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13CONDITIONS OF THE ORAL CAVITY OF SOCIALLY VULNERABLE PERSONS WITH DISEASES
OF THE GASTROINTESTINAL DISORDERS
Davitadze S., Pranchuk K.
David Agmashenebeli University of Georgia Chomakhashvili Z., Putkaradze M.
Batumi Shota Rustaveli State University DOI: 10.5281/zenodo.6579896
ABSTRACT
The article discusses 51 socially vulnerable patients living in Batumi with a diagnosis of various gastrointestinal diseases. The condition of the oral cavity of these patients is examined. And the determination of the intensity revealed a rather high rate of intensity hence more share came from the Missed teeth -594. Caries-190, Filled - 17. By OHI - S Didn't identified good oral hygiene conditions. fair - 10; poor - 25. By CPITIN 3mm -8; 3-4mm - 15; 4-5mm - 6; 6mm and more - 4. 21 respondents with socially vulnerable gastroenterological diseases have stomatitis mainly in the form of aphthous ulcer, the first manifestation of various gastrointestinal disorders of the oral cavity. Erosion of the teeth was detected in three patients, which was localized on the vestibular surface of the upper central incisors, and erosive lesions on the teeth were observed precisely during gas-troesophageal reflux.
Keywords: Oral cavity, gastrointestinal diseases, socially vulnerable.
Introduction
Health care is the primary concern of the state. Therefore, healthcare is crucial for the country's future. According to the World Health Organization, health financing is a function of this system, which focuses on the individual and collective mobilization of funds to meet the population's health needs.
Health is defined as physical, mental, and social well-being and not just the presence of disease. Physical well-being is characterized by adequate physical development, standard birth ability, and the absence of disease. Social welfare refers to the quality of medical care, lifestyle, living conditions, nutrition and demographics. Mental well-being is characterized by less prevalence of mental illness, psychological well-being. Oral diseases: Caries and periodontitis are associated with many somatic diseases. Often they are the cause of a general disease or, conversely, a manifestation of this disease in the oral cavity. Today, a healthy oral cavity is not just about dental health and modern scientific studies confirm the correlation between oral diseases and systemic complications [6,10]. The prevalence of Chronic diseases is more characteristic of the poor social strata. People in economic hardship are often unemployed, lack social support, and have less control over their lifestyle and health. [7].
The daily practical work of the dentist includes the number of patients who have a history of various systemic pathologies, the perfection of a managed treatment plan is a natural result of taking carefully thought-out steps. Anamnesis and clinical examination are the two most important aspects of the patient evaluation process and are so complementary that it is impossible to create a satisfactory treatment plan without combining and reconciling information from these two procedures. [6,12].
Gastroenterological Diseases: Inflammatory bowel disease, gastritis, crohn's disease, gastroesopha-geal reflux disease, gastric ulcer, cholecystitis, and others may be detected orally. [3,8]Chronic gastritis is
one of the most common diseases. Persistent and aggressive inflammation during gastritis causes irritation and dysfunction of the gastric mucosa. The causes of the disease are many - including social status, environmental conditions and hygienic factors. However, the main etiological factor is the result of Helicobacter pylori. At this time on the mucous membrane of the oral cavity are often observed abscesses of various sizes, which is one of the etiological factors of aph-thous stomatitis. For example, oral manifestations that help us diagnose and monitor the disease while ignoring them may lead to misdiagnosis and the appointment of unnecessary and expensive examinations. Numerous studies have shown a link between caries and gastro-esophageal reflux disease. An important role among the immune defense components of the oral cavity is played by nonspecific defense factors generated by different cells that act in the complex. [2,4,5].
People with economic hardships are often unemployed, lack social support, and have little control over their lifestyle and health. purpose of this article is the manifestations of oral cavity disorders, which characterize the socially vulnerable persons with gastrointestinal pathology.
Research material and methodology. As a research method, we used an anonymous sociological survey for which purpose we used a specially created questionnaire; Representatives of each social stratum underwent a primary dental examination with a single dental equipment. To examine oral hygiene, all of our respondents. We use the oral hygiene simplex index. The OHI-Shas two components the debris Index and the calculus index. The six surfaces were examined for this and selected from four posteriors and two anterior teeth. 0 - No debris or stain present; 1 - Soft debris covering not more than one third of tooth surface; 2 -Soft debris covering more than one third, but not more than two-third, of the exposed tooth surface; 3 - Soft debris covering od the exposed two tooth surface; 00,6 - Good oral hygiene; 0,7-1,6 - fair oral hygiene;
1,7-2,5 - non-fair; 2,6 and more poor oral hygiene We also determined the depth of the periodontal pocket with the CPITIN index, a special ball probe is provided for the examination, which has a dark red level of 3.5-5.5 mm and a mass of 25 g. -5 mm - 3 points, if the dark part of the probe is completely visible the upper and lower gingival stones are marked - 2 points, 3 mm - 1. In the absence of inflammatory signs - 0 points. We also used the bleeding index recommended by WHO for periodontal diagnosis, where probing determines bleeding. 0 - mean no bleeding. 1 -.mean there is bleeding. [9] For epidemiology research of dental caries. We defind and measured by (the DMF) index for the prevalence of caries. It calculate D + M +f = DMF. Provided by the World Health Organiza-
Age and
tion 5 levels of the index: very low (0-1,1), low (1,22,6), medium (2,7-4,4), high (4,5-6, 5), very high (6.6 and up) Examinations were conducted using well-known methods in medicine and dentistry, the results were defined according to the standards currently accepted in the country, and they were processed using the SPSS-25 version.
