Prevention dental diseases in children aged 6 to 12 years. State budgetary educational institution higher vocational education First Moscow State Medical University them. THEM. Sechenov

Prevention of dental diseases is the prevention of the occurrence and development of diseases of the oral cavity. The introduction of prevention programs leads to sharp decline the intensity of dental caries and periodontal disease, a significant decrease in the incidence of tooth loss at a young age and an increase in the number of children and adolescents with intact teeth. The cost of preventive methods is, on average, 20 times lower than the cost of treating already existing dental diseases. Dental morbidity in our country is quite high, and its further increase should be expected if the conditions affecting the development of the disease are not changed in a favorable direction.

Methods for the prevention of major dental diseases: Dental education of the population Teaching the rules of rational nutrition; Teaching the rules of hygienic care of the oral cavity; Endogenous use of fluoride preparations; The use of local prophylaxis;

Dental education methods Conversations Lectures Seminars Health lessons Games etc. Methods that provide for the interested participation of the population are called active. Their advantage is the direct relationship and interaction between the specialist and the audience, which ensures best effect impact. Methods that do not require the active participation of the population are called passive. They don't require presence. medical worker, affect long time and to a large audience. The disadvantage is the lack of feedback between patients and a specialist. Dental education, depending on the number of people involved in educational work, is divided into 3 organizational forms: mass, group, individual. The steps that any person must overcome in order to develop a useful habit: knowledge => understanding => belief => skill => habit. understanding => belief => skill => habit.">

general characteristics period from 6 to 12 years The eruption of permanent teeth and the replacement of milk teeth continue. This condition is called "replacement" bite. In already erupted teeth, the formation of roots ends (completely by the age of 14) (i.e. at first they are not formed, and the tooth is already “on the street”, and its root in the jaw only continues its formation and after some time its top closes ). The maxillary sinus is finally formed and acquires a constant size, because. at an earlier age, its development is “interfered” by the rudiments of permanent teeth located in the jaw. The structure of the bone tissue of the jaws is compacted.

Typical problems and symptoms of the period The characteristic problems of this age are an increase in carious teeth due to even poorer hygiene (children go to school, they have no time to do it well in the morning, and control from parents - school-age children is already considered independent).

Typical problems and symptoms of the period Injuries also become very characteristic at this age: broken crowns of permanent incisors (possibly when visiting sports clubs or during independent walks on winter slides). The complexity of these injuries lies in the fact that when the tooth crown is broken off, the pulp of the tooth (the neurovascular bundle inside the enamel and dentin) is often exposed, and in some cases it is not possible to remove the "nerve" and seal the canal, since the tooth root has not yet been formed ( its tip in the jaw is not closed, and it is a bell, like an open funnel, and not a closed cone as in adults). Therefore, the treatment of such teeth is carried out under long-term and constant supervision, requires careful monitoring, as if the doctors grow the root of the tooth, and only then, if necessary, fill the canal.

Typical problems and symptoms of the period Bite pathologies are formed (sucking a pencil or pen in the mouth while studying), open bite (children go to school, the load on the immune system increases, colds become more frequent, as a possible result of untreated rhinitis - adenoids and, accordingly, mainly oral breathing, and as a result of malocclusion). If the permanent chewing teeth were not sealed, then the inflammatory process in the pulp (pulpitis) following caries is also difficult to treat due to unformed roots (only chewing teeth are already multi-rooted teeth, i.e. even more difficult to treat with unformed roots at this age). The roots of the 6th teeth are finally formed, as a rule, by the age, the roots of the incisors by 8-10 years.

Nutritional education Nutrition can affect dental tissue in two ways: first, during tooth formation before eruption and, second, after eruption. For the formation of caries-resistant teeth, one of the main conditions is a complete nutrition of a pregnant woman in terms of quality and quantity, including dairy products, minerals, vitamins, vegetables, and fruits. Of great importance is nutrition in the first year of a child's life, when permanent teeth are being laid and developed. The following nutritional features contribute to the emergence and progression of dental caries in the population: - high content of easily fermentable carbohydrates in food, especially sugar; - increase the frequency of eating; - reducing the consumption of foods that require intensive chewing, which leads to an increase in the flow of saliva and "natural cleansing of the mouth"; - reducing the consumption of food that contributes to the inhibition of dental caries.

Pastes and gels for cleaning teeth Dental powders Mouthwashes Sugar-free chewing gums Toothbrushes Tongue cleaners Interdental brushes (brushes) Dental floss Toothpicks Interdental stimulators Oral irrigators Care products for removable orthopedic and orthodontic structures Interdental brushes, dental floss, toothpicks, interdental stimulators and single-beam specialty toothbrushes can be grouped as interdental oral hygiene products Personal oral care products include:

Toothpaste these are combinations of abrasive material and odorant, interconnected in a cohesive mass; with a toothbrush, it is used to clean the accessible surfaces of the teeth. The main components of toothpaste are: abrasive (scraping) gel-forming and foaming substances dyes fragrances and substances that improve taste qualities active reagents that provide therapeutic and prophylactic properties of the paste Toothpastes

Fluoride-containing toothpastes Elmex-gel toothpastes containing mg/kg of olafur are recommended for use once a week by children aged 6 years and older with an increased risk of dental caries under adult supervision. The use of the gel is also indicated when using orthodontic appliances. The gel, like the paste, is used to brush your teeth for 2 minutes. Children should not swallow the gel. After brushing, rinse your mouth with tap water.

