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The main directions of preventing tooth decay

June 9, 2024

The main directions of preventing tooth decay. General and local caries factors. Endogenous and exogenous prevention of dental caries. Means and methods efficiency evaluation.

Dental caries, also known as tooth decay or a cavity, is an infection, bacterial in origin, that causes demineralization and destruction of the hard tissues (enamel, dentin and cementum), usually by production of acid by bacterial fermentation of the food debris accumulated on the tooth surface.^[1]If demineralization exceeds saliva and other remineralization factors such as from calcium and fluoridated toothpastes, these hard tissues progressively break down, producing dental caries (cavities, holes in the teeth). The bacteria most responsible for dental cavities are the mutans streptococci, most prominently Streptococcus mutans and Streptococcus sobrinus, and lactobacilli. If left untreated, the disease can lead to pain,tooth loss and infection. Today, caries remain one of the most common diseases throughout the world.

O.V.Udovitska (1987) selects 7 basic signs the risk of caries: 1) viscid saliva; 2) acid reaction of environment of cavity of mouth; 3) propensity is to the superficial deposit of dental deposit at the normal hygienical mode;4) hypoplasia enamels of teeth as index of vicious development of enamel; 5) premature eruption of teeth (on a half-year and more — temporal, on a year and more — permanent); 6) and the inherited inclination; 7)toxicosis pregnancies of mother.

Operate these factors it is easier to find out, if to examine the normal state of enamel as a dynamic equilibrium between the permanent processes of de- and remineralisation. In that case, when in dental fabrics the processes of demineralization prevail above remineralisation, there is an area of demineralization as a carious spot. Subsequent progress of process of demineralization enamel and dentine results in formation of carious cavity.

Resistance of dental fabrics is broken

The structure of enamel acts important part in the origin of caries. Homogeneity of its structure rises as far as ripening of enamel, there is smoothing of relief of surface, without prisms areas which mask the heads of prisms appear. Narrowing of scopes of prisms, decline of contrasting of Rettsius’s lines is marked in the proper layers, the volume of mісro spaces diminishes to 0,1—0,2 %, that brings enamels over to multiplying a closeness. The amount of water diminishes in an enamel. Due to entering of ion of fluorine enamel maintenance of fluorine apatites is multiplied in her that promotes her caries resistance. The aggregate of age-old processes which take place in an enamel reduces its mісro porosity and accordingly, and permeability, and promotes caries resistance.

In ripening of enamel an important role belongs to the fluorine the amount of which after eruption of tooth is gradually multiplied. His including is proved from saliva in an enamel. A fluorine regulates the process of absorption of calcium hard fabrics of tooth. Speed of mіneralіzation considerably grows in presence a fluorine. Even during such low concentration of fluorine as a 1:1000 speed of mіneralіzation grows in 3—5 times.

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For determination of resistance of enamel of teeth to the caries apply the test of enamel resistence (TER-TEST); V. R. Okushko, L. I. Kosareva, 1983) He allows to set functional resistance of enamel in relation to acid. A test can be used as initially-diagnostic and also for the objective estimation of efficiency of remineralization therapy during a clinical supervision and treatment of patients. The method of conducting of test is such:

–conduct the professional hygiene of mouth cavity

–the crowns of the teeth process the distilled water and wadding tampon, dry out

–on the vestibular surface of central overhead chisel inflict the drop of a 1% solution of HCl diameter no more than 2mm.

–through 5sec acid is washed off the distilled water

–the crown of the tooth is dried out a wadding tampon

–on a surface crowns inflict a tampon, moistened in 1% water solution of metilen dark blue

–take off dye one motion of wadding tampon from the surface of enamel

–estimate a test after the special to 10 balls color scale

–on an area where mіneralіzation inflict varnish with fluorine

In obedience to 10 balls scale of dark blue color determine the degree of resistance of teeth to the caries:

1-3 marks an area is painted in a pale blue color which determines considerable structurally-functional resistance of enamel and high firmness of teeth to the caries

4-6 marks an area is painted in a blue color which determines middle structurally-functional resistance of enamel and middle firmness of teeth to the caries

7-9 marks an area is resistance in a dark blue color which determines the decline of structurally-functional resistance of enamel and high degree of risk of origin of caries

10 marks an area is painted in a navy which characterizes structurally-functional resistance of enamel and maximal risk of origin of caries is extremely reduced.

