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1、UnitSeventeenORALDISEASES:PREVENTIONISBETTERTHANCUREOraldiseasessuchascariesandperiodontaldisease(infectionsofthegumsandofthetoothsupporttissues)areamongthemostwidespreaddiseasesintheworld.Theyaffectallpopulationstovaryingdegrees.Dentalcariesintheworld:asituationofcontrastTheindexformeasuringtheexte
2、nttowhichapopulationisaffectedbycariesisthemeanDMFT,whichinagroupofindividualscountstheaveragenumberofteeththatareDecayed,Missing(onaccountofcaries)andFilled.Itisasimple,rapidanduniversallyapplicablemeasurementthathasbeenwidelyusedforseveraldecades.Wehavedrawnupascaleforseverityofinvolvementatvariou
3、skeyages:12,35-44,65andover.Atage12the5levelscalevariesfrom0.0to6.6ormore:aDMFTbetween0.0and1.1isconsideredverylow,afigureof6.6ormoreisveryhigh,whileamoderateDMFTisbetween2.7and4.4decayed.AnycountryundertakingananalysisofitsoralhealthsituationcancomparetheresultswithWHO*sworldwideobjective:bytheyear
4、2000nomorethanthreedecayed,missingandfilledteethatage12.Byrepeatingtheanalysisatregularintervals(WHOrecommendsanevaluationeveryfiveyears)itispossibletomonitorthetrendincariesprevalence,toestimatetheneedsforcareandpreventionandtoadjustpersonneltrainingandservicesaccordingly.Itshouldbepointedoutthatth
5、esimplifiedoralhealthsurveymethoddevelopedbyWHOisreliable,veryinexpensive,canbeusedanywhereandprovidescomparabledatabothintherichestcountriesandinthepoorest.WHO*sOralHealthUnitprovidestechnicalsupportfbrepidemiologicalsurveysandprocessescountrydatafreeofchargeonrequest.Theinformationcollectedisstore
6、dintheGlobalOralDataBank(GODB)systeminthecatalogueofUnitedNationsdatabanks,wherebyitispossibletofollowtheworldwidetrend.Everyyearsince1969,WHOhascompiledaworldmapofcariesatage12.In1969theoverallpictureshowedsharpcontrasts:theDMFTwasveryhigh,highoratleastmoderate(between2.7and4.4)intheindustrializedc
7、ountries,whereasitwasgenerallyverylow,lowandoccasionallymoderateinthedevelopingcountries.Overthenexttwodecadestherewasadownwardmovementandsometimesaspectacularfallintheprevalenceofcariesinvirtuallyalltheindustrializedcountries.Inthedevelopingcountriesthegeneraltrendisforcariesprevalencetoincreaseexc
8、eptwherepreventionprogrammeshavebeensetup.Everyyearsince1980theWHOOralHealthUnithascalculatedthemeanglobalDMFTatage12,weightedforpopulation.Theresultinggraphsdisplaythetrendsindentalcariesintheindustrializedcountries,inthedevelopingcountriesandformankindasawhole.Thetrendinthemeansince1980justifiesme
9、asuredoptimismforthenext10years,althoughthesituationisstilldelicateinasmuchasasmallincreaseinveryhighlypopulatedcountriesisallthatisneededtotakethemeanabove3.Whatistheexplanationfbrthespectaculardropincariesprevalenceinsomecountries?Howcanitbepreventedfromrisingagain?Howcantheworseningofthesituation
10、inothercountriesbehalted?Thereplytothesethreequestionsisoneandthesame:prevention,morepreventionandstillmoreprevention.Intheindustrializedcountriesthepromotionoforalhygiene,thewidespreaduseoffluoridetoothpaste,theintroductionoffluorideintodrinkingwaterorsaltinsomecountries,adviceonnutrition(nosweetsb
11、etweenmealsandetc.)arethefactorsbehindanunprecedentedpublichealthsuccessstory!Wherevercommunitypreventionprogrammesaresetup,cariesstopadvancing.Forexample,thishashappenedinBulgaria,FrenchPolynesiaandThailand.Apartfromthefluoridaiionofwater,sahandmilk,whichrequiresmoreadvancedtechnologyandsupervisedc
12、entraladministration,allthemethodsoforalhygienemakeuseofsimpletechniques,costlittleandareperfectlysuitedtoimplementationatprimaryhealthcarelevel.Asaresultof(heprogressmadeinthelast25years,thedevelopingcountriesnowhavetheknowledgeandmeansofpreventionthatwillenablethemtoavoidtheproblemstheindustrializ
13、edcountrieshavehadloface,andindeedstillarefacingataveryhighprice!Inmostindustrializedcountriestheoralhealthservicesstillabsorbbetween5%and11%ofthenationalhealthbudget.Thereisnoreasonatalltocontinuedevotingsubstantialresourcestotreatingaconditionthatcanbepreventedbysimple,variedandinexpensivemeasures
