Епідеміологічні аспекти захворюваності на карієс і особливості розвитку карієсогенної ситуації в дітей з бронхіальною астмою (огляд літератури)

Abstract

Мета роботи – провести аналіз спеціалізованої наукової літератури для узагальнення даних про сучасний підхід до профілактики і лікування карієсу та його ускладнень, а також стану стоматологічного здоров`я дітей із бронхіальною астмою. Матеріали і методи. Проаналізували і вивчили доступну наукову літературу за останні роки, присвячену особливостям поширеності стоматологічних хвороб, профілактиці та лікуванню карієєсу і його ускладнень, а також стану стоматологічного здоров`я дітей із бронхіальною астмою. Висновки. Аналіз літературних джерел, а також власні дослідження продемонстрували необхідність глибшого вивчення представленої проблеми і розробки специфічної програми профілактики карієсу та його ускладнень у дітей із бронхіальною астмою. Tooth decay is the most important early age children problem of the health of oral cavity. It is medical and social problem of many developed countries and countries with transitional economy. According to WHO, in some countries the frequency and the intensity of dental caries decrease, however the same indexes in Ukraine increase rapidly and systematically. The interconnection of dental diseases and general somatic pathology is well known and it occupies one of the leading places among the main reasons of dental caries. The prevalence of bronchial asthma among child population varies from 1% till 18%. Herewith, children with the diseases of respiration organs have higher marks of caries defeat than healthy children. The aim of the work is to carry out the analysis of the specialized scientific literature for the data generalization about modern looks to the prophylaxis and treatment of dental caries, its complications and the condition of dental health in children with bronchial asthma. Materials and methods. We have analyzed and studied the available scientific literature in the last years, which is devoted to the peculiarity of prevalence of dental diseases, prophylaxis and treatment of tooth decay, its complications and the condition of dental health in children with bronchial asthma. According to our research, there are different indexes of caries prevalence and intensity in Ukraine. Thus, in the western regions prevalence come up to 93-100% and intensity 3,4-6,5, whereas in the central and south-east regions the same marks come up to 73-93% and 2,0-4,3. There is a huge influence on the caries prevalence by genetic tendency, attendant somatic pathology, social and hygienic factors. It is generally known that patients with bronchial asthma use inhalation glucocorticosteroids as basic treatment. This fact places them into the group of higher risk of caries development. But the influence of these drugs on the progress of tooth decay and saliva secretion is not well studied. Scientists confirm that the use of inhalation glucocorticosteroids can change chemical and immune compound of oral liquid (the descent of saliva secretion speed, pH, number of calcium, phosphor, lysozyme and the upsurge of saliva viscosity). All these changes along with diminution of Ig A and ptyalin amount makes these children more defenseless to caries and assist in development of cariogenic situation in the oral cavity. Moreover, children with allergic pathology have changes of immune reactivity and dysfunction of albumen and mineral conversion. At the same time the defeat of hard tissues of teeth in children with hypoxia which is determined by inborn and heritable diseases most often appear as the systemic hypoplasia in combination with plural caries. Caries prevalence in children with bronchial asthma is about 88-89% according to the latest news. We need also to draw attention to the changes of the osseous tissues. They depend not only on burden and duration of bronchial asthma, but on the peculiarity of progression of caries process. These children have low mineral density and modified indexes of mineral and bone exchange. All this facts confirm about the systemic character of the bone defeat in this patients. Herewith, the stage of alteration grows up proportional to intensity of tooth decay. Conclusions. Thus, the analysis of literary data, as well as own research, have demonstrated the necessity of in-depth study of described problem and elaboration of specific prophylaxis program of dental caries and its complications in children with bronchial asthma.