CC BY
11Received by the Editor 11.02.2021
IRSTI 76.29.55
UDC 614.2
METHODS OF PREVENTION OF DENTAL DISEASES IN ACCORDANCE WITH THE REQUIREMENTS OF MODERN MARKET CONDITIONS
B. Nalshekov
"International Kazakh-Turkish University named after Khoja Ahmed Yasavi ", Kazakhstan, 161200, Turkestan region, Turkestan city, B. Sattarkhanov Avenue, building 29B
Purpose: to consider ways to prevent dental diseases in accordance with the requirements of modern market conditions.
Task. Analyze literary sources.
Research materials and methods. This review is aimed at describing and analyzing data in the literature on the organization of preventive measures for various factors related to dental diseases.
Results. Taking into account the analysis of the latest literary sources, the article presents modern methods of preventing the risk of dental diseases. A modern definition of terms related to the prognosis of dental diseases is given. The diagnostic criteria necessary to determine the individual risk of dental disease are described. Approaches to therapeutic and preventive measures for people with different degrees of manifestation of risk factors for dental diseases are given.
Key words: dental care, disease, epidemic situation.
СПОСОБЫ ПРОФИЛАКТИКИ СТОМАТОЛОГИЧЕСКИХ ЗАБОЛЕВАНИЙ В СООТВЕТСТВИИ С ТРЕБОВАНИЯМИ СОВРЕМЕННОГО РЫНКА
Нальшеков Б.
"Международный казахско-турецкий университет имени Ходжи Ахмеда Ясави", Казахстан, 161200, Туркестанская область, город Туркестан, Проспект Б. Саттарханов, строение 29В
Цель: рассмотреть пути профилактики стоматологических заболеваний в соответствии с требованиями современного рынка.
Задача: провести анализ литературных источников.
Материалы и методы исследования: данный обзор направлен на описание и анализ имеющихся в литературе данных об организации профилактических мероприятий по различным факторам, связанным с стоматологическими заболеваниями.
Результаты: с учетом проведенного анализа последних литературных источников в статье представлены современные методы профилактики риска возникновения стоматологических заболеваний. Дано современное определение терминов, относящихся к прогнозу стоматологических заболеваний. Описаны диагностические критерии, необходимые для определения индивидуального риска стоматологического заболевания. Приводятся подходы к лечебно-профилактическим мероприятиям для лиц с различной степенью проявления факторов риска возникновения стоматологических заболеваний.
Ключевые слова: стоматологическая.
СТОМАТОЛОГИЯЛЬЩ АУРУЛАРЫНЬЩ ЦАЗ1РГ1 НАРЬЩТЬЩ ЗАМАН ТАЛАПТАРЫНА САЙ ОЛАРДЬЩ АЛДЫН АЛУ ЖОЛДАРЫ
Налшеков Б.
«^ожа Ахмет Ясауи атындагы Хальщаралык; казак-^р^ университета, ^азакстан, 161200, ТYркiстан облысы, ТYркiстан каласы, Б.Саттарханов дацгылы, 29Б гимарат
Максаты: каз1рп нарыктык заман талаптарына сай стоматологиялык аурулардын алдын-алу жолдарын карастыру.
Мшдетк эдеби дереккездерге талдау жYргiзу.
Зерттеу материалдары мен эдктерк Б^л шолу стоматологиялык ауруларга байланысты эртYрлi факторларга алдын-алу шараларын ^йымдастыру туралы эдебиеттеп деректердi сипаттауга жэне талдауга багытталган.
Нэтижелерк Соцгы эдеби дереккездерге жYргiзiлген талдауды ескере отырып, макалада стоматологиялык аурулардьщ пайда болу каушнщ алдын алудьщ заманауи эдiстеpi кеpсетiлген. Стоматологиялык аурулардьщ болжамына катысты теpминдеpдiн казipri аньщтамасы беpiлген. Стоматологиялык аурудын жеке каушн аныктау Yшiн кажетп диагностикалык критерийлер сипатталган. Стоматологиялык аурулардын пайда болу каут факторларынын кеpiну дэpежесi эpтYpлi адамдар Yшiн емдеу-алдын алу ic-шараларына тэсiлдеp келтipiледi.
ТYЙiндi сездер: стоматологиялык кемек, ауру, эпидемиялык жагдай.
