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11«1нноваци в стоматологИ», № 1, 2014 ЕПВДЕМЮЛОГШ, ОРГАН1ЗАЦ1Я, 1СТОР1Я
УДК 616.31-053-053.2/.6
O. V. Den 'ga, M. D., O. E. Rejzvikh, Ph. M. D., V. S. Ivanov, Ph. M. D.
State Establishment "The Institute of Stomatology of the National academy of medical science of Ukraine"
THE STOMATOLOGICAL MORBIDITY OF CHILDREN OF UKRAINE
DURING 1985-2011
The data on the stomatological morbidity of children of Ukraine are given in the article. The contradictoriness of data, connected to the changes of the sources of water supply in some regions, attracts attention. At the epidemiological studies in 2011 in children of 6-7 years old, the authors revealed, that in average the frequency of dental caries of permanent occlusion equals 23,2 % at index CFEt being 0,42.
At the comparison of the data from the identical reviews of1985 and 2011 on the definite localities, the contradictoriness of data, connected to the changes of sources of water supply in some areas, attracts attention.
But there are some areas, in which during the last 19 years (1992-2011) the content of fluorine in drinking water was reduced, but the indices offrequency and intensity of caries have grown respectively from 8 % and by 2,1-2,4 times.
Key words: epidemiology, dental diseases, child population of Ukraine.
О. В. Деньга, О. Э. Рейзвих, В. С. Иванов
Государственное учреждение «Институт стоматологии Национальной академии медицинских наук Украины»
СТОМАТОЛОГИЧЕСКАЯ ЗАБОЛЕВАЕМОСТЬ У ДЕТЕЙ УКРАИНЫ ЗА ПЕРИОД С 1985-2011 ГОДЫ
В статье представлены данные о стоматологической заболеваемости детей Украины. Обращает на себя внимание противоречивость данных, связанных со сменой в некоторых регионах источников водоснабжения. При проведении эпидемиологических исследований в 2011 году у 6 - и 7-ми летних детей нами установлено, что в среднем распространенность кариеса зубов постоянного прикуса у них составляет 23,2 % при КПУз 0,42.
Ключевые слова: эпидемиология, заболевания зубов, население Украины.
О. В. Деньга, О. Е. Рейзвгх, В. С. 1ванов
Державна установа «1нститут стоматологи Нацюнально! академп медичних наук Украти»
СТОМАТОЛОГ1ЧНА ЗАХВОРЮВАН1СТЬ У Д1ТЕЙ УКРА1НИ ЗА ПЕР1ОД З 1985-2011 РОКИ
В статтi представлен дат про стоматологiчну захворюванкть дiтей Украгни. Звертае на себе увагу су-перечтсть даних, пов'язаних зi змiною в деякихрегюнах джерел водопостачання. При проведены епiдемiологi-чних до^джень в 2011 роц у 6 - i 7-ми лiтнiх дтей нами встановлено, що в середньому поширетсть карiесу зубiв посттного прикусу у них складае 23,2 %% при КПУз 0,42.
Ключовг слова: епiдемiологiя, захворювання зубiв, населення Украгни
Comparing the literary data of 1958 and the data of the examination of 12-year-old children in 1985 by the specialists of OSISR, the authors have paid attention at the growth of prevalence of caries. The frequency of caries in urban children has grown by 18,1 %, the intensity of process increased by 1.6
times. In rural area within this period the frequency of caries affection became twice as much. Index CFEt has increased by 3,5 times (tab. 1).
© Den 'ga O. V., Rejzvikh O. E., Ivanov V. S.2014
Table 1
The characteristics of the tendencies of the morbidity with caries in 12-year-old children of Ukraine (according to the literary data and the ones from OSISR)
Literary data (Maslenkova N.V., 1958) The findings by the Institute of Dentistry (1985)
place of investigation prevalence place of investigation prevalence
frequency, % intensity (CFE) frequency, % intensity (CFE)
urban 67,1 2,2 urban 85,2 3,6
rural 43,5 1,0 rural 89,7 3,5
Table 2
The characteristics of the tendencies of the sickness rate of caries cases in 12-year-old children of Ukraine
place of investigation frequency,0/) intensity (CFE)
urban 1985 85,2 3,6
2011 73,6 2,5
rural 1985 89,7 3,5
2011 83,2 4,0
During the following 26 years (1985-2011) this tendency has changed. The frequency of the process in urban 12-year-old children reduces from 85,2 % in 1985 to 73,6 % in 2011, at that the intensity of the process reduces by 1.1 times. In children from rural area the index of the prevalence of the process has altered insignificantly - from 89,7 % to 83,2 %. Index of CFEt has decreased only by 0,5 points (tab. 2).
