INDEX ASSESSMENT OF THE STATE OF THE ORAL CAVITY IN PATIENTS WITH GASTRO-ESOPHAGEAL REFLUX DISEASE
Authors: Kerzyuk O.P. , Rozhko M.M. 
Published: March 2024

It has been established that diseases of the gastrointestinal tract, namely gastroesophageal reflux disease, affect the oral cavity. It should be noted that GERD is one of the most common diseases of the digestive tract in the world. The close relationship of the oral cavity, due to the similarity of functions, the common blood supply, innervation, and the morphological structure of the gastrointestinal tract leads to a violation of immunological reactivity, physical and chemical changes in saliva. SORP is a powerful receptor field that perceives the receptor influences of the whole organism. Numerous studies by clinicians confirm that 75% of patients with ENT pathologies are examined for gastrointestinal tract diseases. With increased acidity of gastric juice, there is hypersalivation, hypertrophy of the filiform papillae of the tongue in combination with foci of desquamation, pallor and swelling of the mucous membrane of the oral cavity, catarrhal gingivitis. With reduced acidity of gastric juice, there is a large number of plaques on the tongue, atrophy of filiform papillae, decreased salivation, dry lips, and angular cheilitis are observed. This is due to the weakening of the pharyngeal and cardinal valves of the stomach, as a result of which the contents of the stomach with its secretory component are thrown into the oral cavity, thereby affecting the taste buds. The index evaluation of the state of the oral cavity based on the index of plaque on the back of the tongue, the index of oral hygiene -OHI-S, the determination of the acidity of the oral fluid in patients with GERD indicates a dependence on the level of acidity of gastric juice. Gastroesophageal reflux disease negatively affects oral hygiene, the acid-alkaline balance of oral fluid, which leads to the formation of pathological processes in the oral cavity. Homeostasis of the oral cavity is maintained due to the acid-alkaline balance, the main indicator of which is the pH of the oral fluid. Oral fluid is considered an integral environment of the human body, therefore metabolic processes affect its composition.

Aim. To study the indexes of the state of the oral cavity according to the indicators: index of plaque on the tongue according to (WTS); pH of oral fluid; hygiene index - OHI-S.

Materials and methods. To achieve the goal, 60 patients aged 25 to 55 years were examined. Of them, 30 are practically healthy people, 30 are patients with gastroesophageal reflux disease (of which 15 have increased acidity of gastric juice, and 15 have been examined with reduced acidity). IN THE RESEARCH PROCESS, WE STUDY INDICATORS index of plaque on the tongue according to (WTS); pH of oral fluid; hygiene index - OHI-S.

 Results. At the initial examination, plaque (W.T.C INDEX) was noted in patients with GERD. Thus, in the main group, the preference for a thick plaque on the back of the tongue was noted. Evaluating the state of oral hygiene (according to the Green-Vermillion index), it should be noted that, in general, hygiene was satisfactory in the main group of the examination. With increased acidity of gastric juice, at the age of 25-35, the satisfactory condition of the oral cavity according to the Green-Vermillion index was noted and was 1.4±0.1, and the group of female patients of the same category had an unsatisfactory state of oral hygiene and was 1.76±0 ,06. With low acidity, the hygienic index of the oral cavity in men aged 25-35 years was 1.3±0.1 and was satisfactory, while in women of the same age it was 2.0±0.4, which was unsatisfactory. Thus, in the 2nd group of women with reduced acidity aged 45-55 years, the indicator was 2.7±0.2, and in men of the same age, it was 2.3±0.3. Thus, when studying the pH of oral fluid in the main group, we noticed that the lower the pH level, the more acidic the environment. The acid-alkaline balance of the oral fluid is important for metabolism. Normally, the acidity of a person varies from 6.8-7.4 pH, and with a high rate of salivation it can reach 7.8 pH. With gastroesophageal reflux, which reaches the oral cavity, a decrease in the pH of saliva leads to pathological changes in the mucous membrane.

Conclusion. So, the studied indices make it possible to assess the hygienic condition of the oral cavity, acid-alkaline balance in accordance with the level of acidity of gastric juice in GERD.