 1990, 24(3):181-188
[9]黄彦,朱洪水,何予敏.不同浓度氟化泡沫对牙釉质再矿化影响的对比研究.[J]江西医药,2007,42(3):189-191
[10]岳松龄.现代龋病学[M].北京:联合出版社,1993;198-212
[11] Moi GP, Tenuta LM, Cury JA. Anticaries potential of a fluoride mouthrinse evaluated in vitro by validated protocols. Braz Dent J. 2008;19(2):91-6.
[12] Reynolds EC. Calcium phosphate-based remineralization systems: scientific evidence? Aust Dent J. 2008 Sep;53(3):268-73.
[13]沈家平,王林,陈宁等.江苏省5~74岁自然人群龋病的现况调查[J]南京医科大学学报,2006,26(12):1283-1287
[14] Beltrán-Aguilar, ED; Barker, LK; Canto, MT; et al. Surveillance for dental caries, dental sealants, retention edentulism, and enamel fluorosis–United States, 1988–1994 and 1999–2002. MMWR. 2005;54(3):1–44.
[15]Oral health surveys: basis methods[J]. 3rd edition. Geneva: World Health Organization, 1987
[16]王俭,郑树国,王晓灵.婴幼儿龋与喂养方式及饮食习惯的相关性研究[J]武警医学院学报,2006:15(5):453-456
[17] Valaitis R, Hesch R, Passarelli C, et al. A systematic review of the relationship between breastfeeding and early childhood caries. Can J Public Health.2000;91(6):411-417
[18] van Palenstein Helderman WH, Soe W, van’t Hof MA. Risk factors of early childhood caries in a Southeast Asian population. J Dent Res. 2006 Jan;85(1):85-88
[19] Hallett KB, O’Rourke PK. Pattern and severity of early childhood caries. Community Dent Oral Epidemiol. 2006 Feb;34(1):25-35
[20] Droz D, Guéguen R, Bruncher P, Gerhard JL, Roland E. Epidemiological study of oral dental health of 4-year-old children in french nursery schools. Arch Pediatr. 2006 Sep;13(9):1222-9. Epub 2006 Jul 24
[21]Thitasomakul S, Thearmontree A, Piwat S, et al. Longitudinal study of early childhood caries in 9-to-18-month-old Thai infants. Community Dent Oral Epidemiol. 2006;34(6):429-36
[22]郑树国,邓辉,高学军,等.低出生体重儿和早产儿乳牙釉质发育缺陷与龋齿易感性的研究[J]中华口腔医学,1998;33(5):270-272
[23]Ersin NK, Eronat N, Coqulu D, et al. Association of maternal-child characteristics as a factor in early childhood caries and salivary bacterial counts. J Dent Child(Chic). 2006;73(2):105-11
[24] Tiberia MJ, Milnes AR, Feigal RJ, et al. Risk factors for early childhood caries in Canadian preschool children seeking care. Pediatr Dent. 2007 May-Jun;29(3):201-8
[25]吕雪芹,朱玲,闫智奇,等.小学生唾液隐血试验与口腔健康相关因素调查[J]口腔医学,2008;28(5)
[26] Murrell S, Marshall TA, Moynihan PJ, Qian F, Wefel JS. Comparison of in vitro erosion potentials between beverages available in the United Kingdom and the United States[J]J Dent. 2009 Dec 3.
[27] Jandt KD. Probing the future in functional soft drinks on the nanometre scale -towards tooth friendly soft drinks.Trends in food science&technology,2006,17(5):263—271.
[28]吕学超,刘英群,李春梅,等.铁、氟联合抑制3种碳酸饮料对牙釉质粉末溶解作用的实验研究.[J]口腔医学研究,2009,25(2):146-148
[29] Devlin H, Bassiouny MA, Boston D. Hardness of enamel exposed to Coca-Cola and artificial saliva. J Oral Rehabil. 2006 Jan;33(1):26-30.
[30] Davis RE, Marshall TA, Qian F, Warren JJ, Wefel JS. Calcium-Fortified 100 Percent Juices Afforded by Commercially Available, In Vitro Protection Against Dental Erosion. J Am Dent Assoc. 2007 Dec;138(12):1593-8; quiz 1615.