Fluoride-containing toothpastes The effectiveness of fluoride-containing toothpastes depends on their fluoride content. The anti-caries effect of toothpaste is enhanced by increasing the concentration of fluoride to 2500 mg/kg. An increase in the content of fluoride for every 500 mg/kg increases the anti-caries effect by 6%. The anti-carious effect of the paste begins when it contains 250 mg/kg F -. The European Commission has set a limit for the concentration of fluoride, which should not exceed 1500 mg/kg. For professional topical use of fluoride in dentistry, gels containing mg/kg F - are produced. Toothpastes

Toothpastes for children The requirements for children's toothpastes are as follows: Low abrasiveness. For temporary teeth and newly erupted permanent teeth, as well as with reduced acid resistance of the enamel, the use of gel pastes is optimal. The RDA value for children's pastes should not exceed SO. Lack of flavoring additives that can make a child want to eat pasta or accustom him to a sweet taste. It is preferable to use neutral, mint or fruit flavors that do not cause rejection in the child. Attractive appearance and child-friendly packaging.

Toothpastes for children Toothpastes for children 7-12 years old: Blend-a-med (Junior Gel) (NaF, phosphates); Colgate junior (0.15% NaF 680 ppm F -); Colgate junior super star (0.76% Na 2 PO 3 F 1000 ppm F -); My first Colgate (NaF); Dental dream for children (0.5% Na 2 PO 3 F 660 ppm F -, calcium lactate); Four Fruit (Na2PO3F, NaF); Mildfresh junior (0.76% Na 2 PO 3 F ppm F -); Sanino Junior (Na 2 PO 3 F); New pearls Junior 7-12 years old (0.76% Na 2 PO 3 F 1000 ppm F -, tea tree oil); Baby pearl complex (Na 2 PO 3 F 500 ppm F -, calcium glycerophosphate); Carimed for children (NaF, calcium gluconate); Prodent for teenagers (NaF + Na 2 PO 3 F).

Toothpastes for children When using toothpastes by children, especially during the period of learning to brush their teeth, parental supervision is necessary. It is known that the antibacterial and remineralizing effect of toothpastes is carried out when the paste is in the mouth for at least 23 minutes, which requires thorough brushing of the teeth.

Tongue Cleaner!!! Small oval brush head with soft edge Toothpaste application area Tiered bristles Non-slip, soft, voluminous handle with curved thumb Toothbrush for the care of the oral cavity of children over 5 years old, who still have milk teeth and permanent teeth have already appeared. For effective brushing of mixed teeth and tongue cleaning For teaching children proper oral hygiene To protect gums To apply the recommended amount of toothpaste For more convenient and effective brushing For convenient and comfortable brushing Colgate Smiles 5+ Colgate Smiles 5+

Solutions for rinsing the mouth For daily rinses, use 0.05%, and for weekly 0.20% sodium fluoride solution. Rinse solutions are recommended both for individual use and for groups of children in classrooms. Solutions for rinsing the mouth are usually divided into two groups of solutions containing antimicrobial agents of the first and second generations. Most of the solutions currently produced belong to the first generation, since their active components are able to block the growth of microorganisms for as little as 30 minutes, and some of them even work for less than 30 minutes.

Toothbrushes At present, there are many models of toothbrushes on sale, differing from each other in the size and shape of the working head, the length and type of elastic bristles, the ratio of the angle of the brush head in relation to its handle, etc. Differences in toothbrush design as well chemical composition and the location of the villi and their tufts have been the subject of numerous studies and publications on the topic of choosing the optimal toothbrush pattern. The literature is dominated by the position that the rounded ends of the bristles of the brush should be soft, made of nylon, and collected in a bundle on a short head. Each toothbrush consists of a handle and a working part-head with bushes of bristles planted in it. IN Lately for the manufacture of brushes, synthetic fiber is used (nylon, setron, perlon, derlon, polyurethane, etc.).

Toothbrushes There are 4 degrees of hardness of toothbrushes: hard, medium hard, soft and very soft. The exception is children's toothbrushes, which are made from soft to very soft bristles. The most effective are brushes of medium hardness and soft ones, since their bristles, being more flexible, clean the gingival groove and better penetrate into the interdental spaces. Very soft brushes are recommended for periodontal disease treatment, when the condition of the gums does not allow vigorous brushing. In the normal condition of the teeth and periodontium, it is recommended to use brushes of medium hardness and soft ones.

