The increase in the prevalence of diseases of hard tissues of teeth and periodontium is associated with the complexity of their etiology and pathogenesis, the number of factors that cause them and the lack of effective modern schemes of primary and secondary prevention. To a large extent this relates to a special category of patients, that is children with mental disorders. In high connection with the prevalence of dental diseases, reduced immunity and the complexity of providing dental care to children with mental retardation, the most effective measure for the maintenance of the function of the tooth-resting apparatus is the prevention of dental diseases. The results of stomatological examination and laboratory studies of children with intellectual decline allowed us to develop a set of treatment and prevention measures aimed at preventing the development of diseases of the tissues of the oral cavity in this category of children, taking into account the degree of cognitive deficits. Material and methods. 55 mentally retarded children were the main group, where the developed complex of medical and preventive measures was applied. The peculiarity of this complex is to give preference to the individual oral hygiene of the given contingent of children, taking into account the reduction of their intelligence. The developed method includes primary and secondary prevention as diseases of hard tissues of the oral cavity, as well as diseases of periodontal tissues. In 50 mentally ill children with diseases of hard tissues of teeth and periodontal tissues, which formed a control group, treatment and prophylactic measures were carried out in accordance with "Protocols of the Ministry of Health of Ukraine providing medical care" in the specialty "Dentistry of childhood". Results and discussion. The obtained results showed that the percentage of the biotope composition of the oral cavity changed in a positive direction in children of the main group, in all terms of observation. In the nearest terms of observation (after 1 month) there was a significant increase in the number of representatives of the resident microflora of the oral cavity and reduction of the pathogenic microflora. In the control group, the positive dynamics of microbiocenosis was observed only in the shortest time after the traditional treatment. In the long run, the dynamics of the microbial landscape increased in the negative direction (6 months after treatment) and reached the limits of the initial data in 12 months, which indicates the inadequacy of traditional treatment. Conclusions. Positive dynamics of microbial landscape of the cavity of the mentally retarded children with caries and chronic catarrhal gingivitis testifies to the effectiveness of the treatment complex taking into account the degree of biocenosis normalization. The latter is confirmed by positive qualitative changes of hard tissues of teeth and periodontal tissues in the nearest and long terms of observation.
Full text: PDF (Ukr) 224K