[31]周学东,刘兴容.饮料导致牙釉质脱矿作用的实验研究.[J]华西口腔医学杂志-2001.19(4).-207-209
[32]何美英,朱玲. DIAGNOdent在龋病诊断中的应用[J]临床口腔医学杂志,2006,22(11):691-692
[33] Droz D, Guéguen R, Bruncher P, Gerhard JL, Roland E. Epidemiological study of oral dental health of 4-year-old children in french nursery schools. Arch Pediatr. 2006 Sep;13(9):1222-9. Epub 2006 Jul 24
[34] Du Min Q, Bian Z, Jiang H, et al. Clinical evaluation of a dentifrice containing calcium sodium phosphosilicate (novamin) for the treatment of dentinhypersensitivity.Am J Dent. 2008 Aug; 21(4):210-4.
[35] Ellwood R, Fejerskov O, Cury JA, et al. Fluoride in caries control. In: Dental caries: The disease and its clinical management. Fejerskov O, Kidd E (Editors). 2nd. ed. Oxford: Blackwell & Munksgaard; 2008. p. 287-323.
[36] ten Cate JM. Review on fluoride, with special emphasis on calcium fluoride mechanisms in caries prevention. Eur J Oral Sci 1997 Oct; (5 Pt 2);105: 461-465.
[37] Raven SJ, Schafer F, Duckworth RM, et al. Comparison between evaluation methods for the anti-caries efficacy of monofluorophosphate-containing dentifrices.Caries Res 1991;25(2): 130-137.
[38] Mascarenhas AK. Risk factors for dental fluorosis: a review of the recent literature. Pediatr Dent 2000 Jul-Aug; 22: 269-277.
[39] Burwell AK, Litkowski LJ, Greenspan DC. Calcium sodium phosphosilicate (NovaMin): remineralization potential. Adv Dent Res. 2009;21(1):35-9. Epub 2009 Jul 31.
[40]Rehder Neto FC, Maeda FA, Turssi CP, Serra MC. Potential agents to control enamel caries-like lesions. J Dent. 2009 Oct;37(10):786-90. Epub 2009 Jun 18.
[41] Queiroz CS, Hara AT, Paes Leme AF, et al. pH-cycling models to evaluate the effect of low fluoride dentifrice on enamel de- and remineralization. Braz Dent J. 2008; 19(1):21-7.
[42] White DJ. The comparative sensitivity of intra-oral, in vitro, and animal models in the‘profile’evaluation of topical fluorides.J Dent Res 1992 Apr;71 Spec No:884-94
[1]Fass E. Is bottle-feeding of milk a factor in dental caries? J Dent Child 1962;29:245-251
[2] Cunnion DT, Spiro A 3rd, Jones JA, et al. Pediatric oral health-related quality of life improvement after treatment of early childhood caries: a prospective multisite study. J Dent Child (Chic). 2010;77(1):4-11.
[3] Iida H, Auinger P, Billings RJ, Weitzman M. Association between infant breastfeeding and early childhood caries in the United States. Pediatrics. 2007 Oct; 120(4):e944-52
[4] Hallett KB, O’Rourke PK. Pattern and severity of early childhood caries. Community Dent Oral Epidemiol. 2006 Feb;34(1):25-35
[5]张晓芳,刘淑杰.婴幼儿龋危险因素的研究近况[J].牙体牙髓牙周病学杂志,2003,13(9):526-529
[6]Gartner LM, Morton J, Lawrence RA, et al. Breastfeeding and the use of human milk. Pediatrics.2005;115:496-506
[7] Valaitis R, Hesch R, Passarelli C, et al. A systematic review of the relationship between breastfeeding and early childhood caries. Can J Public Health.2000;91(6):411-417
[8] van Palenstein Helderman WH, Soe W, van’t Hof MA. Risk factors of early childhood caries in a Southeast Asian population. J Dent Res. 2006 Jan;85(1):85-88
[9] Bowen WH, Lawrence RA. Comparison of the cariogenicity of cola, honey, cow milk, human milk, sucrose. Pediatrics. 2005 Oct;116(4):921-6.
[10]Al Malik MI, Holt RD, Bedi. Prevalence and patterns of caries, rampant caries and oral health in two-to five-year-old children in Saudi Arabia. J Dent Child 2003;70:235-242
[11]Parisotto TM, Steiner-Oliveira C, Duque C, et al. Relationship among microbiological composition and presence of dental plaque, sugar exposure, social factors and different stages of early childhood caries. Arch Oral Biol. 2010 Apr 8.