1985 by the scale of prevalence of caries - entire, mass, high and low (WHO) - the level of morbidity with caries of 12-year-old children the 17 cities of Ukraine are referred to the entire level of morbidity with caries, 13 cities - with mass morbidity, 2 ones with high and only 2 cities - with low level of morbidity.
The intensity of affection with caries was estimated in children according the following levels -high (CFEt>6.0), medium (CFEt=3,0-6,0), low -(CFEt<3,0).In the structure of the intensity of the affection the medium level of affection equals 56,3 %, low level is 37,5 % and only 6.2% at the high level of intensity of affection with caries. The intensity of caries affection in children of Ukraine was divided as that: the high level of affection equaled 7,9 % of cities, the medium one - 44,7 %, and low level is 47,4 % of cities.
At the comparison of the data from the identical reviews of 1985 and 2011 on the definite localities, the contradictoriness of data, connected to the changes of sources of water supply in some areas,
attracts attention. Thus, in Poltava, where the source of water supply was changes, the frequency of fluo-rosis has reduced, but the prevalence of dental caries has grown by 2,4 times, index CFEt has increased by 2,9 times.
The effectiveness of water fluorination is proved by the fact, that during 21 years (1971-1992) of fluor-ination of drinking water in urban village Kalush (Ivano-Frankivs'k region) the frequency of dental caries in 12-year-old children almost twice as reduced and equaled 48 % at decrease of index CFEt by 1,6 times. But in 19 years after the stoppage of water fluorination in 2011 the frequency of the process grew by 25 %, and index CFEt increased by 1,6 times. At that in "twin-city" Dolyna these indices remained unchanged during the last 19 years (tab. 3).
Intensity of affection of teeth with caries in the areas with water fluorination has changed during 40 years and in 19 years after stoppage of fluorination in different ways. Thus, in urban village Kalush in 19 years - the index has lowered by 1.6 times, and in 40 years returned to the previous one, having increased by 1.6 times. In u/v Kalush, located on the North of the country in mountain district, the abrupt reduction of fluorine concentration in table water has caused, to author's opinion, the fast rise of caries morbidity in 12-year-old children, in whom adaptive reactions at pubertal age are unstable.
At that in the fluorosis area (u/v Karlivka in Poltava region) during 26 years (1985-2011) the fre-
quency and intensity of caries has grown almost twice - 66,7 % and 2,0 correspondingly. Undoubtedly, some carious cavities are defects of enamel and dentine from fluorosis affection, but in connection to the identity of the research group these artifacts were minimized.
So, at the comparative analysis of the number of caries cases in children of 12 and 15 years old during 26 years the general tendency to the shortening of frequency and intensity of affection with dental caries
draws attention. This phenomenon is especially obvious in 12-year-old children. Thus, in Lviv the frequency and intensity of caries within this period has reduced by 25 % (from 96,7 % to 73 % and from 4,6 to
2.1 respectively), in Ivano-Frankivs'k - by 30 % (from 93,8 to 63 % and from 4.7 to 2.0 respectively), in u/v Skole - by 10% (from 100 % to 90 % and from 7,4 to
5.2 respectively). In 15-year-old these figures are much less and equal 5-10 % (tab. 4).
Table 3
The frequency and intensity of dental caries in 12-year-old children in some regions of Ukraine
City Year of investigation Frequency of caries, % Intensity of teeth affection with caries*
Lviv 1985 96,7 4,6
2011 73,0 2,1
u/v Skole 1985 100 7,38
2011 90,0 5,2
Ivano-Frankivs'k 1985 93,8 4,7
2011 63,3 2,0
Odesa 1985 68,0 3,5
2011 76,0 2,4
u/v Kalush 1985 48,0 2,4
2011 73,0 3,5
u/v Dolyna 1985 97,8 4,9
2011 93,0 4,9
Poltava 1985 29,7 0,8
2011 70,0 2,3
u/v Karlivka 1985 32,5 0,87
2011 66,7 2,0
Note : * - value of m do not overtop 10 % of value M.
