Bronchial asthma is the most common chronic disease of the respiratory system in childhood. Treatment of bronchial asthma involves the oral administration of B-blockers and inhaled corticosteroids, which causes changes in a number of physical and chemical parameters of the oral liquid. It certainly can not be displayed on species composition and population level of microflora of the oral cavity. The duration and severity of bronchial asthma, as well as the long-term use of these drugs, has a significant effect on the risk of tooth decay in children with bronchial asthma.
The purpose of our study was to evaluate the species composition and quantitative indicators of cariogenic microflora of dental plaque at different stages of caries activity in children with asthma.
The study involved 77 children 7, 12 and 15 years old, suffering from bronchial asthma (for 3-12 years), with moderate and severe degree, who were hospitalized in the Allergic department. Children received inhaled glucocorticosteroids for the treatment of bronchial asthma. The control group consisted of 45 children of similar ages. Dental status was evaluated and microbiological research of dental plaque was conducted to all children.
Thus, in the 7-year-old children with bronchial asthma, the population level of S.mutans was 5,75 ± 0,6 lg cfu / g only at the third stage of caries activity. For this age category important factors in the development of caries are also represented by S.mitis (11, 8± 1, 2%) and S.salivarius (16, 3 ± 1, 6%). In the 12-year-old-children with asthma population-level S.mutans reached a critical level already at the second degree of caries activity 6,0 ± 0,56 lg CFU / g and in the third degree of caries activity it exceeded the critical level of 6,2 ± 0,7 lg cfu / g. In 15- years-old children with asthma population-level S.mutans exceeded the critical level (6, 2 ± 0, 7 lg CFU / g), only at the third degree of caries activity. Thus, the influence of somatic disease (asthma) on the occurence of caries was proven only in 12-year-old children with asthma.
Caries risk was determined by population levels of S.mutans and Lactobacillus spp. The critical level for S.mutans was considered to be 6.0 (as the average value of the logarithms of 1 g of material) and Lactobacillus spp.- 5,0. We proposed to use a complex index of quantitative levels of cariogenic bacteria: the sum of logarithms CFU / g for easy microbiological characteristics of tooth decay. For a conventional one (1 USD) we propose 1lg CFU / g. We consider that the development of caries risk assessment can be carried out not only by the excess population of S.mutans - 6,0 lg cfu / g and Lactobacillus (5,0), but by the sum of these indicators, which can not reach a critical level if they are taken separately. The high risk of the caries development by indicator of S.mutans-Lactobacillus in the 7-year-old children with asthma was found only in the third degree of caries activity (11,55 lg CFU / g).
Noteworthy the high level of standard bacterial indicator of the risk of development of dental caries in 12-year-old children with asthma in the second and third degrees of caries activity (11,5 and 11,8 lg CFU / g).
The highest values of standard bacterial indicator of the caries risk development in the above specified levels of caries activity was set for 15-year-old children with asthma (11.6 and 11,9 lg CFU / g).
Therefore, microbial factor as risk of caries development during asthma is increasingly important and it should be considered during clinical observation and dental care for children with asthma.
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Author Name: N. SMOLAR, O. KORNIYCHUK, S. LESHCHUK
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Keywords: caries, children with asthma, cariogenic microflora