传本书是北京大学口腔医学教材之一，供八年制口腔医学生学习使用。教材分十四章，系统阐述口腔预防医学知识。首先介绍了口腔流行病学、口腔健康调查、龋病预防与控制、氟化物与口腔健康、牙周病的预防、自我口腔保健知识，然后对口腔癌及其他口腔疾病的预防、口腔健康促进、特定人群的口腔保健、社区口腔卫生服务、口腔卫生项目管理进行了系统论述。还对口腔医疗保健中的感染与控制、预防口腔医学社区教学实践进行了总结。本书结合前沿新理念、新概念和新知识，以培养学生的创新性思维和提升临床实践能力为导向。每章后附英文小结和专业名词英文解释。

第一章 绪论
Introduction ···························· 1
第一节 预防口腔医学的基本概念
Essential Conception of Preventive
Dentistry ······························ 1 一、健康的决定因素 ······················· 1 二、疾病的发展阶段 ······················· 2 三、预防医学的定义和内容 ·············· 2 四、预防口腔医学的定义和内容 ········ 2 五、三级预防的原则 ·······················3
第二节 预防口腔医学的发展
Development of Preventive
Dentistry ······························ 4 一、原始启蒙时代 ·························· 4 二、理性发展时代 ·························· 6 三、预防口腔医学的诞生和发展时代 ··· 6 四、21 世纪预防口腔医学的发展时代··· 8
第二章 口腔流行病学
Oral Epidemiology ·················· 11
第一节 概述
Overview···························· 11 一、口腔流行病学的定义 ··············· 11 二、口腔流行病学的作用 ··············· 11 三、口腔流行病学的分类 ··············· 12 四、口腔流行病学的发展 ··············· 13
第二节 口腔流行病学研究方法
Methods of Oral Epidemiology ··· 14 一、现况调查 ······························ 14 二、病例_对照研究······················· 15 三、队列研究 ······························ 19 四、临床试验研究 ························ 21 五、口腔流行病学中的质量控制 ······ 24
第三节 口腔疾病的流行病学状况
the Epidemiology Status of Oral
Diseases····························· 27 一、龋病流行病学 ························ 27 二、牙周病流行病学 ····················· 34 三、其他口腔疾病流行病学 ············ 42
Summary ········································ 53 Definition and Terminology·················· 54 参考文献········································ 55
第三章 口腔健康调查
Oral Health Survey ················· 56
第一节 口腔健康调查基本流程和方法
Basic Methods and Procedures of
Oral Health Survey ················ 56 一、调查方案的设计 ····················· 56 二、调查的组织实施 ····················· 60 三、调查的质量控制 ····················· 62 四、资料的收集和处理 ·················· 64 五、调查报告 ······························ 65
第二节 口腔健康问卷调查
Oral Health Related Questionnaire
Survey······························· 66 一、口腔问卷调查的应用 ··············· 66 二、问卷结构 ······························ 67 三、问卷设计 ······························ 68 四、问卷调查的组织实施 ··············· 70
第三节 口腔健康相关生活质量的评价
Oral Health Related Quality of Life
Assessment ························· 71 一、口腔健康模型 ························ 71 二、口腔健康生活质量评价方法 ······ 72 三、常用口腔健康生活质量量表 ······ 74
1

2
预防口腔医学(第 3 版)
四、量表翻译和应用 ····················· 77 Summary ········································ 79 Definition and Terminology·················· 79 参考文献········································ 79
第四章 龋病预防与控制
Prevention and Control of Dental
Caries ·································· 81
第一节 龋病病因与发病机制
Etiology and Mechanisms of Dental
Caries ································ 81 一、龋病病因 ······························ 81 二、发病机制 ······························ 83
第二节 龋病风险评估与早期龋的诊断
Caries Risk Assessment and
Diagnosis of Incipient Caries ···· 84 一、龋病风险评估概述 ·················· 84 二、龋病风险评估方法 ·················· 84 三、早期龋的诊断 ························ 87
第三节 龋病预防与早期龋的控制
Prevention of Dental Caries and
Control of Incipient Caries ······· 89 一、龋病的三级预防 ····················· 89 二、龋病的预防措施 ····················· 90 三、早期龋的控制 ························ 92
第四节 龋病预防和控制的具体方法
Measures for Prevention and
Control of Dental Caries·········· 93 一、窝沟封闭 ······························ 93 二、预防性树脂充填 ····················· 97 三、渗透树脂 ······························ 98 四、氟化氨银 ······························ 99 五、非创伤性修复治疗 ················· 100
Summary ······································· 103 Definition and Terminology·················103 参考文献······································· 104
第五章 氟化物与口腔健康
Fluoride and Oral Health·········105
第一节 概述
Overview··························· 105 一、氟在自然界的分布与人体氟来源··· 105 二、人体氟代谢 ·························· 106
三、氟化物的防龋机制 ·················107
四、氟化物的其他生理作用 ···········108 第二节 全身应用氟化物
Systemic Fluoride Application ··· 108 一、饮水氟化 ·····························109 二、食盐氟化 ·····························110 三、牛奶氟化 ·····························112 四、氟片 ···································112
第三节 局部应用氟化物
Topical Fluoride Application ···· 114 一、含氟牙膏 ····························· 114 二、含氟漱口液 ·························· 115 三、含氟涂料 ····························· 116 四、含氟凝胶 ····························· 117 五、含氟泡沫 ····························· 118
第四节 氟化物防龋的安全性
Safety of Fluoride in Caries
Control ···························118 一、氟化物的毒性作用 ·················118 二、氟牙症 ································120 三、应用氟化物防龋的注意事项 ·····121
Summary ······································· 123 Definition and Terminology·················124 参考文献······································· 125
第六章 牙周病的预防
Prevention of Periodontal
Diseases ·························· 126
第一节 牙周病的始动因素和发病机制
Initial Factor and Pathogenic Mechanisms of Periodontal Diseases ···························· 126
一、始动因素 ·····························126
二、发病机制 ·····························127 第二节 牙周病的危险因素
The Risk Factors of Periodontal
Diseases ···························· 129 一、局部危险因素 ·······················129 二、全身危险因素 ·······················129 三、社会行为危险因素 ·················130
第三节 牙周病的预防和控制
Prevention and Control of Periodontal Diseases ·············131