An inferior in a high-quality and quantitative relation feed results in the row of violations in the systems of carbohydrate and mineral exchange which sharply loosens resistance of hard fabrics of teeth to the carious factors.

It is bound a promoted cariogenic meal to surplus maintenance in the rations of carbohydrates, diminishing mineral salts by vitamins and other vitally by important for an organism components. Thus consider the promoted use of refined sugars the basic starting mechanism of development of decay of teeth, development of specific microflora and decline of acidity of cavity of mouth, which is a condition which promotesdemineralization of enamels.

Except for composition of rations, in development of caries a large value is given the so-called civilization of feed, which is accompanied the high degree of culinary treatment of meal which diminishes the functional loading on a masticatory vehicle.

It is thus shown many authors that defeat caries mainly: it is related to maintenance of fluorine in water and less measure — in food stuffs, as at the last on territory different districts the level of fluorine hesitates insignificantly. Found out especially high staggered a caries for persons which use water with the very low concentrations of fluorine (at the level of 0,1…0,3 mg/l)

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A considerable place in the origin of caries belongs the carried and concomitant disease. It is set that for adults and children which carried sharp infectious diseases or are ill chronic illnesses of internal organs and systems, especially often there is a decay of teeth.

From the extreme influencing which result in the intensive defeat of hard fabrics of tooth, it follows to specify a radiation on ionizing. As numerous clinical supervisions testify x – ray therapy which is often enough used in a clinic is always accompanied the defeat of teeth regardless of area which tested an irradiation.

Role of saliva.

Most reliable is possibility of change of properties and will make enamels through saliva. Character of saliva selection, quantitative and high-quality indexes, change at some diseases of commons.

All physiology processes of hard fabrics of tooth after eruption flow in interrelation with saliva — biological environment of cavity of mouth.

Basic aspects of participation of saliva in support of homergy of mineral matters in the enamel of teeth followings:

1. The mineralization function of saliva, due to which mіneralіzation of teeth, “ripening” of enamel is carried out after eruption, is supported optimum composition of enamel, there is his renewal.

2. Protective function which consists in protecting of cavity of mouth from the pathogenic action of factors of external environment.

3. Clearing the role of saliva which consists in the permanent mechanical and chemical cleaning of cavity of mouth from tailings of meal, microflora, etc.

Consequently, in physiology terms saliva is the supersaturated solution on maintenance to the calcium and phosphate.

The state of supersaturating of saliva of hydroxide apatites has an important value for saving and support of constancy of dental fabrics in the cavity of mouth, for providing of homergy of mineral components. Supersaturating of saliva, from one side, hinders salts of calcium and phosphate dissolution of enamel, as saliva is already supersaturated such which make an enamel components; from other side, instrumental in diffusion in the enamel of ions of calcium and phosphate, as their active concentration in saliva considerably exceeds such in an enamel, and the state of supersaturating is instrumental in their adsorption on an enamel.

The maiatural regulator of homergy in the cavity of mouth is pH of saliva. In the norm of pH saliva hesitates within the limits of 6,8 — 7,2. The considerable decline of pH saliva, which is contained during 30 mines andmore, is marked after adopting carbohydrates. The decline of pH saliva creates direct influence on its mineralization function she becomes calcium – by a deficit that from mineralization becomes a demineralization liquid.

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Dental deposits

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On permeability of enamel superficial educations have substantial influence on teeth. They are divided on:

– no mineralized: pellicle, dental deposit, dental name – plate

– mineralized: above- and under gingival dental tartar.

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Pellicle

Pellicle— organic tape which appears after eruption of tooth. She has the appearance of dark grey tape, most on the area of fissure, the least – on humps. Pellicle is deprived bacteria. Something later gramme positive cocci penetrate to her. Then colonization goes gramme negative cocci and anaerobes. On their cellular surface there are receptors which have a cognation to glycoproteins. Pellicle protects safety of enamel due to deceleration of transport of ions of calcium and phosphorus to the enamel. The changes of properties of pellicle (structures, composition) can brake or stimulate development of caries. She can be taken off from a surface of enamel only by facilities of abrasives. After its removal at presence of contact of tooth with saliva of pellicle recommences during 20—30 min.

