Evaluation of the oral status in patients with diabetes mellitus

Често срещащите се орални прояви при ЗД водят и до по-често използване на стоматологична помощ. Денталните лекари трябва да контролират диабета на пациентите, защото лечението на заболяванията на устната им кухина ще бъде по-успешно, ако те поддържат кръвната си захар в норма.Слюнката се сектретира от жлезите и е жизнено важна за оралното здраве, тъй като подпомага поддържането на оралната хомеостаза. Тя съдържа: протеини, ензими, глюкоза, неорганични съставки и хормони в различни концентрации, всяка от които има своя собствена функционална роля и значимост. При диабетици изследването на слюнката показва важни промени. В последните години оценката на нейните съставки се превърна във важно диагностично и терапевтично средство.С оглед по-добра превенция и управление норалните заболявания при диабетици е необходимо да се направи цялостна оценка. Тя включва клинични методи за оценка на денталния статус и лабораторно-диагностични методи. Клиничните методи за оценка на денталния статус са преглед и оценка на (зъбния) оралния статус чрез: DMFT индекс (СЗО критерий), без да се отчита загуба на зъби поради травматични и ортодонтски причини; OHI-S индекс на Greene и Vermilion за орална хигиена; DI-S (debris index simplified); CI-S (calculus index simplified); BOP (Bleeding on Probing); PBI (papilla-bleeding index); CPITN (Community Periodontal Index for Treatment Needs); PSR (Periodontal Screening and Recording) за оценка на необходимостта от пaродонтално лечение.Лабораторно-диагностични методи за оценка на денталния статус включват изследване на биохимични параметри в слюнка на диабетици: глюкоза; имуноглобулини: sIgA, Ig G и Ig M; микроелементи; нитрати и нитрити; цитозолни ензими - AST, ALT, ALT, GGT и LDH. Микробиологичен анализ на слюнка: наличие или липса на Candida, Str. Mutansи др. видове патогени. Оценка на функцията на слюнните жлези (нестимулирана и стимулирана слюнка) - ниво на хидратация; консистенция; количество; рН на слюнка; буферен капацитет. Изследване на вкуса - нару-ен вкус за захароза (dysgeusia) и изследване на халитоза.Often occurring oral manifestations in DM lead to more frequent use of dental care. Dentists need to monitor diabetes patients because the treatment of diseases of the oral cavity will be more successful if they keep their blood sugar normal.Saliva is produced by glands and is vitally important for oral health as it helps maintain the oral homeostasis. It contains: proteins, enzymes, glucose, inorganic substances and hormones in different concentrations, each of which has its own functional role and significance. In diabetic patients, the study of saliva shows important changes. In recent years, the evaluation of its components has become an important diagnostic and therapeutic agent.In order to achieve a better prevention and management of oral diseases in diabetics, it is necessary to make an overall evaluation. It includes clinical methods for evaluation of dental status and laboratory diagnostic methods. Clinical methods for evaluation of dental status are examination and evaluation of (dental) oral status by: DMFT index (WHO criterion) without considering the loss of teeth due to trauma and orthodontic reasons; OHI-S index Greene and Vermilion oral hygiene; DI-S (debris index simplified); CI-S (calculus index simplified); BOP (Bleeding on Probing); PBI (papilla-bleeding index); CPITN (Community Periodontal Index for Treatment Needs); PSR (Periodontal Screening and Recording) to assess the need periodontal treatment.Laboratory diagnostic methods for the evaluation of the dental status include a study of biochemical parameters in the saliva of diabetics: glucose; immunoglobulins: sIgA, Ig G and Ig M; microelements; nitrates and nitrites; cytosolic enzymes - AST, ALT, ALT, GGT, and LDH. Microbiological analysis of saliva is performed: the presence or absence of Candida, Str. Mutans and other types of pathogens. Evaluation the function of salivary glands (unstimulated and stimulated saliva) is conducted - level of hydration; consistency; quantity; the pH of the saliva; buffering capacity. Examination of taste is also part of the process - impaired taste of sucrose (dysgeusia) and research on halitosis