一、牙周病的三级预防 ················· 131 二、自我口腔保健措施 ················· 131 三、专业口腔保健措施 ················· 133 四、药物方法 ····························· 133
第四节 口臭的预防和控制
Prevention and Control of
Halitosis··························134 一、口臭形成的原因 ···················· 134 二、口臭的控制和治疗 ················· 136
Summary ······································· 138 Definition and Terminology·················139 参考文献······································· 140
第七章 自我口腔保健
Oral Health Self-care··············141
第一节 刷牙
Toothbrushing ····················· 141 一、牙刷 ··································· 141 二、牙膏 ··································· 143 三、刷牙方法 ····························· 145
第二节 牙齿邻面清洁
Interproximal Plaque Removal ··· 147 一、牙线 ··································· 147 二、牙间隙刷 ····························· 149 三、其他牙齿邻面清洁工具 ··········· 150
第三节 其他自我口腔保健的方法
Self-care Adjuncts ················ 151 一、漱口和漱口液 ······················· 151 二、冲洗和冲牙器 ······················· 152 三、咀嚼无糖口香糖 ···················· 153 四、舌苔清洁 ····························· 153
第四节 修复及正畸患者的自我维护
Implant and Denture Self-care···· 154 一、修复患者的自我维护 ·············· 154 二、正畸患者的自我维护 ·············· 155
Summary ······································· 156 Definition and Terminology·················157 参考文献······································· 158
第八章 口腔癌及其他口腔疾病的预防
Prevention of Oral Cancer and
Other Oral Diseases················159
Epidemiology and Factors Related
to Oral Cancer·····················159 一、口腔癌的行为特征 ·················159 二、口腔癌的癌前病变 ·················162 三、口腔癌的相关致病因素 ···········163
第二节 口腔癌的早期检查、诊断和预防 Detection and Diagnosis of Oral
Cancer and Its Prevention ·······167 一、定期检查与早期诊断 ··············167 二、口腔癌的预防 ·······················169
第三节 其他口腔疾病的预防
The Prevention of Other Oral
Diseases ···························· 171 一、错 畸形的预防····················· 171 二、牙外伤的预防 ·······················174 三、牙本质敏感的预防 ·················176 四、牙磨蚀症的预防 ····················177
Summary ······································· 180 Definition and Terminology·················180 参考文献······································· 181
第九章 口腔健康促进
Oral Health Promotion············182
第一节 口腔健康促进的概念
The Conception of Oral Health
Promotion ·························· 182 一、健康与口腔健康 ····················182 二、健康促进与口腔健康促进 ········182
第二节 口腔健康促进的内容、途径与任务 The Contents, Routes and Tasks of
Oral Health Promotion···········183 一、口腔健康促进的内容 ··············183 二、口腔健康促进的途径 ··············184 三、口腔健康促进的任务 ··············184
第三节 口腔健康促进的计划、实施和评价 Planning, Implementation
and Evaluation of Oral Health
Promotion ·························· 184 一、口腔健康促进的计划 ··············185 二、口腔健康促进的实施 ··············185 三、口腔健康促进的评价 ··············186
第四节 健康教育与口腔健康教育
第一节 口腔癌的特征和相关致病因素
Health Education and Oral Health
目 录
3