The World Health Organization has defined the "European dental health goal for 2020", which states that young people under the age of 18 will not have their teeth knocked out, and the average periodontal condition will be at least 4.0. Other countries than our country are making great progress in the prevention of diseases of the jaw system, especially among children and adolescents. As a result of preventive and educational work, the incidence of caries and periodontal diseases is halved. How low is the level of dental diseases among young people compared to Europe and what types of care are needed now remains the main question in our country. This problem has not been studied to this day [1].
The main part of the population is made up of young people. There are 1,500 high and secondary specialized educational centers in Kazakhstan, where 2 million people study. The health status of students is declining every year and is becoming the main problem. At the same time, the control of young people with dental diseases is not provided at all. Currently, dental abnormalities show a high rate. It is important to take care of the oral cavity from childhood. Diseases of the oral cavity are closely related to a healthy lifestyle, nutrition, ecology, oral hygiene and consulting with a dentist. Several decades of preliminary research have been conducted on this topic, but there are contradictions. Currently, it is necessary to update research and consider ways to reduce dental diseases [2,3].
The only way to reduce diseases of the oral cavity is the availability and quality of dental care. This issue is important for the established people of Kazakhstan. It has not yet been studied how students evaluate the quality, availability of care in public and private dentists and where they actually want to get this care. No financial assistance is provided to this contingent that really needs help. In recent years, diseases of the oral cavity, abnormalities of the dental system have increased, and the number of people in need of dental care has increased [4,5].
According to a study by WHO and various authors, the prevalence of dental diseases is 75-95% among children and 100% among adults. Diseases of the oral cavity take the first place among adults over 35 years old. The main goal of expanding the range of dental treatment is to prevent diseases of the oral cavity. Prevention of dental diseases is the main problem. Special books have been published to combat this problem. Because the main way to combat diseases of the oral cavity is its prevention. It is necessary to implement national and private regional programs in this system [6,7].
Based on the results of scientific work in recent years, programs for the prevention of dental diseases were organized and an analysis of the readiness of the population was carried out. However, at the moment, along with the lack of national programs in our country, there is a lack of the necessary tools for their organization. Due to the low political and economic situation in the country, the need to rely on centralized state assistance for 5-10 years is insignificant [8].
Complex scientific works on the Prevention of dental diseases and dental pathologies are little studied. As a result of modern methods of preventing dental diseases and reducing the incidence of caries and periodontal diseases among adolescents, a great effect has been achieved. Programs for the prevention of dental diseases are being organized abroad and in some regions of Kazakhstan. Employees working in harmful and dangerous institutions are examined [9].
The long-term obsolescence of material and technical base, the reduction of dental staff and the reduction of prevention of dental diseases are now being resumed and are being restored at a rapid pace. For this purpose, data is needed to find out what types of assistance are needed for children and adults. The increase in dental diseases is a major public health problem. The most common disease is tooth decay. At the same time, non-caries diseases of hard tissues of the teeth show a high indicator [10].
Caries and non-caries diseases of hard tissues of the teeth are caused not only by individual morphofunctional features of the dental system, but also by the low level of public literacy about non-compliance with oral hygiene and the prevention of dental diseases, educational activities are carried out less frequently. The living conditions of the population and environmental factors have not been fully studied. This issue not only causes difficulties in implementing preventive programs, but also negatively affects the dental status of the population and the provision of dental care. Oral health occupies an important place for human health [11].
Taking into account these statements, the study of the dental health of the population, the study of the factors that negatively affect it, as well as the study of the organization and dispensation of the conditions of dental care for the population in modern times is very relevant and important at present. The high level of caries and periodontal diseases in all age groups of the population of Kazakhstan and the tendency to their further growth require the search for the most effective and affordable program for the prevention of dental diseases. Low sanitary culture of the population, lack of incentives for the prevention of dental diseases and oral hygiene are characteristic of a significant number of our compatriots [12].
Planning of the program of prevention and provision of dental care is carried out on the basis of studies of dental diseases of the population. In this case, special attention is paid to the study of the prevalence and activity of dental diseases [13].
