- 學位論文
牙齒刷牙後在琺瑯質上的變化-體外研究
Changes of enamel after brushing tooth-in vitro study
摘要
酸性飲食是造成牙齒酸蝕原因之一，在飲用酸性飲料當下，牙齒蝕刻現象立即發生。有關牙齒酸蝕現象的研究很多，但對於酸性飲食後，如何降低牙齒損害的建議與研究卻很少。 本研究目的是藉由體外實驗探討牙齒被酸性物質酸蝕後，先使用易於取得之溶液搖晃沖洗（即模擬漱口行為）後再行刷牙，是否比立即刷牙的行為更能降低磨耗度，以作為未來飲用酸性物質後之建議。本實驗收集尚未蛀牙或破損的牙齒共40個樣本並分為4個組別，每組各有10個樣本，分別為不漱口組、自來水組、綠茶組與含氟漱口水組。 首先本研究使用維克氏硬度機(vickers hardness test)及原子力顯微鏡 (atomic force microscope, AFM)測量樣本前測之硬度 (Hv)、刻痕深度 (nm)以及平均表面粗糙度 (nm)。隨後再經過酸蝕 (浸泡可口可樂3分鐘)後立即進行不同清潔方式進行漱口1分鐘並量測後測。 根據實驗的結果，在刷牙後牙齒本身的刻痕深度變化(流失量)達到統計學上顯著的差異(p<0.001)。且含氟漱口水組可以有效降低牙本質被酸蝕溶液侵蝕而流失的量。而在表面平均粗糙度變化量在經過酸液侵蝕後，亦具有顯著的差異(p<0.001)，同時，含氟漱口水組的平均粗糙度上升幅度最小，且與不漱口、自來水與綠茶組存在統計上的差異(p<0.001, p<0.001, p=0.004)。而硬度變化量在經過酸液侵蝕後，也具有顯著的差異(p=0.002)，其中以綠茶組呈現最大的硬度變化量，而事後檢定結果顯示不漱口與綠茶組之間具有顯著差異(p=0.005)。 任何酸性物質皆可能造成牙齒的磨耗，但若在飲用酸性飲料後能給予漱口水再進行潔牙行為，將能減少食用酸性物質後，刷牙對牙齒造成的磨耗及傷害，冀期延續牙齒的健康。
並列摘要
One of the reasons causing acid corrosion of tooth is acidic beverages. The tooth corroded immediately when drinking acidic beverages and it is irreversible even brush tooth in time. There are many studied about tooth erosion, but there are few pieces researches provided the suggestion to reduce tooth damage. The purpose of this in-vitro study is to investigate if washing tooth by an available solution which simulated gargle behavior and then brushing tooth after tooth corroded can reduce the wear of tooth more effective than brushing tooth right away or not. The results could be a suggestion to avoid tooth erosion after drinking acidic beverages in the future. We collected the tooth samples which were no tooth decay or breakage, then separate into 4 groups and 10 samples for each group. The control group was brushing the tooth immediately after utilizing acidic beverages. The experiment groups were washing the tooth by different solution after utilizing acidic beverages, running water, green tea and mouthwash, respectively. We used Vickers hardness test and atomic force microscope to measure hardness (Hv), depth of indentation (nm) and surface roughness (nm) of all the untreated tooth. Soaked in coke which simulated acidic beverages 3 minutes, then put into different solution and shook 1 minute, but no washing tooth group are dried out directly by nitrogen. According to the results, the changes of the tooth were tested by different mouthwash method. After using utilizing acidic beverages and brushing tooth, the depth of nick was significant to become shallower (p<0.001). In which fluoride mouthwash group can effectively reduce the loss of dentin by etching solution erosion (p<0.001), and there was also a significant difference (p<0.001) in the surface roughness change after acid erosion. In which, the fluoride mouthwash group showed the smallest roughness increase, and exist a statistically significant difference between non-mouthwash, running water and the green tea group (p<0.001, p <0.001, p=0.004). The difference of hardness was significantly decreased after using utilizing acidic beverages and brushing tooth (p=0.002). In which, the green tea group showed the maximum hardness change, and the results showed that there was a significant difference between the non-mouthwash and the green tea group (p=0.005). According to the previous studies, the dietary acid intake is the most important risk factor in tooth wear. However, using the mouth-rinse and then brushing teeth after acid drinking intake that can reduce the tooth wear by brushing teeth and acid subsequent drinking. The purpose is to keep and extend the tooth healthy.