PECULIARITIES OF DENTAL CARIES PREVENTION IN CHILDREN WITH OLIGOPHRENIA

Nowadays dental caries and periodontal diseases are among the most pressing problems in Paediatric Dentistry. Young patients with psychoneurological disorders are a special category among children with somatic pathology. At the same time, the issue of providing dental care to such children is underrepresented. Today, traditional schemes used for the prevention and treatment of caries and periodontal disease in children with mental retardation requires further improvement taking into account the clinical status of children with particular forms of mental retardation, including oligophrenia. Thus, the aim of our study was to develop and evaluate the effectiveness of a complex of measures to prevent dental caries in children with oligophrenia. To assess the effectiveness of the elaborated preventive complex, 56 children aged 12 years with the diagnosis of oligophrenia of I degree of severity (mild mental backwardness) were under observation during 2 years; 27 children received the complex we developed. The group of comparison included 29 children; caries prevention measures for these children were based on regional protocols (hygienic education, keeping oral hygiene, use of fluoride toothpastes). The effectiveness of the developed preventive complex was evaluated 6, 12 and 24 months after the beginning of its implementation according to the following criteria: the growth of dental caries intensity; reduction in the growth of dental caries intensity; level of oral hygiene (OHI-S index); changes in the biocenosis of the oral cavity (in 1 and 6 months of the observation). The results of the examination after the 6 month observation period have shown the dental caries intensity in children of the main group is 6.65 ± 0.45 teeth that is 1.02 times lower than in the children of the comparison group (6.79 ± 0.26 teeth, p ˃0.05). Thus, the growth of dental caries intensity in the children of the main group is, on average, 0.41 ± 0.05 tooth, which is significantly lower than in children of the comparison group (0.58 ± 0.06 tooth, p <0.05 ). The reduction in the growth of caries intensity in children who received the developed preventive complex was 41.46%. Thus, during two years of the observation, the growth of caries intensity in children of the main group is 1.52 ± 0.08 tooth that is 1.74 times lower than in children of the comparison group (2.64 ± 0.9 tooth, p <0, 05). The reduction in the growth of caries intensity in children who received this preventive complex is, on average, 42.42%. The effectiveness of the proposed preventive complex for children with oligophrenia and carious lesions was also evaluated by using the hygienic Green-Vermillion index. According to the data obtained, at the period of inclusion into the study, the children in both groups demonstrated nearly the same indices of the oral hygiene. However, over the period of the study, the indices of the hygiene index between the children of the main group and the comparison group differed significantly. The application of preventive complex in children with oligophrenia resulted in better oral hygiene than in that the children of the comparison group. This can be explained by professional hygiene, quality control of toothbrushing and hygiene education of children and their parents. The effectiveness of the elaborated complex of preventive measures was also evidenced by changes in the oral biocenosis in the children of the main group in 1 and 6 months of the observation. The findings of microbiological studies showed that the microbial spectrum of the oral cavity changed toward the healthier balance in the children of the main group during the observation period: there was gradual decrease in pathogenic microflora and an increase in symbiotic microflora. Thus, the analysis of findings obtained over the two year observation period in children with oligophrenia, who received the complex of measures to prevent dental caries prevention has confirmed its effectiveness by reducing the growth of caries intensity, the reduction in the growth of caries intensity, hygiene improvement and normalization of oral microbiocenosis.