Американский Научный Журнал DENTAL STATUS OF CHILDREN WITH AUTISM RESIDING IN THE REGION WITH ECOTOXICANTS

American Scientific Journal № ( 31) / 2019 9

МЕДИЦИНА И СТОМАТОЛОГИЯ

DENTAL STATUS OF CHI LDREN WITH AUTISM RE SIDING IN THE REGION WITH
ECOTOXICANTS

Galeeva Regina Rimovna
Bayburina Elza Kamilovna
Ganieva Olga Nikolaevna
Mikryukova Anastasia Konstantinovna
Vasfieva Elvina Ildusovna
Department of Pediatric Dentistry and Orthodontics,
Bashkir State Medical Univers ity, Ufa

Annotation . According to the results of the questionnaire and dental examination, it can be judged that
autistic children living in the region with ecotoxicants hav e not yet developed a habit of oral hygiene, there is a
high prevalence of dental caries, poor oral hygiene, and insufficient dental care. The study of the dental status of
children with autism showed the need for the active participation of a dentist in t he formation of children's proper
oral care skills, which is the key to dental hea lth and improve the quality of life of children with this pathology.
Keywords : autism, children, dental status

Introduction. Autism (from Latin autu еs, meaning
‘self’, ‘imme rsion in oneself’) is both a specific
diagnosis and a general term that refers to all specific
emotional disorders [1, 2]. This disease is characterized
by a violation of mental and emotional development,
causing problems in commun ication, relationships wi th
others and learning [3, 4]. Autism occurs as a result of
a variety of biological, genetic and environmental
causes [5 –7]. Children with this pathology usually have
a low level of development of self -care skills, this is
due to t heir behavior, attention deficit, and reduced
learning ability [8]. There are also sensory problems,
for example, hypersensitivity to toothbrush bristles and
the taste of toothpaste or tooth powder, which forces
children to avoid brushing their teeth [9]. In addition,
autistic chi ldren often have a pronounced food
dependence on sweets. All this leads to a violation of
the dental health of children with somatic disease [10 -
14]. In such regions as the Republic of Bashkortostan,
a high concentration of various industrial sectors (oil
and gas production and transportation, petrochemicals,
oil refining, chemistry, instrumentation and machine
building, ferrous and non -ferrous metallurgy, mining,
and highly developed agro -industrial complex) poses a
potential dange r to human health [15, 16 ]. Ecotoxicants
have a wide range of toxic effects, causing the
occurrence of biochemical changes in the body,
neurotoxic, gonadotoxic, genotoxic, embryotoxic and
teratogenic effects, negatively affecting the growth and
development of the body, including t he dentition. In
this regard, the assessment of dental status among
children with autism is of particular importance [17 –
19]. Given the characteristics of autistic children,
without disturbing their psyche, it is necessary to
gradu ally develop habits of or al hygiene [1 -5].
The aim of the study was to study the dental status
of children with autism, living in the region with
ecotoxicants.
Materials and methods. The study was carried out
on the basis of the Ufa Special Correctional B oarding
School No. 92 for students with disabilities, the
Children's Dental Clinic No. 7 of Ufa and the
Department of Pediatric Dentistry and Orthodontics
with a course of IDPO of Bashkir State Medical
University. At the time of the survey, 159 children wi th
disabilities were enro lled in the boarding school, 47 of
them with autism, of which 16 were at home. A dental
examination was performed on 31 children with autism
from 6 to 18 years old. Before each examination, a
conversation was held with each child i n a playful
manner about the importance of teeth in a person’s life,
possible diseases, the importance of oral hygiene, and
the need for regular dental examinations. In connection
with the peculiarities of the course of the underlying
disease, a dental exa mination of children was carried
out together with teachers, medical staff of the boarding
school. Examination of the oral cavity was carried out
using a standard dental tool kit. To assess the intensity
and prevalence of the carious process, the KPU denta l
index was used. The str ucture of this index was
revealed, while indicators K (caries), P (fillings), and U
(extracted teeth) were separately calculated. The level
of dental care (USP) was determined. To assess the
hygienic condition of the oral cavity of the examined
children, t he PHR oral hygiene efficiency index was
used (Podshadley A.G., Haley P., 1968). Also, to study
the level of oral hygiene of the examined children,
questionnaires were drawn up in the form of a special
conversation questionnaire (a nalysis of the level of o ral
hygiene) at the Department of Pediatric Dentistry and
Orthodontics with a course of IDPO BSMU, consisting
of 15 questions. Using the questionnaire, it was
established how much children and parents are aware
of the purpose of th e teeth, good nutrition, attitude to
the dentist, and whether oral hygiene is adequately
implemented. In addition to the questionnaire for
studying the level of oral hygiene, a questionnaire was
compiled to analyze the anamnestic information
obtained as a result of a survey of par ents. This analysis
served as the basis for obtaining objective data on the
individual characteristics of the child, the overall
picture of the etiopathogenesis of violations of the basic
functions of the dentofacial system, and de ntal status in
general.

