超声波洁治器联合舌刷和舌刮治疗老年人口臭的临床疗效

The clinical effect of ultrasonic cleaner combined with tongue brush and scraping in the treatment of halitosis in elderly

目的探讨超声波洁治器联合舌刷和舌刮治疗老年人口臭的临床疗效。方法选取2019年5月至2021年5月该院口腔门诊就诊的具有口臭的老年患者160例,年龄60~75岁。采用随机数字表法分为研究组A、B、C和对照组,每组40例。对照组患者采用氯己定含漱液冲洗口腔,研究组A患者采用舌刷和舌刮刷舌进行治疗,研究组B患者采用超声波洁治器进行治疗,研究组C患者采用舌刷、舌刮和超声波洁治器进行联合治疗。采用感官法检测4组患者治疗前后口臭值,挥发性硫化物(VSCs)检测仪检测4组患者VSCs值,并分析舌苔厚度(Tt)和舌苔面积(Ta),检测牙周袋探诊深度(PD)及菌斑指数(PLI),探讨牙周病、舌苔与口臭的关系。结果4组患者治疗后口臭值、VSCs值均明显下降,差异均有统计学意义(P<0.05);研究组A患者治疗后口臭值、VSCs值与对照组比较,差异均无统计学意义(P>0.05);研究组B、C患者治疗后口臭值、VSCs值均明显低于对照组和研究组A,研究组C患者治疗后口臭值、VSCs值均明显低于研究组B,差异均有统计学意义(P<0.05)。对照组患者治疗前后Tt、Ta、PD、PLI值比较,差异均无统计学意义(P>0.05);研究组A、C患者治疗后Tt、Ta值均明显降低,差异均有统计学意义(P<0.05),但2组患者Tt、Ta值比较,差异均无统计学意义(P>0.05)。研究组B、C患者治疗后PD、PLI值均明显降低,且研究组C患者治疗后PD、PLI值均明显低于研究组B,差异均有统计学意义(P<0.05)。VSCs值与口臭值呈明显正相关(r=0.852,P<0.05),VSCs、口臭值与Ta值均呈较强正相关(r=0.487、0.394,P<0.05),与Tt值均呈较弱正相关(r=0.288、0.265,P<0.05),与PLI值均呈较强正相关(r=0.678、0.524,P<0.05),与PD值均呈较弱正相关(r=0.257、0.240,P<0.05)。结论老年人口臭值与VSCs、Ta、PLI值均呈正相关。舌苔超声波洁治器联合舌刷和舌刮治疗法可显著改善老年人口臭,降低VSCs水平,改善其Tt、Ta、PD、PLI值等。

Objective To explore the clinical effect of ultrasonic cleaner combined with tongue brush and scraping in the treatment of halitosis in elderly.Methods A total of 160 elderly patients with halitosis,aged 60 to 75,who attended to the dental clinic of this hospital from May 2019 to May 2021 were selected.All subjects were divided into experimental group A,B,C and the control group,with 40 cases in each group.The patients of control group was treated with chlorhexidine gargle.The patients of experimental group A was treated with tongue brush and scraping.The patients of experimental group B was treated with ultrasonic scaler.The patients of experimental group C was treated with tongue brush,scraping and ultrasonic scaler.The sensory method was used to detect oral rank(OR),and the volatile sulfur compounds(VSCs)detector was used to detect the VSCs value of the patient,while the tongue coating thickness(Tt)and tongue coating area(Ta)were analyzed before and after treatment.The periodontal pocket probing depth(PD)and plaque index(PLI)were detected to explore the relationship between periodontal disease,tongue coating and bad halitosis.Results After treatment,the values of OR and VSCs in the four groups decreased significantly(P<0.05).There were no significant differences in OR and VSCs between the experimental group A and the control group(P>0.05).The OR and VSCs values of experimental group B and C were significantly lower than those of the control group and the experimental group A(P<0.05).The OR and VSCs values of the experimental group C were significantly lower than those of the experimental group B(P<0.05).The values of Tt,Ta,PD and PLI in the control group had no significant change before and after treatment(P>0.05).The values of Tt and Ta in the experimental group A and the experimental group C reduced significantly than those before the treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).The values of PD and PLI in the experimental group B and C reduced significantly.The values of PD and PLI in the experimental group C after treatment were significantly lower than those of the experimental group B(P<0.05).The results of correlation analysis showed that VSCs and OR had a significant positive correlation(r=0.852,P<0.05).VSCs,OR and Ta had a strong positive correlation(r=0.487,0.394,P<0.05),a weak correlation with Tt(r=0.288,0.265,P<0.05).OR and PLI had a strong positive correlation(r=0.678,0.524,P<0.05),and a weak correlation with PD(r=0.257,0.240,P<0.05).Conclusion The value of OR in the elderly has a positive correlation with the VSCs,Ta and PLI.Ultrasonic cleaner combined with tongue brush and scraping can significantly improve the halitosis of the elderly,reduce the level of VSCs,and improve the level of Tt,Ta,PD and PLI.