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.

Keywords: children with mental retardation, diseases of hard tissues of teeth, periodontal tissue diseases, therapeutic and prophylactic complex

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1. Afanaseva LR. Otsenka klinicheskogo sostoyaniya i vozmozhnostey profilaktiki zabolevaniy tkaney periodonta u detey s narusheniem razvitiya intellekta [Evaluation of the clinical status and possibilities for the prevention of periodontal tissue diseases in children with intellectual disabilities]. Abstr. PhDr. (Med.). SPb, 2000. 19 p. [Russian]
2. Bezvushko EV, Mykychak IV. Vzayemozv’yazok kariyesu zubiv iz somatychnoyu patolohiyeyu v ditey, yaki prozhyvayut u rayonakh, riznykh za ekolohichnoyu sytuatsiyeyu [Interrelation of caries of teeth with somatic pathology in children living in districts different in the ecological situation]. Ukrainskyy stomatolohichnyy almanakh. 2012; 4: 115–7. [Ukrainian]
3. Bezrukova IV. Mikrobiologicheskie i immunologicheskie aspekty parodontita [Microbiological and immunological aspects of periodontitis]. Parodontologiya. 2000; 33: 3–7, 21–3. [Russian]
4. Bokaya VG. Samokontroliruemaya gigiena polosti rta – effektivnyy sposob profilaktiki stomatologicheskikh zabolevaniy [Self-controlled oral hygiene - an effective way to prevent dental diseases]. Stomatologiya dlya vsekh. 2000; 3: 17–9. [Russian]
5. Borovskiy EV, Leontev VK. Biologiya polosti rta [Oral cavity biology]. M: Meditsina; 1991. 304 p. [Russian]
6. Smolyar NI, Leus PA, Bezvushko EV, Luchynskyy MA, Chukhray NL. Vyznachennya osnovnykh chynnykiv ryzyku nedostatnoyi efektyvnosti profilaktyky kariyesu zubiv i zakhvoryuvan parodonta za Yevropeyskymy indykatoramy stomatolohichnoho zdorov'ya [Determination of the main risk factors for inadequate prevention of dental caries and periodontal diseases by European indicators of dental health]. Novyny stomatolohiyi. 2014. № 3. 86–90. [Ukrainian]
7. Voevoda OO. Klinichna efektyvnist kompleksnoyi profilaktyky karioznykh urazhen zubiv u ditey [Clinical efficacy of complex prevention of carious lesions of teeth in children]. Visnyk problem biolohiyi i medytsyny. 2012; 4(2): 225–8. [Ukrainian]
8. Ivanov VS. Stomatolohichna zakhvoryuvanist ditey doshkilnoho ta molodshoho shkilnoho viku m. Odesa (chastyna 1) [Dental morbidity of children of preschool and junior school age in Odessa (part 1)]. Visnyk stomatolohiyi. 2013; 1: 121–5. [Ukrainian]
9. Voloshina IM, Chesnokova MG, Romanov AA, Prudnikov LR. Izuchenie mikrobiotsenoza rotovoy polosti detey na fone razlichnoy aktivnosti karioznogo protsessa [The study of the microbiocenosis of the oral cavity of children against the background of various activities of the carious process]. Sbornik nauchnoy ctatey II regionalnoy nauchno-prakticheskoy konferentsii s mezhdunaronym uchastiem po detskoy stomatologii. Khabarovsk; 2012: 50–3. [Russian]
10. Kaminska TM. Retrospektyvni doslidzhennya sotsialno-hihiyenichnykh aspektiv zdorov'ya shkolyariv [Retrospective studies of social and hygienic aspects of schoolchildren's health]. Megdunarodnyy zhurnal pedyatryy, akusherstva y hynekolohyy. 2014; 5(2): 5–9. [Ukrainian]
11. Prokhno OI. Kompleksna profilaktyka stomatolohichnykh zakhvoryuvan u ditey z psykhonevrolohichnymy vadamy [Comprehensive prophylaxis of dental diseases in children with psycho-neurological defects]. Abstr. PhDr. (Med.). K; 2007. 24 p. [Ukrainian]