Behavioral and socio-demographic risk factors for the development of dental caries in children from 3 to 6 years of age

Увод: Рисковият профил е общо понятие, включващо различни начини за оценка на оралното здраве. Той може да бъде направен на няколко нива: обществено или групово за дадена популация; индивидуално; локално за определени зъби.Цел: Да се установят основните рискови фактори за кариеса на временните зъби, действащи в изследваната група деца, чрез анкета на родителите им.Материал и методи: Оценка на стандартните рискови фактори за развитие на зъбен кариес. Оценка на индивидуалните специфични рискови фактори на всяко дете.Обект на наблюдение: родители на деца от гр. Варна и Варненска област. Обем на наблюдение са 100 лица. Единици на наблюдението: пациенти от 3 до 6 години с необходимост от профилактика и лечение на зъбния кариес на временното съзъбие.Определихме корелацията между OHI, риск, възраст и dmft при временни зъби - Pearson Correlation index. След обработка на резултатите и определяне на акцентите е проведено същинското изследване чрез обработката на данните с пакет за математическо-статистическа обработка SPSS v.20.0.Резултати: Наличието на кариесогенен плаков биофилм, покриващ временните зъби и повърхности, открихме при 100% от децата, включени в проучването.От поведенческите фактори умерено до силно влияние върху развитието на кариес оказват честотата на миенето на зъбите (r= -0,44 p<0,001) и употребата на въглехидратни (захарни) храни и напитки (r=0,51 p<0,001). От социодемографските фактори само социалният статус показва обратнопропорционална умерена зависимост с риска от развитие на кариес (r=-0,39 p<0,001), т.е. колкото по-ниско е образованието на родителите, толкова повече се увеличава рискът от развитието на кариес.Заключение: Анализът в нашето проучване доказва силното влияние на въглехидратното хранене и лошата орална хигиена върху развитието и прогресирането на кариозния процес във временното съзъбие. От всички изследвани фактори установихме, че децата имат висок риск от зъбен кариес.Introduction: The risk profile is a general concept that includes different ways of assessing oral health. It can be made at several levels: public or group for a given population; individually; locally for certain teeth.Aim: To identify the main risk factors for temporary teeth caries in the examined group of children, through a survey of their parents.Materials and Methods: Assessment of standard risk factors for development of dental caries was conducted, as well as an assessment of the individual specific risk factors of each child. The objects of observation were parents of children from Varna and Varna district. The survey volume was 100 individuals. The units of observation were patients from 3 to 6 years of age requiring prophylaxis and treatment of dental caries of the temporary dentition.We have identified the correlation between oral hygiene index (OHI), risk, age and decayed/missing/ filled teeth (DMFT) in temporary teeth - the Pearson Correlation Index. After processing the results and de-termining the highlights, the actual study was conducted by processing the data with a mathematical and statistical processing package SPSS v 20.0.Results: Incidence of cariogenic plaque biofilm covering temporary teeth and surfaces was found in 100.0% of the children included in the study. From behavioral factors related to dental caries (r =-0.44 p<0.001), the use of carbohydrate (sugar) foods and beverages (r = 0.51 p <0.001) had moderate to strong influence on caries development. Of socio-demographic factors, only social status showed reverse proportional moderate dependence on the risk of caries development (r =-0.39 p<0.001). The lower the education of parents was, the higher the risk of developing caries was.Conclusion: The analysis in our study demonstrates the strong impact of carbohydrate consumption and poor oral hygiene on the development and pro-gression of the carious process in the temporary dentition. Through all the factors examined, we found that children had a high risk of dental caries

The Role of an Interdisciplinary Approach in the Presence of Multiple Tooth Decay and Mouth Breathing: A Case Report

Today, the overall distribution and severity of tooth decay among children are increasing at considerable rates. In addition to the main etiological factors, orthodontic status and harmful habits also impact caries risk levels. Mouth breathing, related to open bite, significantly enhances the predisposition of teeth to the initiation and progression of caries and periodontal disorders. The purpose of this study is to evaluate oral health status under conditions of mouth breathing, focusing on the role of an interdisciplinary healthcare approach.A 9-year-old female with a history of diagnosed adenoid hypertrophy, staying and sleeping predominantly with an open mouth, was examined. The assessment of oral health status was based on epidemiological indices of caries, as well as conventional clinical indicators such as PLI, GI, PBI, and criteria for evaluating deviations from orthognathic occlusion. Caries risk levels were also assessed using a questionnaire.A caries-non-resistant mixed dentition with a considerable number of active non-cavitated, cavitated, and complicated carious lesions was identified. The patient was diagnosed with generalized moderate plaque-induced gingivitis. Anamnestic data indicated uncontrolled sugar intake, unsatisfactory oral hygiene, and irregular dental visits, corresponding to a definitively high caries risk.The common health condition of adenoid hypertrophy necessitates consultation with a specialist in otorhinolaryngology. The associated symptom of mouth breathing requires collaboration with an orthodontist to improve oral health status and, consequently, the quality of life

