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研究生:陳美彤
研究生(外文):Mei-Tung Chen
論文名稱:含漱包裝飲料後,唾液致齲細菌生態變化之探討
論文名稱(外文):The Ecosystemic Changes of Cariogenic Bacteria in Saliva after Rinsing by Packaged Beverages
指導教授:黃純德黃純德引用關係
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:口腔衛生科學研究所碩士班
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2006
畢業學年度:94
語文別:中文
論文頁數:116
中文關鍵詞:飲料唾液致齲細菌
外文關鍵詞:beveragesalivacariogenic bacteria
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研究背景:
現今社會對食品的健康觀念日漸提升,低醣飲料及具有防齲效益的代醣類取代原糖成份的食品日益增加,目前一般民眾與學童攝取這些飲料後,飲料的致齲性究竟如何是我們關心的議題。
研究目的:
1. 分析含漱包裝飲料前後,唾液致齲細菌的數量與生態變化。
2. 探討飲料中糖濃度與pH值對變異鏈球菌成長的影響。
3. 探討最具致齲性的包裝飲料?
研究方法:
本研究以立意取樣,選擇高雄某國中一年級學生36名接受含漱飲料對致齲細菌的影響研究。首先,讓受測者接受臨床口腔檢查,經分別含漱三種不同飲料後,搜集其不同時間點之唾液樣本,將所搜集檢體塗抹在配製好的特殊培養基上,經實驗室檢測判讀紀錄致齲細菌培養成長的記錄。所得資料使用JMP5.12以基本統計量、Wilcoxon signed rank sum test、Kruskal-wallis test、spearman rank correlation coefficient及simple linear regression進行統計分析。
結果:
研究結果顯示,使用測試的乳酸飲料含有多數的活性乳酸菌。
也因而含漱乳酸飲料後,致齲性LB菌一分鐘內顯著性的增加。SM菌在60 分鐘後OD值提升至0.12(p=0.0070),故對牙齒的潛在危機極大。含漱飲料前後一小時SM菌量總變化不因飲用何種飲料有所改變(P=0.3345),但仍因添加含糖飲料使用而增加SM菌的量。在菌種的成長速度來看在測試飲料種類間,以乳酸飲料的促進細菌生長作用最大,其次為柳橙汁,再者碳酸飲料。在測試飲料糖濃度與SM菌的OD值成長狀況下未觀察到統計上顯著性相關。唯有測試飲料pH值與含漱前後口腔SM菌的成長OD值的相關最強(r=1.00,p??0.0001)。
結論:
SM菌在使用測試飲料期間,雖發現有短暫的稀釋作用或抑菌作用。但在30分鐘左右可回復原來的菌量,有促進細菌生長的效果。乳酸飲料飲用後最好立即喝水漱口清潔口腔,喝完柳橙汁(果蔬汁)及碳酸飲料後,也應於三分鐘內完成口腔清潔的動作。
Background:
The health concept of food has been improved gradually in society. Low sugar beverages and caries prevention function of substituted sugar products have increasingly replaced those products with raw sugar compositions . After people and school children absorb these beverages, how these beverages cause caries is the topic that we are concerned.

Objectives:
1. Analyze the quantity and the ecological changes of cariogenic bacteria in saliva. before and after gargling the packaged beverages.
2. Discover the influence of sugar concentration and pH value of beverages on the growth of streptococci mutans(SM).
3. Discover the most cariogenic packaged beverages?
Methods:
Thirty six junior high school students at grade one level in the Kaohsiung area were selected and tested to find out the influence of cariogenic bacteria by gargling beverages. First, the tested persons accepted a clinical oral cavity examination and gargled three different kinds of beverage, then the saliva samples were collected at different test times. The collected tested samples were daubed on formulated special medium. The cultivated records of cariogenic bacteria were measured by inspecting and interpreting the records in the laboratory. The data obtained were statistically analyzed by JMP5.12 with basic statistics amount ,Wilcoxon signed rank sum test, Kruskal-wallis test, spearman rank correlation coefficient and simple linear regression methods.

Results:
The results of this study showed that this brand of lactate beverage tested really contained the active Lactobacilli spp. The cariogenic LB bacteria had been noticeably increased after gargling the lactate beverage for one minute, OD value of SM bacteria increased to 0.12 (p=0.0070) after 60 minutes. The potential crisis, therefore, to the teeth is great. After gargling the beverages, the total number of variations for bacteria remained unchanged before and after one hour, regardless of the kind of beverages drunk (P=0.3345). Beverages with added sugar still increased the amount of SM bacteria. The growth speed in bacteria among different kinds of tested beverages, the improved effects of bacteria growth from lactate beverages were the best. Second was the orange juice, then the carbonated drink. Under the grow-up state for sugar concentration of beverages tested and OD value of SM bacteria, it was not observed to be significantly correlated to statistics. Only the tested pH value of beverages and growth OD value of SM bacteria before and after gargling beverages had the strongest relationship (r=1.00,p??0.0001).


