Вікові особливості стану гігієни порожнини рота в дітей шкільного віку

Abstract

Проведено обстеження 412 дітей 6-16 років, яке дало можливість порівняти показники гігієни порожнини рота з урахуванням періоду навчання в початковій, середній чи старшій школі та стану твердих тканин зубів (наявність чи відсутність каріозних уражень). Стан гігієни порожнини рота визначали за індексами Федорова-Володкіної та Гріна-Вермільона (Green–Vermillion). Для об’єктивної оцінки стану гігієни порожнини рота краще використовувати індекс Гріна Вермільона. Особливу увагу слід звертати на стан гігієни порожнини рота дітей початкової школи, оскільки в них він гірший, ніж у дітей середньої і старшої школи. Не спостерігали значного покращення стану гігієни в дітей старшого віку в порівнянні з дітьми середньої школи, що викликає необхідність проведення постійного навчання і контролю за доглядом порожнини рота в дітей шкільного віку.

Обследование 412 детей 6-16 лет позволило сравнить показатели гигиены полости рта с учетом периода обучения в начальной, средней или старшей школе и состояния твердых тканей зубов (наличие или отсутствие кариозных поражений). Состояние гигиены полости рта определяли по индексам Федорова-Володкиной и Грина-Вермильона (Green-Vermillion). Для объективной оценки состояния гигиены полости рта лучше использовать индекс ГринаВермильона. Особое внимание следует обращать на состояние гигиены полости рта детей начальной школы, поскольку в них оно хуже, чем у детей средней и старшей школы. Отсутствие значительного улучшения состояния гигиены у детей старшего возраста по сравнению с детьми средней школы вызывает необходимость проведения постоянного обучения и контроля по уходу за полостью рта у детей школьного возраста.

One of the most important reasons of dental caries appearance in children is improper oral hygiene which results in the accumulation of plaque containing significant amount of pathogenic microflora. Its vital activity products cause demineralization of tooth hard tissues. This is relevant for children of all ages but the most important in first years after teething as teeth are poorly mineralized and have tendency to the appearance of carious process. Totally 412 children aged 6 to 16 years old attending organized children's collectives (schoolchildren from 1st to 11th year of studying) were examined. Oral cavity examination was carried out according to the generally accepted method. The level of oral hygiene was determined by Fedorov-Volodkina’s and GreenVermillion’s indices. The research was conducted in the each age period separately and in age groups corresponding to 6-9 years (group I - elementary school), 10-13 years (group II - secondary school), 14-16 years (group III - high school). Statistical processing of the obtained data was carried out using the Student’s method. The results were considered significant at p <0.05. Analysis of oral hygiene level according to Fedorov-Volodkіna’s technique revealed that children aged 6 to 9 years (I group) had “unsatisfactory” oral hygiene level. The research of each age period reveals that only children of 9 years old take care after their oral cavities properly. We have detected significant differences of oral hygiene level of children with caries and with intact teeth. The worst oral hygiene level was observed in children of 6 years old affected by caries. In children 10-13 years old (Group II) the average index of oral hygiene is 2.20 ± 0.08 points which corresponds to unsatisfactory level. This is a slightly better index comparing to the previous age group. At the every age, the hygiene index in children affected by caries is worse comparing to those who aren’t affected by it (p <0,05). In children from the high school affected by caries the level of of the oral cavity hygiene ranges from 2,27 ± 0,09 in 11 years to 2,60 ± 0,21 in 10 years. These results correspond to the unsatisfactory level, but probable age differences were not discovered. Children without caries have “satisfactory” level of oral hygiene in 10 years and 11 years old and “good” level at 12 and 13 years. Thus, we observe the improvement of oral hygiene level in children with increasing of their age, especially for those with intact teeth comparing to the primary schoolchildren. High school children (Group III) also had an unsatisfactory average hygiene index (2.34 ± 0.10 points) and unsatisfactory rates of caries for children, which corresponded to the indices of I and II observed groups. In children who had no carious lesions detected the level o oral f hygiene at 14, 15 and 16 years was “good”. This fact indicates improvement of manual skills on oral health care of high school children. For more objective study concerning the oral hygiene cavity of different children, the Green-Vermillion’s index was also used. It makes possible assessment the state of the entire oral cavity. The average index of oral hygiene in children of the Ist group corresponds to the average value and is evaluated as “satisfactory” state of oral hygiene (Table 2). In children with caries (1.29 ± 0.09 points) and with intact teeth (0.99 ± 0.04 points) we observe the corresponding clinical situation. Significant changes were found in children of 9 years with intact teeth comparing to 6, 7 and 8 years old children. Thus, we observe an improvement of oral hygiene skills in children from elementary school. Children without caries lesions of the ІІnd and ІІІrd research groups have “satisfactory” and “good” of oral hygiene level. For those with caries in all age periods the result is “satisfactory”. The index of oral hygiene for children with and without caries have significant difference. In order to assess the level of oral hygiene objectively the preference should be given to Green Vermillion’s index. Particular attention should be paid to the level of oral hygiene of children from elementary school pupils, since it is worse comparing to the oral hygiene level of children from secondary and high school. We do not observe a significant improvement in oral hygiene in senior children comparing to ones from secondary school. This causes the necessity in constant education and control over oral cavity care in schoolchildren.