The results and discussion. To achieve the set goal, we studied the oral cavity condition of gastroen-terological patients. A total of 51 representatives of socially vulnerable strata were interviewed, including 31 female respondents and 20 male respondents ranging in age from 20-74 years. We studied five age groups: 20-34 years, 35-44 years, 45-54 years, 55-64 years, and 65-74 years (Table № 1).
Table № 1.
Gender
Respondents Age Submit
20-34 35-44 45-54 55-64 65-74
Female 8 8 11 2 2 31
Male 3 5 5 5 3 20
Sumbit 11 12 16 7 5 51
It is relevant to mention the marital status of Regarding the official monthly income, which directly
these respondents. The study has revealed that - 39 out of 51 respondents have four or more family members. 4 - respondents were single, two-members - 1, Three-member - 4, and tree respondents did not answer. Noteworthy is that the more children a family has, the more it needs useful livelihood lives and social conditions.
Respondents are unemployed. The state provides for their living expenses with a minimum subsistence allowance. Therefore, the answer of all respondents to the question. Employment is negative.
hinders the possibilities of diagnosis and treatment of gastroenterological diseases?
Thus, 90% of the socially vulnerable respondents refuse to visit a dentist due to lack of financial resources because dental care is a very expensive service. Summarizing the obtained data showed that in the current socio-economic conditions, the inclusion of Georgia and, in particular, the population of Adjara in the group of socially vulnerable people is mainly due to high unemployment, low education, and high quality of marriage (Table № 2)
Table № 2
Education of patients with gastrointestinal disorders
Frequency Percent Valid Percent Cumulative Percent
Higer 5 9.6 9.8 9.8
Middle class education 43 82.7 84.3 94.1
Valid Student 1 1.9 2.0 96.1
No amswer 2 3.8 3.9 100.0
Total 51 98.1 100.0
Missing System 1 1.9
Total 52 100.0
It is important to know the purpose of the visit to the doctor, as socially vulnerable people often do not have the opportunity to visit the doctor. Probably 32 out of 51 respondents could not answer the question. 12 respondents indicated that they visited the doctor for emergency care; whereas 5 respondents made a planned visit; one visit was performed for a surgical intervention.
According to our research, the following diseases are diagnosed as gastroenterological diseases in the socially vulnerable population: gastritis - 26 patients, ulcer - 8, gastro-esophageal reflux - 6; esophagitis -5; cholecystitis + gastritis - 2; Esophagitis + Gastritis - 2; Cholecystitis - 1 (Table №3).
Table №3.
Gastroenterological diagnoses named by the respondents
GI tract disorders
Frequency Percent ValidPercent CumulativePercent
Gastritis 27 52.9 52.9 52.9
Ulcer 8 15.7 15.7 68.6
Esophagitis 5 9.8 9.8 78.4
GERD 6 11.8 11.8 90.2
Valid Cholecystitis 1 2.0 2.0 92.2
No answer 1 2.0 2.0 94.1
Cholecystitis + Gastritis 1 2.0 2.0 96.1
Esophagitis + Gastritis 2 3.9 3.9 100.0
Total 51 100.0 100.0
Causes of these diseases are eating disorders - 14 in respondents, CNS diseases - 1, nutrition + stress -6, eating disorders + other - 26, eating disorders + CNS diseases - , no Answered - 1. Almost all 49 patients have eating disorders. Symptoms that patients report include pain in the epigastrium (34), abdominal
distention (21), burning sensation in the stomach (11), heartburn (5), nausea and vomiting (7) and increased acidity (5), digestive problems (6) and bad breath (1). The duration of these complaints ranges from 2 months to 22 years. Medical research is an essential part of diagnosing the disease. (Table № 4).
Table № 4.