4
预防口腔医学(第 3 版)
Education ·························· 187 一、健康教育 ····························· 187 二、口腔健康教育 ······················· 188
第五节 口腔健康教育的策略和方法
Strategies and Methods of Oral
Health Education ·················188 一、口腔健康教育的策略 ··············188 二、口腔健康教育的方法 ·············· 189
第六节 口腔健康教育的计划、实施和评价 Planning, Implementation
and Evaluation of Oral Health
Education ·························· 190 一、口腔健康教育的计划 ·············· 190 二、口腔健康教育的实施 ·············· 190 三、口腔健康教育的评价 ·············· 191
Summary ······································· 192 Definition and Terminology·················192 参考文献······································· 193
第十章 特定人群的口腔保健
Oral Health Care for the Target
Population ··························· 194
第一节 妇幼口腔保健
Oral Health Care for Pregnant
Women and Young Children ····194 一、妊娠期妇女的口腔保健 ···········194 二、婴幼儿的口腔保健 ················· 196 三、学龄前儿童的口腔保健 ··········· 199
第二节 中小学生口腔保健
Oral Health Care for School
Children ···························· 200 一、中小学生的特征 ···················· 200 二、常见的口腔健康问题 ·············· 201 三、口腔保健 ····························· 202
第三节 老年人口腔保健
Oral Health Care for the Elders··· 204 一、老年人的特征 ······················· 205 二、常见的口腔健康问题 ·············· 205 三、口腔保健 ····························· 206
第四节 残疾人口腔保健
Oral Health Care for Compromised
Populations ························ 207 一、残疾人的特征 ·······················208
二、常见的口腔健康问题 ··············208
三、口腔保健 ·····························209 Summary ······································· 213 Definition and Terminology·················213 参考文献······································· 213
第十一章 社区卫生服务与社区口腔卫生服务
Community Health Service and Community Oral Health Service ························· 214
第一节 社区卫生服务概述
Overview of Community Health
Service ·····························214 一、社区和社区服务 ····················214 二、社区卫生服务 ·······················215
第二节 社区口腔卫生服务
Community Oral Health Service ··· 222 一、社区口腔卫生服务的概念 ········222 二、社区口腔卫生服务策略 ···········222 三、社区口腔卫生服务的周期 ········225 四、社区口腔卫生服务发展状况 ·····233
Summary ······································· 238 Definition and Terminology·················239 参考文献······································· 239
第十二章 口腔卫生项目管理
Oral Health Project
Management····················241
第一节 项目管理概述
Overview of Project
Management ··················· 241 一、项目管理的发展过程 ··············241 二、项目管理的概念 ····················242
第二节 口腔卫生项目管理基本概念与基
本程序
Basic Concept and Program of Oral
Health Project Management·····243 一、基本概念 ·····························243 二、基本程序 ·····························244
Summary ······································· 250 Definition and Terminology·················251 参考文献······································· 251

第十三章 口腔医疗保健中的感染与控制
Infection Control in Dental
Practice····························252
第一节 口腔医疗保健中的感染传播
Infection Transmission in Oral
Medical Care ······················ 252 一、医院感染的定义及分类 ··········· 252 二、口腔医疗保健中的传染源 ········ 253 三、口腔医疗保健中的感染传播 途径 ··································· 254 四、口腔医疗保健中的易感人群 ····· 255
第二节 口腔医疗保健中的感染控制措施
Measures of Infection Control in
Oral Medical Care ················ 255 一、患者的检查与评价 ················· 255 二、标准预防 ····························· 256 三、口腔器械的消毒与灭菌 ··········· 260 四、口腔诊疗环境的消毒 ·············· 264 五、口腔医疗废物的处理 ·············· 265
第三节 口腔医疗保健中的感染性疾病
Infectious Diseases in Oral Medical
Care ································· 265 一、获得性免疫缺陷综合征 ··········· 265 二、乙型病毒性肝炎 ···················· 266 三、结核病 ································ 267 四、梅毒 ··································· 268 五、传染性疾病的上报 ················· 268
第四节 新型冠状病毒肺炎疫情期间口腔
诊疗的感染防控
Infection Control in Oral Medical Care during Corona Virus Disease 2019 ································268
一、新型冠状病毒肺炎疫情的流行 情况 ···································268
二、新型冠状病毒肺炎的病原学和 流行病学特征 ······················· 269 三、新型冠状病毒肺炎的临床表现 ··· 269 四、口腔门诊诊疗操作风险 ··········· 269 五、口腔门诊治疗中的防控 ··········· 269
Summary ······································· 271 Definition and Terminology·················272 参考文献······································· 272
第十四章 预防口腔医学社区教学实践
Preventive Dentistry Practice in
Community ······················· 274
第一节 预防口腔医学社区教学基地的建设
Construction of Preventive Dentistry Practice Base in Community ························ 274
一、预防口腔医学社区教学基地 建设的构想和建设 ·················274 二、预防口腔医学社区教学基地 建设的应用和展望 ·················275
第二节 预防口腔医学社区教学实践教程
Community Preventive Dentistry
Practice Instruction···············276 一、标准一致性检验 ···················· 276 二、口腔健康检查 ······················· 277 三、口腔问卷调查 ······················· 278 四、个别深入访谈和小组讨论 ········ 279 五、口腔健康教育 ······················· 281 六、调查资料的统计与分析 ··········· 282 七、口腔预防适宜技术 ················· 284 八、社区口腔保健计划的制订 ········ 286
中英文专业词汇索引··························· 288 彩图················································ 291