CC BY
24cord and the dorsal root ganglia/ BMC Neurosci. 2019 Apr 25;20(1):18. doi: 10.1186/s12868-019-0502-z
6. Xuhui Hou, Songbai Yang, Jian Yin. Blocking the REDD1/TXNIP axis ameliorates LPS-induced vascular endothelial cell injury through repressing oxida-tive stress and apoptosis /Am J Physiol Cell Physiol. 2019 Jan 1;316(1):C104-C110. doi: 10.1152/aj-pcell.00313.2018.
7. Juan M Jimenez-Andrade, Monica B Herrera, Joseph R Ghilardi, Marina Vardanyan, Ohannes K Melemedjian, and Patrick W Mantyh. Vascularization of the dorsal root ganglia and peripheral nerve of the
mouse: Implications for chemical-induced peripheral sensory neuropathies/ Mol Pain. 2008; 4: 10
8. Electron microscopy. Methods and protocols. Edited by John Kuo. // USA, Totowa, New Jersey: Humana Press Inc., 2007, 608 p.
9. Jessica M., Micaela G., Vincenzo M., Cristina C., Saverio N., Roberta M., Miriam S., Francesca B., Federica S., Stefano R., Maria C., Francesca O., Rocco M., Sara P., Ernesto P., Carolina M. And Vincenzo M. The Role of endothelial dysfunction in peripheral blood nerve barrier: molecular mechanisms and pathophysiological implications // Int. J. Mol. Sci. 2019, 20, 3022; doi:10.3390/ijms20123022.
CARIES COURSE IN CHILDREN. THE CURRENT STATE OF THE ISSUE
Kotelban A.
PhD, Associate Professor, Chernivtsi, Ukraine, Department of Pediatric Dentistry Bukovynian State Medical University
Moroz P.
PhD, Associate Professor, Chernivtsi, Ukraine, Department of Surgery № 1 Bukovynian State Medical University Zhyrulyk Ju.
Student of stomatological faculty Bukovynian State Medical University
Abstract
Undoubtedly, the most common disease of the oral cavity in childhood is caries. This dental nosology is one of the oldest and most common in the world.
The results of epidemiological studies show that a high prevalence of caries of temporary teeth is observed in children under two years. In different regions of Ukraine, this figure remains consistently high. This indicates the need to start preventive measures from an early age, taking into account the regional characteristics of the formation of dental pathology.
Factors in the development of dental caries are individual. There are more than 100 causes of the risk of dental caries in childhood. They can be of different intensity and nature, there are different options for their interaction.
Keywords: caries, prevalence, dental health, children, S. Mutans.
According to the WHO, the incidence of dental caries in different countries and among different contingents ranges from 80% to 98%. In the last two decades, there has been a trend of increasing incidence among children, especially in economically developed countries, and by 6-7 years, 80-90% of children have caries of varying depth [21]. In Ukraine, these indicators also remain quite high and tend to increase [2,4,6].
Clinical observations indicate the rapid progression of caries, which occurs in the early stages after the eruption of temporary teeth. Thus, in children of the first year of life caries of temporary teeth occurs in approximately 12-15% of cases, in children 3 years of age increases to 60%, and reaching 6 years of age is found in 85% of subjects [7].
In adolescents, the prevalence of caries of permanent teeth is high, in 12-year-olds this figure averages 64.8%, and among 15-year-olds - 76% [4].
In our opinion, children of 5-7 years of age deserve special attention, as this period of a child's life is a turning point due to the significant psychological, physical and mental load on the child's body during preparation and the first year of school. This period coincides with the eruption of the first permanent teeth -
molars, which in turn also has an impact on the growth and development of the body as a whole and on the ecosystem of the oral cavity.
The frequency of dental caries is different in different regions of Ukraine. High levels of dental caries are registered in the studied Lviv, Ivano-Frankivsk, Chernivtsi, Zakarpattia, Chernihiv, Khmelnytsky, Luhansk regions [7]. Regions with an average level of morbidity include Mykolayiv, Kherson, Odesa, Vinny-tsia, Ternopil, Zhytomyr, Zaporizhia regions and the Crimean Autonomous Republic [4, 7]. Low levels of dental caries have been found in Poltava, Sumy, Kyiv, Dnipropetrovsk, Kharkiv, Kirovohrad regions [2, 4, 7]. Particularly relevant medical and social research among the population of regions with a pronounced mi-cronutrient deficiency, which determines the endemic nature of the area. The growth of epidemiological indicators of caries in some regions depends on environmental and geophysical factors, including contamination by radionuclides, heavy metals, pesticides and other xenobiotics; urbanization of the region and the state of reactivity and adaptive-compensatory capabilities of the organism [1].
