A basic study on arrangement of the oral health care program for nursing/care

本研究目的在建立一个口腔护理计画安排的资讯。研究对象为严重身心障碍儿童（人）收容机构中的居家儿童（人），他们接受医疗、护理和功能康复护理。根据龋病严重程度，采用WHO标准评价患者的口腔健康状况。牙周状况用PMA指数评价，牙龈指数（GI）、简化口腔卫生指数（OHI-S）和菌斑指数（PlI）用于口腔卫生状况。此外，作为口腔健康状况的其他评估（口腔粘膜疾病、咬合状况、舌菌斑状况、口腔板和口腔粘膜卫生等）考察从这些评估中研究了与患者沟通的困难，并讨论了口腔健康管理的严重性。结果表明，各年龄组龋病的发展变化不大，牙周指数（PMA-I、GI）均呈上升趋势。口腔卫生状况未发生变化。PMA-I、GI、OHI-S、PlI值呈显著正相关。牙龈增生患者的PMA-I GI值高于非牙龈增生患者。但经口腔保健管理后，两组间无显著性差异。患龋率（D率/人）是评价长期残疾患者龋病严重程度的有效指标。因此，龋病患病率（D牙）是龋病评估的必要条件。牙龈和口腔卫生状况需要各种方法来建立有关口腔保健计划安排的信息。

The purpose of this study is to set up an information on arrangement of the oral health care program for nursing/care. The institutionalized and homebound child (person) in a facility for child (person) with Severe Mental and Physical Handicapped those who are getting medical, nursery and functional rehabilitative cares were investigated. The dental conditions were evaluated according to caries seriousness using WHO guideline. Periodontal conditions were evaluated using PMA Index and Gingival Index (GI), Oral Hygiene Index-Simplified (OHI-S) and Plaque Index (PlI) were used for Oral Hygiene condition. In addition as other estimates for oral health conditions (oral mucosa disease, occlusal condition, condition for tongue plaque, oral hygiene on plate and oral mucosa etc.) were investigated. The difficulty to communicate the patients was studied from these evaluations and the seriousness of oral health management was discussed. The result was as follows.The development of caries was not so changed and the periodontal value (PMA-I, GI) was getting higher in each age group. Oral Hygiene condition was not so changed. The value of PMA-I, GI, OHI-S, PlI showed significantly co-relation. The value of PMA-I GI in gingival hyperplasia patients was higher in non-gingival hyperplasia patients. However, there was no significant difference between the two groups after oral health care management. The caries prevalence (D rate per person) is effective estimate for long-term handicapped patients in evaluating caries seriousness. Therefore, the caries prevalence (D teeth) is essential for dental caries evaluation. Gingival and oral hygiene conditions need various kinds of approach to set up information on arrangement of the oral health care program.