As a result of the research, the average prevalence and activity of caries, the mild form of periodontal diseases in children and adolescents, in the absence of a prevention program, is transferred to the severe form in adults at the population level. This, in turn, leads to an increase in the need for therapeutic, Surgical, Orthopedic, and orthodontic treatment. World experience in the fight against dental diseases is based on the development and implementation of national and regional preventive programs, the WHO European Regional Bureau has developed a program document "XXI century health - health for all in the XXI century". It reflects the main political achievements of WHO in healthcare for all in the European region, as well as the dental health of the population. About 870 million people live in the European region, so the program for this region focuses on issues related to different countries, as well as in the countries of Central and Eastern Europe [14].
The regional bureau carries out its activities in the area of strategic achievement of Health for all in three main areas:
- formation of a lifestyle that contributes to the preservation and strengthening of health;
- creating an environment that promotes human health;
- development of prevention, treatment and care services.
In recent years, numerous studies have proven that it is possible to reduce the level of dental diseases through the large-scale introduction of primary prevention. The most effective is the program developed on the basis of protein analysis of a certain region.
Up to the present time, epidemic dental examinations of all age groups of the population in South Kazakhstan region have not been conducted in full. The lack of data on the epidemic situation in the region, the dynamics of the leading trend in the incidence of caries in children and adults, and risk factors hindered the development and implementation of a preventive program based on dental diseases. These include caries and inflammatory diseases of periodontal disease (gingivitis, periodontitis) [15].
Healthcare system in the new social - economic conditions
At all times, in the market economic conditions of all countries, the main task of health care is to solve three main problems: how to cover the financing of health care at the time of increasing the necessary prices for things and services; how to adequately cover basic medical care for the entire population; how to improve the quality of medical care.
Previously, it was believed that the higher the chances of developing healthcare, the lower the cost [16].
This statement dates back to the early 90s. Today, new ideas, hypotheses and concepts are needed that meet the requirements of the time. At that time, many states developed in two main
directions. The first is that human health depends not only on health care and the funds allocated for it, but also on lifestyle and personal characteristics, environmental conditions. The second is to increase the effectiveness of the Health Organization's work. In the development of healthcare, the main ways to increase the indicator of improving the health of the population with minimal costs have been considered for many years. These stages of reform lasted for many years and are still under consideration today [17]. According to the decisions of different countries studying the health system, there is no optimal version of this problem in any country that can serve as an example for other countries.
The course of health reform is similar in the CIS countries, and in Kazakhstan it is slightly different.
The collapse of the country's economy has negatively affected funding, reducing beds and doctors, and reducing the availability of medical care to the population, especially in rural areas [18].
Secondly, the influence of the first causes indicates a decrease in the health of the population.
Thirdly, according to the reform plan of the revised scientific research work developed at a very low rate, especially the department related to the economy.
Fourth, the reforms were carried out without comprehensive consideration or discussion.
In healthcare, it has a negative impact on market relations. The main goal of managers in the healthcare system is to comprehensively consider the effectiveness and results of methodological and methodological relationships. Adaptation to processed Technologies has been scientifically studied and practical interests market demand [19].
The current method is not able to provide general and uniform preferences of the population in the field of healthcare. Getting out of the economic impasse will help solve other problems.
Problems and prospects of dental care organizations.
The main goal of healthcare organizations is to organize timely local and general (high-quality, in accordance with the requirements of the developed time, based on the latest achievements of Science and practice) assistance to the population. The main task here is to provide primary health care (PHC), clinics. However, the situation with outpatient care does not meet modern requirements [20].
According to the authors' notes, today this problem can be solved by expanding the territorial structure of outpatient medical organizations (family outpatient clinics, consultative and diagnostic polyclinics, specialized outpatient organizations and collectives), as well as with the help of paid medical care organizations.
Among the medical care provided to the population, dental care is the most common and main type. In the population's demand for medical care, dental care is second only to therapeutic care.
Dental care in our country is based on the administrative - group method (strictly centrally defined norms and regulations, large-scale indicators based on the latest indicators, the only source of funding, etc.), as well as the management method is not effective, the interest of employees in improving the quality of dental care provided is not provided, the indicators are based on the number of seals and visitors). The quality of dental health of the population is not provided. From the point of view of the authors, repeated visits to the doctor for the treatment of one tooth negatively affect the complete treatment of a lack of time [21].
According to official indicators, the quality of dental care decreased in the late 90s. Assistance to the population, including children's dentistry, is weakened compared to the previous decade.