It is well known that dental caries is a multifactorial, diet-associated disease manifested by foci of enamel demineralization. The etiology and pathogene-sis of dental caries are well studied and known. Factors in the development of dental caries are individual. There are more than 100 causes of the risk of dental caries in childhood. They can be of different intensity and nature, there are different options for their interaction. The prevalence of dental caries depends on the socio-economic status of the family, environmental factors, fluoride exposure, dental prophylaxis, and is determined by the composition and structure of enamel and other tooth tissues, specific and nonspecific oral protection factors, quantitative and qualitative indicators of oral fluid. the presence of bad habits, the properties of plaque, and all this depends on the general condition of the body [4-8].
In general, factors can be varied: both exogenous and endogenous. External factors leading to the development of caries should be considered: demographic, such as age, gender, ethnicity and level of education; anthropometric, consisting of height, body mass index, waist coverage; environmental factors, including diet, frequency of brushing, water quality and fluoride levels in water [6]. Probably, the external factors should include the composition of the microbiota of the oral cavity: biofilms of teeth and saliva. It is known that female caries affects women more often than men [16]. Among the environmental factors, the most significant are the content of fluorides in water consumption and the level of oral hygiene. In addition, important socio-economic factors, such as the level of education in the family, which determines the understanding of the role of oral hygiene and the rational observance of personal hygiene rules for the preservation of teeth [5-8]. An important role is played by diet and taste preferences of the individual, in particular the consumption of sweet foods [9]. As an external factor should also be noted environmental pollution, especially in industrial regions and cities, which can affect the condition of tooth enamel and, consequently, cause caries [10].
Internal factors include genetic factors, features of tooth morphology, saliva composition, salivation rate and others [16].
However, the key to the development of caries, regardless of age, is the microflora of the oral cavity. The human microbiome functions as part of non-specific immunity, for example, competing for essential nutrients and creating unfavorable conditions for exogenous microorganisms that can be pathogenic to the host. More than 700 bacterial taxa have been identified in the oral cavity [13-15]. These are aerobic and anaerobic microorganisms, various types of fungi, viruses, protozoa, among them the most common are facultative anaerobes, in particular a-hemolytic streptococci. The second largest group is lactic acid bacteria. Much of the oral ecosystem is non-pathogenic, the rest is conditionally pathogenic. Its composition can change under the influence of various adverse factors that reduce the body's defense mechanisms. As a result, there are quantitative and qualitative shifts in the population of microorganisms in the oral ecosystem. The relationship in the
ecological system "microorganisms - oral cavity - external factors" determine all subsequent stages of caries [2]. That is why the oral microflora is divided into two categories: cariogenic and non-cariogenic. The first in caries is more common, the second - less often.
The best known cariogenic microorganisms are S. mutans and lactobacilli colonies. In fact, before the discovery of S. Mutans, lactobacilli were considered the main etiological factor of dental caries due to the high correlation between the amount of Lactobacillus in saliva and the rate of caries [9-15]. However, the interpretation of this correlation as a causal relationship was erroneous. Van Houte and colleagues acknowledged that the relatively low affinity of lactobacilli for the tooth surface is due to the fact that mechanical retention may play an important role in their colonization on the tooth surface. Taken together, these observations suggest that streptococci and other acidogenic bacteria in the oral cavity create the necessary niche (precarious lesion) capable of mechanically retaining lactobacilli. A feature of the retention niche is the mechanical content of food, sources of carbohydrates. Thus, caries is a stagnant acidic environment rich in carbohydrates, where lactobacilli can thrive [9-15].
Thus, most epidemiological studies have shown that the high level of Str. mutans and Lactobacillus in the oral cavity are associated with a high prevalence of dental caries [9-15]. It is well known that these microorganisms have a high degree of adhesion to tooth enamel and have significant acid-producing function of teeth [21,22].
Therefore, further epidemiological studies, the search for improved diagnostic methods and new treatment and prevention programs are needed.
References
1. World Health Organization. Oral health surveys: basic methods. 5th ed. Geneva: WHO; 2013. 132 p. Available from: https://apps.who.int/iris/bit-stream/han-
dle/10665/97035/9789241548649_eng.pdfj ses-
sionid=CC353237043DFA4D54CBFF6817B75D67?s
equence=1.
2. Tanner AC, Kressirer CA, Faller LL. Understanding caries from the oral microbiome perspective. J Calif Dent Assoc. 2016;44(7):437-446. PMID: 27514155.
3. Удина ИГ, Гуленко ОВ. Молекулярно-гене-тические механизмы развития кариеса. Генетика. 2018;54(4):426-434. DOI: 10.1134/S1022795418040154.
4. Anitha C, Konde S, Raj NS, Kumar NC, Peeth-amber P. Dermatoglyphics: a genetic marker of early childhood caries. J Indian Soc Pedod Prev Dent. 2014;32(3):220-224. DOI: 10.4103/09704388.135828. PMID: 25001441.