Toothbrushes For children up to 12 years of age, soft brushes with a working head up to 25 mm are recommended. It is important for parents to monitor the condition of the brush. Depending on its quality, the brush can be used for brushing teeth, i.e. within 2 months (Marthaler T.M., 1988; 1990). A - 3 rows of tufts B - 4 rows of tufts

Toothbrushes When choosing a toothbrush, the following basic rules should be followed (Marthaler T.M., 1990): the brush should have a comfortable handle and not rotate during brushing; the design of the brush should not determine its movement; the brush should not contribute to horizontal movements; (d) the brush must be appropriate for the person's age

Oral care using the company's toothbrush (2 times a day after meals, brush your teeth for at least 2 minutes, tongue - 10 seconds) The outer surface of the teeth is cleaned with sweeping movements in the direction from the gum to the edge of the tooth. The brush head is placed at an angle of 45 0 to the surface to be cleaned. The inner surface of the rear (chewing) teeth should be cleaned in a circular motion, the front teeth - in short vertical movements. The chewing surface of the teeth is cleaned by moving the brush back and forth. Higher bristles at the tip of the brush provide better access to the back teeth Tongue cleansing uses a unique pad on the back of the brush head to remove bacteria that cause bad breath

Teeth brushing methods Teeth brushing methods recommended by many authors differ from each other in the nature of the movement of the toothbrush on the surface of the teeth, namely vertical, horizontal, circular, vibrating and sweeping. A detailed analysis of the available literature data indicates significant disagreements between the authors in assessing their effectiveness, with the exception of the circular method, the Bass method. A toothbrush at an angle of 45° with respect to the long axis of the tooth with circular sweeping movements frees the surface of the tooth from plaque.

Dental floss floss The main purpose of using floss is to thoroughly remove plaque from hard-to-reach side surfaces, as well as to remove food debris that gets stuck between the teeth. Waxed and unwaxed thread, round and flat thread are used, regardless of this, with the correct use of the thread, the cleaning efficiency is the same. A flat and waxed floss is more comfortable as it passes through contact points more easily, does not break, and covers more of the tooth surface. For this purpose, you can use a silk or harsh thread.

Sealants (sealants) for enamel fissures The next stage of preventive treatment after filling active carious lesions is the coating (sealing) of fissures and pits with sealants, which are a plastic material that acts as a physical barrier for cariogenic bacteria. Silants can stop the carious process for early stages its development. The procedure for applying sealants is quite simple, but requires careful implementation of the manufacturer's instructions, and especially to prevent moisture from entering the surgical field.

Fluoride Varnish The market is currently dominated by fluoride varnishes Duraphat, Duraflor, Fluor Protector, Cavity Shield (Colgate Oral Pharmaceuticals; Pharmascience, Montreal, Canada; Ivoclar/Vivadent and OMNII Oral Pharmaceuticals, respectively). Duraphat, Duraflor and OMNII contain 5% sodium fluoride and Fluor Protector 0.1% sodium fluoride.

Phosphate-acidified sodium fluoride gels Applications of acidified gels must be carried out with extreme caution, preventing the possibility of swallowing, and in this regard, the WHO Expert Committee on Dentistry recommended that the following rules be followed: the amount of gel placed in the mouthguard should not exceed 2 ml or 40% of its volume for the application of individual teeth in custom-made trays, no more than 5-10 drops of gel should be used; the patient should be in a chair in a sitting position, and his head is slightly tilted forward; cover with petroleum jelly remove the remnants of saliva with a saliva ejector at the end of the application, the duration of the application should be no more than 4 minutes, after the applications the patient is not recommended to eat for 30 minutes. With the active course of caries, it is recommended to repeat the application of the gel every six months do not leave the patient unattended during the application, store the gel out of reach of strangers

Pathogenetic prevention Remineralizing therapy "Remodent" "Osteovit" "Vita" Remineralizing calcium-phosphate-containing gels Remineralizing solutions obtained by dialysis of salt solutions through semipermeable membranes fluoride gels53% Teeth cleaning with fluoride-containing pastes16-30% Electrophoretic introduction of fluorides29% Fluoride varnishes40-45% Dental fissure isolation Up to 90% Knappvost deep fluoridation95%

The use of fluorides in programs of mass prevention of dental caries Method of application of fluoride gels All measures must be taken to minimize the ingestion of the gel by the patient. Limit the amount of gel to 2 ml, which is approximately 40% of the volume of an individual spoon. Limit the amount of gel placed on the sponge to 5-10 drops. Place the patient in a sitting position with the head tilted forward. Use a saliva ejector throughout the procedure. After the procedure, the patient must spit saliva or hold a saliva ejector for 30 seconds. Keep the container of gel away from the patient. Don't leave the patient alone. The duration of the procedure should not exceed four minutes.

Use of fluoride in mass dental caries prevention programs Self-administered gels Care must be taken to minimize ingestion of the gel by the patient. FLUORIDE GELS Concentration F - Use self use (ppm) professional use (12300 ppm) 2x/year professional treatments 1x/week home use

The use of fluorides in the programs of mass prevention of dental caries Fluoride varnishes Varnishes are applied to the teeth with a brush or with a special syringe. The effectiveness of varnishes has been confirmed in community dental caries prevention programs. Recently, the use of fluoride varnishes as an alternative method of preventing dental caries has been increasing due to the low labor intensity for the staff and the small time spent for the patient. The use of fluoride varnishes is recommended 2-3 times a year in patients at risk of caries. There are no contraindications.

