Dental status of geriatric patients with disorder of cognitive functions and their medical and social characteristics

Aim: analysis of medical and social characteristics and assessment of the dental status of geriatric patients with cognitive impairment.Materials and methods. The study was carried out at the Department of Therapeutic Dentistry. We analyzed the responses and laboratory results of 43 patients aged 60–92 years. The main methods used in the study were: questioning (Fox test), sialometry, saliva pH determination, microbiological analysis (of the upper respiratory tract) for fungal microflora.Results obtained showed that an objective study of the secretory function of the salivary glands according to the method of M.M. Pozharitskaya found that the average rate was 0.2 ± 0.004 ml/min, and the average saliva pH was 5.7 ± 0.04. The medical and social portrait of a geriatric patient indicates that mainly patients with impaired cognitive functions seeking dental treatment and prophylaxis were women, whose average age was 76.03 ± 2.8 years, as a rule, they were representatives of the humanitarian and natural-scientific professions, 75% are married. According to the results of the Fox test, it was found that 60% of patients complained of dry mouth of a different nature. The perception of dry mouth was statistically significantly dependent on gender (P = 0.025) and the presence of chronic diseases (P = 0.004). Women (OR = 1.17, P = 0.026) with chronic diseases (OR = 2.97, P = 0.002) were more likely to suffer from dry mouth.

DEPENDENCE OF CHANGES IN THE HYGIENIC CONDITION OF THE ORAL CAVITY AND PERIODONTIUM IN CHILDREN WITH MALIGNANT TUMORS ON THE DURATION OF POLYCHEMYTHERAPY AND QUANTITIES OF CYTOSTATIC DRUGS

It is known that the course of cancer and chemotherapy adversely affect the components of homeostasis of the oral cavity, which causes stomatotoxicity. However, scientific publications have not yet provided generalized results of research on the pathogenetic mechanisms of the dental pathology formation during chemotherapy, which constitutes the relevance of this publication. The aim of the research was to study the effect of different regimens of the second course of chemo- therapy on the hygienic condition of the oral cavity and periodontium in children with malignant tumors of the abdominal cavity. The dissatisfaction with our results obtained after the first course of chemotherapy on various regimens prompted us to further research. A survey of two previously formed clinical groups was performed. All of them resumed the treatment in the oncohematology department of the Poltava Children's City Clinical Hospital following a 3-4 week break between courses. Each patient was treated according to an individual program but in the absence of dental care. The dental status was assessed using the Green-Vermillion, Papillary-Marginal-Alveolar (PMA), and Pa- pilla Bleeding Index. The study of cytograms from the surface of the gingival margin of the frontal part of the mandible was carried out taking into account the methodology developed by our department's staff. The calculation was per- formed in 10 visual fields. Statistical processing was performed according to standard conditions. Research results and their discussion. It should be noted that in the comparative aspect, the indexes of Green-Vermillion, PMA, and RВI at the end of the first year were 1,8, 1,3, and 1,6 times worse than in the second observation group which received more cytostatic drugs. At the end of the second course of chemotherapy, the dryness of the mucous membrane accompanied by a decrease in oral fluid, which became viscous, was observed in 14 children (70,0%) of the first and 18 of the second group (85.7%). In addition, 15 people in the first group (75,0%) and 19 in the second one (90,4%) complained of pain and bleeding gums, which worsened when eating. At the same time, all children noted pain in the muscles that are adjacent to the lower jaw and involved in articulation. On external examination, only 2 children of the first (10,0%) and 1 of the second group (5%) had a red normal-coloured lip border, while the rest had exfoliation, cracks, and angular cheilitis. The oral mucosa mostly looked pale and pasty, except for 7 people of the second group (35,0%), who had manifestations of erythema. Localized erosions covered with fibrinous plaque were detected in 4 of these patients (20,0%) on the background of erythema. In addition, 12 children (60,0%) of the first group and 19 children of the second one (85.7%) showed swelling and redness of the gingival marginal edge, and the probing of the gingival sulcus provoked bleeding in all children of both groups. Green-Vermillion indexes increased by 1,5 and 1,7 times in the first and second groups, PMA increased by 1,4 times in both groups, and RВI was 1,4 and 1,5 times higher in the respective compared groups. The examination of cytograms revealed more pronounced changes in the second group where the epithelium with signs of intermediate stages of the differentiation prevailed. There was increased desquamation of the superficial layer of the gums and the increased number of peripheral blood elements, especially destroyed neutrophils. Thus, the generalization of the results obtained at the end of the second course of chemotherapy showed that the Green-Vermillion index was 1,8 times higher, and PMA and SВI indices were 1,4 times higher in the second observation group which received more cytostatics. That is, the severity of the manifestations of dental status disorders is directly proportional to the severity of the regimen. Conclusion. The prolongation of the second course of chemotherapy in children with abdominal malignant tumors provoked a significant deterioration of dental status. Major changes occurred in the group of children who received more cytostatic drugs simultaneously, which requires a balanced approach to designing differentiated treatment plans and prevention measures depending on the complexity of antitumor therapy regimens. Prospects for further research. The obtained results indicate the need to develop a set of differentiated treatment and prevention measures aimed at eliminating or improving changes in children that occur in the oral cavity under the influence of polychemotherapy.

