Prevention and treatment of diseases gingivitis in children
Kokhorov Mansurjon Kodirovich
Andijan State Medical Institute (Uzbekistan)
Diseases of gingivitis constitute one of the most important problems in connection with the widespread, complex nature of the lesion involving other organs and systems in addition to the tissues of gingivitis in the pathological process. In children, adolescents and young people, early forms of inflammatory diseases of gingivitis are mainly detected, and with increasing age of patients, the frequency and severity of destructive changes in the periodontium increases. Therefore, the prevention of these diseases is of particular importance.
Keywords: gingivitis, prevention, treatment, children.
Болезни десен составляют одну из важнейших проблем в связи с широкой распространенностью, комплексным характером поражения с вовлечением в патологический процесс помимо собственно тканей гингивита других органов и систем. У детей, подростков и лиц молодого возраста в основном выявляются ранние формы воспалительных заболеваний гингивита- гингивиты, а с увеличением возраста пациентов нарастает частота и тяжесть деструктивных изменений в пародонте. Поэтому приобретает особое значение профилактика этих заболеваний.
Ключевые слова: гингивит, профилактика, лечения, детей.
According to the WHS, 80 % of the world's adult population is susceptible to gingivitis diseases, leading to the loss of teeth, the appearance of foci of chronic infection in the oral cavity, a decrease in the reactivity of the body, microbial sensitization, the development of allergic conditions and other disorders. In childhood, the main disease of gingivitis is chronic catarrhal gingivitis, which proceeds without clear clinical manifestations and does not cause concern for children. Inflammatory gum disease is widespread among people of various age groups, including more than half of children. Such diseases very often cause other dental diseases and the loss of the teeth themselves. Therefore, it is simply necessary to identify and treat all diseases of the oral cavity, which quite often can go unnoticed [1,4,8].
Gingivitis is one of the diseases of the dentition, which is characterized by inflammation of the gingival mucosa [1,2,3]. As for other tissues that make up the gums, they remain unharmed during this disease. The ligamentous apparatus and bone tissue are not prone to changes. Basically, there is an inflammation of gingivitis in the area of several teeth [3,7]. The area of inflammation can vary depending on the age of the patient, the consistency and quality of oral care, etc [7,8]. The localization of this disease is basically the same — all areas that are poorly amenable to hygiene measures. To identify the first signs of gingivitis diseases and to carry out a complex of therapeutic and preventive measures, an annual preventive examination of healthy children is required. Signs of gingivitis pathology may be the first symptoms of serious diseases of the body (endocrine, hematological, etc.), which increases the responsibility of the pediatric dentist for their timely detection and treatment [1,5,6].
The aim is to offer a set of therapeutic and prophylactic measures to improve the state of hygiene of the oral cavity and gingivitis tissues, increase the level of dental health and reduce the need for treatment of children and adolescents. Prevention should promote the proper development of the body in the prenatal and early period after birth, in the process of formation and growth in childhood. Women in whom pregnancy proceeds against the background of general pathology need comprehensive rehabilitation with the participation of relevant specialists. The nutrition of a pregnant woman should be high in calories and fortified. Breastfeeding during the first months of a baby's life is extremely important for the baby's growth and development. Active sucking on the mother's breast stimulates proper jaw growth and gingivitis tissue formation. When transferring to artificial feeding in order to prevent gingivitis diseases, you should choose a tight nipple with a small hole, shaped like a mother's nipple. The composition of the diet, the order of introduction and the type of complementary foods are prescribed by the pediatrician, but the dentist should recommend teaching the child to eat solid food as early as possible (from 6–7 months), he should be given pieces of raw fruits, vegetables, dry cookies, bread, etc..P. This will help prevent «chewing laziness», stimulate blood circulation in the dentition, the formation of gingivitis, improve salivation and self-cleaning of the mouth. After the eruption of deciduous teeth, vigorous chewing movements also contribute to the physiological formation of gingivitis tissues. Chewing of solid food is very favorable for this, both with temporary and with replaceable and permanent bites. The cleansing effect of chewing is complemented by oral care.
