American Journal Of Social Sciences And Humanity Research
112
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VOLUME
Vol.05 Issue05 2025
PAGE NO.
112-116
10.37547/ajsshr/Volume05Issue05-27
Improving Methods of Exogenous Prophylaxis of
Permanent Teeth in Children of Specialized Special
Schools
INDIAMINOVA Gavkhar Nuriddinovna
Doctor of Philosophy medical sciences (PhD), Samarkand State Medical University, Uzbekistan
Received:
28 March 2025;
Accepted:
24 April 2025;
Published:
26 May 2025
Abstract:
Objective: to improve methods of early diagnosis, treatment and prevention of caries of permanent
teeth in mentally retarded children attending special schools.
Methods: During the study, general clinical, laboratory, biochemical, functional, instrumental and statistical
methods were used. The object of the study was 220 pupils attending special boarding schools No. 62 and 63 of
Samarkand city and Akdarya district, respectively, from 2018 to 2021.
Results: The prevalence of dental caries in mentally retarded children studying in specialized schools depends on
their level of socialization, nutrition and the presence of Down syndrome. The risk group includes socialized
children without Down syndrome: the caries intensity index was 3.8 4.9; 5.8, and the prevalence is 42.0, 76.0 and
85.0% in children 8, 10 and 12 years old, respectively. The prevalence of caries in children with Down syndrome
was lower - 33.0, 64.0 and 72.0% in children 8, 10 and 12 years old, respectively.
Conclusions: According to the results of applying a special preventive algorithm, the number of cariogenic
microorganisms on the teeth slightly decreased from the initial values. Thus, the most optimal treatment regimen
with a high therapeutic effect in mentally retarded patients has been identified, which makes it possible to
increase the effectiveness of treatment and reduce its time.
Keywords:
Dental caries, periodontal disease, epidemiological study, caries intensity, mental retardation.
Introduction:
Currently, caries is the most common
dental pathology in the world, which is explained by its
medical and social significance and an increase in the
incidence rate among the population from year to year.
According to the World Health Organization (WHO), "...
the prevalence of caries among dental diseases is 63.3-
88.7%, in particular in healthy 12-year
—
olds - 37.8-
50%, and in 15
—
year-olds - from 57.7% to 84.7%, that
is, these indicators increase with age [1,4,6]. When
studying the average prevalence of caries in children
with mental retardation, their high level was revealed,
while it was found that in children with mild mental
retardation at the age of 13-18, this pathology occurs
in up to 100% of cases and is associated with the
severity of the underlying disease. Currently, the early
diagnosis of caries in children with mental retardation,
the appointment of measures to prevent complications
of this pathology, taking into account the pathogenetic
properties and reducing the number of relapses of the
disease are among the problems that require a solution
in medicine [2,5,9].
A number of scientific studies are being conducted
worldwide aimed at providing dental care to children
with mental retardation, prescribing treatment based
on the underlying disease (mental retardation) and
further improving these methods [6,7,10,12]. In this
regard, it is especially important to conduct scientific
research aimed at improving the range of measures for
the individual selection of therapies, assessing the
quality of life of patients, as well as introducing
effective treatment into practice, taking into account
the use of general anesthesia in children with mental
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
retardation, taking a number of medications for the
underlying
neurological
disease,
in
particular
antipsychotics,
antidepressants,
tranquilizers,
nootropics that cause hyper- or hyposalivation,
decreased pain sensitivity, which in turn contribute to
the transition of the acute form of the disease into a
chronic one [3, 11, 12].
Dental care for mentally retarded children is fraught
with a number of difficulties due to their lack of contact
due to an underlying disease (mental disorders and
behavioral disorders, diseases of the nervous system)
and requires treatment of this group of children under
general anesthesia, which is not always possible due to
their concomitant severe somatic pathology. In
addition, not all institutions of this type have dental
offices. All this dictates the need to find new forms of
dental care for mentally retarded children, one of the
important components of which should be prevention
[1,2,5]. We implemented a program for the prevention
of dental diseases in children with disabilities, but most
of them were aimed at children with mild to moderate
mental retardation, which took into account not only
the degree of mental retardation, but also the learning
of oral care skills, the degree of socialization and the
child's diet.
The purpose of the study: To improve the methods of
prevention of caries of permanent teeth in children
with intellectual disabilities based on ozone therapy in
sealing the fissures of teeth.
METHODS
220 patients with intellectual disabilities from
specialized boarding schools No. 62 in Samarkand and
No. 63 in Akdarin district were examined, including
between 6, 9 and 12-year-old boarding school students
(Fig. 1). Depending on age, gender, diet, type of major
neurological diseases, presence of Down syndrome and
degree of During the socialization of children, the
hygienic condition of the oral cavity was studied with
the use for a certain period of time of a special program
aimed at preventing caries of permanent teeth, the
level of their effectiveness is determined. General
clinical, instrumental, functional and statistical
methods were used to solve the tasks. The following
indicators were evaluated: -the prevalence of caries;
the intensity of caries of permanent teeth according to
the CPI index; the clinical condition of periodontal
tissues was assessed according to the PMA index in the
Parma modification.
Figure 1. Distribution of patients by age.
To assess the risk of dental diseases, a microbiological
study of plaque was conducted, for which 26 children
from subgroup 1 and 24 people from subgroup 2 were
randomly selected. For microbiological examination,
dental supragingival plaque was collected by scraping
with a sterile excavator. The prevention program
included teaching children oral hygiene and health
education with the staff of the institution and the
parents of some of the students who attended the
boarding school (Fig. 2). Individual prevention methods
were also carried out:
Professional oral hygiene;
Remineralizing therapy- applying fluoride-containing
varnish to teeth;
Sealing the fissures of permanent teeth using ozone.