Use of fluoride in programs of mass prevention of dental caries FLUORIDE RINSE RINSES Daily Weekly 0.05% sodium fluoride solution (230 ppm) keep out of the reach of children 0.2% sodium fluoride solution (900 ppm) (or 2 times a week) do not recommended for children under 6 WHO, 1994

FLUORIDED TOOTHPASES FOR CHILDREN Fluoride sodium fluoride sodium monofluorophosphate aminofluoride Efficacy Doses of fluoride Use Quality early age possible mild forms of dental fluorosis Not recommended

Chewing gum does not directly affect cariogenic factors plaque microorganisms substrate (food carbohydrates) fluorine deficiency except for F-containing chewing gum stimulates saliva secretion mineral substances microelements buffer properties bactericidal properties removal of food debris

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Statistical data

It is known that during the physiological course of pregnancy, the prevalence of caries is 91.4%, periodontal disease occurs in 90% of cases, lesions of previously intact teeth, mainly with an acute course of the carious process, in 38% of patients. Secondary caries, progression of the carious process, enamel hyperesthesia occur in 79% of pregnant women. A clinical feature of the course of the carious process in pregnant women is its rapid spread not only along the periphery, but also into the depth of the tooth tissues, which in a short time leads to the development of complicated caries. By the end of the second half of pregnancy, periodontal tissue damage is 100%.

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Medical Data

In pregnant women, an increased sensitivity of intact teeth to chemical thermal mechanical stimuli is determined, as well as non-carious lesions in the form of wedge-shaped defects and vertical pathological abrasion of teeth.

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The need for therapeutic dental care for pregnant women occurs in 94.7% of cases, orthopedic - in 56.1%, emergency surgical interventions - in 2.2% of cases. total number pregnant. It is noted that during pregnancy, an increase in dental morbidity is due not only to changes occurring in the body of a woman as a whole, but also to a deterioration in the state of hard dental tissues, which is associated with: a change in the microflora of the oral cavity, a decrease in the resistance of tooth enamel to acids.

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Prevention of dental caries and periodontal disease in pregnant women has a dual goal: to improve the dental status of a woman; to carry out antenatal prevention of dental caries in children. Measures for the prevention of dental diseases during pregnancy should be organized taking into account the severity of dental diseases and the course of pregnancy.

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The health of the mother during pregnancy affects the development of the child's teeth, especially during the 6-7th week, when the process of laying teeth begins. Studies of the rudiments of teeth have shown that during the pathological course of pregnancy, the mineralization of the enamel of the teeth of the fetus slows down, and often stops at the stage of initial calcification.

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Allocate a group of factors, the action of which disrupts the full formation of the dentoalveolar system. These include: the presence of extragenital pathology in the mother; complications of pregnancy (toxicosis of the first and second half); early artificial feeding. stressful situations during pregnancy; diseases of newborns and infants;

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Already in the early stages of pregnancy, the condition of the hard tissues of the teeth and periodontium deteriorates against the background of an unsatisfactory hygienic state of the oral cavity and shifts in the composition of the oral fluid. This necessitates the need for preventive measures throughout the entire period of pregnancy.

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Women are recommended to carry out a set of general preventive measures, including: the correct mode of work and rest, good nutrition, vitamin therapy. Full sleep up to 8-9 hours stay on fresh air in combination with dosed physical activity, it contributes to the flow of oxygen into the body.

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Nutrition

Nutrition should be varied, with the necessary amount of vitamins and minerals. In the first half of pregnancy, a woman's body needs a continuous supply of protein. In the second half, the need for vitamins, trace elements and mineral salts increases. Vegetables and fruits should be regular ingredients in the diet. The main sources of vitamins should be food, as well as taking multivitamin preparations - Dekamevit, Undevit, Gendevit, etc.

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Multivitamins

Multivitamin preparation with mineral additives "Pregnovit" containing vitamins A, D2, B1, B2, B6 hydrochloride, B12 cyanocomplex, calcium pantothenic acid, iron furamate, anhydrous calcium phosphate is prescribed in the following dosages: up to 4 months of pregnancy - 1 capsule with 5 to 7 months - 2 capsules from 8 to 9 months - 3 capsules per day. The drug is especially effective in iron deficiency anemia, the development of which can lead to a decrease in the intake of iron with food, a violation of its absorption, multiple pregnancy, prolonged breastfeeding

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Dentist

To achieve the maximum effect, it is necessary to conduct a medical examination of women throughout the entire period of pregnancy and coordinate the work of a gynecologist and a dentist, to whom a woman should be referred at the first visit to the antenatal clinic. In the dental office it is necessary to organize: training in rational oral hygiene with controlled brushing of teeth, assistance in the selection of basic and additional hygiene products; sanitation of the oral cavity; professional hygiene; carrying out remineralizing therapy in order to increase the resistance of tooth enamel.

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Promoting medical knowledge

Of particular importance is the organization of educational work on the prevention of dental diseases and motivation for caring for the teeth of children immediately after their eruption. In addition, dental education should include: breastfeeding until the child reaches the age of 12 months, recommendations on limiting sugar in the diet of children (up to 20 g per day) on the rules for using a pacifier. The implementation of a complex of therapeutic and preventive measures undoubtedly improves the state of the dental health level of both the mother and the unborn child.