Pellicle acts considerable part in the processes of diffusion in the superficial layer of enamel, giving the last selective permeability. In addition, pellicle protects an enamel from the action of matters, that her dissolve.

The thickness of pellicle on the separate areas of crown hesitates from 1—2 to 10 mcm. The thinnest she wherein teeth clear up well, and most shown in fissures, oear neck and lateral surfaces of crown.

Pellicle of tooth is instrumental in attaching to his surface of microorganisms and formation of dental name-plate.

Dental name-plate

A dense dental raid or dental name-plate for the exposure of which coloring is needed the special solutions takes place above pellicle. A name-plate takes place above and under gums, more frequent in a near neck area andfissures. Formation of name-plate begins from tacking of bacteria to pellicle or to the surface of enamel. Microorganisms register to the tooth by sticky interbacterial matrix. The amount of raid is certain appears already in 2 hours after the careful cleaning of teeth. The maximal accumulation of name-plate takes place during 30 days.

A dental name-plate consists of microorganisms, cages of epitheliums, leucocytes and macrophage. Bacteria are 10% hard remain of name-plate, all other is intercellular matrix.
Intercellular matrix of raid contains organic (squirrel, polysugars, fats) and inorganic (calcium, phosphorus, potassium, sodium, fluorine) matters. Carbohydrates present in matrix are presented by dextran — polysugar what is formed by bacteria. He appears by streptococci from sugar.

A name-plate grows due to permanent stratification of new bacteria. As far as growth of name-plate its mіkrobial flora changes from predominance of cocci (mainly gramme positive) to more difficult population with maintenance of stick similar microorganisms.

At first a name-plate consists of characteristic cocci. Streptococcus are 50% bacterial flora with predominance of Str. mutans which has most carious action. To the extent of that how a name-plate is thickened, inwardly her anaerobic terms are created and a flora changes accordingly. The source of feed of superficial microorganisms, for certain, a mouth environment is. Deep bacteria for the growth use the metabolic products of other bacteria of name-plate and components of its matrix. It leads to that on a 2—3th day gramme negative cocci and sticks appear in a name-plate, on 4—5th — fusobacteria, the amount of anaerobes is sharplymultiplied. From 30 to the 90th day the amount of streptococci diminishes to 30—40% and the number of stick similar are multiplied to 40%.

Consequently, during 1—2 days of formation of name-plate in her prevails Str. mutans, his carious action determined making them of plenty of suckling acid in presence carbohydrates. It results in the local falling of pH (to 5,0) directly on the surface of enamel under a dental name-plate and to the increase of permeability of enamel. At the protracted support of critical level of ions of hydrogen there is acid dissolution in the least proof areas of enamel (interprismatic matter, Rettsius lines) with subsequent penetration of acids in the subsuperficial layer of enamel and her demineralization. Subsequent formation of organic acids on the surface of enamel strengthens the processes of demineralization that results in formation of micropore in an enamel, filled microorganisms and products of their metabolism. The amount of anaerobes grows thus.

Certainly that than higher speed of formation of dental name-plate the more so expressed her cariogenic action. For children which have the promoted index of dental name-plate, the increase of intensity of caries takes place in three times quick than for children with a low index. Except for it caries for children develops in those cases, if in mіcroflora of dental name-plate prevails Str. mutans.

However much numerous factors influence on cariogenic action of dental name-plate, in particular, mіcroflora of cavity of mouth, amount of carbohydrates which are used, quantitative and high-quality composition of saliva, its physical and chemical properties, maintenance in her mineral components: than higher level of calcium and phosphorus, the less cariogenic potential of name-plate.

A dental name-plate on the surface of tooth mechanically insulates an enamel from the action of saliva.

Sugars is instrumental in formation of name-plate, reproduction of microorganisms which then use them for about presentation it cariogenic actions.

A soft dental deposit is a yellow or grey – white soft and sticky deposit which not densely adjoins to the surface of tooth. He is visible without coloring the special solutions and can be partly washed off the stream of water. Accumulates in a night-time especially for persons which do not carry out the regular care of cavity of mouth.