Conclusion:
During tested periods of beverages with SM bacteria, transient dilution function or bacteriostasis function were found; however, the amount of original bacteria can be regained in about 30 minutes, there existed the effects of promoting the growth of bacteria. Drink water immediately and clean mouth after a lactate beverage is drunk ; the mouth should also be cleaned within three minutes after drinking orange juice (fruit and vegetable juice ) and carbonated beverages.
目錄
頁次
誌謝 Ⅰ
中文摘要 Ⅱ
英文摘要 Ⅳ

第壹章 緒論
第一節 研究背景 01
第二節 研究目的 03

第貳章 文獻探討
第一節 唾液之成份與齲齒關係 04
第二節 唾液的年齡、性別變化 08
第三節 口腔微生物在個體年齡的變化 09
第四節 致齲細菌與齲齒的相關性 11
第五節 飲料中醣類對齲齒危險性關係 15
第六節 影響口腔致齲細菌成長因素 19

第參章 研究方法與材料
第一節 研究對象 29
第二節 研究設計 29
第三節 研究架構 37
第四節 研究限制 37
第五節 名詞解說 38
第六節 資料分析 41

第肆章 結果
第一節 飲料對唾液致齲細菌影響之基本資料分析 42
第二節 唾液乳酸菌在各飲料類別間的關係 44
第三節 飲料類別與SM菌在測試時間點前後變化的關係 44
第四節 飲料類別與SM菌在測試時間點的關係 45
第五節 含漱飲料測試前後,SM菌基本OD值、含漱後總
OD變化值、回復基本OD值所需時間與最後一次
OD值之比較 47
第六節 飲料糖濃度(%)、飲料pH值與平均唾液變異鏈球菌
成長OD值的相關 47




第伍章 討論
第一節 實驗設計 49
第二節 飲料與變異鏈球菌OD值的變化關係 51
第三節 飲料與致齲力之探討 53
第四節 如何選擇市售包裝飲料 54

第陸章 結論與建議 55

參考文獻 56
表格目錄(中文表格、英文表格) 65
表 1、飲料類別平均唾液SM菌及LB菌OD值在測試時間點的變化情況表(N=30) 65
表 2、飲料類別平均唾液LB菌OD值在測試時間點的前後變化情況表(N=30) 68
表 3、經重覆抽樣後原始樣本與子樣本在飲料類別平均唾液變異鏈球菌在測試時間點之檢定 69
表 4、純水類平均唾液SM菌和LB菌OD值在測試時間點的變化情況表(n=11) 70
表 5、飲料類別平均唾液SM菌OD值在測試時間點的前後變化情況表(n=11) 71
表 6、飲料類別與平均唾液變異鏈球菌在測試時間點的關係(n=11)
72
表 7、含漱飲料測試後,SM菌基本OD值、含漱後總OD變化值、回復基本OD值所需時間與最後一次OD值之比較(n=11) 73
表 8、測試飲料含糖濃度與pH值 74
表 9、飲料糖濃度(%)、飲料pH值與口腔平均唾液變異鏈球菌成長OD值的相關係數 74
Table 1、Distribution of different beverage kinds and salivary cariogenic bacteria’s optical density value at different test times( N=30) 75
Table 2、Different beverage kinds and salivary lactobacilli spp’s optical density value at different test times (N=30) 78
Table 3、The test of primary sample and subsample’s streptococcus mutans optical density value at different test times 79
Table 4、Distribution of the water’s salivary cariogenic bacteria’s optical density value at different test times (n=11) 80
Table 5、Different beverage kinds and salivary streptococci mutans optical density average value at different test times (n=11)
81
Table 6、Variation of different beverage kinds and salivary streptococci mutans optical density average value at different test times (n=11) 82
Table 7、Baseline streptococci mutans optical density、total change
of optical density value、time of returning baseline streptococci
mutans optical density value and optical density value of the last
test time after mouth rinse of the packaged beverages (n=11) 83
Table 8、Sugar (%) and pH value of the test beverages 84
Table 9、Association between salivary streptococci mutans optical density average change value with sugar (%) and pH value of the test beverages 85

圖目錄 86
圖 1、齲齒病因四環圖 86
圖 2、90-94年國人平均每人飲料消耗量 86
圖 3、流體飲料對唾液致齲細菌之變化與影響之文獻架構圖 87
圖 4、研究與實驗步驟流程圖 88
圖 5、研究架構圖 89
圖 6、飲料類別唾液變異鏈球菌在測試時間點的變化曲線圖 89

附錄 90
附錄一 台灣2000年兒童齲齒狀況 90
附錄二 90-94年度國人平均飲料消耗量表 90
附錄三 口腔三大唾液腺及其開口、分佈位置、腺體的種類 90
附錄四 人類唾液的組成 91
附錄五 Streptococci鏈球菌的特性 94
附錄六 口腔鏈球菌的生化鑑別表 95
附錄七 Lactobacilli乳酸桿菌的特性 96
附錄八 S.M菌與LB菌對齲齒的相關研究調查比較 97
附錄九 口腔微生物受飲食、唾液、牙齦溝液、微生物產物、氣態
環境和宿主因素所影響 98
附錄十 會影響牙菌斑形成的主要應用化學干擾製劑 98
附錄十一 市售包裝飲料喜好調查表 99
附錄十二 家長同意書 100
附錄十三 飲料成分分析表 101
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