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Scheme for the prevention of dental diseases in pregnant women:

TACTICS. OB/GYNECOLOGIST At the first visit to the antenatal clinic, refer the woman to the dentist. Explain the need for training in rational oral hygiene, dental treatment, professional hygiene.

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DENTIST 1. Examination of the oral cavity, individual recommendations for dental care. 2. Training in rational oral hygiene. 3. Professional hygiene with an interval of 2-3 months. 4. Motivation of women to care for children's teeth immediately after their eruption. 5. Recommendations for limiting sugar in the diet of children to 20 g per day and the use of pacifiers.

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PEDIATRICS 1. Promotion of breastfeeding. 2. Recommendations on diet, limiting sugar intake to 20 g per day. 3. Motivation of parents for regular visits to the dentist, starting from the age of 6 months.

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Let's not forget that

When carrying out preventive and therapeutic dental measures in pregnant women, it must be taken into account that the woman should be in a semi-sitting position, since the horizontal position provokes an increase in intra-abdominal pressure in combination with relaxation of the smooth muscles of the gastrointestinal tract, clinically manifested by heartburn, nausea, vomiting, chest pain . Manipulations should be carried out under the control of heart rate, heart rate, blood pressure, changes in which are possible at the appointment and are caused by psycho-emotional stress associated with a visit to the dentist and the expectation of pain.

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"Prevention of Dental Diseases"

Plan

I Introduction:

1) Determination of the prevention of dental diseases;

2) Goals and objectives of prevention;

3) The relevance of the topic.

II main part.

Methods for the prevention of major dental diseases:

1) Dental education of the population;

2) Teaching the rules of rational nutrition;

3) Teaching the rules of dental care for the oral cavity;

4) Endogenous use of fluoride preparations;

5) The use of local prophylaxis;

6) Secondary prevention (sanation of the oral cavity).

III Summary

IV Conclusions

V Bibliography

I Introduction.

Prevention of dental diseases is the prevention of the occurrence and development of diseases of the oral cavity. The introduction of prevention programs leads to a sharp decrease in the intensity of dental caries and periodontal diseases, a significant decrease in cases of tooth loss at a young age and an increase in the number of children and adolescents with intact teeth. The cost of preventive methods, on average, is 20 times lower than the cost of treating dental diseases that have already arisen.

Dental morbidity in our country is quite high, and its further increase should be expected if the conditions affecting the development of the disease are not changed in a favorable direction.

Goals and objectives of prevention:

Reducing the intensity and prevalence of dental caries; an increase in the number of people without caries.

Decrease in the percentage of individuals who have signs of periodontal tissue damage; reduction in the number of sextants with bleeding, tartar and pathological pockets in the key age group in accordance with the index of need in the treatment of periodontal diseases.

Relevance of the topic:

The topic of prevention of dental diseases is very relevant, since the results of numerous studies show that the intensity of the main dental diseases (dental caries and periodontal disease) among the Russian population is quite high.

So, in three-year-old children, the intensity of caries in temporary teeth is on average 3.7, that is, in every three-year-old Russian child, almost 4 teeth are affected by caries.

In the future, with age, there is a significant increase in caries activity. By the age of 15, the average number of affected teeth among adolescents reaches 8.0. In the adult population, the incidence of dental caries reaches 100%.

As for the state of periodontal tissues, it turned out to be unsatisfactory in the majority of the Russian population, regardless of age and place of residence. By the age of 35-44 and older, almost all the examined patients had severe periodontal lesions with a predominance of tartar and periodontal pockets of various depths.

Concerning Belgorod region, then in 2000 periodontitis was registered in 52, 18 cases, and in 2001 - 96.70 cases.

II main part.

Methods for the prevention of major

dental diseases:

1) dental education of the population;

2) teaching the rules of rational nutrition;

3) teaching the rules of hygienic care for the oral cavity;

4) endogenous use of fluoride preparations;

5) the use of local prophylaxis;

6) secondary prevention (sanation of the oral cavity).

Methods of dental education are conversations, lectures, seminars, health lessons, games, etc.

Methods that provide for the interested participation of the population are called active. Their advantage is the direct relationship and interaction between the specialist and the audience, which ensures the best impact.

Methods that do not require the active participation of the population are called passive.

They do not require the presence of a medical worker, they affect a long time and a large audience. The disadvantage is the lack of feedback between patients and a specialist.

Dental education, depending on the number of people involved in educational work, is divided into 3 organizational forms: mass, group, individual.

The steps that any person must overcome in order to develop a useful habit: knowledge => understanding => belief => skill => habit.

Teaching the rules of rational nutrition.

Nutrition can affect tooth tissues in two ways: first, during tooth formation before eruption and, second, after eruption.

For the formation of caries-resistant teeth, one of the main conditions is a complete nutrition of a pregnant woman in terms of quality and quantity, including dairy products, minerals, vitamins, vegetables, and fruits. Of great importance is nutrition in the first year of a child's life, when permanent teeth are being laid and developed.