This conglomerate, unlike a name-plate, does not have a clear structure. Microbes enter in his composition, the cast – off epithelium of mucus shell, leucocytes, and also fats and proteins of saliva. A soft deposit settles not only on the surface of teeth but also on the mucus shell of gums, especially in the places of their bad self cleaning. This type of deposits assists development of inflammatory processes of margіnal paradontium under act of local irritating factors — toxic products of vital functions of microorganisms of soft dental deposit. Tailings of meal stay too long in the cavity of mouth, especially in intradental intervals. Sticky products are wares of flours and pastry cooks, porridges — can stick and on other surfaces of teeth and to remain there on a few hours. In the conditions of cavity of mouth there is fermentation, rotting or disintegration of tailings of meal and products which are selected as a result of these processes stimulate the vital functions of microorganisms of cavity of mouth, growth of dental name-plates, influence on displacement of pH of mouth liquid.

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Soft dental deposit

Dental tartar it a dental name-plate mineralized in essence.

There is super gingival and sub gingival. On 90 % consists of inorganic remain among which basic seat is taken by salts of calcium.

Dental stone, — it dental name-plates are in essence mineralized. Their mіneralіzatіon takes place as a result of increase of pH of mouth liquid, and, fall in sediment of salts of phosphorus, calcium. Stagnation of saliva can promote to it. Before the change of pH name-plate the vital functions of microorganisms are drawn also. By a mineral spring there is a mouth liquid a super gingival tartar, and sub gingival — gingival. Mіneralіzatіon of name-plate consists in binding by the proteins -polysugars complexes of name-plate of salts of calcium. The concentration of calcium in a mineralized name-plate can in 10 times exceed its maintenance in saliva. Education a tartar depends on character of meal: a soft meal accelerates this process and the hard brakes him.

Mіneralіzation of name-plate begins on its surface which she is fastened to the tooth from matrix, and then takes microorganisms. As a rule, a dental stone is covered no mineralized name-plates. Education a stone lasts to the size, to characteristic for every individual.

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Super gingival tartar takes place above the gingival edge of mucus shell, densely adjoining to the surface of tooth. He shows by itself hard or clay similar formation of rather yellow-white color. The color of stone can change under act of dyes which are in food products. More frequent in all he is localized on the tongue surface of lower frontal teeth and on the surfaces of cheeks of lateral teeth which are placed opposite the conclusion channel of parotid of salivary gland.

Sub gingival it follows to examine a dental stone as a result of inflammatory process in regional paradontіum, caused more frequent in all a name-plate, because in connection with inflammation in tooth-gingival sulcus the amount of gingival liquid grows with the greater concentration of mineral salts. Sub gingival tartar is localized in gingival sulcus that under the edge of mucus ash and adjoins to the surface of tooth more densely than super gingival. Consistency of him is also denser, color — from rifle-green to the umber. Finding out a sub gingival tartar is possible only by sounding of tooth-gingival connection. This type of mineralized dental deposits meets for children considerably rarer than super gingival. The last appears for children (35—70%), as a rule, not early than 9—10-years-old age.

A dental tartar contains to 90% inorganic components as crystals of salts of calcium (phosphate, carbonate), magnesium and row of other microelements. Organic part of the tartar are carbohydrates, proteins, fats of microorganisms, leucocytes, cast – off epithelium. In a sub gingival tartar found out salivary squirrel, and correlation of calcium and phosphorus considerably higher than in super gingival.

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TOOTH-PASTES

Now different tooth-pastes are the most widespread mean for the care of cavity of mouth.

They are folded usually

– abrasive filler

– linking component

– superficially-active matters

– antiseptic – preservative.

