THE STATE OF HARD TISSUE OF TEMPORARY TEETH IN CHILDREN FROM ORPHANAGES AND BOARDING-SCHOOLS
The caries of temporary teeth is still one of the actual problems in the world and in Ukraine. Numerous risk factors of this disease are particularly aggressive against the background of adverse medical and social factors specific to children from orphanages. Thus, according to the literature, 64% of children in orphanages there are with complication of intrauterine development, 10% - with congenital or hereditary diseases; 30-40% of children coming from alcoholic`s families, 50% - from mothers and 13% - from fathers with tuberculosis, syphilis, diabetes, or mental illness. Therefore, the adaptive abilities of this group of children are reduced because their health is formed in a whole range of adverse medical and social, psychological, biological and genetic factors. Most of these children have thyroid diseases, diseases of gastrointestinal tract, respiratory pathology, otolaryngology and kidneys diseases. However, 94,6% of children in orphanages have low immunity and overall resistance, high prevalence of recurrent herpetic infection as a marker of immune disorders. It has been proved that children of boarding -schools have not only high rates of tooth decay, but the poor quality of treatment. Especially critical is the situation in orphanages and boarding -schools which are not equipped by dental rooms.
The purpose of the study is to analyze the state of hard tissue of temporary teeth in children from boarding schools and orphanages for differentiated preventive and therapeutic measures.
Material and methods. 440 children at the age of 3,5,7,9,12 years from boarding –schools and orphanages that formed the main group and 155 Lviv `s preschool and school children (comparison group) were examined. To assess the state of hard tissue of teeth were determined prevalence (%) and intensity of caries (df). The results were statistically processed using Student’s test.
Results of the research. It has been found that the prevalence of caries of temporary teeth in children from boarding- schools and orphanages, on average, 72,06 ± 6,07%, in comparison group of children - 56,93 ± 4,01% (p<0.01). It was found higher prevalence of caries of temporary teeth in 3-year-old children of main group as compared with preschool children of Lviv (68,5 ± 7,09% and 39,2 ± 4,07% respectively (p < 0,001). Up to 7 years in children of boarding -schools prevalence of caries of temporary teeth increases to 94,6 ± 6,07%, decreasing to 78,09 ± 4,09% in 9 years and to 29,63 ± 1,07% at 12 years, due to the physiological replacement of temporary teeth. In the comparison group observed a similar trend. Significant differences between dental caries of girls and boys we have not found, so the gender analysis was not performed. However, in the main group was found the high rates of intensity of caries of temporary teeth, which significantly differed from that of the comparison group. Thus, the intensity of caries of temporary teeth in children from boardingschools, on average, 5,38 ± 0,51 to 3,38 ± 0,17 in children of comparison group (p<0.001). It was found that 3 years-old children of boarding- schools have high intensity of caries of temporary teeth (df = 5,89 ± 0,56). Instead, the children of comparison, this index almost twice as small and amounted 3,20 ± 0,34 (p <0.001). In 5 years, these index is 6,97 ± 0,85 in the main group and 4,96 ± 0,34 (p <0.01) in the comparison group. Up to 7 years the caries intensity of temporary teeth in children of both groups increased and amounted 8,60 ± 0,85 and 5,15 ± 0,34 (p<0,001), respectively. The important indicator of the dental care is a quality of dental health, which is determined by the structure of index "df". Thus, untreated caries teeth "d", which accounts for one child from orphanages, on average, 4,8 ± 0,45 that is 89,22 ± 9,07%, in the comparison group this index is twice lower and amounted 2,06 ± 0,19 (60,94 ± 4,77%) (p <0.001). This significant difference is seen in all age groups (p <0,001). However, the analysis of treated teeth "f", showed that one child in the main group has, on average, only 0,58 ± 0,16 treated tooth, which is significantly lower than children comparison group (1,32 ± 0, 09 tooth, p <0,001). Especially significant difference of this indicator between children of the main group and the comparison group was found in 7-year-olds, indicating a very low level of treatment of children from orphanages, as opposed to children who live in families and run by parents (0,59 ± 0,26 tooth and 2,83 ± 0,22 tooth respectively, p <0.001). We analyzed the prevalence of dental caries in children considering boardingschools and the availability of dental surgeries. Thus, it was found significantly higher prevalence and intensity of dental caries in children in settings where no dentist offices and not conducted a systematic preventive examination of the oral cavity. Thus, on average, caries of temporary teeth was found in 75,46 ± 4,75% of children from orphanages where no dentist offices with an average intensity of caries df = 6,25 ± 0,55 of tooth, which is significantly higher as compared with index of children from boarding- schools, which have dentist offices, where the prevalence of caries is 61,90 ± 5,07% at df = 4,83 ± 0,59 of tooth. Also was found that in the structure of the index "df" of children from boarding- schools where no dentist offices, the indicator of treated teeth "f" is often equal "0" in all age groups and on average was only 0,34 ± 0,03 treated tooth, which is significantly lower than in children, staffed by dental offices, and index f = 1,79 ± 0,12 (p <0,001). Thus, the high level of caries in children from orphanages demonstrates the need for special attention to the health of this category of children, including the timely prevention of tooth decay.
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