PREVENTION OF PERIODONTAL DISEASES AT CHILDREN · Classification of the periodontal diseases...
Transcript of PREVENTION OF PERIODONTAL DISEASES AT CHILDREN · Classification of the periodontal diseases...
PREVENTION OF PERIODONTAL
DISEASES AT CHILDREN
Ukrainian Medical Dental Academy
The Chair of Pediatric Therapeutic Dentistry
with Dental Diseases Prevention
Lecturer: doc. Vashchenko I. Yu.
THE PERIODONTIUM
STRUCTURE AND FUNCTIONS
Periodontium –
("Perio" means 'around';
"dontal" means 'tooth‘)
morpho-functional complex of tissues which consist of:
cementum;
alveolar bone;
gum;
periodontium.
Functions of the periodontium:
nutritive;
sensation;
attachment & support
All components of the periodontium form a
FUNCTIONAL SYSTEM that provides attachment
for the tooth to the bone of the jaw AND permits the
tooth to withstand the forces of mastication
Classification of the periodontal diseases
(according to WHO):
gingivitis- the gums
inflammation, caused
by the unfavorable
influence of local and
common factors, which
flows without
disturbance of the
circular ligamentum
integrity;
periodontitis - the
inflammation of the
periodontial tissues,
which characterized by
the progressive
destruction of
periodontium and bone
tissue;
Periodontosis – a degenerative disease of the tissues that
surround and especially support the tooth such as the
supporting bone or the periodontal ligament.
idiopathic defeats – progressive lysis;
periodontomy – tumor processes in the periodontal tissues.
Basic etiological factors
of the periodontal diseases
Local:
Hygienic state of the oral cavity:
dental plaque, dental calculus
Irritating factors: carious defeats, defective fillings
and prostheses, orthodontic apparatuses.
Orthodontic apparatuses
Disturbance of occlusion and bite anomaly.
Disturbance of nose respiration.
Anomaly structure and the arrangement of
some soft tissues of the oral cavity organs.
Functional underloading or the overload of
maxillofacial region.
General:
Genetics
Smoking and tobacco use
Stress
Fluctuating hormones
Diabetes
Medications
Poor nutrition
Women and Periodontal Health
Puberty
Menstruation
Pregnancy
Oral Contraceptives
Menopause
The periods of taking the preventive
measures dependent on age
Prenatal period - period of the pregnancy:
the healthy means of the life of the pregnant woman;
rational nourishment;
the fulfillment of the gynecologist councils.
Breast period (first year of life):
breast feeding;
fight with the harmful habits;
the surgical intervention apropos of the anomalies of the fastening of soft tissues of the cavity of mouth.
Period of the temporary bite formation:
- the active valuable of mastication;
- correct of shaping of the oral cavity functions;
- the sanitation of the oral cavity;
- hygienic instruction and training;
- the formation of correct to bite.
Period of the formation of the constant bite:
- the elimination of the harmful factors, which disrupt
increase and formations of jaws;
- the instruction of hygienic care of the oral cavity;
- the timely treatment of the initial manifestations of
the hard tissues diseases and periodontal tissues.
Pathogenesis of the periodontal diseases
(R. J. Genko et ol., 1990)
1 stage - colonization of bacteria (predominantly Str.Sanguis та Actinomyces).
2 stage - stage of the invasion (microorganisms and theirfragments they penetrate in gum through the epitheliumof groove or pocket to different depth even of up to thesurface of alveolar bone).
3 stage - the damage of tissues occurs in two ways:
the direct action of bacteria or products of their vitalactivity;
the indirect action, which depends on the state of thehuman organism.
4 stage - stage of regeneration.
The classification of dental debris
(Pahomov T.N., 1982)
Unmineralised Mineralised
•pellicula; a) the supragingival calculus;
•plaque; b) subgingival calculus.
•soft dental debris;
•food debris.