QUESTIONNAIRE FOR THE PATIENT'S HEALTH IN THE DENTAL ANAMNESIS

Purpose: The study aims to test the knowledge of a selected group of parents of child patients regarding the diagnosis, the health status of the children, and the choice of a medical institution in the Varna region. Material and methods: Respondents answered questions about knowledge concerning: general health, a change in general health, child's admission to hospital and whether it was ill during the last three years, whether a doctor is treating the patient for a general medical or systemic disease, pain that has occurred at the moment, and how parents choose a medical institution with modern dental services and others. For data analysis, we applied a test and mathematical model of SPSS v. 20. Results: Nine children (22.50%) of the surveyed participants are currently complaining of pain caused by a dental problem. Parents report two children with past dental illnesses. The main source of information about the services offered by the University Medical and Dental Center in the city of Varna is relatives and acquaintances who have used the center's services (40.00%), followed by the information published on the Internet (30.00%). Conclusions: The study improves the parents’ knowledge, the choice of clinical and paraclinical methods in the anamnesis, diagnosis, methods and quality of treatment in childhood. The obtained results are also applied in the future planning of new clinical and treatment goals

The knowledge of dentists for preventive influence of the caries process

The line of knowledge runs from the general social, legal, financial and managerial framework. It is necessary to present the object of professional activity, the peculiarities of professional work and the methods for its optimization. Subjects of the survey were 100 dentists who perform treatment of deciduous teeth from the city of Varna, Bulgaria. The individual addressed anonymous survey was fulfilled during educational, clinical and organization meetings at the Faculty of Dental Medicine-Varna and on the territory of the city of Varna. The interviewed dentists encounter difficulties with the diagnosis of the initial dental caries in primary dentition. The dentists included in the survey rely mainly on their theoretical and practical experience and routine clinical methods for non-invasive treatment of the initial dental caries. Work experience and the specialty do not have a significant impact on the awareness of dentists about the new criteria related to the diagnosis and prevention of dental caries in the primary dentition. The age, work experience and specialty of dentists are factors for their awareness of the new approaches to treatment of children, as doctors up to 30 years of age, with a recognized specialty and work experience up to five years are more informed

Risk factors associated with the development of dental caries in Bulgarian children

The purpose of this study was to examine the risk factors associated with the development of dental caries in children in Bulgaria. The research has been carried out at the Faculty of Dental Medicine, in the period 2015-2016, with the permission of the University Scientific Research Committee and informed consent signed by each parent. The subject of observation was parents of children from Varna region in Bulgaria. The results were statistically processed with SPSS v.20.0, using variation and comparison (chi-square) analyzes. For significance level we assume p&lt;0.05. The volume of observation encompasses 100 persons. Units of observation are patients aged three to six years with the need for prevention and treatment of dental caries of the primary dentition. The registration was done in a specially developed questionnaire, including 22 questions, each with the possibility of more than one answer. In processing the obtained data, Student's criterion was used to compare the mean values of two independent samples. In a comparative analysis of the results, we found that 71.01% of children aged three to six years visit a dentist, and patients use fluoride only in the form of toothpaste containing fluoride. When studying the knowledge and behavior of parents in the direction of risk factors for the development of dental caries and oral prophylaxis, need for a new approach of pediatric dentists has been found, focused on programming preventive and non-invasive treatment of children according to their individual needs