10 American Scientific Journal № ( 31) / 20 19
The results of the study. In the study of the history
of children's lives, it was noted that children with
autism were born from 1 -3 pregnancies and childbirth.
In this case, the course of the pregnancy of their
mothers was complica ted mainly by infectious
diseases. In most cases, premature birth, weak labor and
rhodostimulation were used. The birth weight of
children ranged from 1486 to 4100 grams. Most of the
children were breast -fed (64.51%), some were
breastfed (35.48%). Of the c oncomitant pathology,
aga inst the background of the underlying disease in
children with autism, posture disorders (curvature of
the spine, 51.61%), feet (22.58%), myopia (25.80%),
astigmatism (16.12%), angiopathy were noted retina
(9.67%), delayed psycho -speech development
(35.48% ), mental retardation (25.80%), speech
impairment (29.03%), adenoids (9.67%), gastritis (9.67
%), endemic goiter (3.22%), neurogenic bladder
(3.22%), gallbladder dyskinesia (6.45%),
pyelonephritis (3.22%). On external examination, most
children with autism revealed such bad habits as thumb
sucking (12.90%), lower lip bite (22.58%), tongue
between teeth (51.61%), nail biting habit ( 12.90%),
pull all objects into the mouth (3.22%), as well as
dento -jaw system dysfunctions: respirator y failure (oral
- 58.06, mixed - 32.25%), swallowing (infantile type -
74.19% ), sluggish, too long chewing (51.61%), speech
(expressive speech, echolalia, tachylalia, bradylalia).
During an examination of the oral cavity during
swallowing, a tongue was la id between the teeth,
hyp ertonicity of the muscles surrounding the oral
fissure (buccal, chewing, circular, temporal, lateral
wing -shaped), which led to spastic tension of the lips,
and after examination it was observed at rest weakness
of the circular mus cle of the mouth (61.29%) . The
muscles of children on the one hand are excessively
contracted, and on the other hand are hypotonic. This is
due to the imbalance between the processes of
excitation and inhibition. At the same time, they have a
certain speci ficity in muscle tension: it is quickly
replaced by relaxation and again turns into tension.
Anomalies were observed in the structure and
attachment of the frenum of the lips and tongue
(22.58%), bite (cross, distal, deep, open, straight) and
teeth (vestib ular and oral position, t ortoanomaly,
transposition, microdentia, hyperodontia), most often
combined in all children examined. The level of oral
hygiene by the pH index was unsatisfactory (2.1). The
intensity of the carious process in the KPU index was
5.3 , the prevalence was 80%. In the structure of the
index, the component “K” accounted for 81.25, “P” -
10, “U” - 8.75%. The level of dental care in the USP
index was insufficient - 10%. A survey (analysis of the
level of oral hygiene) revealed: most childre n do not
brush their teet h twice a day and do not devote adequate
time to brushing their teeth (54.83%); almost no one
uses additional oral hygiene products and does not
cleanse the surface of the tongue from plaque; 19.35%
of children have bleeding gums w hen brushing their
teeth; almost all children visit the dentist as necessary,
only a small part refuses to go to the doctor (12.90%).
Conclusions Based on the results of the questionnaire
and dental examination, it can be judged that autistic
children livi ng in the region with eco toxicants have not
yet developed a habit of oral hygiene, there is a high
prevalence of dental caries, poor oral hygiene, and
insufficient dental care . The study of the dental status
of children with autism showed the need for the active
participation of a dentist in the formation of children's
proper oral care skills, which is the key to dental health
and improve the quality of life of children with this
pathology.

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RISK FACTORS FOR CONG ENITAL MALFORMATIONS OF THE MAXILLOFACIA L REGION

Chuikin Oleg Sergeyevich
Viktorovna Viktorova Tat yana
Gilmanov Marsel Venerevich
Muratov Azamat Maratovich
Galiakberov Ildar Shafkatovich
Department of Pediatric Dentistry and Orthodontics,
Bashkir State Medical University , Ufa

Annotation . The article provides a review of the literature on the study of the causes of congenital
malformations and dentofacial anomalies, the identification of which is a prerequisite for substantiating and
conducting an integrated system for the prevention of this pa thology in children and adolescents.
Key words : congenital malformations; neural tube defects; crevices of the upper lip and palate, dentition.

Congenital malformations (CHD) occupy a
leading position in the structure of childhood
morbidity, disability an d mortality and represent an
important medical and social problem. [1 -10]
The causes of congenital malformations can be
varied: the effects of teratogens, maternal diseases,
chromosomal aberrations, mutations of certain genes,
and others. However, in a sig nificant part of cases, the
nature of VLD remains unknown. It seems most likely
that the etiology of congenital malformations is
multifactorial; in other words, both the genotype of the
mother and the fetus, as well as the influence of
environmental factor s, affect the risk of congenital
malformations. In the 60s of the last century, the first
evidence appeared in the world literature that impaired
folate metabolism and folic acid deficiency in pregnant
women can affect the risk of spontaneous abortion and
neural tube defects in the fetus. [5 -15] This discovery
aroused keen interest: in numerous studies of the 80 -
90s it was shown that the consumption of multivitamins
with a high content of folic acid or folate -rich foods
before conception and in early pregna ncy reduces the
frequency of neural tube defects - as in m others who
already have a baby with such a pathology, and in
women without a history of fetal neural tube defects.
Many of these works were performed on small samples,
and it remained unclear whethe r folate itself or other
multivitamin components had a pro tective effect.
To date, several dozen studies have been carried
out to study the association of polymorphic variants of
folate metabolism genes with the risk of congenital
malformations. Most of th e work was performed on
samples of 200 -300 people in the e xperimental and
control groups and focused on several of the most
studied single nucleotide polymorphisms (SNPs), such
as MTHFR C677T (rs1801133), RFC1 A80G
(rs1051266), MTR A2756G (rs1805087 ), MTH FD1
G1958A (rs2236225).
In recent years, large works have begun to appear
that analyze the associations of certain nucleotide
substitutions with different types of CDF. However,
associations with specific SNPs identified in some
studies are not always repr oduced in other studies. With
confidence, only the associa tion of the MTHFR 677TT