CLINICAL INDICES OF DENTAL STATUS OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASES
Authors: Yemelyanova N. Yu. 
Published: January 2019

The article deals with the main dental manifestations in COPD comorbid with CHD on the background of received basic therapy. Chronic obstructive pulmonary disease (COPD), and often coronary heart disease (CHD) associated with it are some of the somatic diseases that have dental manifestations. COPD manifests itself as a persistent restriction of airway patency and is associated with increased chronic inflammatory response of respiratory tract to the action of harmful particles or gases. COPD is often complicated by CHD which combination occurs in more than 55% of cases. It is known that the drugs that are used to treat these diseases have a side effect on the oral cavity.

The aim of the study was to research complaints and the clinical status of the oral cavity in patients with cardiorespiratory pathology.

Material and methods of the study: 130 patients with a verified diagnosis of COPD and CHD taking baseline therapy have been questioned and examined according to the domestic and international protocols for diagnosis and treatment. All patients were divided into three groups depending on the duration of therapy for the underlying disease: 1A group (49 patients with duration of treatment not more than 3 years), 1B group (40 patients with duration of therapy from 3 to 5 years) and 1C group (41 patients with duration of treatment more than 5 years). The questionnaire included the presence and nature of complaints and questions about individual oral hygiene. The definition of dental status has been carried out according to the standard scheme. Statistical processing has been carried out with the calculation of the median, interquartile range, the Mann-Whitney and c-square test.

Results of the study. The main stomatologic complaints of all patients are dryness in the oral cavity, taste distortion, halitosis and hyperesthesia. The most common complaint of the vast majority of all patients was dryness in the oral cavity, which, in the respondents' opinion, was associated with the basic therapy of somatic disease. It is typical that frequency of these complaints occurrence was significantly higher in the group that takes long-term medications for COPD and СHD. The sensation of saliva lack was eliminated by mouth rinsing with water, however, despite the fact that relief was immediate, its duration was no more than two hours. The increased sensitivity of the teeth is associated with a violation of mineral metabolism due to a decrease of remineralizing properties of saliva and release of mineral components from the hard tissue of the teeth under the drugs. Patients form each of the groups noted distortion of taste sensations, which were associated with the beginning drugs intake. The main clinical changes were found in the mucous membrane of the lips, cheeks and papillary apparatus of the tongue, the severity and prevalence of these changes increased with duration of the disease. Almost all patients have got various clinical and morphological pathological changes in periodontal tissues. However, if the ratio of inflammatory changes to atrophic in 1A group is 1: 4.5, then in the 1C group this ratio is 1: 2.

Conclusions: The frequency and intensity of dental complaints and clinical manifestations increase with the duration of COPD and CHD. All changes have been caused by the influence both of somatic pathology itself and side effects of medications. Thus, the study of the long-term side effect of drug therapy on the oral cavity of patients with somatic pathology seems relevant, and the variety of manifestations requires the development of adequate comprehensive diagnostic and prophylactic methods.