Examinations
Frequency Percent ValidPercent CumulativePercent
Valid Consulting general practitioner 18 35.3 35.3 35.3
Esophagoduodenoscopy 15 29.4 29.4 64.7
Ecoscopy 1 2.0 2.0 66.7
Laboratory examinations 2 3.9 3.9 70.6
Consulting GP + Lab exams 15 29.4 29.4 100.0
During the mentioned period, out of 51 examined patients, only 41 were receiving medical treatment, 1 - underwent only a surgical treatment, 5 - underwent combined medical and surgical treatment, 4 - respondents did not answer the question.
Various chronic diseases significantly affect Human Health. To this question, "How has this disease affected your health?" 35 respondents indicated that the influence on the condition has been imposed by various nutrition disorders. 16 patients did not answer the question.
The answer of 45 respondents to the question "What is the main reason for not going to the doctor" is the financial inaccessibility; three respondents did not answer the question. Two respondents, only in case of pain, consider it necessary to visit a doctor. One has fears of medical care. All respondents think that medical services are quite expensive; the state does not fund their gastroenterology services, so they find it difficult to conduct examinations. Seven respondents did not answer the question. Thirteen of them paid for the gastroenterological examination at their own expense. Six patients received emergency medical care.
One of the most essential medical services is studying the oral cavity condition. Our respondents
were also interviewed in the field of dental services. Patients are mostly referred for pain. 11 patient orthopedic and surgical services - 2; therapeutic and orthopedic services - 3; 8respondents did not answer the question.
When asked what respondents think how economically acceptable is dental care, the majority (49 respondents) answered that it is quite expensive and unaffordable, and only two respondents mentioned that it is acceptable for them for this period. The medical program developed by the Batumi Municipality Health and Social Care Service, provides dental services to beneficiaries. Most of our respondents receive dental services from here. On the other hand, 27 respondents did not answer 12 questions and paid for the rest at their own expense.
Respondents most often receive information about oral care products from 22 relatives, media - 1; dentist - 9; media + relatives - 4; dentist + media + relatives - 4, relatives + dentist-9. Did not answer - 4. The low level of sanitary-hygienic knowledge and habits leads to a low level of prevention and treatment. The respondents' demand for preventive measures is not seen at all, it is quite bad because prevention is directly related to the prevention of dental diseases (Table№ 5).
Table №5.
Education and DMF index
Correlations
Education and DMF index DMF Education
Dmf Pearson Correlation 1 -.198*
Sig. (2-tailed) .045
N 103 103
Education Pearson Correlation -.198* 1
Sig. (2-tailed) .045
N 103 103
*. Correlation is significant at the 0.05 level (2-tailed).
Distinguish between professional and individual oral hygiene. Personal hygiene involves the regular removal of plaque from the surface of the teeth and gums. Oral hygiene products include toothbrushes, dental floss and interdental brushes, toothpaste and various therapeutic-prophylactic elixirs. It should be noted that none of the respondents use other oral care products, while the majority of respondents use toothpaste and brush only when they remember; only 17 respondents use it regularly. 19 of the respondents think that dental care belongs only to the category of medical services, 1 respondent thinks it belongs to a series of aesthetic services and 29 respondents state that such assistance is both aesthetic and medical. "What kind of quality material do the respondents choose?" The most frequently revealed was the following: None of the individuals indicated the use of high quality material, while 24 respondents said that they choose the service with low quality material, and 24 respondents said that they use medium quality material, 3persons did not answer the question.
It is also interesting to note the issue of morbidity in this contingent. It should be noted that members of the socially vulnerable group living in the Adjara region who were suffering from gastroenterological pathology also suffered from other systemic diseases. The study revealed: 7 cases of diseases of the cardiovascular system, 3 cases of the pathology of the mus-culoskeletal system, 9 cases of endocrine lesions, 3
Impact of nutrition on
cases of other general diseases, combined diseases of the bone-joint diseases, + other systemic diseases. 1 -Cardiovascular + endocrine + bone-joint diseases, 4 -Cardiovascular + bone - joint diseases, 3 - Endocrine + bone-joint diseases, 2 - Cardiovascular + other systemic diseases, 21 - The respondent did not answer the question. It is noteworthy that patients indicate nephrological, allergic, and gynecologicalpatients indicate nephrological, allergic, and gynecological diseases.
When asked whether general illnesses affected the respondents' health, 36 answered in the affirmative, 2 answered in the negative, and 11 did not answer the question.
One of the important factors in the development of gastrointestinal diseases is eating disorders. It is important to define the eating schedule, the question, "How many times a day do you eat?" Twenty-six re-spodent eat unregularly:, 5 respondents did not answer the question. More than half of the respondents eat irregularly. Healthy eating and the selected food ration determine a healthy lifestyle. The food ration was distributed in this way vegetables + meat + fruits + pastries - 9 respondents, in 4 cases the main ration is presented in the form of vegetables + fruit + bread only Bread-cookies - 3, only vegetables - 5, vegetables + fruits - 1. Vegetables + meat - 1, vegetables + meat + bread-cookies - 2, vegetables and bread-cookies - 27 (Table №6)
Table №6.