0
10
20
30
40
50
60
70
32
40
41
42
65
8
лет
9
лет
10
лет
11
лет
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
Figure 2. Professional oral hygiene, dental fluoridation.
Currently, it has been established that the effectiveness
of sealing dental fissures depends not only on the
quality of the filling material, but also on the quality of
antiseptic treatment of the oral cavity. In dental
practice,
0.006%
solutions
of
chlorhexidine
bigluconate, 0.02% ethacridine lactate and 5%
solutions of dimexide are widely used as antiseptics.
But these disinfectants have a number of
disadvantages. Caries prevention was carried out using
ART to ensure that the children included in the
examination were not afraid of dental examination and
voluntarily continued visits. The surfaces of the
permanent teeth of the children who make up the main
group were treated with ozone, and a modern remedy
Fissurite F, specially developed for the prevention of
primary caries of milk, permanent and mixed teeth,
was used as a sealant (Figure 3).
Fissurite F is characterized by the presence of a 3%
fluorine-preserving separation resin (matrix), a small
amount of solid particles (borosilicate glass), which are
highly resistant to mechanical and chemical erosion. A
small amount of filler increases the ability of the drug
to penetrate microcracks and deep fissures. This
product has high adhesion to enamel and high
strength, does not dissolve in an aqueous medium and
releases 4-5 mg of fluoride for 190 days.
Recently, due to the increasing allergization of the
population, decreased sensitivity to antibiotics,
increased cost of medicines, and non-medicinal
treatments have become increasingly popular. Among
them is ozone therapy, which is deservedly becoming
more widespread all over the world. This is due to the
properties of ozone to influence the transport and
release of oxygen into tissues, and its disinfecting
effect. Ozone is used in therapy, surgery, obstetrics and
gynecology, dermatology, dentistry and cosmetology.
Conclusion: the data obtained from 9 and 12-year-olds,
before the program was implemented, served as
internal control for groups of children who entered the
prevention program at the ages of 6-8 and 9-11 years.
At the same time, the group of 9-year-olds is the
comparison group for the other groups of 9-year-olds
and becomes the main group three years after these
children reach the age of 12. For children who joined
the prevention program at the age of 12, 15-year-old
children previously examined served as a control
group. The prevalence and intensity of dental caries in
mentally retarded children depended on socialization,
which determines lifestyle and diet, as well as on the
presence of Down syndrome.
The incidence of dental caries in mentally retarded
children living in boarding schools depends on their
socialization, which determines certain lifestyle and
nutrition features. The risk group consists of socialized
children without Down syndrome: the prevalence of
caries was 31.0, 62.0 and 83.0% with intensity
0[0;1,17], 2[0;4], 4[3;5] 6, 12, and 15-year-olds,
respectively. In non
–
socialized children without Down
syndrome, the prevalence of caries was low - 0, 18.0
and 22.5% in 6, 12 and 15-year-olds, respectively, while
children with Down syndrome had no dental caries.
Mild gingivitis prevailed in socialized children (55, 50,
and 50% among 6, 12, and 15-year-olds, respectively),
moderate gingivitis prevailed in non-socialized children
(47.1 and 41.6% in 6 and 15-year-olds, respectively)
and severe gingivitis (38.6% in 12-year-olds).
45[26;67,5]. The inability to take full-fledged oral care
on their own makes this group of children particularly
vulnerable to periodontal diseases. The prevalence of
dental caries in mentally retarded children enrolled in
specialized schools depends on their level of
socialization, nutrition, and the presence of Down
syndrome. The risk group includes socialized children
without Down syndrome: the caries intensity index was
3.8- 4.9; 5.8, and the prevalence was 42.0, 76.0, and
85.0% in children aged 8, 10, and 12, respectively. The
prevalence of caries in children with Down syndrome
was lower - 33.0, 64.0 and 72.0% in children aged 8, 10
and 12 years, respectively. As a result of the
microbiological examination of teeth, noticeable
negative changes in the composition of the microflora
American Journal Of Social Sciences And Humanity Research
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
of the teeth of children without Down syndrome,
relatively socialized mentally retarded, including an
increase in species of the genus Streptococcus,
considered cariogenic, indicates a high potential of the
carious process.
CONCLUSIONS
1. The prevalence of dental caries in mentally retarded
children enrolled in specialized schools depends on
their level of socialization, nutrition, and the presence
of Down syndrome. The risk group includes socialized
children without Down syndrome: the caries intensity
index was 3.8- 4.9; 5.8, and the prevalence was 42.0,
76.0, and 85.0% in children aged 8, 10, and 12,
respectively. The prevalence of caries in children with
Down syndrome was lower - 33.0, 64.0 and 72.0% in
children aged 8, 10 and 12 years, respectively.
2. As a result of microbiological examination of teeth,
noticeable negative changes in the composition of the
dental microflora of children without Down syndrome,
relatively socialized mentally retarded, including an
increase in species of the genus Streptococcus,
considered cariogenic, indicates a high potential of the
carious process.
3. During the two years of the implementation of the
preventive program, a positive increase in hygiene
indicators was noted. Satisfactory hygienic condition
was observed in 64.2%, good hygienic condition in
35.2%, unsatisfactory hygienic condition in 0.6% of
children.
4. The use of ozone as part of the comprehensive
prevention of caries in children with intellectual
disabilities, taking into account their mental and
physical abilities, has yielded positive results. No
negative complications were observed in children
during complex ozone-oxygen treatment, and the use
of this method continued to be comfortable and
painless for patients.
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