Irreversible Pulpitis Of Primary Teeth

Острото възпаление на пулпата започва от забавянето на кръвния ток в областта на дразненето с наличие на аглутинация на червените кръвни клетки- еритроцитите в средата на кръвоносните съдове и струпване от полиморфоядрени левкоцити. Под действието на хемотаксични фактори левкоцитите се преместват в зоната на възпалението. При дезинтегрирането левкоцитите избират протеолитичните ензими в големи количества, в резултат на което области на гноен ексудат се появяват в пулпата. Други биоактивни, агресивни вещества на възпалението въздействат и в резултат на което нараства и пропускливостта на съдовете. Това е механизма на излизане на клетките от кръвната циркулация и плазмата и от кръвното русло в пулпната тъкан. Увеличава се осмоларитета, развива се хипоксия и ацидоза в пулпата на зъба. Описаният процес предопределя развитието на възпалението, дразненето на нервните окончания и причинява спонтанна болка.Acute inflammation of the pulp starts with the slowing of blood flow in the area of irritation with the presence of agglutination of red blood cells - erythrocytes in the middle of the blood vessels and accumulation of polymorphonuclear leukocytes. Under the action of chemotaxic factors, the leukocytes move to the inflammation site. In disintegration, leukocytes select proteolytic enzymes in large quantities, resulting in areas of purulent exudate occurring in the pulp. Other bioactive aggressive substances in the inflammation act and as a result, the permeability of the vessels also increases. This is the mechanism via which the cells leave the blood circulation and the plasma and move from the bloodstream into the pulp tissue. The process described predetermines the development of inflammation, irritation of nerve endings and causes spontaneous pain

Risk assessment for the development of caries from 3 to 6 years

Увод: Корекцията в поведението помага за самоконтрол на оралната среда и недопускане на развитие на кариозни лезии.Цел: Оценка на риска на някои от рисковите фактори (слюнка и орална хигиена).Материал и методи: Предмет на изследване - рискът от кариес на временните зъби. Обект на изследване са деца на възраст от 3 до 6 г. Проучването се реализира във Факултет по дентална медицина, МУ-Варна. За да се оцени рискът от въглехидратното хранене, се възлага на родителите на 30 от децата да водят „Хранителен дневник` за период от 7-10 дни. Децата се преглеждат с анамнеза и подробно регистриране на клиничен статус. Оценката се получава и с помощта на теста „GC Saliva - Check Mutans`, като се спазва точно методиката на теста.Децата от експерименталната група (30) боледуват от кариес и имат поставени обтурации до етапа на изследване. Приемайки това, си поставихме задачата в това изследване да анализираме степента на някои присъстващи рискови фактори при децата от 3 до 6 години и да ги сравним с контролната група деца (30), които не боледуват от кариес.Резултати: Изследванията показват, че разликата между двете групи за честотата на въглехидратните приеми е съществена. Обратимите активни кариесни лезии означават, че оралната околна на временните зъби среда е силно кариесогенна. Оралната хигиена е висок рисков фактор за развитието на началния дентален кариес при голям брой от изследваните деца. Анализът на данните за оценката на кариесогенната микрофлора от микробиологичните изследвания показаха, че почти 100% от децата на експерименталната група (боледуващи и лекувани от кариес) са с високо микробно число на Streptococcus Mutans и висок риск от развитие на кариес между 3 и 6-годишна възраст.Изводи: 1. Оценката на риска е лесна и достъпна за клинично изпълнение задача. 2. Изграждането на подробни данни за всеки клиничен случай на дете от оценката на риска, диагностиката, диференциалната диагностика и окончателната поставена диагноза ни осигурява точния план за лечение за всеки един пациент.Introduction: Correction in the behavior allows self-control the oral environment and prevention of the development of carious lesions.Objective: To assess the risk of certain risk factors (saliva and oral hygiene).Materials and Мethods: Subject of research - the risk of caries of temporary teeth. Subject of the study are: Children aged 3-6 years. The research was carried out at the Faculty of Dental Medicine - Varna. In order to assess the risk of carbohydrate diet the parents of 30 children were assigned to keep a food log for a period of 7-10 days. Parents recorded in the log everything they had given as a food to their child, everything they had consumed and the time at which each food was taken for 10 days (excluding weekends). Children are examined with a history and detailed registration of clinical status. The assessment was obtained with the help of test „GC Saliva - Check Mutans`, following carefully the methodology of the test. Children are medically clinically healthy, without specifics in their health. Children from the experimental group (30) suffer from tooth decay and have fillings set until the stage of study. Assuming this, we set ourselves the task in this study to analyze the extent of any risk factors present in children aged 3 to 6 years and compare them with the test group of children who do not suffer from caries (30).Results: Studies show that the difference between the two groups for the frequency of carbohydrate intake is essential. The results show that oral hygiene is a high risk factor for the development of initial dental caries in a large number of the children studied. Data analysis for the assessment of the cariogenic microflora from the microbiological studies have shown that almost 100% of the children of the experimental group (suffering and with treated caries) have a high micro bial count of Streptococcus Mutans and high risk of developing caries between 3 and 6 years of age.Conclusions: 1. An evaluation of risk is a task easy and affordable for clinical performance. Building up similar details for each clinical case per child from the risk assessment, diagnosis, differential diagnosis and the final diagnosis provided us the exact treatment plan for each patient. 2. Taking the so obtained results of the risk assessment for each child patient one prepares individual programs for prevention and non-invasive treatment of children aged 3 to 6 years