In diseases of gingivitis in children, hygienic oral care is an essential link in complex therapy. The greatest effectiveness of this measure is achieved provided that the doctor during the entire period of treatment teaches the child the basic rules for brushing teeth and controls them, gives recommendations on oral hygiene. Taking into account the child's age, the dentist gives recommendations on the choice of a toothbrush, toothpaste and products for hygienic oral care.
He recommends that parents themselves carry out oral hygiene in a child up to the age of 3 years, observing the correct technique for brushing teeth. The dental market is filled with various products for hygienic oral care in children. The unique shape of the R. O. C. S. PRO Baby avoids excessive pressure on your baby's teeth and gums while brushing without damaging the gums and immature tooth enamel. Toothbrush handle R. O. C. S. PRO Baby is made of high quality safe PET plastic. R. O. C. S. Toothpaste PRO Baby is designed to care for babies' teeth from a very young age up to 3 years.
Principles of treatment of gingivitis diseases in children. Treatment of gingivitis diseases in children should be comprehensive. The complex is made taking into account the etiology of the disease, the nature and severity of inflammatory and dystrophic changes in tissues and data from a special clinical and laboratory study. If the child has general somatic or chronic systemic diseases, the general treatment plan should be agreed with the pediatrician or specialist of the appropriate profile. In children with reduced rates of immunological reactivity of the body, stimulating therapy should be carried out as prescribed by the pediatrician.
In the presence of inflammation in soft tissues, various anti-inflammatory drugs are used. For this purpose, various dosage forms are used: ointments, pastes, aerosols, which are used in the form of applications and rinses, are injected into the periodontal pockets. To remove the sensitivity of the hard tissues of the teeth, which often accompanies the disease of gingivitis, the teeth are treated with fluoride varnishes or pastes. From the huge arsenal of anti-inflammatory drugs for the local treatment of gingivitis diseases, enzyme preparations, antibiotics, antiseptics, and also drugs that promote tissue restoration are widely used. An important role in the treatment of gingivitis diseases is played by the elimination of various kinds of traumatic factors in the oral cavity using pediatric, surgical and orthopedic interventions. Defects such as shortened frenulum of the lips and massive cords of the mucous membrane, the small vestibule are eliminated only by surgery. In the presence of pathological changes in the periodontium, great importance is attached to the elimination of dentoalveolar anomalies using orthodontic treatment methods. Correctingmalocclusion is mosteffective in childhood.
Topical treatment of gingivitis in children. Treating gingivitis in childhood is difficult. The disease in most cases is difficult. It is advisable to consult such a child by specialists: a therapist, orthodontist, surgeon to develop an individual treatment plan. Therefore, early recognition of the disease and the prevention of severe changes are of great importance. Before starting treatment, it is very important to exclude systemic diseases of the child, and if they are detected, to treat them with a pediatrician of the appropriate profile. The role of the dentist in the treatment of patients with idiopathic diseases usually comes down to making a presumptive diagnosis, referring the patient to a specialist of the appropriate profile, and in the future — to carrying out symptomatic therapy (sanitation of foci of infection, anti-inflammatory treatment, 1 % hydrocortisone ointment, 10 % methyluracil ointment for gingival dressings, tooth extractions, etc.). General treatment of gingivitis diseases in children. The general treatment of gingivitis diseases provides not only etiological factors, but also the mechanism of development of individual links of pathology. In this regard, general treatment is determined by the state of health of the child and includes treatment of the underlying disease, increasing the body's defenses. It must be strictly individualized. Vitamin therapy. The most effective complex of vitamins C, P, E, A, D, group B. The need for vitamins in children is much higher than in adults. This is due to the peculiarities of the growing organism — the tension of metabolic processes, the rapid growth and development of the child. For diseases of gingivitis, vitamins are taken in doses 2–3 times higher than the daily requirement of healthy children. The course of treatment is 2–4 weeks.