Table 4
The frequency and intensity of dental caries in 15-year-old children in different regions of Ukraine
City Year of investigation Frequency of caries, % Intensity of teeth affection with caries*
Lviv 1985 88,9 6,7
2011 80,0 4,1
u/v Skole 1985 96,7 7,4
2011 100,0 3,6
Ivano-Frankivs'k 1985 96,9 5,3
2011 86,7 4,7
Odesa 1985 78,0 4,6
2011 80,9 3,0
u/v Kalush 1985 85,0 3,6
2011 86,7 5,5
u/v Dolyna 1985 94,9 7,1
2011 96,7 7,8
Poltava 1985 74,5 2,3
2011 76,7 4,0
u/v Karlivka 1985 46,2 1,64
2011 76,7 3,0
Note : * - value of m do not overtop 10 % of value M.
But there are some areas, in which during the last 19 years (1992-2011) the content of fluorine in drinking water was reduced, but the indices of frequency and intensity of caries have grown respectively from 8 % (u/v Kalush) and by 2,1-2,4 times (Poltava, u/v Karlivka).
At epidemiological investigations in 2011 in children of 6 and 7 years old the authors determined that on the average in Ukraine the frequency of dental caries of permanent occlusion equals 23,2 % at CFEt being 0,42. The lowest affection in children of 6 and 7 years old was noticed in u/v Dolyna (10 % and
0,17). The highest one was in Odesa (25,8 % and 0,42) and in u/v Karlivka (46,1 % and 0,85). The high frequency and intensity of dental caries in Poltava and u/v Karlivka is connected, evidently, to the second affection of teeth, affected with fluorosis. At the temporary occlusion the lowest affection is in children from Poltava and u/v Karlivka (63,3 % and 76,9 %) at the lowest intensity of affection (CFt =1,83 and 2,38 respectively). The other regions of Ukraine at the average have the same frequency -from 90 % to 100% at CFt from 4,70 to 7,43 (tab. 5).
Table 5
The frequency and intensity of dental caries in children of 6 and 7 years old in different regions of Ukraine in 2011
City Frequency of dental caries, % Intensity of teeth affection with caries*
Temporary teeth Permanent teeth CFt CFEt
Lviv 100,0 24,1 5,62 0,48
u/v Skole 86,7 23,3 5,27 0,47
Ivano-Frankivs'k 90,0 16,7 4,70 0,37
u/v Kalush 96,7 23,3 7,43 0,40
u/v Dolyna 96,7 10,0 6,03 0,17
Poltava 63,3 16,7 1,83 0,33
u/v Karlivka 76,9 46,1 2,38 0,85
Odesa 81,5 25,8 3,46 0,42
Average 87,9 23,2 4,60 042
No te : * - value of m do not overtop 10 % of value M.
Table 6
The structure of the indices CFp and CFEp in children of 6 and 7 years old in different regions of Ukraine, %
City Temporary occlusion Permanent occlusion
C F complications C F E complications
Lviv 87,21 12,79 11,63 80,77 19,33 0,00 0,00
u/v Skole 93,83 6,17 12,43 100,0 0,00 0,00 42,55
Ivano-Frankivs'k 88,46 11,54 10,87 43,40 56,60 0,00 13,04
u/v Kalush 98,30 1,70 12,62 100,0 0,00 0,00 0,00
u/v Dolyna 93,42 6,58 18,52 100,0 0,00 0,00 0,00
Poltava 79,27 20,73 6,54 81,82 18,18 0,00 0,00
u/v Karlivka 88,64 11,36 0,00 95,29 4,71 0,00 0,00
Odesa 46,87 53,13 18,32 35,56 64,44 0,00 21,31
At studying the components of the index CFp, the authors have paid attention to the fact, that in this age group (except in Odessa) dental caries prevails (from 52,22 % to 98,30 %), and the complications of which are from 0 % (u/v Karlivka) to 18,52% (u/v Dolyna) (tab. 6).
In the index CFEp the same tendency remains. Unfortunately, in all examined regions, except Ivano-Frankivs'k (43,40 %) and Odesa (35,56 %), dental caries equaled from 80,77% (Lviv) to 100 % (u/v Skole, u/v Kalush, u/v Dolyna).