The following nutritional features contribute to the emergence and progression of dental caries in the population:

High content of easily fermentable carbohydrates in food, especially sugar;

Increasing the frequency of eating;

Reducing the consumption of foods that require intense chewing, which leads to an increase in saliva flow and "natural cleansing of the mouth";

Reducing the intake of food that contributes to the inhibition of dental caries.

Individual oral hygiene.

Individual hygiene involves the careful and regular removal of dental deposits from the surfaces of the teeth and gums by the patient himself using various hygiene products.

There are many methods for brushing your teeth. One of them is the standard method of brushing teeth Pakhomov G.N. It consists in the following: brushing the teeth begins with a site in the region of the upper right chewing teeth, sequentially moving from segment to segment. In the same order, teeth are cleaned in the lower jaw.

When cleaning the vestibular and oral surfaces of molars and premolars, the toothbrush is placed at an angle of 450 to the tooth and cleansing movements are made from the gums to the tooth. The chewing surfaces of the teeth are cleaned with horizontal movements. When cleaning the oral surface, the brush handle is placed perpendicular to the occlusal plane of the teeth. Finish cleaning in a circular motion.

The main tool for brushing your teeth is a toothbrush.

There are 5 degrees of hardness of toothbrushes: very hard, hard, medium, soft, very soft.

The most widely used brushes are of medium hardness.

Toothpicks are designed to remove food debris from the interdental spaces and plaque from the side surfaces of the teeth.

Fluxes are designed to thoroughly remove plaque and food debris from hard-to-brush contact surfaces of teeth.

Toothpastes should be good at removing soft plaque, food debris; be pleasant in taste, have a good deodorizing and refreshing effect and have no side effects: locally irritating and allergenic.

The main components of toothpastes are abrasive, gel-forming and foaming substances, fragrances, dyes.

The most popular therapeutic and prophylactic agent is fluoride-containing toothpastes. The entry of fluoride into tooth enamel increases its resistance to acid demineralization due to the formation of structures more resistant to dissolution.

Toothpastes containing stone, sodium phosphates, calcium and sodium glycerophosphates, calcium gluconate, zinc oxide in their composition have a pronounced anti-caries effect.

Recently, therapeutic and prophylactic toothpastes have been widely used, which include several medicinal plants(sage, peppermint, chamomile, echinacea, etc.).

Chewing gum is a tool that improves the hygienic state of the oral cavity by increasing the amount of saliva and the rate of salivation, which helps to clean the surface of the tooth and neutralize organic acids secreted by plaque bacteria.

Dental elixirs are intended for rinsing the mouth. They improve the cleaning of the surfaces of the teeth, prevent the formation of plaque, and deodorize the oral cavity.

Endogenous methods of application of fluorides.

The use of fluoride binders for the prevention of dental caries can be divided into two main methods - systemic (endogenous) - the intake of fluorides into the body with water, salt, milk, in tablets or drops; and local (exogenous) - the use of solutions, gels, toothpastes, varnishes.

Means for topical application.

Fluoride varnishes. They are used to prolong the period of fluoride exposure to enamel. They form a film adjacent to the enamel, which remains on the teeth for several hours, and in fissures, crevices and microspaces - for several days and even weeks.

The average reduction in the growth of caries in the application of varnish is 50%.

Fluorine-containing solutions and gels.

Use preparations with a high concentration of sodium fluoride (2% sodium fluoride solution).

An effective remineralizing drug is "Remodent", used in the form of a solution for application and toothpaste.

Fissure sealants

The purpose of sealants is to create a physical barrier that prevents oral microorganisms and end products of their vital activity from entering the retention areas of the enamel.

Fissure sealing steps:

Etching of tooth enamel with 35-37% phosphoric acid for 15-

20 seconds;

Washing off acid from the surface of the tooth with a water-air jet;

Repeated isolation of the tooth from saliva with cotton rolls and a saliva ejector;

Drying the etched surface with air. Etched enamel should be dull, matte, chalky white.

The sealant should be applied immediately with a thin layer over the entire fissure-pit network of the chewing surface, while excluding the formation of air bubbles and overestimation of the occlusal height of the tooth.

Control over the setting of the sealant is carried out in the following terms: in a week, a month, six months and a year.

III Summary

Thus, from the foregoing, it follows that in the absence of prevention programs at the population level, the relatively low incidence of dental caries and the mild degree of periodontal disease in children and adolescents turns into a rather severe form in adults, which, in turn, leads to an increase in the need for therapeutic, surgical and orthopedic treatment.

IV Conclusions

Considering that the intensity of the main dental diseases among the population of Russia is quite high, the knowledge and implementation of preventive measures is of great importance.

In dental education, in addition to dentists, psychologists, educators and other training specialists should participate.

It is advisable to start motivation with teachers and medical workers of children's institutions. After that, meetings should be organized with the parents of the children, explaining to them the possibility and importance of preventing diseases of the teeth and gums, talking about the rules and features of brushing children's teeth.

An important step is the motivation of children. Classes with children should be strictly differentiated depending on their age: if it is better to conduct classes with young children in the form of a game, then it is necessary to talk with older children in the same way as with adults.

