Американский Научный Журнал DENTAL STATUS IN CHILDREN WITH CHRONIC RENAL FAILURE IN HEMODIALYSIS

Abstract. Chronic renal failure (CRF) is a severe somatic disease leading to disability. Especially difficult is CRF in childhood. In a growing organism, pronounced metabolic, immune processes, intoxication processes occur. The gradual loss of kidney function, a prolonged state of uremia is accompanied by the occurrence of changes in various organs and systems of the child’s body, including the oral cavity. The purpose of this study was to study the dental status in children with chronic renal failure on hemodialysis. According to the results of the study, pathological changes in the oral cavity in patients with chronic renal failure undergoing hemodialysis were identified, which indicate the need for the development of corrective therapeutic and preventive measures in order to optimize the prevention and treatment of dental diseases. Скачать в формате PDF
22 American Scientific Journal № ( 31) / 20 19
DENTAL STATUS IN CHI LDREN WITH CHRONIC R ENAL FAILURE IN HEMO DIALYSIS

Chuikin Sergey Vasilievich
Department of Pediatri c Dentistry and Orthodontics,
Bashkir State Medical University , Ufa
Morozova Nataliya Sergeevna
Moscow State Medical University named after I.M. Sechenov

Abstract . Chronic renal failure (CRF) is a severe somatic disease leading to disability. Especially difficult is
CRF in childhood. In a growing organism, pronounced metabolic, immune processes, intoxication processes occur.
The gradual loss of kidney function, a prolonged state of uremia is accompanied by the occurrence of changes in
various organs and s ystems of the child’s body, inc luding the oral cavity. The purpose of this study was to study
the dental status in children with chronic renal failure on hemodialysis. According to the results of the study,
pathological changes in the oral cavity in patien ts with chronic renal failure u ndergoing hemodialysis were
identified, which indicate the need for the development of corrective therapeutic and preventive measures in order
to optimize the prevention and treatment of dental diseases.
Key words : сhronic renal insufficiency, hemodialysis , stomatological status.

Introduction Chronic renal failure (CRF) is a
severe somatic disease leading to disability. Especially
difficult is CRF in childhood. In a growing organism,
pronounced metabolic, immune pr ocesses, intoxication
processes occur. A g radual loss of kidney function is
accompanied by the occurrence of changes in various
organs and systems of the body, including from the
dentofacial system [1; 3; 7]. The high susceptibility to
various dental disea ses [2 -9], the features of their
clinical course depending on the functional state of the
kidneys, the influence of pharmacokinetics and
hemodialysis procedures were a prerequisite for
studying the features of dental status in terminally ill
children with chronic renal failure. O.A. Moskalenko
[10 -15] while studying the condition of the oral cavity
in patients with chronic renal failure revealed a rather
high prevalence of dental diseases in patients with this
pathology - 96.6%. So, the prevalence of caries in
patients with chronic renal failure wa s 92.4%, receiving
hemodialysis - 91.2%; the intensity of caries in patients
with chronic renal failure was higher than in healthy
people, KPU = 5.40. The mucous membrane of the oral
cavity and periodontal tissue a re a sensitive
reflexogenic zone. Therefor e, violations of the sensory
and reflex functions of the oral cavity can be expected
under various pathological conditions of the body [16 -
19]. From them one can judge the severity of shifts in
the neurodynamics of the centers that regulate the
activity of the organs of the oral cavity, taste and
salivation function. In patients with chronic renal
failure, the physiological desquamation of the filiform
papillae is inhibited, so the tongue is often dry,
“overlaid” [5 ]. In connection with the release by the
salivary glands of a large amount of urea, which under
the influence of saliva enzymes passes into ammonia,
halitosis is constantly observed. A frequent subjective
symptom of a mucosal lesion is its burning, sorenes s.
Possible occurrence of candidiasis of t he oral cavity,
the development of herpetic stomatitis. The cause of the
appearance of viral and fungal infection, obviously, is
a decrease in both general and local factors of
nonspecific protection, as well as in toxication inherent
in renal failure [1]. So, according to the literature, it
follows that patients with chronic renal failure have
quite significant changes in the oral cavity. The main
mechanism for the occurrence of these changes is the
accumulation of nitrogenous products in the body,
impaired mineral metabolism, and periodontal
hemodynamics.
Objective. Study of dental status in children with
chronic renal failure undergoing hemodialysis.
Materials and research methods. The work
presents the results of a survey of 52 children with
chronic renal failure in the terminal stage who are on
outpatient programmed hemodialysis at the Center for
hemodialysis and kidney transplantation of the
Republican Children's Clinical Hospital in Ufa, aged
15 –18 years, the ma in group 1; Group 2 consisted of 30
children with chronic renal failure in the compensation
stage. The control group included 30 children of the
same age without kidney disease and other chronic
diseases. Hemodialysis was performed on an artificial
kidney apparatus Fresenius 4008 Н, 50 08S, 5008 with
dialyzers F4 -F7, FX40; FX60 under standard
conditions using a bicarbonate solution. The dialysis
program in patients was individual, taking into account
the "dry weight", weight gain in the interdialysis period
and other parameters, was 9 ho urs a week for 2
sessions. Kt / v was -1.3 -2. Children were included in
the study with the informed consent of each of them and
their parents. The study conducted a study of dental
status. To assess the dental status, the state of the oral
mucosa and tongu e was determined. To assess the
condition of the teeth, indicators recommended by the
WHO expert committee were used. Statistical data
processing was performed using computer programs
Microsoft Excel and the application package Biostat
Primer for Windows M cGraw -Hill.
Results and discussion. When examining the oral
cavity in children with chronic renal failure treated with
hemodialysis, we took into account the subjective
sensations of children in the oral cavity. Children with
chronic renal failure undergoi ng hemodialysis (group
1) in some cases complained of xerostomia: dry red
border of the lips in 73.1 ± 6.2% of cases, in group 2 of
children in 46.7 ± 9.1% of cases (p0.05, differences are
not significant); gum bleeding in grou p 1 occurred in
30.8 ± 6.4% o f cases, in group 2 in 23.3 ± 7.7% of cases
(p> 0.05, differences were not significant), in the
control group 6.7 ± 3 , 4% of cases (p0.05, the