Studying the changes in the structure of index CFEp in 12-year-old children in investigated regions of Ukraine, the authors have observed the consider-
able growth of the number of filled teeth in comparison to carious ones (Lviv, Ivano-Frankivs'k, u/v Kalush, u/v Dolyna). Yet, in some regions the number of carious teeth has increased considerably in comparison to the filled ones (u/v Skole, Poltava, u/v Karlivka). So, in Poltava in 1985 the ratio C:F was 2,1:1, in 2011 it was already 5,2:1. In u/v Karlivka in 1985 the ratio C:F equaled 1:6, now -6,2:1. The changes of the components of the index CFEp in 12-year-old children in different regions of Ukraine during 26 years (from 1985 to 2011) are given in the tab. 7.
In 15-year-old teenagers these changes are almost the same. So, if earlier (in 1985) in Lviv in
such patients the ratio C:F equaled 1:1,1, in 2011 it is 1:4. In Ivano-Frankivs'k this ratio in 1985 was 1,5:1, in 2011 - 1:12,6. In u/v Kalush and u/v Dolyna these ratios have improved less considera-
bly. Thus, in u/v Kalush earlier C:F was like 1:1, at present it is 1:2,5. In u/v Dolyna the ratio equaled 1:2 in 1985 and 1:3 in 2011.
Table 7
The changes of the structure of the index CFEp in 12-year-old children in different regions of Ukraine during 26 years
City Year of investi gation CFEp, abs. CFEp, %
C+F+E C F E comp. C F E comp.
Lviv 1985 139 78 58 3 - 56,1 41,7 2,2 -
2011 76 33 42 1 4 43,5 53,3 1,2 11,8
u/v Skole 1985 213 78 128 7 0 36,6 60,1 3,3 0
2011 190 107 76 7 28 56,42 40,0 3,6 26,05
Ivano-Frankivs'k 1985 149 94 53 2 0 63,1 35,6 1,3 0
2011 74 19 55 0 5 25,6 74,4 0 25,4
u/v Kalush 1985 94 78 14 2 0 83,0 15,0 2,0 0
2011 134 41 92 1 3 30,6 68,7 0,7 7,3
u/v Dolyna 1985 219 105 113 1 0 48,0 51,6 0,4 0
2011 195 67 121 7 16 34,3 62,0 37 23,77
Poltava 1985 25 17 8 0 0 68,0 32,0 0 0
2011 74 62 12 0 2 83,8 16,2 0 3,38
u/v Karlivka 1985 35 5 30 0 0 14,3 85,7 0 0
2011 74 64 10 0 0 862 13,8 0 0
Table 8
The changes of the structure of the index CFEp in 15-year-old children in different regions of Ukraine during 26 years
City Year of investi gation CFEp, abs. CFEp, %
C+F+E C F E comp. C F E comp.
Lviv 1985 180 84 90 6 0 46,7 50,0 3,3 0
2011 149 30 119 0 4 20,0 80,0 0 13,0
u/v Skole 1985 220 105 105 10 0 47,7 47,7 4,6 0
2011 121 53 57 11 14 43,7 47,1 9,2 26,7
Ivano-Frankivs'k 1985 168 97 66 5 0 57,7 39,3 3,0 0
2011 168 12 149 7 1 7,1 89,3 3,6 7,5
u/v Kalush 1985 143 68 65 10 0 47,5 45,5 7 0
2011 199 53 135 11 4 26,7 67,9 5,4 7,34
u/v Dolyna 1985 277 99 170 8 0 35,7 61,4 2,9 0
2011 324 77 228 19 4 23,8 70,4 5,8 5,06
Poltava 1985 108 21 86 1 0 19,4 79,6 1 0
2011 142 102 39 1 1 71,9 27,5 0,6 0,88
u/v Karlivka 1985 64 12 49 3 0 18,7 76,6 4,7 0
2011 98 75 22 1 4 76,7 224 0,9 5,2
The planned preventive measures have worsened in Poltava and u/v Karlivka, where the ratio of carious and filled teeth before was 1:4.1. In 2011 it became 2,6:1 and 3,4:1 respectively. The change in
the components of index CFE in 15-year-old children in different regions of Ukraine during 26 years is given in the tab. 8.
