INITIAL FORMS OF DENTAL FLUOROSIS – TO TREAT OR NOT?

Kaskova L. F., Amosova L. I., Berezhnaja O. E., Soloshenko Yu. I., Morgun N. A.

CONTENTS

Scentific article

Relevance of fluorosis is caused by a significant spread of disease through Ukraine not only in regions with a high content of fluoride in drinking water, but also in areas with optimal and even reduced concentration of trace elements in water sources. There is an opinion that it makes no sense to treat the initial forms of dental fluorosis, as they themselves disap-pear over time. But studies that have proven that these enamel fluorosis lesions disappear, because “self-healing” and not because they are moving in a more severe form, was conducted. The purpose of the investigation. To study the dynamics of untreated fluorosis lesions of permanent teeth of schoolchildren in the city of Poltava and prove that the initial form of fluorosis should not be left untreated. Object and methods. To solve this problem our study of 80 maxillary incisors with signs of early forms of dental fluorosis in 20 pupils 1 – 3 classes of secondary schools that belong to health groups 1 and 2 and living in the Kiev region of Poltava in the same social conditions . The choice of this age group was due to the timing of teeth eruption or statement that the final maturation of enamel occurs most intensively during the first year after the eruption of the tooth. A survey of children conducted at the Poltava City Children’s Clinical dental polyclinic and included a survey and clinical assessment of the oral cavity. While collecting complaints and anamnesis find out the place of birth, place and conditions of residence of the child, a source of water, the nature of feeding, transferred and co morbidities, visiting kindergartens. Particular attention is paid to health measures (seasonal trips in the summer) and a history of prevention of dental fluorosis. Assessment manifestations of dental fluorosis was performed according to the criteria of Dean, as recommend-ed by WHO experts. Registration of fluorosis from 0 to 5 based on the evaluation conducted by the Dean criteria (points) two most affected teeth. Determination of the chalk area smudges conducted our proposed method. The initial thought is very mild fluorosis when chalky enamel changes took less than 25% of tooth surfaces – 2 points, and easy – with lesions from 25% to 50% of the surface of the tooth – 3 points. The criterion for the improvement of the affected enamel was considered disappearance or reduction in size chalk stains. The criterion of degradation was considered to increase the size of the affected fluorosis enamel, appearance of new chalky spots, pigmentation or erosion. During the process stabilization the size of fluorosis patches, color and integrity of the enamel did not change. During the first year of observation improvement of the affected fluorosis enamel is not registered in any tooth. Stabilization was found in 45,0±5,6% of the teeth, including very light fluorosis which was previously diagnosed in 30,0±5,1% of the teeth, light – to 15,0±3,9% of the teeth. The deterioration of the affected fluorosis enamel diagnosed in 55,0±5,6% of the teeth. For the second year observation improvement of fluorosis lesions diagnosed as not in any tooth. Stabiliza-tion of dental fluorosis, compared to the first year, decreased significantly (p< 0. 001) and was detected only in 18,8±4,4% of the teeth. So if children are to live in the endemic fluorosis area, without treatment (secondary prevention) are very light and light forms of the disease within 1 – 2 years pass in a heavier form, and in the sixth of children in the affected teeth, there are new focuses of fluorosis.

children, fluorosis of teeth, initial forms, treatment

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