American Scientific Journal № ( 31) / 2019 23

differences are not significant), in the control group
there were no complaints of a burning sensation in the
oral cavity and an unpleasant taste in the mouth.
Children with ESRD who are on hemodialysis noted
increased tooth sensitivity from thermal and chemical
stimuli. So, hyperesthesia in this group was noted by 23
children - 44.2 ± 6 .9%, in the 2nd group of chil dren the
frequency of dental hyperesthesia was 10.0 ± 5.5%
(p0.05, the difference was not significant); language
overlay in 1 group of children - in 78.8 ± 5.7% of cases,
in 2 group of children - in 73.3 ± 8.08% of cases (p>
0.05, the difference is not sig nificant), in the control
group the phenomenon of hyperkeratosis, puffiness and
tightness of the tongue were not observed. We have
studied the prevalence and intensity of dental caries in
children with chronic renal failure who are on
hemodialysis treatmen t. The prevalence and intensity
of caries in various groups of examined children are
presented in table 1. When analyzing the data of the
table, it can be seen that the prevalence of caries in
children with chronic renal failur e on hemodialysis was
(group 1) 88.5 ± 4.4% of cases, in 2 group of children -
86.7 ± 6.4 (p> 0.05, the difference is not significant), in
the control group the prevalence of caries was 83.3 ±
6.8% of cases (p <0.05, the difference is not significant)
. Th e intensity of dental caries in children with chronic
renal failure on hemodialysis was 4.21 ± 0.24); in the
2nd group of children it was 3.92 ± 0.1 (p> 0.05, the
difference was not significant), in the control group -
3.4 ± 0.28, the difference was signif icant (p <0.05).
Hygiene of t he oral cavity was evaluated by the Green
– Vermilion index. The average plaque in children with
ESRD undergoing hemodialysis treatment was 2.2 ±
0.06; it was assessed as a poor level of hygiene; in the
2nd group of children - in 1.54 ± 0.06 (p0.05, the
difference is not significant), the result in the control
group was 56.7 ± 9.1% of cases (p <0.05, the difference
was significant), in the control group the indicator was
1.27 ± 0.02 (p <0.05, the difference was significant).
Fin dings. High prevalence of den tal diseases in
children with chronic renal failure undergoing
hemodialysis, frequent complaints of xerostomia of dry
red border of the lips, oral mucosa, burning sensation
in the mouth and unpleasant taste in the mouth were
revealed. Changes in the oral c avity depend on the
functional state of the kidneys, the effects of
pharmacokinetics and the hemodialysis procedure. The
results obtained in the study of the dental status in
children with chronic renal failure undergoing
hemod ialysis can increase the effe ctiveness of the
development of therapeutic and preventive measures in
this group of patients and indicate the need for the
development of therapeutic and preventive measures in
order to increase the effectiveness of comprehens ive
prevention and treatment of dental diseases.