Bacteria are the primary cause of periodontal disease. Bacteria
continually grow and form an invisible film on the teeth called
plaque. Plaque is simply a sticky yellowish-white film
composed of bacteria, small particles, proteins, and mucus. This
plaque continuously accumulates on the teeth and gums. With
proper brushing and flossing plaque is easily removed.
Plaque that is not completely removed every day by brushing
and flossing leads to a hard substance known as tartar (or
calculus).This hardened plaque can no longer be removed with
simple brushing and flossing. It must be removed by a dentist.
Calculus grading scale
Planning of prevention measure for patients
with the periodontal disease:
Complex of examination with plague control;
To use the periodontal index (CPITN, PI, BPI and et.)
Make a diagnosis;
Make individual treatment plan according to the acute or
chronic stages of disease;
– recommended the medial or soft hardness of bristles:
“Soft”, “Sensitive Plus”, “Sensitive”;
– treatment, treatment-preventive toothpaste;
– choice the mouth wash; mouth rinse;
The method of tooth brushing: may be Charter, Bass. Control
test after tooth brushing;
Make a professional hygiene (scaling)
Planning of prevention measure for patients
with the periodontal disease (cont):
Endogenous prevention of periodontal disease
(recommended for patient)
– vitamins, complex preparation which include the
vitamins, remineralization preparation with micro- and
macro- elements;
– special rational regime of eating (diet);
– make a examination of common organism, make a
relative ship between dentistry disease and somatic
health.
Exogenous treatment preventive measures.
Daily Dental CareBrushing Guidelines.
Use a dry brush. (plaque deposits were reduced by 67%, and gum
bleeding dropped by 50%).
Place the brush where the gum meets the tooth, with bristles resting
along each tooth at a 45-degree angle.
Begin by dry brushing the inside the bottom row of teeth, then the inner
top teeth, and last the outer surfaces.
Wiggle the brush back and forth so the bristles extend under the gum
line.
Scrub the broad, biting surfaces of the back teeth.
Dry brushing should take about a minute and a half.
A paste is then applied, and the teeth should again be brushed in the
same way.
The tongue should be scrubbed for a total of about 30 seconds.
Rinse the toothbrush thoroughly
Flossing should finish the process. A mouthwash may also be used.
Toothpaste
The object of a good toothpaste is to reduce the
development of plaque and eliminate periodontal causing
microorganisms without destroying the organisms that
are important for a healthy mouth.
Mouthwashes
The value of many mouthwashes is highly
controversial. Many have only temporary
antibacterial value. Some can even harm
the mucous membrane, and they can be
dangerous for children who drink them.
Those that are considered plaque fighters
are chlorhexidine (prescription) and
Listerine, which is available over the
counter.
Scaling and Root Planing
The initial stage of
treatment is usually a
thorough cleaning that may
include scaling to remove
plaque and tartar deposits
beneath the gumline.
Periochip A tiny piece of gelatin filled with chlorhexidine.
To control bacteria and reduce the size of periodontal pockets.
Chip is placed in the pockets after root planing, where the
medicine is slowly released over time.
Atridox A gel that contains the antibiotic doxycycline .
To control bacteria and reduce the size of periodontal pockets.
Placed in pockets after scaling and root planing. Antibiotic is
released slowly over a period of about seven days.
Actisite Thread-like fiber that contains the antibiotic
tetracycline. To control bacteria and reduce the size of
periodontal pockets .
These fibers are placed in the pockets.
The medicine is released slowly
over 10 days.
The fibers are then removed.
Arestin microspheres. Tiny round particles
that contain the antibiotic minocycline.
To control bacteria and reduce the size of
periodontal pockets.
Microspheres placed into pockets after
scaling and root planing. Particles release
minocycline slowly over time.
Periostat A low dose of the medication
doxycycline that keeps destructive enzymes
in check
To hold back the body’s enzyme response –
if not controlled, certain enzymes can break
down bone and connective tissue. This
medication is in pill form. It is used in
combination with scaling and root planing.
Thank you for attention!