14、.Butthereneedstobethepoliticalwilltogiveprioritytoprevention.*Whatabouttheperiodontaldisease?Towardstheendofthe1960smostdentalepidemiologistssharedtheviewthatperiodontaldiseases,unlikecaries,weremorecommoninthedevelopingcountriesthanin(heindustrializedcountries.However,theavailabledatawereveryfragme
15、ntaryanddifficultorimpossibletocomparesincetherewerenofewerthanfivedifferentindicesincommonuse.Thisplethoraofmethodswascompoundedbythedifficultyofcollectingdatafromadults;aproblemthatislessseriousinthecaseofcaries,wherethekeyageis12years.Withthedefinitionofaperiodontalindex,whichveryquicklyachievedw
16、ideinternationalacceptance,theepidemiologyofperiodontaldiseaseshasmadegreatstrides.TheCPITN(CommunityPeriodontalIndexofTreatmentNeeds)wasproposedbyaWHOscientificgroupandrecommendedintheearly1980sbyajointworkinggroupfromWHOandtheFDI(InternationalDentalFederation).Thisindexrecordstheperiodontaldisease
17、sintermsoffourclinicalsigns:1. Bleedingfromthegum2. Presenceofcalculus3. Presenceofshallowperiodontalpockets4. PresenceofdeepperiodontalpocketsAperiodontalpocketisconsideredtobepresentwhenthegum,undertheeffectofinflammationand/orinfection,retracts,formsapocketandnolongeradherestothetooth.Theligament
18、sbecomeimpairedandthetoothbecomesincreasinglyloose.Tomeasureperiodontalstatus,themouthisdividedintosixpartsorsextants.Aspeciallydesignedprobeisusedtotestthecondition(1,2,3or4)ofthegumaroundthetoothselectedastheindextoothforeachsextant.Ifseveralclinicalsignsarepresentsimultaneously,(hemostsevereissel
19、ected.WHOhascompileddataonoverIOOsurveyscarriedoutintheagegroup35-44years.Thesedatashouldbetreatedwithcaution,sinceveryfewofthemprovideanationalestimate.Neverthelesstheyareofgreatinterestbecausetheyconsistentlyshowasimilarpatternfrequencyandseverityofinvolvement,whichchallengessomegenerallyacceptedi
20、deasaboutthedistributionandtheetiologicalprocessofperiodontaldisease.Thedatashowthatthepercentageofpeoplewhohavedeeppocketsandthemeannumberofsextantsperpersonalsodisplayingdeeppocketsarelowioverylow.Thismeansthatthesevereformsofperiodontaldisease,thoserequiringcomplicatedsurgeryarefarfromcommon.More
21、over,(hereseemstobenodifferenceinfrequencybetweenindustrializedcountriesanddevelopingcountriesforthesevereformsofperiodontaldisease.Ontheotherhand,theinitialforms(bleedingandcalculus)aremuchmoreprevalentinthedevelopingcountries.Inthelightofthesedataitmaybestatedthatgeneralizedperiodontaldestructioni
22、srarein40-year-oldadults.Somepeopleshowsomesignsofsuchdestruction,butonlyalimitedpartoftheirdentitionisaffected.Itseemsthattheinitialforms(bleedingandcalculus)donotnecessarilyleadon(olheadvancedstagesofthedisease,exceptincertainminoritygroups.Howcanthesediseasesbeprevented?Afterafewdaysofcarefulclea
23、ningoftheteeth,thebleedingstopsinthevastmajorityofcasesandtheinflammation,thecauseofmuchdiscomfort,alsoregresses.Therearevariouspossiblepreventionpolicies:hygienef8rthemostcommonandleastseriousforms;developmentofproductsthatactagainstthedestructivetypesofperiodontitis.Awholefieldofresearchloprotect(
24、heriskgroupsisopeningup.1. gum.gingivacalculus,tartar2. FooddebrisDentalplaque3. index,indicesmeanDMFT4. D-DecayedM-Missing(onaccountofCaries)5. F-FilledKeyages(indexagegroups)6. oralhealthsituationregularintervals7. monitorcariesprevalence8. simplifiedreliable9. epidemiologicalsurveyVOCABULARY牙齦牙結(jié)石
25、食物殘?jiān)谰咧笖?shù)，索引斌（牙）均失補(bǔ)指數(shù)年齡組口腔健康狀況定期，間隔一定時(shí)間監(jiān)測(cè)，監(jiān)督患融簡(jiǎn)化的可靠的流行病學(xué)調(diào)查10. preventiveprogrommeonrequest11. databankcompile(d)12. Sharpcontrast(s)downward13. upwardspectacularfall14. virtuallyweightedforpopulation15. Justify,justifiesoptimism16. graphworsening17. halt(ed)unprecedented18. supervisedfluoridation19.