Attention should be paid to the inadmissibility of taking vitamins without a doctor's prescription. Uncontrolled use of vitamin preparations will be ineffective at best, and harm health at worst. It is advisable to prescribe remineralizing therapy — Calcium-D3 Nycomed 1 tablet contains 500 mg of elemental calcium and 200 IU of vitamin D3, 1–2 tablets per day 20–25 days 2–3 times a year. Hyposensitizing therapy. Since with the disease of gingivitis in children, conditions arise that contribute to the sensitization of the body, and often the pathological process in the periodontium unfolds on an allergic background, it is advisable to prescribe hyposensitizing agents to such patients. The appointment of hyposensitizing therapy should be preceded by the setting of allergic reactions. When choosing hyposensitizing drugs (tavegil, suprastin, pipolfen, diphenhydramine, diazolin), the state of the nervous system should be taken into account. With the disease of gingivitis in children, stimulating agents are prescribed: fibs, prodigiosan, retabolil, metacil, pentoxil, imudon. When prescribing these funds, one should take into account the initial state of the body's reactivity, the mechanism of action of the drug, the features of the course of the disease of gingivitis. In cases of a progressive course, when a complex of local measures does not give the proper effect, broad-spectrum antibiotics and sulfa drugs are prescribed. Treatment is carried out according to the generally accepted scheme for 3–4 weeks. The use of these drugs helps to eliminate inflammation in the tissues of gingivitis, to normalize metabolic processes in them. A balanced diet is of great importance for the treatment of gingivitis diseases. The child's food should be varied and contain complete, easily digestible proteins, minerals, fats, carbohydrates, vitamins. For a balanced diet, the diet should include foods containing the required amount of mineral salts and trace elements, primarily calcium and fluoride.
Conclusions:
- The use of a complex of preventive measures, including dental education with training in the rules of oral care, professional hygiene and the use of therapeutic and prophylactic agents containing antibacterial and anti-inflammatory components, made it possible to reduce inflammation in the periodontal tissues
- The proposed complex of therapeutic and prophylactic measures allows to improve the state of oral hygiene and gingivitis tissues, to increase the level of dental health and to reduce the need for treatment of children and adolescents.
References:
- Giermo P., Rosing KK, Susin S., Oppermann R. Periodontal disease in Central and South America. Periodontol 2000.2002; 29 (1): 70–8. https://doi.org/ 10.1034/j.1600–0757.2001.290104.x [Links]
- Botero JE, Rosing KK, Duque A., Jaramillo A., Contreras A. Periodontal disease in children and adolescents in Latin America. Periodontol 2000.2015 February; 67 (1): 34–57. https://doi.org/10.1111/prd.12072 [Links].
- Vinogradova T. F. Atlas of dental diseases in children. Tutorial. — M.: Medpress-inform, 2010.-- 168 p.
- Danilevsky N. F., Borisenko F. V. Diseases of gingivitis.- Kiev: Health, 2004. 464 p.
- Karakov K. G., Solovieva O. A., Alfimova A. O., Khachaturyan E. E., Mkhitaryan A. K. Treatment of chronic generalized catarrhal gingivitis with the use of immobilized drugs in the collection: topical issues of modern medicine / Collection of scientific papers based on the results of the interuniversity annual correspondence scientific and practical conference with international participation. Non-profit partnership «Innovation center for the development of education and science». Ekaterinburg, 2014.S. 213–215.
- Kuryakina N. V., Kutenova T. F. Diseases of gingivitis. — N. Novgorod: 2000.-- 158 p.
- Kuryakina N. V. Pediatric therapeutic dentistry. — Nizhny Novgorod: Publishing house of NGMA, 2004.-- 516 p.
- Lepekhina O. A. The prevalence and features of the clinical course of gingivitis in schoolchildren of the city of Voronezh at different ages periods: Author's abstract..... Candidate of Medical Sciences — Voronezh, 2011–24p.
- Ivanov V. S. Diseases of gingivitis. — M.: Medicine, 2003.-- 328 p.