Issues of ensuring the quality and effectiveness of private medical organizations.
The further development of medical and preventive organizations in the future is important, regardless of the type and type of service provided by the organization.
This question has been studied by many authors in recent years.
In comparison with other sectors of the economy, the quality of healthcare is considered in three aspects: medical, social, and economic. These aspects are closely related. But this does not mean that these aspects cannot be separated. Qualitative decomposition in health care evaluates
these aspects according to various criteria [22].
The main criterion that determines the effectiveness of medical care is the quality of medical care. Quality of medical care refers to the need and purpose of its application. Quality is characterized by accessibility, efficiency, and other categories. The quality of medical care is determined by two main concepts: technical quality, the ability of the employee to carry out medical care in various ways that are convenient for work, and the convenience of the patient. The quality of equipment in providing medical care is important for both the patient and the medical professional [23].
The evaluation of each type of health department, that is, medical professionals in a separate group, doctors (private), prompted the researchers to look for a different way to evaluate.
Medical organizations should be created in accordance with the needs of the population. Then the population will become the main subjects and assessors of medical organizations. It is possible to develop the healthcare system through control and evaluation mechanisms [24].
The main direction of the system of development of medical care organizations, the development of specialized medical care. High costs are spent on providing the population with high-quality medical care.
The order of the healthcare organization to dentists is aimed at prevention of dental diseases and quality treatment of diseases. For this purpose, an in-depth and comprehensive analysis is carried out, and new methods are being sought. The assistance provided by dentists to the population should be reflected in the final result: improving health, reducing dental diseases.
In government organizations, quantitative and qualitative units of Labor are used to evaluate the work of dentists [25].
The information provided (the number of patients, the number of prostheses installed, the number of patients examined and treated) does not allow us to conduct a full analysis. The number of patients examined cannot give any assessment of dental care, so it is impossible to characterize performance indicators.
In order to assess the quality in dentistry, the indicators indicated in the planned oral health care are: need for treatment, rehabilitation, percentage of recovered, percentage of complicated caries, ratio of uncomplicated caries to complicated caries, ratio of cured teeth to dislocated teeth. To assess the effectiveness of planned rehabilitation, it is recommended to determine the ratio of the number of cured teeth and the number of dislocated teeth [26].
The analysis of dental care is determined by the intensive index. The composition of the CSE includes previously performed work (previously laid seal and torn teeth). In this regard, H of the seals placed per year require replacement. "C"-caries, "S"-seal, "E"-extracted. According to this index, we see a low quality of dental treatment.
A convenient method is to determine the result of assistance provided by the CSE index in the treatment of dental diseases.
The situation with the provision of paid and free dental care is still unknown. This issue was comprehensively considered from a medical and social economic point of view in the 2000s.
It is necessary to demand a deep and comprehensive consideration of the medical and diagnostic process of private dental organizations and their proper management activities.
References
1. ВОЗ. Руководство по методам регистрации стоматологического статуса населения. - Женева. 1995. - 28 c.
2. Минбатырова А.А. Социально-гигиенические аспекты организации стоматологической помощи в крупном мегаполисе Шымкент: Дис. ... ученой степени магистра. - Шымкент, 2015. - 60 с.
3. Каплан З. М. Медико-социальные основы формирования стоматологического здоровья молодежи: Автореф. дис. ... канд. мед. наук. -М., 2007. - 24 с.
4. Супиева Т.К. Лекции по стоматологии детского возраста. Вып. 1. - Алматы, 2013. - С. 76-102.
5. Нургазина Г. К. Социальные проблемы функционирования негосударственной стоматологической службы //Медицина (Алматы). - 2000. - Т. 5, № 6. - С. 2-4.
6. Янушевич О.О., Бутова В.Г., Умарова К.В. Анализ видов, структуры и объемов стоматологической помощи, оказываемой в соответствии с классификатором медицинских услуг по программе ОМС взрослому населению при лечении всех заболеваний пародонта //Русский стоматологический журнал. - 2012. - № 5. - С. 46-49.
7. Working profiles of dental hygienists in public and private practice in Finland and Norway./ Tseveenjav В., Virtanen J.I, Wang N.J., Widstrom E.// Int J Dent Hygiene. - 2009. - V. 7, № 1. - P. 17-22.