[12]AAPD (American Academy of Pediatric Dentistry). Policy on Early Childhood Caries (ECC): Classifications, consequences, and preventive strategies. 2008 [Accessed Dec 17, 2008]. Available at:
[13] Droz D, Guéguen R, Bruncher P, Gerhard JL, Roland E. Epidemiological study of oral dental health of 4-year-old children in french nursery schools. Arch Pediatr. 2006 Sep;13(9):1222-9. Epub 2006 Jul 24
[14]王俭,郑树国,王晓灵.婴幼儿龋与喂养方式及饮食习惯的相关性研究[J]武警医学院学报,2006:15(5):453-456
[15]Hashim R, Williams SM, Murray Thomson W. Diet and caries experience among preschool children in Ajman, United Arab Emirates. Eur J Oral Sci. 2009 Dec;117(6):734-40.
[16]Neumark-Sztainer D, Wall M, Perry C, Story M. Correlates of fruit and vegetable intake among adolescents. Findings from Project EAT. Prev Med 2003;37:198–208.
[17]Champagne CM, Bogle ML, McGee BB, Yadrick K, Allen HR, Kramer TR, et al. Dietary intake in the lower Mississippi delta region: results from the Foods of our Delta Study. J Am Diet Assoc 2004;104:199–207.
[18]Dye BA, Shenkin JD, Ogden CL, Marshall TA, Levy SM, Kanellis MJ. The relationship between healthful eating practices and dental caries in children ages 2–5 years in the United States, 1988–1994. J Am Dent Assoc 2004;135:55–66.
[19] Nunn ME, Braunstein NS, Krall Kaye EA, et al. Healthy Eating Index Is a Predictor of Early Childhood Caries. J Dent Res. 2009 April ; 88(4): 361–366
[20]Ersin NK, Eronat N, Coqulu D, et al. Association of maternal-child characteristics as a factor in early childhood caries and salivary bacterial counts. J Dent Child(Chic). 2006;73(2):105-11
[21] Tiberia MJ, Milnes AR, Feigal RJ, et al. Risk factors for early childhood caries in Canadian preschool children seeking care. Pediatr Dent. 2007 May-Jun;29(3):201-8
[22]Kagihara LE, Niederhauser VP, Stark M. Assessment, management, and prevention of early childhood caries. J Am Acad Nurse Pract. 2009 Jan;21(1):1-10.
[23]Patrick DL, Lee RS, Nucci M, et al. Reducing oral health disparities: a focus on social and cultural determinants. BMC Oral Health. 2006 Jun 15;6 Suppl 1:S4.
[24]张晓芳,刘淑杰.婴幼儿龋病相关因素的初步研究.牙体牙髓牙周病学杂志,2003,13(1):24
[25]郑树国,邓辉,高学军,等.低出生体重儿和早产儿乳牙釉质发育缺陷与龋齿易感性的研究[J]中华口腔医学,1998;33(5):270-272
[26] Peretz B,KallaI.Baby bottletooth decay and complications during pregnan cy an d delivery Pediatr Dent,1997,19:34
[27] Dimitrova MM.A study of pregnant women's knowledge of children's feeding practice as a risk factor for early childhood caries. Folia Med (Plovdiv). 2009 Oct-Dec;51(4):40-5.
