【摘要】

  《中国口腔健康发展报告(2012)》由中华口腔医学会、中国口腔清洁护理用品工业协会指导编纂,民族口腔护理用品企业——重庆登康口腔护理用品股份有限公司参与其中。它是我国首次出版的口腔医学与社会学交叉的蓝皮书。

  《中国口腔健康发展报告(2012)》由总报告、综合篇、牙本质敏感流行病学调查报告、牙本质敏感的研究和防治、国内口腔护理用品状况篇、实践篇及附录组成。在编纂过程中,得到了中华口腔医学会、中国口腔清洁护理用品工业协会以及相关大学、研究所等单位及高层专家的大力支持。收到的稿件超过60余篇,考虑到本书的定位和篇幅,经编委会仔细讨论斟酌,选用了其中的20余篇。

  本书体现了以下特点:

  一是综合性,围绕牙本质敏感主题及最新进展,充分体现了中华口腔医学会、中国口腔清洁护理用品工业协会、研究机构和社会各方面关于牙本质敏感研究的最新成果和进展。

  二是实用性,充分体现了中华口腔医学会、中国口腔清洁护理用品工业协会对牙本质敏感现状、诊断、防治等问题的分析和指导。

  三是权威性,该书所有文章来自国内知名学术组织、行业协会及知名大学的口腔医学院等教学科研单位,代表了目前该领域的学术研究水平。

  四是前瞻性,该书所收文章充分反映和体现了牙本质敏感预防和治疗的国内外最新研究趋势和前景。

  这些文章对我国牙本质敏感的流行病学、诊断、预防和治疗提供了全面的资料,对口腔医学界、口腔清洁护理用品工业界相互了解、合作以解决牙本质敏感问题、维护人们口腔健康将起到明显的推动作用,对防治牙本质敏感政策和策略的修订和完善将起到明显的推进作用,对促进我国人民口腔健康、提高生活质量将起到积极、明显的作用。

【序】

  近年来随着我国人民生活水平的不断提高,口腔健康已成为民众极为关注的社会热点问题。口腔医学领域中的常见病多发病,例如发病率极高的龋病、牙周炎等,已逐渐成为民众口中常用的名词,各类媒体上也不断出现这些名词,这说明我国人民已经摆脱“牙病不算病”的落后观念,开始关注口腔健康以及口腔健康对全身健康的影响、对生活质量的影响。最近这几年一个新的名词又反复出现,那就是“牙本质敏感”。因为它也是一个发病率极高的口腔疾病,而且严重影响患者的饮食选择,使患者在餐饮过程中时时遭受痛苦。所有冷热酸甜的食物刺激都会让患者痛苦不已。因此对抗牙本质敏感,让患者不再时时遭受进食时的折磨,是口腔医学工作者及口腔护理用品企业义不容辞的责任。相关的口腔医学专家们也在为此不断进行研究,付出心血。

  三年前,在重庆登康口腔护理用品股份有限公司的积极支持下,中华口腔医学会组织牙本质敏感专家组,就牙本质敏感的一系列问题进行了系统研究。现在又与社会科学文献出版社合作,就国人口腔健康的热点问题,以“口腔健康皮书”的形式,编写相关的研究报告出版发行。我认为这对大众进一步关注口腔健康,深入了解口腔健康的重要性以及学习维护口腔健康的相关知识,是一件很有意义的事情。

  今年将出版这套蓝皮书的第一册,这是有关“中国人牙本质敏感”情况的报告。内容涵括了中华口腔医学会牙本质敏感专家组的多位专家撰写的专题研究报告,多个地区国人牙本质现状的调查报告,牙本质敏感诊断、预防、治疗的研究报告,有关口腔保健护理用品的状况分析和介绍以及近年来中华口腔医学会为解决大众牙本质敏感问题所做的一系列工作等。

  我相信这本蓝皮书无论对口腔医学工作者还是民众来说都是值得阅读的,业内同道通过阅读它将更加深入系统地了解牙本质敏感的发病、诊断、预防和治疗情况,以更好地指导自己的临床实践,同时科学地指导患者预防、治疗牙本质敏感,为患者造福。对于民众而言,通过阅读本书可了解牙本质敏感的危害,及时到口腔医生那里获得明确诊断,在日常生活中合理选择口腔保健用品,正确使用相关产品,减少这一极为普遍的口腔疾患对身体健康的影响、对生活质量的影响。这二者均具有重要意义。

  感谢中华口腔医学会牙本质敏感专家组的所有专家在百忙之中为这本书的编写出版作出的贡献!感谢民族口腔保健产品企业——重庆登康口腔护理用品有限公司和中国口腔清洁护理用品工业协会对本书的出版给予的大力支持和帮助,感谢社会科学文献出版社关注口腔健康,为本书编辑出版付出的心血!