FEATURES OF DENTAL STATUS OF PATIENTS WITH SARS-COV-2

At the end of 2019, an outbreak of a new coronavirus infection occurred in the People's Republic of China with an epicenter in the city of Wuhan [26]. The causative agent was given the temporary name 2019-nCoV. The World Health Organization officially named the infection-COVID-19 on February 11, 2020. The official name of the causative agent of infection SARS-CoV-2, was assigned by the international committee on the taxonomy of viruses [22]. A number of authors have established that the main role is played by receptors of angiotensin converting enzyme 2 (ACE2) in the penetration of the virus into target cells [19]. It is known that the transmission of SARS-CoV-2 occurs more often by airborne droplets during close contact with infected patients [15], as well as through direct contact with infected people and infected objects [17, 18, 20]. For healthcare professionals, SARS-CoV-2 has set tasks related to the rapid diagnosis and provision of medical care to patients. Currently, information on the clinical features, epidemiology, prevention and treatment of this disease is limited [13, 14]. To date, there is a limited amount of literature describing the dental status in patients diagnosed with SARS-CoV-2. Thus, the purpose of this study was to study the state of oral mucosa and substantiate its changes in patients with a laboratory-confirmed diagnosis of SARS-CoV-2 of mild to moderate severity, with or without concomitant oral coinfection. On the other hand, knowledge of the peculiarities of the dental status of Sars-CoV-2 patients and timely rational treatment of diseases of the oral cavity should constitute an important stage in the algorithm for their specialized therapy [2]. The work carried out a comprehensive assessment of the state of the oral cavity and the need for dental treatment in patients with Sars-CoV-2. The conclusions are based on the results of a simple observational clinical study, in which a comparative assessment of dental status indicators was carried out in 40 patients with Sars-CoV-2 and 20 somatically healthy individuals of the same sex and age.

DENTAL STATUS AND MINERAL COMPOSITION OF DENTAL TISSUES IN CHILDREN DEPENDING ON THE LEVEL OF ANTHROPOGENIC LOAD

Anthropogenic load significantly affects the human body. It used to think that children, due to the high metabolism, are most susceptible to the effects of the urban ecosystem. Unfavorable environmental factors affect children's health, including dental health. Heavy metals tend to accumulate in the human body, namely in bones, hair, nails, and teeth. This can serve as an indicator of the technogenic load on the body. The process of maturation of tooth enamel is closely related to the intake of mineral components into the child's body. The aim of the work is a comparative analysis of the dental status and mineral composition of hard dental tissues in children at different levels of anthropogenic load. Material and methods. With the help of basic and additional examination methods, a comparative analysis of the dental status of primary school children was carried out and described. Using atomic emission spectrometry, the mineral composition of the hard tissues of the teeth of the children under study was studied. Results. It was found that in children in an area with a high anthropogenic load, the prevalence of dental caries and the presence of systemic hypoplasia of the enamel of permanent teeth are higher. Also, these children showed a relatively low caries resistance of the enamel and the content of micro-macroelements in the hard tissues of the teeth. Conclusions. To study dental morbidity in children of primary school age at different anthropogenic loads, it is necessary to carry out a complete examination, including basic and additional research methods. Also, laboratory methods of examination are recommended, namely, the determination of the mineral composition of the hard tissues of the teeth.