[28]Thitasomakul S, Thearmontree A, Piwat S, et al. Longitudinal study of early childhood caries in 9-to-18-month-old Thai infants. Community Dent Oral Epidemiol. 2006;34(6):429-36
[29]Chan S,Tsai JsI,King NM.Feeding and oral hygiene habits of preschool children in Hong Kong and their caregivers’dental knowledge and attitudes.International Journal 0f Paediatric Dentistry,2002,12.322
[2]Fass E. Is bottle-feeding of milk a factor in dental caries? J Dent Child 1962;29:245-251
[3] Lazarchik DA, Frazier KB. Dental erosion and acid reflux disease: an overview [J]. Gen Dent. 2009 Mar-Apr; 57(2):151-6
[4]陈亚刚,李雪,胡德渝,等.徐州市5岁和12岁儿童酸蚀症调查研究[J]华西口腔医学杂志. 2009,27(5):565-567
[5]楚金普,周学东.牙齿硬组织脱矿与再矿化的研究方法[J]国外医学口腔医学分册2006,1(33):3-5
[6] Huys mans MC, Longbottom C. J Dent Res, 2004, 83 (Spec Iss C): C48-C52
[7]White DJ. J Clin Dent, 1991, 3(1):6-14
[8]Zero DT, Rahbek I, Fu J, et al. Caries Res, 1990, 24(3):181-188
[9]黄彦,朱洪水,何予敏.不同浓度氟化泡沫对牙釉质再矿化影响的对比研究.[J]江西医药,2007,42(3):189-191
[10]岳松龄.现代龋病学[M].北京:联合出版社,1993;198-212
[11] Moi GP, Tenuta LM, Cury JA. Anticaries potential of a fluoride mouthrinse evaluated in vitro by validated protocols. Braz Dent J. 2008;19(2):91-6.
[12] Reynolds EC. Calcium phosphate-based remineralization systems: scientific evidence? Aust Dent J. 2008 Sep;53(3):268-73.
[13]沈家平,王林,陈宁等.江苏省5~74岁自然人群龋病的现况调查[J]南京医科大学学报,2006,26(12):1283-1287
[14] Beltrán-Aguilar, ED; Barker, LK; Canto, MT; et al. Surveillance for dental caries, dental sealants, retention edentulism, and enamel fluorosis–United States, 1988–1994 and 1999–2002. MMWR. 2005;54(3):1–44.
[15]Oral health surveys: basis methods[J]. 3rd edition. Geneva: World Health Organization, 1987
[16]王俭,郑树国,王晓灵.婴幼儿龋与喂养方式及饮食习惯的相关性研究[J]武警医学院学报,2006:15(5):453-456
[17] Valaitis R, Hesch R, Passarelli C, et al. A systematic review of the relationship between breastfeeding and early childhood caries. Can J Public Health.2000;91(6):411-417
[18] van Palenstein Helderman WH, Soe W, van’t Hof MA. Risk factors of early childhood caries in a Southeast Asian population. J Dent Res. 2006 Jan;85(1):85-88
[19] Hallett KB, O’Rourke PK. Pattern and severity of early childhood caries. Community Dent Oral Epidemiol. 2006 Feb;34(1):25-35
[20] Droz D, Guéguen R, Bruncher P, Gerhard JL, Roland E. Epidemiological study of oral dental health of 4-year-old children in french nursery schools. Arch Pediatr. 2006 Sep;13(9):1222-9. Epub 2006 Jul 24
[21]Thitasomakul S, Thearmontree A, Piwat S, et al. Longitudinal study of early childhood caries in 9-to-18-month-old Thai infants. Community Dent Oral Epidemiol. 2006;34(6):429-36
[22]郑树国,邓辉,高学军,等.低出生体重儿和早产儿乳牙釉质发育缺陷与龋齿易感性的研究[J]中华口腔医学,1998;33(5):270-272
[23]Ersin NK, Eronat N, Coqulu D, et al. Association of maternal-child characteristics as a factor in early childhood caries and salivary bacterial counts. J Dent Child(Chic). 2006;73(2):105-11
[24] Tiberia MJ, Milnes AR, Feigal RJ, et al. Risk factors for early childhood caries in Canadian preschool children seeking care. Pediatr Dent. 2007 May-Jun;29(3):201-8
[25]吕雪芹,朱玲,闫智奇,等.小学生唾液隐血试验与口腔健康相关因素调查[J]口腔医学,2008;28(5)
[26] Murrell S, Marshall TA, Moynihan PJ, Qian F, Wefel JS. Comparison of in vitro erosion potentials between beverages available in the United Kingdom and the United States[J]J Dent. 2009 Dec 3.
[27] Jandt KD. Probing the future in functional soft drinks on the nanometre scale -towards tooth friendly soft drinks.Trends in food science&technology,2006,17(5):263—271.
[28]吕学超,刘英群,李春梅,等.铁、氟联合抑制3种碳酸饮料对牙釉质粉末溶解作用的实验研究.[J]口腔医学研究,2009,25(2):146-148
[29] Devlin H, Bassiouny MA, Boston D. Hardness of enamel exposed to Coca-Cola and artificial saliva. J Oral Rehabil. 2006 Jan;33(1):26-30.