26、 administrationoralhygiene20. primaryhealthcarehealthbudget21. devotesubstances22. priorityinexpensivemeasures23. share(d)periodontaldiseases24. fragmentaryplethora25. periodontalindexinternationalacceptance26. strides(s)CPITN(CommunityPeriodontalindexofTreatmentNeeds)27. FDI(InternationalDentalFede
27、ration)bleedinggum28. shallowperiodontalpocketsdeepperiodontalpockets29. retract(s)adhere(s)30. ligament(s)impaired31. loosesextant(s)32. speciallydesignedprobeindextooth33. simultaneouslycaution34. similarpatternfrequency預(yù)防項(xiàng)目（計(jì)劃）根據(jù)要求資料庫(kù)（數(shù)據(jù)瘁）編制鮮明對(duì)比向下的，下降的向上的，上升的引人注目的下降事實(shí)上，實(shí)際上：加權(quán)人口證明（認(rèn)為）有道理，為.-提供依據(jù)樂(lè)觀
28、（主義）座標(biāo)圖，曲線圖（使）惡化、變壞停止、止步，休息空前的，無(wú)先例的在監(jiān)督指導(dǎo)下的氟化管理口腔（清洗）衛(wèi)生初級(jí)衛(wèi)生保健衛(wèi)生預(yù)算獄（身），貢獻(xiàn)，專心致力于實(shí)質(zhì)的，有價(jià)值，有實(shí)力的重點(diǎn)，優(yōu)先廉價(jià)措施分享，分擔(dān)牙周疾病片斷的，殘缺不全的過(guò)多（剩）牙周指數(shù)國(guó)際承認(rèn)（接受）邁進(jìn)，進(jìn)步社區(qū)牙周治療需要指數(shù)國(guó)際牙科聯(lián)盟牙齦出血淺牙周袋深牙周袋退縮，萎縮附著，吸附韌帶受損傷的（牙淞動(dòng)（牙周）區(qū)段專門(mén)設(shè)計(jì)的探針指數(shù)牙同時(shí)，一齊小心、慎重類似方式（模式、形式）頻數(shù)68. etiological69. display70. prevalent71. initialform72. regress(es)73. ri
29、skgroup病因果的展現(xiàn)，展示流行的早期階段(形式)消退；退回危險(xiǎn)人群Notes1. 長(zhǎng)句分析(課文第二段第一句)：1) towhich引入個(gè)定語(yǔ)從句apopulationisaffectedbycaries。這里的which是指Theindexo2) 下面一個(gè)Which指themeanDMFT,又引入一個(gè)定語(yǔ)從句“inagroupofindividualscountstheaveragenumberofteeth.3) that也是一個(gè)關(guān)系代詞，代表事物較多見(jiàn)，在從句中作.主語(yǔ)thataredecayed,missing(onaccountofcaries),filled.2. keyag
30、es.又可稱in山xages(groups),指有代表性的年齡(組)，又稱指數(shù)年齡(組)。3. 5levelScaleofDMFT世界衛(wèi)生組織(WHO)規(guī)定的以12歲兒童恒牙患炳狀況為基準(zhǔn)的5個(gè)水平，如下：0.01.1verylow,很低1.22.6low,低2.74.4moderate,中等6.5high,高6.5 veryhigh,很高4. WHO：WorldHealthorganization世界衛(wèi)生組織成立于1948年，中國(guó)是發(fā)起國(guó)之一。5. WHO*soralHealthUnit：世界衛(wèi)生組織口腔衛(wèi)生處“Unit”相當(dāng)于我國(guó)衛(wèi)生部?jī)?nèi)的一個(gè)“處級(jí)”水平。6. GlobalOralDataBank(GODB)：全球口腔資料(數(shù)據(jù))庫(kù)，從屬于聯(lián)合國(guó)(UN)資料庫(kù)內(nèi)。7. Overthenexttwodecades=inlasttwodecades在過(guò)去的2()年中8. Except除XXX之外besides除XXX之外(還有)例如：besidesfluoridespitandfissuresealantarealsoimportantforcariesprevention.9. EPITN現(xiàn)已常用CPI,作為牙周健康狀況調(diào)查的記分標(biāo)準(zhǔn)，通常用WHO推薦的帶有刻度的標(biāo)淮探針進(jìn)行檢查。
專業(yè)英語(yǔ) Unit 17教案.docx