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THE RESULTS OF A SUR VEY OF PARENTS ON TH E PREVENTION OF DENT AL DISEASES IN
CHILDREN WITH CONGEN ITAL CLEFT LIP AND P ALATE

Akateva Galina Grigoryevna
Chuikin Oleg Sergeyevich
Grin Eduard Aleksandrovich
Kuchuk Kris tina Nikolaevna
Bilak Anna Grigoryevna
Gareeva Dilara Rafaelevna
Department of Pediatric Dentistry and Orthodontics,
Bashkir State Medical University , Ufa

Abstract . The article presents data from a survey of 160 parents of children with cleft lip and pal ate to assess
the level of awareness of the prevention of dental diseases. An insufficient level of parents' awareness on the
prevention of dental diseases in childre n with congenital cleft lip and palate has been established, which indicates
the need to i mprove the work on health education and hygienic education.
Keywords : children, parents, questioning, cleft lip and palate, prevention.

Relevance. Currently, there is a tendency towards
an increase in the birth rate of children with congenital
malformati ons of the maxillofacial region. The most
common and severe malformation of the maxillofacial
region is congenital cleft of the upper lip and palate
(VRGN) and accounts for up to 16.4% of the total
number of all congenital malformations. [1 -10] The
birth r ate of children with this defect in the Republic of
Bashkortostan is 1: 554 newborns, in Ufa - 1: 454
(Chuykin S.V. et al., 2016). Along with the increase in
the number of births of children with this pathology, an
increase in somatic and dental morbidity is noted. The
dental status of such children is also often burdened.
Dental morbidity is caused by the presence of the main
pathology, in which functions important for a person
(functions of the articulatory apparatus, formation of
respiration and correct speech) are impaired
(Tsyplakova M.S. et al., 2016). [10 -15] The lack of
sustainable hygiene skills in preschool children reduces
the effectiveness of preventive measur es for dental
caries and periodontal diseases (Kuzmina E.M. et al.,
2015). Poor sanitary culture adversely affects the
effectiveness of preventive measures (Hamadeeva
A.M. et al., 2016). [16 -19]
The goal is to evaluate the awareness of parents of
children with congenital cleft lip and palate and their
motivation for the prevention and treatme nt of dental
diseases.
Materials and methods. We conducted a survey of
160 parents of children with preschool children with
advances in primary care. The questionnaire used was
developed at the Department of Pediatric Dentistry and
Orthodontics with a cour se of IDPO FSBEI HE
“Bashkir State Medical University” of the Ministry of
Health of Russia. The questionnaire included 20
questions regarding the causes o f the development of
dental diseases, the frequency of brushing, the features
of oral hygiene in child ren with ARH, the reasons for
going to the dentist, and methods of prevention and
treatment of dental diseases.
Results and conclusions. Oral hygiene is a basic
method for the prevention of dental diseases. We
appreciated the awareness of parents about how old a
child should brush their teeth. Only 32 (20.0%) of the
respondents answered that teeth should be brushed
from the moment of teething. 60 (37.5%) - believe that
teeth should be brushed from the age of 2, 45 (28.1%)
- from 3 years of age, and 23 (14.4 %) of the parents
surveyed said that they should be brushed from 4 years
and older.
The vast majority of parents - 150 (93.75%)
indicated that their child ren use a children's toothbrush
and toothpaste to care for the oral cavity, 10 (6.25%)
answered that t hey use only a toothbrush. 82 (51.25%)
of the respondents replied that oral care in children was
carried out twice a day, 56 (35.0%) replied that once a