In vitro studies with X-ray diffraction

Увод: Различните зъби и зъбни повърхности са с променлив риск от развитие на кариес. Напълно развитият емайл се състои от карбонат хидроксилапатит (КХА) (92-93% тегловно за временните зъби) и по-малко от 1-2% тегловно от органични вещества. Емайлът няма клетки и следователно не може да бъде биологично възстановен. Целта на изследването е анализ на покритието, отложено върху емайла на временните зъби. Материал и Методи: Обектът представлява временни зъби, върху емайла на които е нанесено покритие от минерализиращ лак Clinpro™ White Varnish with TCP (Tri-Calcium phosphate) (3M). Изследването се направи във „Високотехнологична лаборатория за специализирани рентгенови методи и томография` на апарат за рентгеноструктурен анализ, система Empyrean, производство на PANalytical. Резултати и Обсъждане: При измерванията от приповърхностният тънък филм, експериментът показва отместване на пиковете към по-големи ъгли, отговарящи на наличен флуорапатит. Анализът на покритието показа - Флуорапатит (Fluorapatit, Apatit-(CaF)) с обща формула Ca5[F|(PO4)3]. Изводи: Наблюдава се формиране на покритие в следствие на дифузия на йони от лака към повърхността на емайла на зъба. Покритието е изградено предимно от флуорапатит. В дълбочина на емайла постепенно преобладаваща фаза става хидроксилапатита. Направеният анализ на сърцевината на зъба показва, че е изграден от хидроксилапатит и калцит.Introduction: Different teeth and tooth surfaces with a variable risk of developing caries. Fully developed enamel consists of hydroxylapatite carbonate (KHA) (92-93% by weight of the temporary teeth) and less than 1-2% by weight of organic substances. Enamel no cells and therefore can not be biologically restored. Objective: The purpose of the study is an analysis of the coating deposited on the enamel of deciduous teeth.Methods: The hotel is on temporary teeth enamel which is coated with lacquer mineralization Clinpro™ White Varnish with TCP (Tri-Calcium phosphate) (3M). The study is done in‚ High-tech laboratory for specialized X-ray and tomography methods „of an apparatus for X-ray system PANalytical Empyrean. Results: Measurements of the near-surface thin film experiment shows shift peak at larger angles corresponding to available fluorapatite. Analysis of the coating: Fluorapatite (Fluor Apatite, Apatite- (CaF)) of the formula Ca5 [F | (PO4) 3].Conclusions: There is formation of the coating due to the diffusion of ions of the lacquer to the surface of the enamel of the tooth. Cover is constructed mainly of fluorapatite. In the depth of enamel gradually becomes predominant phase hydroxyapatite. Analysis of the core shows that the tooth is composed of hydroxyapatite and calcium

Dental caries management by risk assessment among children

Dental caries is the highest-frequency oral disease. The purpose of this study is to assess the risk of developing dental caries for groups of children aged three to six in the city of Varna, Bulgaria, taking into account clinical risk factors. The population of this study included 300 children aged 3 to 6 years. Hence, as many 30 children for the experimental and 30 children for the control groups were included in the study with saliva tests. After that, standardized means of decayed, filled surfaces (DFS) index was estimated. The teeth of the children in the experimental group were covered for three months with Clinpro™ White Varnish. The Research Ethics Committee at the MU-Varna University approved the study. We applied the Greene and Vermillion oral hygiene index. Biostatistics was conducted with a specialized package for statistical analyzes was used StatSoft, STATISTICA manual (Software system for data analysis STATISTICA 10.0, 2010. The results in our study show the strong influence of carbohydrate nutrition and poor oral hygiene on the development and progression of the caries process. The results of the study of the frequency of caries lesions on surfaces show a value of 6.35±0.65. Caries lesions on 1 and 2 surfaces predominate (23.75%). Almost 100% of the children in the control group had Streptococcus mutans and a high risk of caries. From the risk assessment results obtained for each child patient, individual prevention programs are prepared for children