Choice of dental treatment in adolescent children based on the results of monitoring brain oxygen saturation – cerebral oximetry
Authors: Koval O.I. 
Published: May 2020

To solve the problem of choosing the method of oral cavity sanitation, it is necessary to determine a safe period of time for performing dental procedures of varying severity and the number of visits. This will provide the opportunity to formulate clear indications for oral sanitation in conditions of general anesthesia in order to minimize the risk of cognitive dysfunctions against the background of hypoxic damage to the brain. The purpose of the study: to establish a safe period of time for various dental procedures in school-aged children on an outpatient dental appointment based on an objective method for assessing brain oxygen saturation – cerebral oximetry; determine the indications for the rehabilitation of the oral cavity under general anesthesia. Dental examination and dental procedures of varying severity were performed for 102 children under the age 12-18 years (424 teeth were treated) at the Dental Medical Center at the Bogomolets National medical University. In order to determine the oxygen saturation of the brain, the cerebral oximetry method was used. To predict cognitive changes against the background of organic brain disorders, we used the results of J. Meixensberger et al. (1998), where the main task of the dentist was considered to prevent a decrease in cerebral oximetry by more than 20%. Statistical processing of the results was performed using Microsoft Office Excel. It is established that the timing of the manipulations associated with preventive measures does not depend on the type of phobias. In children with a “light” temperament, it is 34'-35', with a “complex” temperament and temperament it is “warm up for a long time” – 30'. In children with an “easy” temperament, the safe period of time for conducting manipulations that are associated with the treatment of caries and its complications, regardless of the type of phobia, is 42'. In children with a temperament “a long time warms up”, a safe period of time for carrying out manipulations that are associated with the treatment of caries and its complications, regardless of the type of phobia, is 37'. In children with a “complicated” temperament, a safe period of time for conducting manipulations that are associated with the treatment of caries and its complications in the presence of “elementary” phobias is 35', in the presence of “cryptogenic” phobias – 30'. Indications for rehabilitation of the oral cavity in conditions of general anesthesia at average caries is – children with a “light” temperament, regardless of the type of phobia with a DMF ≥8; children with a “complicated” temperament and “elementary” phobias with a DMF ≥2; “cryptogenic” phobias with DMF ≥1; children with a temperament “warm up for a long time” regardless of the type of phobia with a DMF ≥2; for deep caries – children with a “light” temperament, regardless of the type of phobia with a DMF ≥4; children with a “complicated” temperament and “elementary” phobias with a DMF ≥2; “cryptogenic” phobias with DMF ≥1; children with a temperament “warm up for a long time” regardless of the type of phobia with a DMF ≥1; for chronic fibrous pulpitis – children with a “light” temperament, regardless of the type of phobia with a DMF ≥6; children with a “complicated” temperament, regardless of the type of phobia with a DMF ≥1; children with a temperament “warm up for a long time” regardless of the type of phobia with a DMF ≥2; at chronic periodontitis – children with a “light” temperament, regardless of the type of phobia with a DMF ≥6; children with a “complicated” temperament and “elementary” phobias with a DMF≥2; “Cryptogenic” phobias with DMF ≥1; children with a temperament “warm up for a long time” regardless of the type of phobia with a DMF ≥1. Thus, the treatment of teeth in the conditions of general anesthesia in children aged 12-18 years provides more radical methods of treatment with the obligatory follow-up consultation of the orthodontist in order to preserve the chewing, articulatory functions and to ensure the full development of the dental apparatus.