8. Нсенгиюмва Ф., Ташимова Б. Г. Показатели кариеса и заболеваний пародонта у студентов города Алматы. //Вестник КазНМУ. - 2002. - № 3. - С. 174-176.
9. Алдашева М. А. Влияние факторов окружающей среды на стоматологический статус детей и подростков Республики Казахстан. //Проблемы стоматологии. - 2003. - № 2. - С. 84-86.
10. Калашников В. Н. Научное обоснование модели стратегического развития стоматологической службы региона и системы менеджмента качества медицинских услуг: Диссертация ... доктора медицинских наук. - Ростов -на- Дону, 2008. - 352 с.
11. Пивень Д.В., Агапитов А.Е., Купцевич А.С. Об актуальных вопросах формирования службы профилактической медицины //Менеджер здравоохранения. - 2007. - № 6. - С. 25-29.
12. Турчиев А.Г. Оптимизация системы лечебно-профилактических мероприятий в государственных стоматологических учреждениях на муниципальном уровне: Автореферат диссертации . кандидата медицинских наук: 14.02.03 / Турчиев А.Г. - М., 2012. - 23 с.
13. JuliusM. education System dental hygienists in Europe //Dental College. - 2007. - No1. -P. 2.
14. Данилов Е.О. Социологическая оценка текущего состояния стоматологической службы. // Социальная гигиена и история медицины. - 1997. - № 3. - С. 23-25.
15. Ломагин В.В. Влияние факторов рыночных отношений на внедрение новых технологий в стоматологической практике: Автореф. диссертации на соискание ученой степени кандидата медицинских наук. - М, 2003. - 28 с. .
16. Abram O.G., Shevchenko S. S. New opportunities to reduce dentophobia in children when using Twinkies Old in the treatment of uncomplicated forms of caries of deciduous teeth //Dental South. - 2007. - No. 6. - P. 30-32.
17. Каплан М. З. Анализ затрат на услуги стоматологов // Безопасность жизни и здоровье: матер. Величественный: Науч. конф. с междунар. Участием, посвященная Героя Социалистического труда, академику АМН СССР, проф. Кроткову Ф. Г. - М., 2007. - с. 12.
18. Каплан М. З. Совершенствование организации стоматологической помощи населению на основе системы сбалансированных показателей: Дис. ... д.м.н. . - М., 2007. - 130 с.
19. Кузовкова Ю. V. «Концептуальные подходы к формированию системы управления рисками в стоматологической службе»: Автореферат диссертации на соискание ученой степени кандидата медицинских наук. - М., 2006ю - 25 с.
20. Куницына Н.М., Мещеряков Д.Г. Анализ основных показателей стоматологической помощи в Белгородской области / Проблемы территориального здравоохранения: Сборник научных трудов. Выпуск 6. -Москва, 2004. - С. 39-42.
21. Организация системы профилактики стоматологических заболеваний детского населения России. Концепция/Кулаков А.А., Колесник А.Г., Шестаков В.Т. и др. -М.: ГЭОТАР-Медиа, 2006. - 96 с.
22. Леонтьев В. К., Безруков В. М. Стоматология в XXI веке. Попытка сделать прогноз // Стоматология. - 2001. - Т. 79, № 6. - С. 4-5.
23. Леонтьев В.К. Концепция развития стоматологии в России. Электронный ресурс. URL: http://www.medicus.ru/stomatology/specialist/ (дата обращения 02.06.14).
24. Алимский А.В. Перспективы и возможные направления трансформации государственной стоматологической службы страны // Экономика и менеджмент в стоматологии. - 2010. - № 3 (32). - С. 17-22.
25. Fu Y Jang B, Yin H. Perspectives on dental education in mainland China //Int Dent J. - 2006. - Vol. 56. -P. 265-271.
26. Relations between Internet use, socio-economic status (SES), social support and subjective health./ Wangberg S. C., Andreassen H.K., Prokosch H. U. et al. //Health Promotion International Oxford University Press. -2007. - Vol.23, № 1. - P. 70 - 77.
Author for correspondence: Nalshekov Bekbolat Zhumashovich - assistant of the department of preventive medicine and dental disciplines Shymkent Medical Institute, the International Kazakh-Turkish University im.H.A.Yasavi; bolatbek.bolat@list.ru; +7 705 980 81 85