[30] Davis RE, Marshall TA, Qian F, Warren JJ, Wefel JS. Calcium-Fortified 100 Percent Juices Afforded by Commercially Available, In Vitro Protection Against Dental Erosion. J Am Dent Assoc. 2007 Dec;138(12):1593-8; quiz 1615.
[31]周学东,刘兴容.饮料导致牙釉质脱矿作用的实验研究.[J]华西口腔医学杂志-2001.19(4).-207-209
[32]何美英,朱玲. DIAGNOdent在龋病诊断中的应用[J]临床口腔医学杂志,2006,22(11):691-692
[33] Droz D, Guéguen R, Bruncher P, Gerhard JL, Roland E. Epidemiological study of oral dental health of 4-year-old children in french nursery schools. Arch Pediatr. 2006 Sep;13(9):1222-9. Epub 2006 Jul 24
[34] Du Min Q, Bian Z, Jiang H, et al. Clinical evaluation of a dentifrice containing calcium sodium phosphosilicate (novamin) for the treatment of dentinhypersensitivity.Am J Dent. 2008 Aug; 21(4):210-4.
[35] Ellwood R, Fejerskov O, Cury JA, et al. Fluoride in caries control. In: Dental caries: The disease and its clinical management. Fejerskov O, Kidd E (Editors). 2nd. ed. Oxford: Blackwell & Munksgaard; 2008. p. 287-323.
[36] ten Cate JM. Review on fluoride, with special emphasis on calcium fluoride mechanisms in caries prevention. Eur J Oral Sci 1997 Oct; (5 Pt 2);105: 461-465.
[37] Raven SJ, Schafer F, Duckworth RM, et al. Comparison between evaluation methods for the anti-caries efficacy of monofluorophosphate-containing dentifrices.Caries Res 1991;25(2): 130-137.
[38] Mascarenhas AK. Risk factors for dental fluorosis: a review of the recent literature. Pediatr Dent 2000 Jul-Aug; 22: 269-277.
[39] Burwell AK, Litkowski LJ, Greenspan DC. Calcium sodium phosphosilicate (NovaMin): remineralization potential. Adv Dent Res. 2009;21(1):35-9. Epub 2009 Jul 31.
[40]Rehder Neto FC, Maeda FA, Turssi CP, Serra MC. Potential agents to control enamel caries-like lesions. J Dent. 2009 Oct;37(10):786-90. Epub 2009 Jun 18.
[41] Queiroz CS, Hara AT, Paes Leme AF, et al. pH-cycling models to evaluate the effect of low fluoride dentifrice on enamel de- and remineralization. Braz Dent J. 2008; 19(1):21-7.
[42] White DJ. The comparative sensitivity of intra-oral, in vitro, and animal models in the‘profile’evaluation of topical fluorides.J Dent Res 1992 Apr;71 Spec No:884-94
[1]Fass E. Is bottle-feeding of milk a factor in dental caries? J Dent Child 1962;29:245-251
[2] Cunnion DT, Spiro A 3rd, Jones JA, et al. Pediatric oral health-related quality of life improvement after treatment of early childhood caries: a prospective multisite study. J Dent Child (Chic). 2010;77(1):4-11.
[3] Iida H, Auinger P, Billings RJ, Weitzman M. Association between infant breastfeeding and early childhood caries in the United States. Pediatrics. 2007 Oct; 120(4):e944-52
[4] Hallett KB, O’Rourke PK. Pattern and severity of early childhood caries. Community Dent Oral Epidemiol. 2006 Feb;34(1):25-35
[5]张晓芳,刘淑杰.婴幼儿龋危险因素的研究近况[J].牙体牙髓牙周病学杂志,2003,13(9):526-529
[6]Gartner LM, Morton J, Lawrence RA, et al. Breastfeeding and the use of human milk. Pediatrics.2005;115:496-506
[7] Valaitis R, Hesch R, Passarelli C, et al. A systematic review of the relationship between breastfeeding and early childhood caries. Can J Public Health.2000;91(6):411-417
[8] van Palenstein Helderman WH, Soe W, van’t Hof MA. Risk factors of early childhood caries in a Southeast Asian population. J Dent Res. 2006 Jan;85(1):85-88
[9] Bowen WH, Lawrence RA. Comparison of the cariogenicity of cola, honey, cow milk, human milk, sucrose. Pediatrics. 2005 Oct;116(4):921-6.
