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高齲齒風險患者之風險分析、治療與照護暨病例報告

Management of a Patient with High Caries Risk-A Case Report

摘要


高齲齒率的原因不僅是以往一般所認知的口腔衛生不良,經常有大家忽略的飲食或口水問題。本病例報告是關於高齲齒風險患者之齲齒處理(caries management),利用特製化表格做系統化風險分析後,發現主要病因是口水量較少及飲食習慣不良造成多處齲齒,故給予口腔衛生指導、飲食方式、口乾照護之建議,建議病人使用氟化物(CPP-ACP+fluoride gel),完成初步風險評估及急性處理後再以caries control filling方式做初步疾病控制,可降低口腔內細菌的數量,並促進去礦化之區域再礦化。之後根據各牙齒蛀牙情況,小型窩洞選用直接複合樹脂充填,大型窩洞則用嵌體充填復形。完成窩洞治療後,請病人每三個月回診,並持續使用額外的氟化物加強保護,以防止齲齒再發。

並列摘要


Apart from oral hygiene, oral health care professionals often overlook other important cariogenic factors such as improper diet habits and insufficient saliva for patient with high caries risk. In this article, the authors utilize a chairside caries risk assessment worksheet to systematically identify the individual risk factors and make recommendations for the patient. After that, Caries control filling is done to eliminate the bacterial infection as quickly as possible and to promote the remineralization process. Following the assessment of restorability and prognosis for each individual tooth, proper restorations are placed. A 3-months recall and additional fluoride regimen are recommended to prevent the recurrence of caries.

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