FEATURES OF CONDITION OF PERIODONTAL TISSUES IN DISABLED CHILDREN WITH MENTAL DISORDERS

Abstract

98 disabled children with mental disorders in children aged 2 to 18 years living in Zaporizhzhya and Zaporizhzhya region were observed. High prevalence and intensity of diseases of parodontium tissues. Analyzing the data of contemporary literature it can be concluded that the provision of dental care to children with mental disorders requires special attention. In practice, we face to the problem of impossibility to perform the existing protocols of dental treatment as well as implementation of preventive procedures for such children. It is connected with the specific behavior of children with mental disorders. In this group of such patients it is necessary to optimize the development of modern methods of prevention and to improve the dental care approach. Aim of the research: to study the features of the condition of periodontal tissues and mucous membrane in children with mental disorders: to examine the condition of oral hygiene; to evaluate the status of periodontal tissues; to study the features of dentoalveolar anomalies. Materials and methods. 98 disabled children with mental disorders aged from 2 to 18 years were examined. Diagnosis of the underlying disease was established by child psychiatrist. Children were divided into the age categories accordingly to the periods of teeth development: temporary bite – 2-5 years old (group I, 39 children), changeable bite – 6-10 years old (group II, 31 children), permanent bite – 11-18 years old (group III, 28 children). Oral hygiene was evaluated according to Yu.A. Fedorov and V.V. Volodkina, Green and Vermillion. Processing of quantitative indices was carried out using Student's t-test (Р £ 0,01). Condition of periodontal tissues were evaluated on the basis of determination of papillary-marginal-alveolar index (PMA) in the modification of Parma (1960) and communal periodontal index CPI (1998) recommended by the WHO. Features of dentoalveolar disorders were evaluated by visual dental inspection because imprints of teeth cannot be made due to the underlying disease. Results. Analyzing Fedorov-Volodkina index it can be noted that unsatisfactory hygiene condition (2,1-2,5 points) is the highest in children of group II (23,02±0,2), whereas in group III this figure is 14,32±0,02 and in group I – 6,45±0,02. Very bad hygiene index (3,5-5,0 points) is in children of group I – 32,01±0,02, group II – 12,03±0,24, in group III – 25,02±0,23. Results of the evaluation of oral hygiene by Green-Vermillion index coincide approximately. There is poor oral hygiene in children of group I (43,01±0,56), and in group II (17,04±0,56) and group III (13,02±0,45) this figure is twice less, it is connected with the use of hygiene products and objects of oral care. Evaluating the state of oral hygiene we should note unsatisfactory hygienic condition of the oral cavity in 30% of children, in most of them oral hygiene is bad (33,3%) and very bad (33,3%). Prevalence of gingivitis is high: in group I – 58,23% of children, in group II – 63,25% of children; in group III – 74,11% of children. The prevalence of inflammatory periodontal tissue diseases in children of group III is 35,50±0,19, in group II – 15,11±0,09, in group I – 1,25±0,23. Bleeding is observed in each group, but more in children of group III (6,08±0,12). The data of dental survey indicate the early loss of temporary molars (in 89% of children of group I) and the first permanent molars in 18,4% of children of group II, in 43% of the examined children of group III. Conclusions. 1. Unsatisfactory oral hygiene is observed in all age groups of the examined children (in group I: bad – 33,23±0,02, very bad – 32,01±0,02; in group II: bad – 22,02±0,02, very bad – 12,03 ± 0,24; group III: bad – 12,02±0,11, very bad – 25,02±0,23). 2. The high level of periodontal tissues lesions in temporary and permanent teeth, absence of treatment of these diseases are determined. 3. The problem of early loss of temporary molars in children of 2-5 years, permanent molars in children of 6-11 and 11-15 years, and the need for specialized orthodontic care are established. Due to all these factors, the study of this problem is a topical issue for the identification and development of the complex of medical, rehabilitation and prevention methods to improve dental care for disabled children with the diseases of the central nervous system.

Keywords

• disabled children with mental disorders, gingivitis, periodontitis.