Patients on methadone therapy and sleep apnea

Introduction: Methadone is an opioid, which is prescribed for the treatment and management of opioid addiction. Despite its frequent use, caution should be exercised as it has side effects. Assessment of the patient's clinical condition may be influenced and exacerbated by respiratory side effects. Sleep apnea is one of the side effects, which are observed in patients, treated with methadone.Aim: The aim of the study is to see if there are interactions between methadone treatment and sleep apnea and if so - to determine how much methadone affects sleep.Materials and Methods: In this study, we examined 36 patients, addicted to drugs and treated with methadone. To compare the results we received, we used database articles from Medline, Cochrane Database of Systematic Reviews, Google Scholar, PubMed, Springer Link, Journals of Sleep Medicine and Anesthesia and Analgesia, as well as other non-indexed pages. Results: From the survey we established: 80.6% (29) of patients on methadone therapy have problems with sleep; 9 (25%) have insomnia; 38.9% (14) feel morning fatigue; 16.1% (13) experience daytime sleepiness and 36.1% have a change in mood; 19.4% (7) of respondents say that their sleep is short and 16.7% report snoring; 75% do not have problems with falling asleep and 30.6% wake up frequently during the night.Conclusion: Our study found that the majority of drug addicts reported poor sleep quality. In the treatment of patients with sleep apnea as a result of opioids, collaboration between specialists, monitoring of patients and a combination of different types of sleep apnea treatment is extremely important

Working with addicted patients - meaning, recognition and management

Introduction: Drug abuse is common and is on the rise. Addiction usually occurs among younger people. The risk of dealing with drug addicts is high.Aim: The purpose is to analyze the risks, importance and guidelines in management when dealing with drug addicted individuals, which determines the approach and specifics of their treatment.Materials and Methods: A critical analysis has been made on the available scientific literature over the past 10 years. The results of articles published in Pubmed, Google Scholar, PubMed Central, and ScienceDirect were analyzed and compared. Our own study was conducted among 47 patients on methadone treatment.Results: Opiate addiction, most commonly heroin, is one of the forms of drug abuse that is considered to be potentially harmful. Other commonly used drugs are the stimulants amphetamines, cocaine and methamphetamines. Dependent individuals lead a chaotic lifestyle, neglecting nutrition, health and personal hygiene, incl. oral hygiene. Very often, drug users are at great risk, such as overdose, infectious diseases and subsequent complications of non-treatment.Conclusion: A proper approach to drug addicts is needed to protect doctors and patients, and in order to achieve a better physical, mental and emotional, incl. oral health. Recognizing drug addicts and treating them properly are key points in good management

The effect of the prolonged use of narcotic substances on oral health

Introduction: Drug use is a socially significant problem, involving different groups regardless of their age, gender, race and religion. The significant growth of drug abusers worldwide requires the development of a model and algorithm for the diagnosis, treatment and behavior of dental practitioners in regard to these patients. Aim: The aim of this article is to summarize the data from the scientific literature, reading the current studies of Bulgarian and foreign authors, in order to identify variations in oral pathology induced by drug abuse.Materials and Methods:A search has been conducted, using Google Scholar, Web of Science, PubMed, Scopus, and ScienceDirect. The keywords were: "drugs", "research", "patients", "oral health", "effect", "oral pathology".Results:After a thorough study of available literature, we were able to summarize results showing that patients with long-term drug abuse had significantly worse oral health. Drug addicts had a much higher DMFT than control group scores. The periodontal status of patients showed reduced oral hygiene habits, resulting in elevated levels of Streptococcus mutans, actinomycetes and others; as well as xerostomia.Conclusion:The study has allowed us to conclude that continued use and abuse of narcotic drugs has a bad effect on patients' oral health.Introduction: Drug use is a socially significant problem, involving different groups regardless of their age, gender, race and religion. The significant growth of drug abusers worldwide requires the development of a model and algorithm for the diagnosis, treatment and behavior of dental practitioners in regard to these patients. Aim: The aim of this article is to summarize the data from the scientific literature, reading the current studies of Bulgarian and foreign authors, in order to identify variations in oral pathology induced by drug abuse.Materials and Methods:A search has been conducted, using Google Scholar, Web of Science, PubMed, Scopus, and ScienceDirect. The keywords were: "drugs", "research", "patients", "oral health", "effect", "oral pathology".Results:After a thorough study of available literature, we were able to summarize results showing that patients with long-term drug abuse had significantly worse oral health. Drug addicts had a much higher DMFT than control group scores. The periodontal status of patients showed reduced oral hygiene habits, resulting in elevated levels of Streptococcus mutans, actinomycetes and others; as well as xerostomia.Conclusion:The study has allowed us to conclude that continued use and abuse of narcotic drugs has a bad effect on patients' oral health