[10]Al Malik MI, Holt RD, Bedi. Prevalence and patterns of caries, rampant caries and oral health in two-to five-year-old children in Saudi Arabia. J Dent Child 2003;70:235-242
[11]Parisotto TM, Steiner-Oliveira C, Duque C, et al. Relationship among microbiological composition and presence of dental plaque, sugar exposure, social factors and different stages of early childhood caries. Arch Oral Biol. 2010 Apr 8.
[12]AAPD (American Academy of Pediatric Dentistry). Policy on Early Childhood Caries (ECC): Classifications, consequences, and preventive strategies. 2008 [Accessed Dec 17, 2008]. Available at:
[13] Droz D, Guéguen R, Bruncher P, Gerhard JL, Roland E. Epidemiological study of oral dental health of 4-year-old children in french nursery schools. Arch Pediatr. 2006 Sep;13(9):1222-9. Epub 2006 Jul 24
[14]王俭,郑树国,王晓灵.婴幼儿龋与喂养方式及饮食习惯的相关性研究[J]武警医学院学报,2006:15(5):453-456
[15]Hashim R, Williams SM, Murray Thomson W. Diet and caries experience among preschool children in Ajman, United Arab Emirates. Eur J Oral Sci. 2009 Dec;117(6):734-40.
[16]Neumark-Sztainer D, Wall M, Perry C, Story M. Correlates of fruit and vegetable intake among adolescents. Findings from Project EAT. Prev Med 2003;37:198–208.
[17]Champagne CM, Bogle ML, McGee BB, Yadrick K, Allen HR, Kramer TR, et al. Dietary intake in the lower Mississippi delta region: results from the Foods of our Delta Study. J Am Diet Assoc 2004;104:199–207.
[18]Dye BA, Shenkin JD, Ogden CL, Marshall TA, Levy SM, Kanellis MJ. The relationship between healthful eating practices and dental caries in children ages 2–5 years in the United States, 1988–1994. J Am Dent Assoc 2004;135:55–66.
[19] Nunn ME, Braunstein NS, Krall Kaye EA, et al. Healthy Eating Index Is a Predictor of Early Childhood Caries. J Dent Res. 2009 April ; 88(4): 361–366
[20]Ersin NK, Eronat N, Coqulu D, et al. Association of maternal-child characteristics as a factor in early childhood caries and salivary bacterial counts. J Dent Child(Chic). 2006;73(2):105-11
[21] Tiberia MJ, Milnes AR, Feigal RJ, et al. Risk factors for early childhood caries in Canadian preschool children seeking care. Pediatr Dent. 2007 May-Jun;29(3):201-8
[22]Kagihara LE, Niederhauser VP, Stark M. Assessment, management, and prevention of early childhood caries. J Am Acad Nurse Pract. 2009 Jan;21(1):1-10.
[23]Patrick DL, Lee RS, Nucci M, et al. Reducing oral health disparities: a focus on social and cultural determinants. BMC Oral Health. 2006 Jun 15;6 Suppl 1:S4.
[24]张晓芳,刘淑杰.婴幼儿龋病相关因素的初步研究.牙体牙髓牙周病学杂志,2003,13(1):24
[25]郑树国,邓辉,高学军,等.低出生体重儿和早产儿乳牙釉质发育缺陷与龋齿易感性的研究[J]中华口腔医学,1998;33(5):270-272
[26] Peretz B,KallaI.Baby bottletooth decay and complications during pregnan cy an d delivery Pediatr Dent,1997,19:34
[27] Dimitrova MM.A study of pregnant women's knowledge of children's feeding practice as a risk factor for early childhood caries. Folia Med (Plovdiv). 2009 Oct-Dec;51(4):40-5.
[28]Thitasomakul S, Thearmontree A, Piwat S, et al. Longitudinal study of early childhood caries in 9-to-18-month-old Thai infants. Community Dent Oral Epidemiol. 2006;34(6):429-36
[29]Chan S,Tsai JsI,King NM.Feeding and oral hygiene habits of preschool children in Hong Kong and their caregivers’dental knowledge and attitudes.International Journal 0f Paediatric Dentistry,2002,12.322