从单一口腔疾病转向患者整体:个体化预防的理念。

Advances in Preventive Medicine Pub Date : 2020-05-20 eCollection Date: 2020-01-01 DOI:10.1155/2020/6752342
Gerhard Schmalz, Dirk Ziebolz
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引用次数: 15

摘要

口腔疾病非常普遍,是全球负担。因此,预防它们似乎是必不可少的。最近,已经制定了不同的策略,主要集中在单一口腔疾病或状况的存在。这篇文章的目的是构建个性化的牙科预防保健的当代概念,其中的重点是从观察孤立的口腔健康切换到观察病人作为一个整体。个体化预防措施的基础是以病例为导向的概况,包括综合以风险和需求为导向的参数。风险概况包括系统性疾病、药物和生活方式领域内的不同风险因素,这些因素固有地构成潜在的并发症风险(例如,感染性心内膜炎)和/或口腔疾病(例如,牙周炎)。需求概况包括来自口腔疾病、牙科修复/矫治以及具有潜在发病风险的牙科结果(例如,龋齿的重新发展)和/或口腔疾病的潜在进展(例如,现有的龋齿病变)等方面的因素。在这些参数的基础上,预防措施的总体框架和内容以及维持时间间隔应根据患者的具体情况进行调整。这一概念的含义可能会增加安全性,有效性和效率的预防在牙科保健。另一个重点领域是初级预防,即侧重于保持口腔健康,而不是与疾病有关的方法。然而,需要临床验证来证明所提出的模型的益处。个体化预防促进了从以疾病为中心的模式向以患者为中心的模式的转变,并为建立牙科预防保健的当代概念提供了一种潜在的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Changing the Focus to the Whole Patient instead of One Oral Disease: The Concept of Individualized Prevention.

Changing the Focus to the Whole Patient instead of One Oral Disease: The Concept of Individualized Prevention.

Changing the Focus to the Whole Patient instead of One Oral Disease: The Concept of Individualized Prevention.

Changing the Focus to the Whole Patient instead of One Oral Disease: The Concept of Individualized Prevention.

Oral diseases are highly prevalent and a global burden. Accordingly, their prevention appears essential. Recently, different strategies have been developed, mainly focusing on the presence of singular oral diseases or conditions. This article aims to construct a contemporary concept of individualized preventive care in dentistry whereby the focus is switched from viewing oral health in isolation to viewing the patient as a whole. The basis for individualized prevention measures is the case-oriented profile, including the synthesis of risk- and need-oriented parameters. The risk profile comprises different risk factors within the fields of systemic diseases, medications, and lifestyle that inherently pose a potential risk of complications (e.g., infectious endocarditis) and/or oral diseases (e.g., periodontitis). The needs profile includes factors originating from the aspects of oral diseases, dental restorations/appliances, and dental results with a potential risk of pathogenesis (e.g., the de novo development of caries) and/or the potential progression of oral diseases (e.g., an existing caries lesion). Based on these parameters, the general framework and content of prevention measures, as well as the maintenance interval, should be adapted to the individual patient. The implications of this concept might increase the safety, effectiveness, and efficiency of prevention in dental care. A further area of focus is primary prevention, that is, a focus on the preservation of oral health instead of a disease-related approach. However, clinical validation is needed to prove the benefits of the model presented. Individualized prevention promotes a shift from a disease-focused model to a whole-patient-focused model and provides a potential approach for establishing a contemporary concept for preventive care in dentistry.

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