Drug Addicted Patients – Oral Health and Management // Наркозависими пациенти – орално здраве и мениджмънт

Drugs are chemicals that affect a person's physical, mental and social functions by altering them in various ways. Drug use and abuse have increased in recent years and are socially significant worldwide. Increasingly, various medical professionals are involved in preventive and therapeutic activities related to substance-dependent patients. The professional training and awareness of individual doctors are at different levels. This requires a generalization of the problem and related oral and somatic pathology. Relatively often, in general dental practice, diagnosing various diseases of the oral mucosa and hard dental tissues, dentists are faced with general somatic conditions and diseases. Some of them may be related to the use and abuse of certain substances. Given the growing number of drug addicts worldwide, dentists are increasingly working with people who abuse drugs. The observed oral pathology is always severe, but it is not yet described in sufficient detail in the scientific literature. The detection of changes in the oral mucosa and hard tooth tissues in drug addicts and the development of an explicit algorithm of work aimed at prevention and treatment reflects the great practical importance and relevance of the problem due to the ever-increasing number of these patients in dental practices.Наркотиците са химични вещества, които оказват влияние върху физическите, психическите и социалните функции на човека, като ги променят в различни аспекти. Употребата и злоупотребата на наркотични вещества е нараснала последните години и е социално-значим проблем в световен мащаб. Все по-често различни медицински специалисти са въвлечени в превантивни и терапевтични дейности, свързани с пациенти, зависими от вещества. Професионалната подготовка и информираност на отделните лекари е на различно ниво. Това налага обобщаване на проблема и свързаната с него орална и общосоматична патология. Относително често, в общата дентална практика, диагностицирайки различни заболявания на оралната лигавица и твърди зъбни тъкани, лекарите по дентална медицина се сблъскват с общосоматични състояния и заболявания. Част от тях могат да бъдат свързани с употребата и злоупотребата на определени субстанции. Предвид нарастващия брой на наркозависими в световен мащаб, денталните медици все по-често работят с хора, злоупотребяващи със зависими вещества. Оралната патология, която се наблюдава винаги е тежка, но все още не е достатъчно подробно описана в научната литература. Установяването на промени по оралната лигавица и твърдите зъбни тъкани у наркозависими и изработване на ясен алгоритъм на работа, целящ профилактика и лечение, отразяват голямото практическо значение и актуалност на проблема, поради непрекъснато увеличаващия се брой на тези пациенти и в денталните практики

ORAL AND DENTAL STATUS OF BULGARIAN PATIENTS – A 5-YEAR STUDY

Introduction: Oral diseases are major health problem for society. Demographic, health, personal and clinical factors influence the DMFT index of patients. There is a connection between oral hygiene habits, smoking, amount of food, frequency of intake and the spread of oral diseases. The lack of attention for oral care leads to the appearance of oral lesions. Purpose: The main aim of this study is to determine the factors for oral pathology and to find if there is a correlation between oral status of the patients, their dental habits and attitude to oral health. Participants and methods: Subject of this social study are 603 patients, 380 women (63%) and 223 (37%) men, range age 18 – 82 years. All of them are from North-Eastern Bulgarian regions – Varna, Dobrich, Shumen and Targovishte. Every patient has been asked to answer 20 questions and has undergone a clinical examination. DMFT index was recorded. Results: We found oral mucosal lesions as leukoplakia, lichen planus, Candidal infections, fissured tongue, lingual varicosities and mucocele in 11.44% of patients. Dental caries was found to be prevalent in almost all examined patients. DMFT index varied from 5.01±3.6 to 16.45±4.9 in different age groups. Data about tooth brushing and using of additional methods for controlling the biofilm was also presented. The results showed that younger patients have better oral and dental health and pay more attention on maintaining their oral hygiene. Conclusions: The oral and dental status of the Bulgarian patients can be assessed as average damaged with high treatment needs. To make it better a lot of health promotional and dental preventive activities are needed especially in the field of improving hygiene habits, use of additional funds for hygiene and more frequent dental visits of the whole population