Correlation by Pearson correlation
Impact of nutrition on gastrointestinal diseases gastrointestinal diseases Nutrition
gastrointestinal diseases PearsonCorrelation 1 .310*
Sig.(2-tailed) .027
N 51 51
Nutrition PearsonCorrelation .310* 1
Sig.(2-tailed) .027
N 51 51
*. Correlationissignificantatthe0.05level(2 -tailed).
The respondents' relationship with tobacco and alcohol in everyday life gives us more or less an idea of the attitude towards a healthy lifestyle, which is clearly evidenced by the answers to the questions: "Do you smoke or not" and "How often do you drink alcohol?". 14 of them were smoking, and in 39 they received a negative answer, 1 person did not answer the question, as for alcohol consumption, 3 respondents3 respondents3 respondents3 respondents3 respondents
often consumed it often consumed it, rarely by 8 respondents, alcohol was not consumed at all by 38 respondents. They did not answer the question at all.
Our research found that digestive tract diseases are often found in different groups of the population, so we decided to study the oral cavity of socially vulnerable people with gastroenterological disorders. We studied 51 patients. We determined the condition of the periodontium in the study population. High degree
of periodontal activity and high prevalence were revealed. We conducted diagnosis according to the Bleeding Index provided by the World Health Organization. Bleeding was positive in most patients.
This is confirmed by signs of inflammation such as edema, which was observed in 27 respondents, hyperemia in 26 cases, retraction in 7 cases, and probing bleeding in 27 respondents. Here we have to consider the oral hygiene index for the presence of stones and
plaque. According to our research data, in 31 cases, soft plaque was observed, of which 26 were pigmented, the cool plaque was detected in 24 respondents, and gingival stone was found in 24 gums. The hygienic index was determined by means of a simplified hygienic index where a very high index of 2, 9 was revealed, which indicates poor oral hygiene The hygiene index is unsatisfactory in 10 patients and poor in 25 patients (Table № 7).
Table № 7
Oral-S hygiene index.__
OHI-S Index Frequency %
0-1.2 Good oral hygiene 0 0
1.3-3.0 fair oral hygiene 10 19,6
3.1-6.0 Poor oral hygiene 25 49
Periodontal pocket depth was also determined (Table № 8):
Table № 8
Periodontal pocket depth __
Pocket depth values Frequency %
0 No sign of imflamatory 0 0
1 point (3-mm) 8 15,6
2 point (3-4mm) 15 29,4
3 point (4-5mm) 6 11,7
4 point (6-mm and more) 4 7,8
Determining the prevalence and intensity of car- terological patients is 100%; The caries intensity was ies revealed a fairly high rate of intensity from here 16.8 (Table № 9) more share came from the Misses teeth -594. Caries-190, Filled- 17. The prevalence of caries in gastroen-
Table № 9
DMF- index.
Caries Fill Miss DMF
N52 Valid 51 51 51 51
Missing 0 0 0 0
Mean 3.96 .33 12.20 16.82
Median 4.00 .00 4.00 14.00
Mode 0 0 28 28
Std. Deviation 3.847 1.260 12.058 9.010
Range 11 6 28 24
Sum 202 17 622 858
Erosion localized to the vestibular surface of the upper central incisors was detected in three patients with non-functional diseases. In comparison, artificial crowns were detected in six patients in single metal and metal-ceramic crowns.
It is essential to consider the subjective data of patients. Most have pain from a variety of irritants and patients complaining of bad breath and aesthetic discomfort. Two groups of stomatitis are widespread from oral mucosal diseases: independent stomatitis and symptomatic stomatitis. In the first case, the causes are different: trauma, virus, fungus, microorganisms and various allergens. In the second case, systemic diseases gastroenterological, endocrine-cardiovascular, and diseases. In addition, 21 respondents with socially vulnerable gastroenterological disorders have aphthous ulcers of the oral mucosa.
Oral disease associated with disease of the gastrointestinal tract.[1]
Conclusion: Prevalence of caries in gastroenterological patients is 100%, the intensity of caries is -16.8. The number of extracted teeth exceeds the number of carious and decayed teeth. The hygienic index is unsatisfactory in 10 patients and poor in 25 patients. Periodontal pocket depth 3-mm - 8; 3-4mm - 15; 45mm - 6; 6-mm and more - 4.Gastroenterological pathology was detected in respondents who ate irregularly and also poorly processed food in the oral cavity due to the absence of teeth.
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