PECULIARITIES OF HARD CARIES OF TEMPORARY TEETH IN CARE IN CHILDREN 4-5 YEARS OLD WITH ADENOID VEGETATIONS
Authors: Ulasevych L.P. 
Published: June 2022

Nowadays, the high prevalence of caries in the population of Ukraine is not surprising. Unfortunately, in some areas especially those with low fluoride rate in potable water, the incidence of caries can reach 100%. The polyetiological concept of dental caries progression creates obstacles in effective treatment and prevention, which would reduce caries rates. Children under the age of 6 are in the risk group for dental caries.

The somatic state directly and indirectly contributes to the development of cariogenic situation in preschool children. Adenoid hypertrophy is a quite common disease among this group of children; it ranks one of the leading places in the structure of the peadiatric diseases and its prevalence makes up 60%. Diseases of the pharyngeal tonsils have been found out to impact on the quantitative and qualitative indicators of oral fluid, promote insemination of the oral cavity with acid-producing bacteria, reduce the resistance of hard tissues of deciduous teeth.

In order to solve this problem, 103 children aged from 3 to 5 with adenoid hypertrophy were surveyed. Children from Poltava (Ukraine) had no difference in social statue and living conditions. The presence of adenoid hypertrophy was confirmed by patients` medical records, which also contained the information about the duration of concomitant pathology (less than a year, more than a year). All children were checked for the dental caries intensity, the DEF indices (t) (D – decayed deciduous teeth, E – extracted deciduous teeth due to caries complications, F – filled deciduous teeth) and def (s) (d – surfaces of carious deciduous teeth, e – extracted deciduous teeth, f – filled surfaces of deciduous teeth) were determined, the hygienic condition of the oral cavity was assessed using the Fedorov-Volodkina’s index (1971). The study of the caries intensity of temporary teeth (DEF (t)) was based on assessing caries activity by Vinogradova in accordance with the average intensity in each age group of Poltava. The significance was established as p≤0.05.

Depending on the degree of caries intensity determined with the above mentioned indices, the research groups of 3 – 5 year old children with adenoid hypertrophy were formed. Thus, 51.5% of the children had I stage (compensated) dental caries intensity, 36.9% of children had II stage (subcompensated) caries intensity and 11.7% had III stage (decompensated) of caries intensity. The study of caries in deciduous teeth revealed a significant difference between the observation groups (p≤0.05).

The analysis of the obtained results revealed the existence of a direct average correlation between the indicators of the state of oral hygiene in children with adenoid hypertrophy and the intensity of caries according to DEF (t) index (r = “+ “0,6)

The study results indicate a more intense caries in deciduous teeth in the children with more than a yearlong adenoid hypertrophy in the medical history. Mainly the oral type of respiration in children with the diseases of pharyngeal tonsils creates the grounds for the development of cariogenic situation.

Poor oral hygiene in children with adenoid hypertrophy can be explained by xerostomia due to oral or mixed breathing as well as opportunistic microflora presence and pH shift towards more acidic.

The obtained results provide a background for further research and improvement of preventive complexes targeting at elimination of mechanisms that contribute to the cariogenic situation in the oral cavity of children, considering the presence of somatic disease.