中华口腔医学会会长 王 兴

2011年9月30日

【前言】

胡德渝

  牙本质敏感是常见的口腔疾病之一,患病率较高,国内外不同的研究表明8%~57%的成年人群患有牙本质敏感,而在患有牙周疾病的人群中,其患病率高达72.5%~98%。

  尽管一百多年前就已开始有牙本质敏感的相关文献报道,但牙本质敏感的研究一直没有得到社会和口腔医学专业足够的重视。由于长期对牙本质敏感问题的忽视,不少口腔医生对该病缺乏正确的认识,存在着误诊、漏诊和治疗效果不理想等状况。随着发达国家以及我国人群龋病患病率的下降,人们对牙周疾病和牙齿疼痛例如牙本质敏感的关注程度在不断上升。近二十年来国际上对牙本质敏感的研究和文献报道也越来越多,学者们对牙本质敏感的流行病学、发病机制机理、风险因素、诊断及治疗均做了大量研究和有益的探索,提出了很多积极有效的预防和治疗措施。2002年在维也纳举行的世界牙科大会专门邀请了世界著名专家成立了关于牙本质敏感问题的工作组,讨论了由各种情况引起的牙本质敏感的诊断、预防及治疗问题,以提高人们对牙本质敏感的认识。同年,加拿大牙科协会也专门成立了牙本质敏感顾问委员会,通过对全加拿大牙科医生及流行病学专家的广泛调查后发现,大部分口腔专业人士对牙本质敏感认识不足甚至认识错误,因此顾问委员会在总结经验及查阅文献的基础上编写了牙本质敏感指南,较系统地论述了如何对该疾病进行诊断、预防和处理。

  近年来,随着我国经济的发展、人民生活水平的提高,碳酸饮料、果汁和运动饮料已成为人们的日常消费品,被经常饮用。这导致了牙釉质被酸蚀和患牙本质敏感风险的增加。同时我国已进入老龄化社会,随着年龄的增长,老年人口牙齿硬组织的丧失也将导致牙本质敏感人群逐渐扩大。我国对牙本质敏感的研究较少且零散,大多集中在对牙本质敏感治疗效果的探索上,缺乏对我国人群牙本质敏感相关预防和治疗措施的研究,在已经发行的教科书和其他口腔医学书籍中,也缺乏对该疾病的系统叙述。为了对我国人群牙本质敏感进行系统的流行病学调查,了解和分析成年人中牙本质敏感的患病率及相关风险因素,并结合我国实际情况提出有效的诊断标准、预防和治疗措施,中华口腔医学会成立了“牙本质敏感专家组”,开展了我国城市地区成人牙本质敏感流行病学调查以及口腔医生对牙本质敏感的认知和诊治的现况调查。随后又对中小城镇人群的牙本质敏感情况进行了调查。在此基础上,制定了我国牙本质敏感的诊断和防治指南,以期了解我国人群牙本质敏感现状,提高口腔医生对牙本质敏感的认识和诊治水平。

  2008年对北京、上海、广州、武汉、成都和西安市6个城市7939名20~69岁成人的随机抽样调查表明:40.7%的受检者自述有牙齿敏感的症状,结合气枪吹气诊断并排除龋齿等其他引起疼痛的疾病,受检人群牙本质敏感的患病率为29.7%,人均牙本质敏感牙数为1.4颗。50~59岁年龄组人群牙本质敏感的患病率最高,为39.1%。2009年对北京、上海、武汉、西安、广州、重庆、沈阳以及成都等地八个中小城镇及农村的成人进行调查,发现受检人群牙本质敏感的患病率男性为30.4%,女性为39.4%,人均敏感牙齿1.5颗。50~59岁年龄组人群牙本质敏感的患病率最高,为40.6%。被诊断为牙本质敏感症者中,22.42%的受检者报告过敏感症状,而12.11%的受检者先前未报告敏感症状,经检查诊断出敏感症状,未报告敏感者占检出敏感人群的35.08%。调查结果说明牙本质敏感是一个普遍的口腔健康问题,应该引起人们足够的重视。