Thus, it follows from the foregoing that in order to improve dental health at the population level, the efforts of not only specialists, but also society as a whole, are necessary. A public opinion should be formed that taking care of oral health is as necessary as taking care of the beauty of one's appearance.

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Sanitation of the oral cavity in children and its role in the prevention of dental diseases. Clinical examination of the children's population at the dentist.

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SECONDARY PREVENTION 1. Early timely detection of the first signs of the disease in the oral cavity 2. The use of traditional methods of treating diseases (therapeutic, surgical) in order to prevent their progression.

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The main groups of secondary prevention measures 1. National: Sanitation of the oral cavity of children and adolescents Sanitation of pregnant women Medical examination of the children's population 2. Individual: Regular removal of dental deposits Treatment of gingivitis Treatment of initial forms of caries Surgical and orthodontic measures Physiotherapy

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The sanitation system is a regular examination after a certain time and sanitation of the oral cavity. Treatment of all teeth affected by caries and its complications (permanent and temporary). Removal of supra- and subgingival dental deposits. Replacement of irrational fillings Removal of destroyed and untreated teeth and roots. Treatment of periodontal and oral mucosa diseases Detection and treatment of malocclusion at early stages

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The planned sanitation should cover the entire child population. Sanitation is carried out at least 1 time per year, professional examinations 2 times a year. Sanitation should include the whole range of activities for each child. Planned reorganization is accompanied by an analysis of morbidity, a study of the dynamics of morbidity, taking into account the effectiveness of measures. Hygienic education of children, the formation of their oral care skills.

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Sanitation forms 1. Individual 2. Single 3. Planned Sanitation methods 1. Centralized 2. Decentralized

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1. Centralized Pros: Possibility of additional examination methods. The presence of junior and secondary honey. personnel. Possibility of carrying out physiotherapy Consultation of dentists of other specialties. The possibility of removing temporary teeth Cons: The need to accompany children to sanitation Disengagement of schoolchildren from school The child gets tired waiting for an appointment

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Decentralized Pros: 100% sanitation coverage Students do not leave their classes No need to transport children and accompany them The doctor is not limited in time It is possible to carry out sanitary and educational work Cons: There is no possibility of additional examination methods and physiotherapy Impossibility of removals No possibility of consulting other specialists Possibly inadequate equipment.

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Documentation 1. Sanitation card, form No. 267 Life history, child's health status, oral hygiene status, fill in the dental formula. 2. Dentist's work record book Daily work record 3. Dentist's monthly work report

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Quantitative indicators of sanitation 1. Percentage of children in need of sanitation among those examined 2. Number of missing teeth per 1000 children 3. Sanitation coverage: number of sanitized / number in need of sanitation x 100% 4. Sanitation coverage of patients with uncomplicated caries 5 Coverage of sanitation of patients with complicated caries cured in one visit. 6. The number of cases of complicated caries in temporary teeth, permanent teeth per 1000 children

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Qualitative indicators of rehabilitation 1. Duration of treatment 2. Timeliness of treatment 3. Completeness of treatment 4. Outcomes of treatment

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Clinical examination is a method of public health services, including a set of recreational activities. This is a method of dynamic monitoring of the health status of a practically healthy population and patients with chronic diseases.

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Clinical examination of children in the first 3 years of life. 1. Healthy children. 2. Healthy children, but with risk factors for caries. 3. Children with malformations of tooth tissues: hypoplasia, dental caries, malocclusion formed by the age of 3.

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Preschoolers and schoolchildren 1. healthy children children without dental caries and risk factors for its development 2. healthy children with risk factors for caries 3. children with damage to hard dental tissues, with caries, risk factors for its development, KPU=1-4 4. presence of caries, presence of risk factors caries, KPU=5-7 5. Presence of caries, its complications, KPU>8 Damage to immune zones by caries, presence of foci of demineralization, growth of caries per year 3 or more

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Antenatal prophylaxis - the impact on the child's body before birth through the mother's body.

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Pregnant women are a special group of patients: during pregnancy, a woman's oral health worsens (caries and other diseases). It is believed that all predispositions to diseases are laid in fetal development.

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Goals of dental care for pregnant women:

To improve the dental status of the most pregnant woman To carry out antenatal prevention of caries in children

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Violation of the dental status in a pregnant woman is associated with:

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1. The risk of developing caries in the second half of pregnancy. Due to changes in calcium metabolism in the body. Normally, this goes unnoticed, but if a woman suffers from frequent toxicosis (histosis), gastrointestinal diseases, chronic kidney diseases, then the distribution of calcium is more noticeable: the bones are more apart, there is less calcium in saliva, calcium enamel does not receive enough, the active development of the carious process. The construction of the fetal skeleton begins after the 20th week of pregnancy.

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2. Periodontal disease. Gingivitis and periodontitis. They include the pathology of the gums, bone tissue and root cementum. These changes are associated with hormonal imbalance.

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There is an increased release of the hormone of the pituitary gland and gonads. The production of gonadotropic and thyroid-stimulating hormone increases, which leads to swelling of the skin and mucous membranes (including PR). Progesterone and estrogen increase the keratinization of the mucosa of the PR and provoke edema. On the mucosa, the accumulation of large layers of obedient epithelium is favorable for the development of pathogenic microflora in the PR.

