Analysis of the condition of solid tissues of teeth and the level of dental care provided to children with rheumatic diseases

Abstract

Relevance. Rheumatic diseases strongly influence the condition of the oral cavity, salivary glands and the temporomandibular joint, that, along with poor oral hygiene in children and active growth, increases the risk of oral disease development. The growing number of rheumatic diseases in children requires evaluation of the oral cavity condition and assessment of the provided dental services; enhancement of the professional oral care in children with rheumatic diseases through the comprehensive evaluation of the quality of the performed dental procedures and development of caries prevention measures based on the analysis of the epidemiological survey results.Materials and methods. 316 children with rheumatic pathology aged 1 to 18 years were examined. The children were divided into three age groups: group I – 1-5 years, group II – 6-12 years, group III – 13-17 years. The Oral hygiene and past dental experience questionnaire was developed for each group. Hard dental tissue condition and caries intensity level (df – in group I, df+DMF – in group II, DMF – in group III) were assessed, the oral hygiene index was calculated by the child age. On dental examination, past caries treatment and its complications were considered, the level of dental care (LDC) according to Leus was assessed.Results. The received data on caries intensity in all age groups and all medical conditions were analyzed. The values corresponded to the high and very high intensity (4.2 to 13); the values were 1.89 – 3 times higher than the values received during the epidemiological survey in children of the same age groups in Russia. Multiple primary and secondary (as a complication after the previous dental treatment) caries, associated with poor oral hygiene, was detected. The data revealed that the dental care level in children with rheumatic diseases was ‘poor’ and ‘insufficient’ The interview of the children and their parents showed that 91% of children had never had preventive treatment and 89% of children visited the dentist less than twice a year. The examination revealed that secondary caries, that had developed in 50% of children after the treatment of caries and its complications, and bad fillings, that had to be replaced.Conclusions. Thus, indirect influence of the main disease on the hard dental tissues in children was revealed – motivation for dental treatment and good oral hygiene was decreased for the lack of knowledge. The analysis of dental treatment quality in such children was insufficient. Only emergency dental visits as well as inappropriate materials and methods used for the treatment of caries and its complications result in secondary caries. So, customized treatment approach and prevention programs should be developed and introduced for the oral care in children with rheumatic diseases according to the main disease course, administered background therapy and the level of dental health education.