  本报告收入了上述两个全国牙本质敏感的调查报告,中华口腔医学会牙本质敏感专家组制定的《牙本质敏感的诊断和防治指南》,以及口腔医学领域、口腔清洁护理用品工业协会的专家、学者、企业家的相关文章。

  本书的构思、编撰、出版得到了中华口腔医学会、中国口腔清洁护理用品工业协会、社会科学文献出版社、重庆登康口腔护理用品股份有限公司等单位的大力支持,在此表示诚挚的感谢。

  我们期待本书的出版作为口腔健康蓝皮书的第一部,有一个良好的开端,在此基础上不断完善和进步,不断提高,为发展我国口腔卫生事业和促进人民的口腔健康作出贡献。

【目录】
BI   总报告

B. 1 中国人口腔健康状况········································································冯希平/001
       一  中国人口腔健康状况··········································································/003
       二  中国人口腔健康发展趋势······································································/014


BII   综合篇

B. 2 牙本质敏感概述·····························································刘  曦  荣文笙  胡德渝/023
B. 3 牙本质敏感的诊断和防治指南·······································中华口腔医学会牙本质敏感专家组/039


BIII   牙本质敏感流行病学调查报告

B. 4 我国城市地区成人牙本质敏感的流行病学调查 ············荣文笙  胡德渝  冯希平  台保军  章锦才  阮建平/046
B. 5 我国中小城镇及农村地区成人牙本质敏感流行病学调查报告·····································荣文笙/057
B. 6 成都市青年人群牙本质敏感流行病学调查研究·····················谭晨珊  胡德渝  范  旭  李  雪  阙克华/066
B. 7 上海市区成人牙本质敏感流行病学调查·································· 叶  玮  王国荣  吕  进  冯希平/073
B. 8 北京部分地区成人牙本质敏感的流行病学调查······················刘  曦  梁  妍  荣文笙  王伟健  徐  韬/080
B. 9 我国口腔医生对牙本质敏感的认知情况:问卷调查报告··································荣文笙  胡德渝/089


BIV   牙本质敏感的研究和防治

B. 10 牙龈退缩与牙本质敏感····································································章锦才/097
B. 11 酸蚀症、磨耗、磨损、牙颈部非龋性缺损等与牙本质敏感······································台保军/116
B. 12 临床控制牙本质敏感的方法··························································曾  艳 高学军/128
B. 13 口腔卫生与牙本质敏感····································································王伟健/135
B. 14 抗敏感牙膏功效成分的研究进展·······································李  刚  付莹莹  钟亦思  胡德渝/138
B. 15 抗牙本质敏感牙膏研发现状及展望····················································蒋  玮  张  环/156


BV   国内口腔护理用品状况篇

B. 16 中国口腔护理用品工业的历史与发展现状····················································相建强/164
B. 17 中国消费者的口腔护理用品消费习惯························································蒋   玮/183


BVI   实践篇

B. 18 中华口腔医学会抗牙本质敏感相关行动·····················································丁笑乙/194
B. 19 冷酸灵的抗牙本质敏感行动···········································冷酸灵抗牙本质敏感研究中心/200


BVII   附录

B. 20 我国城市地区成人牙本质敏感流行病学调查方案··················································/211
B. 21 我国中小城镇成人牙本质敏感流行病学调查方案··················································/212
【Abstract】

  Blue Book of Oral Health was edited by the Chinese Stomatological Association (CSA) and China Oral Care Industry Association (COCIA), National Oral Care Products Enterprise—Dencare (Chongqing) Oral Care Co. , Ltd jointly participate. It is the first oral health blue book published in China, cross-linking oral and social sciences.

  This book is composed of the following chapters: General report; Comprehensive report; Epidemiological report on dentin hypersensitivity; Researches, Prevention and treatment on dentin hypersensitivity; Present situation of oral health care products in China; Social activities and Appendix.

  The completion of this book would not have possible without enormous support from the Chinese Stomatological Association (CSA), China Oral Care Industry Association (COCIA), many dental schools from deferent universities, some research institutes and distinguished scientists.

  Over 60 articles have been received, which after thorough, critical and careful evaluation by the editorial board, more than 20 articles were selected to be edited and published.