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As a result, hypertrophy and hyperemia of the gums, further development of cervical caries due to prolonged inflammation of the gums. The processes of excessive formation of gum tissue are activated. Tumor-like formations - epulis. Gum growths in the form of papillae or fungi.

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Signs of activation of the carious process:

It is typical for people with metabolic diseases, adolescents, pregnant women. The appearance of white spots on the enamel (caries in the white spot stage - focal demineralization of the enamel).

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The appearance of new carious cavities in a short period of time. Rapid loss of fillings. Subject to all technologies, we can observe a recurrence around the filling, chipped fillings, etc. The carious process is quite active.

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Factors contributing to the development of dental diseases in a pregnant woman:

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General somatic pathology - metabolic disorders, chronic diseases of the gastrointestinal tract, chronic enterocolitis and diseases of the biliary tract, diseases of the kidneys (pyelonephritis) and the thyroid gland (hypothyroidism).

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The presence of dentoalveolar anomalies (narrowing of the upper and lower dentition (crowding of teeth), anomalies of the frenulums (short frenulums of the tongue and lips - their tension leads to ischemia of the gum tissue), small vestibule of the PR (tissue tension, transitional folds, gum ischemia, inflammation). Unsatisfactory oral hygiene.

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Studies have shown that 94% of pregnant women need therapeutic treatment and 54% need orthopedic care.

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Features of the intrauterine period of development of the dentoalveolar system:

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4 - 5 weeks - the formation of the jaw bones of the fetus and the soft tissues of the face. The impact of aggressive factors leads to the formation of crevices.

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6 - 7 weeks - laying the rudiments of temporary teeth, teeth may not be laid or supernumerary teeth.

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17 - 18 weeks - the laying of the rudiments of permanent teeth begins. Can develop edentulous or supernumerary teeth

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Week 20 - mineralization of the rudiments of milk incisors begins. Enamel may be slightly mineralized, future teeth are susceptible to caries. Non-carious lesions such as enamel hypoplasia may form.

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Week 28 - the rudiments of milk fangs and molars begin to mineralize. There is an active mineralization of the fetal skeleton.

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32 - 34 weeks - the mineralization of the rudiments of the first permanent molars begins. 38 weeks - the beginning of the mineralization of the first permanent incisors.

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Violation of the intrauterine period of development leads to:

Growth disproportion and impaired maturation of organs and systems Morphological and functional immaturity of tissues and organs of the dentition The child develops a predisposition to caries and various non-carious lesions of hard dental tissues develop

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Factors that disrupt the normal formation of the AF system:

Chronic diseases of a woman (extragenital pathology) Histosis of the second half of pregnancy, hereditary factors Occupational hazards Chronic stressful situation

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Dental care program for pregnant women:

Registration of a pregnant woman for dispensary registration (in the first 12 weeks). The dentist develops the frequency of visits. According to the standard: up to 20 weeks - 1 time per month, from 20-32 weeks - 2 times a month, after 32 weeks 3 times a month. But at least the appearance once a trimester.

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Activity:

Sanitation of the oral cavity (before pregnancy) Dental caries is being treated Monitor periodontal diseases. !Periodontogenic toxins easily pass the hematoplacental barrier

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Features of rehabilitation measures:

The ideal time for treatment is the second trimester (at other times it is impossible to prescribe X-ray diagnostics, antibiotics, organogenesis is underway; in the third trimester, a stress factor can cause the onset of labor, a pregnant woman cannot be treated lying down - the uterus with the fetus can press the inferior vena cava - a drop in blood pressure, dizziness, frequent pulse, loss of consciousness, if necessary, treat sitting, in extreme cases, half-sitting.

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There are no contraindications to anesthesia. Use an articaine series of anesthetics, 1: 200,000 - the content of a vasoconstrictor. Antibiotics are not prescribed - tetracycline (violation of mineralization), aspirin is not prescribed - blood thinning. Timely removal of decayed teeth

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Preventive courses aimed at preventing caries and preventing periodontal diseases:

Prediction of caries in a pregnant woman (enamel resistance test, clinical determination of the rate of enamel remineralization, etc.) high risk or low. Correction of calcium metabolism.

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The appointment of calcium preparations inside. This controversial issue. On the one hand, it is a vital element. daily requirement healthy person up to 25 years 1000 mg / day, after 25 years 800 mg / day. In pregnant women 1500 mg / day. In lactating 2000 mg / day. In children 600 - 800 mg / day.

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Calcium preparations: calcium D3 nycomed - pregnancy and lactation, contains calcium carbonate; Calciimide - from mussel shells, contains calcium citrate; Vitrumcalcium - calcium carbonate; Gravinova; Calcisandesforte. Calcium gluconad and glycerophosphate are poorly absorbed from the gastrointestinal tract - they are not prescribed. In the first place is citrate, in the second is calcium carbonate. They are prescribed in the second half of pregnancy, but it is better to consult with an obstetrician-gynecologist, an observing doctor.

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Know about chronic kidney disease, chronic enterocolitis accompanied by diarrhea. Phosphate-rich foods inhibit calcium, as do strong teas and coffees.