INDIVIDUAL ORAL HYGIENE IN CHILDREN WITH ACUTE FORMS OF LEUKEMIA

Legenchuk O., Mozgova O., Volkova S.

DENTISTRY

Scentific article

According to the literature, the number of malignant diseases in childhood is greatly increased, including blood diseases. The purpose of our research is to study changes in the oral cavity of children with acute forms of leukemia, to justify the choice of personal hygiene products of the oral cavity, depending on the clinical course, the forms and stages of treatment of the underlying disease. Results of the research and their discussion. The condition of oral cavity mucous membrane is studied in 80 children aged 2 to 18 years with acute leukemia, of which 29 with acute myeloblastic leukemia, with acute lymphoblastic disease – 51. Of these, at the stage of the first acute period there were 27 children, 14 at the stage of clinical remission and 9 children at the relapse stage. All children from 2 to 7 years old held hygienic measures, determined the state of hygiene of the oral cavity using the index of Fedorov – Volodkina, and children from 7 to 18 – the index Green – Vermillon. In determining the Fedorov – Volodkin index, we have established high indicators of the hygienic index. The average value of the Green – Vermillon index makes it possible to assess the state of hygiene as bad. On the background of a severe general condition, various lesions of the oral mucosa of the viral, candidiasis and toxic etiology develop. In this period, the use of food, manipulation of oral hygiene is limited, which is associated with manifestations of hemorrhagic syndrome and pain in the mucous membrane and gums, which in turn is a threat to the development of generalized infection. During a certain period a child can not use a toothbrush and a paste. After the course of chemotherapy, with the normalization of blood parameters it is possible to conduct professional hygiene and sanitation of the oral cavity. We consider it advisable to give recommendations to parents about the need for regular monitoring of the individual hygiene of the patient’s oral cavity as an integral part of the complex of therapeutic and prophylactic measures as an important preventive measure for the occurrence of lesions of the mucous membrane of the oral cavity. At the beginning of the course of treatment for the underlying disease, it is necessary to teach children and their parents methods of brushing teeth, recommend tools and hygiene items. Recommend a rational toothbrush in shape, size of the working part (head), depending on the size of one segment of the teeth of two incisors and the fangs on the upper jaw, or analogous to the temporary teeth. By rigidity, this should be a medium rigidity brush, which is used in the absence of lesions on the mucous membrane of the oral cavity. It is better to immediately buy several brushes, taking into account their replacement in the future due to possible changes in the oral cavity, which may arise as a comprehensive treatment of the underlying disease. In a period when it is not possible to use a toothbrush, we recommended a rubber bubble for washing the mouth and a pin (type of pean) that may be needed in the future as an alternative to the toothbrush. In the treatment of children who were in the active phase of acute leukemia, for individual oral hygiene, we recommend soft bristle toothbrushes and complex therapeutic and prophylactic toothpastes containing fluoride and broad spectrum antiseptic (triclosan, cetylperidine chloride, chloroxidine, active supplements). These pastes, in addition to cleansing action, have anti-inflammatory, antimicrobial activity, haemostatic, anti-allergic, antifungal activity, as well as promote regeneration processes. To prevent the above listed side effects, hygiene should be changed every 2-3 weeks, brush your teeth 2-3 times a day. Before brushing teeth and after each meal, we recommended to rinse mouth with rinses in the form of ready-to-use chemist’s forms that contain antibacterial agent, immunomodulators, herbal antioxidants. Rinsers can be made in the form of infusions, from various types of medicinal plants (chamomile medicinal, sage, St. John’s wort, nettle, millennial, etc.). During the period of clinical remission (maintenance therapy) of acute leukemia, it is necessary to recommend toothpastes that have a pronounced antiinflammatory and anticarcinogenic action. During the treatment of recurrence of acute leukemia, when the general condition of the child deteriorates considerably, the individual hygiene needs to be continued. Since a baby can not use a toothbrush during this period, we recommended the use of liquid personal hygiene products in the form of rinses, oral trays. Conclusions. Thus, the individual hygiene of the oral cavity and the choice of hygiene should be adequate to the general condition of the child and the state of the oral mucosa.

асute leukemia, children, individual oral hygiene

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«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 349-352 pages, index UDK 616.31-083-053.2:616.155.392

10.29254/2077–4214–2017–4–3–141–349-352