  This book has the following characteristics:

  A. Comprehensiveness: The book provides a wide-ranging, in depth review of dentine hypersensitivity including scientific research results and current progress in this field from Chinese Stomatological Association, China Oral Care Industry Association, dental research institutes in China and from around the world.

  B. Practical: This book contains extensive information for the scientist and clinician on status, diagnosis, prevention, treatment, analysis and instruction on product development.

  C. Authority. The manuscripts come from famous academic associations, professional associations, dental schools and research institutes at the forefront of research in this field.

  D. Prospective. The manuscripts accepted represent the latest discoveries in the prevention and treatment of dentine hypersensitivity.

  These research articles provide a comprehensive understanding on epidemiology, diagnosis, prevention and treatment of dentine hypersensitivity. Its aim is to foster greater mutual understanding and cooperation between the academic dental field and oral hygiene product industry; leading to further development of dentine hypersensitivity preventive strategies.

  Oral health is part of general health and essential for a good quality of life. This book seeks to apply evidence-based strategies in dentine hypersensitivity with the intention of translating evidence into an action plan of oral health promotion, prevention and treatment of oral diseases, specific for the improvement of oral health related quality life and health management systems.

【Contents】
BI General Report
B.1 Oral Health Status of Chinese Population

Feng Xiping / 001

  1. Oral Health Status of Chinese Population

/ 003

  2. The Trends of Oral Health in Chinese Population

/ 014

BII Comprehensive Report
B.2 Review on Dentin Hypersensitivity

Liu Xi, Rong Wensheng and Hu Deyu / 023

B.3 Guideline on Diagnosis, Prevention and Treatment of Dentin Hypersensitivity

Expert Group on Dentinal Hypersensitivity of CSA / 039

BIII Epidemiological Report on Dentin Hypersensitivity
B.4 A National Survey on Dentin Hypersensitivity in Chinese Urban Adults

Rong Wensheng, Hu Deyu,Feng Xiping, Tai Baojun,

Zhang Jincai and Ruan Jianping / 046
B.5 A National Survey on Dentin Hypersensitivity in Chinese Adults in Rural Areas

Rong Wensheng / 057

B.6 Epidemiological Survey of Dentin Hypersensitivity of Young People in Chengdu City

Tan Chenshan, Hu Deyu, Fan Xu, Li Xue

and Que Kehua/ 066
B.7 The Epidemiological of Dentin Hypersensitivity among Adults in Shanghai Municipality

Ye Wei, Wang Guorong, Lü Jing and Feng Xiping / 073

B.8 A Epidemiological Survey of Dentin Hypersensitivity among Adults in Beijing

Liu Xi,Liang Yan, Rong Wensheng, Wang Weijian

and Xu Tao/ 080
B.9 A Questionnaire Survey on Dentin Hypersensitivity in Chinese Dentists

Rong Wensheng, Hu Deyu / 089

BIV Researches, Prevention and Treatment on Dentin Hypersensitivity
B.10 Gingival Recession and Dentin Hypersensitivity

Zhang Jincai / 097

B.11 Erosion, Attrition, Abrasion, Non-Carious Cervical Lesion and Dentin Hypersensitivity

Tai Baojun / 116

B.12 Clinical Methods on Control of Dentin Hypersensitivity

Zeng yan, Gao Xuejun / 128

B.13 Oral Health and Dentin Hypersensitivity

Wang Weijian / 135

B.14 Present Situation of Researches on Functional Components of Desensitizing Toothpaste

Li Gang, Fu Yingying, Zhong Yisi,and Hu Deyu / 138

B.15 Present Situation and Development Trends of Desentitizing Toothpaste and Related Products

Jiang Wei, Zhang Huan / 156

BV Present Situation of Oral Health Care Products in China
B.16 Development History and Present Situation of Chinese Industries on Oral Health Care Products

Xiang Jianqiang / 164

B.17 Consumption Habits of Chinese Consumers on Oral Health Care Products

Jiang Wei / 183

BVI Social Activities
B.18 Related Activities on Dentin Hypersensitivity of Chinese Stomatological Association(CAS)

Ding Xiaoyi / 194

B.19 Activities on Dentin Hypersensitivity of Lengsuanling

Research Center of Lengsuanling Anti-sensitivity / 200

BVII Appendix
B.20 Protocol of National Survey on Dentin Hypersensitivity in Chinese Urban Adults

/ 211

B.21 Protocol of National Survey on Dentin Hypersensitivity in Chinese Rural Adults

/ 212