5. Shaffer JR, Wang X, McNeil DW, Weyant RJ, Crout R, Marazita ML. Genetic susceptibility to dental caries diers between the sexes: a family-based study. Caries Res. 2015;49(2):133-140. DOI: 10.1159/000369103. PMID: 25612913. PMCID: PMC4449725.
6. Шаковець HB, Терехова ТМ. Захво-рюванють на кaрieс зyбiв у дiтей раннього вiкy та ïï взаемозв'язок з рiзними факторами ризику. Профшактична та дитяча стоматолопя. 2015;1(12):38-42. Доступно на: http://nbuv.gov.ua/UJRN/ptdc_2015_1_11.
7. Якубова II, Кузьмша ВА. Раннш дитячий кaрieс. Стан проблеми в УкраМ. Современная стоматология. 2017;(1(85)):48-54. Доступно на: http://nbuv.gov.ua/UJRN/ss_2017_1_13.
8. Скульська CB, Шнайдер СА, Пиндус ТО. Порiвняльнa оцiнкa ефективносп використання за-собiв первинно1' профшактики кaрieсy постiйниx зyбiв у дней шк1льного вiкy. Wschodnioeuropejskie Czasopismo Naukowe. Медицинские науки. (East European Scientific Journal. Medical Sciences). 2019;(12(520):58-62. Доступно на: https://eesa-journal.com/2020/01/10/porivnyalna-ocinka-efektivnosti-vikoristannya-zasobiv-pervinno%D1 %97 -profilaktiki-kariyesu-postij nix-zubiv-u-ditej -shkilnogo -viku-58-62/.
9. Wendell S, Wang X, Brown M, Cooper ME, DeSensi RS, Weyant RJ, et al. Taste genes associated with dental caries. J Dent Res. 2010;89(11):1198-1202. DOI: 10.1177/0022034510381502. PMID: 20858777. PMCID: PMC2954250.
10. Чуйкин СВ, Егорова ЕГ, Акатьева ГГ, Аверьянов С.В. Особенности профилактики кариеса зубов у детей в крупном промышленном городе. Стоматология детского возраста и профилактика. 2011;10;3(38):41-45.
11. Леус П.А. Клиническая индексная оценка стоматологического статуса: учеб.-метод. пособие. Минск: БГМУ, 2009. 60 с.
12. Петрушанко Т.О., Череда В.В., Лобань Г.А. Яшсний склад мшробюценозу порожнини рота оаб молодого вшу з рiзною iнтенсивнiстю кaрieсy. Cвiт медицини та бiологiï. 2013;1:57-59.
13. Скатова Е.А., Макеева М.К., Шакарьянц А.А. Практические аспекты определения риска развития кариеса. Проблемы стоматологии. 2010;3:13-18.
14. Шаковець Н.В., Терехова Т.М. Захворюванють на Rapiec 3y6iB у дiтей раннього вшу та ii взаемозв'язок з рiзними факторами ризику. Профшактична та дитяча стоматолопя. 2015 ;1(12) :38-42.
15. Caufield P.W., Schön C.N., Saraithong P., Li Y., Argimon S.: Oral lactobacilli and dental caries: a model for niche adaptation in humans. J Dent Res 2015;94(9):110S-118.
16. Dianawati N., Setyarini W, Widjiastuti I., Rid-wan R.D., Kuntaman K. The distribution of Streptococcus mutans and Streptococcus sobrinus in children with dental caries severity level. Dent. J. (Majalah Kedokte-ran Gigi). 2020;53(1):36-39.
17. Ghazal T., Levy S.M., Childers N.K., Carterd D.J. Caplana J.J., Warren J., Cavanaugh J.E. Mutans Streptococci and Dental Caries: A New Statistical Modeling Approach. Caries Res 2018;52:246-252
18. Ghazal T., Levy S.M., Childers N.K., Broffitt B., Cutter G.R., Wiener H.W., Kempf M.C., Warren J., Cavanaugh J.E. Factors associated with early childhood caries incidence among high caries-risk children. Community Dent Oral Epidemiol 2015;43:366-374.
19. He J., Li Y., Cao Y. The oral microbiome diversity and its relation to human diseases. Folia Microbiologics 2015; 60(1):69-80.
20. Lemos J. A. The biology of Streptococcus mutans. Gram-Posit. Pathog. 2019;1:435-448. https://doi.org/10.1128/9781683670131.ch27 .
21. Priya, A., Kumar, C.B.M., Valliammai, A. et al. Usnic acid deteriorates acidogenicity, acidurance and glucose metabolism of Streptococcus mutans through downregulation of two-component signal transduction systems. Sci Rep. 2021;11:1374. https://doi.org/10.1038/s41598-020-80338-6.
22. Tanner A.C., Kressirer C.A., Faller L.L. Understanding caries from the oral microbiome perspective. J. of the California dental association. 2016;44 (7):437-46.