EVALUATION OF AN ELECTRONIC PERIODONTAL PROBE VERSUS A MANUAL PROBE IN THE PERIODONTAL DIAGNOSIS OF CHILDREN AGED 12-14 YEARS

Objective: The purpose of the trial is to comparatively analyze an electronic, pressure-calibrated probe third generation Parometer (Orange) and a standard, manual measurement probe WHO 621 (C type) in the context of taking periodontal variables when assessing periodontal status in childhood. Materials and methods: The subject of the study were 28 children aged between 12 and 14 years (12 boys and 16 girls). All patients were clinically examined, and the data were recorded on a specially prepared card. The recorded clinical variables contain: Assessment of oral hygiene habits (type of toothbrush, frequency of brushing); OHI as per Green Vermillion; Registration of dental status; Depth of gingival sulcus (on all teeth) with both types of probes; BOP (bleeding on probing), percentage of bleeding units with both types of probes; Taking into account the complete time needed to take the findings and the sensation of pain experienced by a digital rank scale during probing. Results and conclusion: The average depth of gingival sulcus measured with a mechanical periodontal probe was 1.62 mm, and with an electronic one - 1.38 mm (p <0.05). Values ​​for BOP with both types of probes showed an average of 0.30 ± 0.29, which is 30% of all bleeding units examined (p> 0.05). The time for recording the periodontal indices with both probes is, on average, 10 minutes. In both probes, the discomfort of about grade 4 was observed according to the ranking scale used to read sensitivity (p <0.05). There is a more pronounced sensitivity when using an electronic periodontal probe.

Socio-demographic Factors, Dental Status, Oral Health Knowledge & Attitude, and Health-related Behaviors in Dental Visits Among 12-year-old Shenzhen Adolescents: a Multilevel Analysis

Background: Dental visits can provide education, prevention and treatment measures for teenagers, and help to form correct oral health knowledge and attitude. The purpose of this study was to evaluate the effects of socio-demographic factors, dental status, oral health literacy, and health-related behaviors on dental visits in early 12-year-old adolescents.Methods: 953 subjects aged 12 in Longhua District of Shenzhen were investigated. The questionnaire and clinical examination were applied in schools, and two-level logistic regression models were constructed to interpret the effect of individual and contextual factors on Shenzhen adolescents' dental visits.Results: A total of 27.6% of the participants had not been to a dentist. After the multiple factors binary logistic regression analysis, it confirmed that the following variables: Shenzhen hukou (OR =2.133, 95% CI: 1.429-3.185)，moderate caries (OR =1.404, 95% CI: 1.022-1.928) and severe caries (OR =2.546, 95% CI: 1.461-4.437)，Angle Class II malocclusion( OR =1.703, 95% CI: 1.134-2.556), sometimes or never toothbrushing (OR =2.985, 95% CI: 1.491-5.975), Dental floss usage (OR =1.829, 95% CI: 1.250-2.677), having had a toothache within the last 12 months (OR =1.469, 95% CI: 1.086-1.986), high Knowledge attitude level (OR =1.570, 95% CI: 1.106-2.229), moderate Knowledge attitude level (OR =1.534, 95% CI: 1.073-2.193), were associated factors for dental visit experience.Conclusions: The dental visits of 12-year-old children in Longhua District of Shenzhen is affected by multi-dimensional factors. It is suggested that oral health education should be strengthened, good oral hygiene habits should be cultivated, and the needs and utilization of oral health services for non-Shenzhen adolescents should be paid attention to, so as to effectively improve the overall oral health level of adolescents.

TOOTH WEAR IN CHILDREN - PREVALENCE, CLINICAL FEATURES AND RISK FACTORS

Introduction: Pathological tooth wear in children with primary dentition can be a result of various harmful habits, risk factors and nocturnal bruxism. It is difficult to be distinguished from physiological tooth wear. Aim:To study caries prevalence, tooth wear prevalence, its clinical characteristics and its relationship with bruxism in children aged 3 - 7 years. Materials and methods: The object of the study are 222 children, divided into 5 age groups - from 3 to 7 years. The examined children underwent a clinical examination, during which the following were registered: dental status, caries prevalence, the type, degree and prevalence of tooth wear. Information on the presence and characteristics of nocturnal bruxism in the examined children was obtained from the parents. The results were statistically processed with SPSS-19. Results: Tooth wear is found in more than 2/3 of the examined children (P<0.05). The highest average number of abraded teeth is present in 6- and 7-year-old children - about 7. Tooth abrasion affects 75% of canine teeth, 37.6% of incisors and 11.8% of molars in children aged 3-7 years. The predominant severity of wear is that in the inner ½ of the enamel (degree 1b) and occurs in 41.7% of children (P<0.05). 1/3 of the examined children have nocturnal bruxism (P<0.05). In almost 90% of them, tooth wear was found (P<0.05). Conclusions: There is an increase in the severity of tooth abrasion with age in children between 3-7 years. Nocturnal bruxism is almost always accompanied by tooth wear.