Component parts

Components

Abrasive filler

Chalk (carbonate of calcium), aeroseel, silikgel, alumogel,alumosilikat, 2 calcium – phosphate, 3 calcium – phosphate,pirophosphate calcium, insoluble metaphosphate sodium,kaolin, synthetic resins, polymeric connections ofmetilmetacrylat

Moistening

Glycerin, polyethilenglikol, sorbitol

Gel formative linking

matter

Sodium of karboksilmethiltseluloza, oksiethiltselyuloza,koragenat, alginat of sodium

Antiseptic, preservative

Benzoat of sodium, tetraborat sodium, boric acid, nipagin,nipazol, paraformal’degid, ethers of laraoksibenzoil acid, chlorgeksidin, triklozan, propilparaben

Suds formative matters

Laurilsulfat of sodium

Matters which improve qualities of tastes

Xilіt, xilitan, sorbіt, saccharin

Aromatizator

Essential oils to crumple and other sharply smelling plants; synthetic aromatizators

Dye

Tartrazin, rodamin, cosmetic dark blue

Water

Biologically active matters which influence on mіneralіzatіon of fabrics of tooth

Fluorides, separate microelements and polymineral complexes, extracts of medical plants, enzymes, separate vitamins and their complexes

Abrasives fillers

Setting of matters of abrasives consists in cleaning, polishing of surface of tooth and in providing of viscidity to pasture. Pastes have cleansing ability higher with a high abrasive, polishing — with low. It was also set that the matters of abrasives can react with inorganic connections of enamel of tooth.

In more early standards of tooth-pastes connections of calcium were used in this quality. By a classic abrasive a chalk was chemically besieged.

A chalk (carbonate of calcium) is presently used rarely, as this abrasive is badly combined with medical additions and owns a large wearing away action. Modern tooth-pastes on chalky basis (Perlі, Phosphodent,Ftorodent, Extra) contain a high-quality chalk with low maintenance of oxides of aluminium and iron.

Silicic connections as systems of abrasives of tooth-pastes began to be used from the end of 70th, that at the beginning of development of silicic technology. Dioxide of silicon is well consonant with connections of fluorine and other active components, owns the controlled abrasive, that allows create to pasture with the wide range of the set properties. He also provides optimum pH — 7, due to which to pasture on the basis of dioxide of silicoormalize acid – alkaline balance. Dioxide of silicon (SiO₂xH₂O) is more frequent used in an amount 15—25 % on weight.

Presently there is a wide enough assortment of the so-called without abrasives facilities — gel similar of transparent tooth-pastes, got on the basis of connections of oxide of silicon, treated the special method. Gel similarto pasture own high suds formative ability, have a pleasant taste and attractive original appearance. In addition, due to formation of underlying structures of waters, gel allows to plug in his composition chemically incompatible matters, as a water shell hinders a chemical reaction between them. At immaturity or promoted abrasion of hard fabrics of teeth the low abrasive of gel similar pastes does them the best.

Except for these matters paste can contain also and medical – prophylactic additions (provitamins and vitamins, extracts and extracts of different medical plants, salt, microelements, enzymes and other matters).

Linking gel similar agents

Used for the receipt of homogeneous past similar consistency of tooth-paste. They can be natural and synthetic.

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Moistening

Provide a moisture retaining effect. Polyatomic alcohols are glycerin (15—25 % on weight), polyethilenglikol — used in composition tooth-pastes for the receipt of plastic mass: these connections are instrumental in saving, retaining of moisture in paste at its storage, promote the temperature of its freezing, multiply stability of suds which appears at cleaning of teeth, improve qualities of tastes to pasture. For retaining of moisturesorbitol is often used.

Other constituents of tooth-paste

As taste addition is often used 0,1 % to the saccharin. The sweetness of saccharin in 400—500 times exceeds the sweetness of sugar. Sodium salt of saccharin is used quite often.

Sorbіt turns out at proceeding in fructose. His sweetness in 2 times less, than sweetness of sugar.

Xilіt is a product of metabolism in an organism. Contained in plants, fruit (strawberries), vegetables (to the bow, carrot). Does not assimilate most types of microorganisms. Products with xilіt are not added microbiological decomposition. The sweetness of xilіt in 2 times exceeds the sweetness of sugar. Owns pleasant taste and creates the cool feeling in a company. Stimulates making of saliva, what instrumental inremineralization of enamel.

The role of aromas is carried out by mint butter, eucalyptus, mentol, lemon butter (not more than 1,5 %).

Active agents of tooth-pastes

More frequent in all the matters of the followings groups enter in the complement of tooth-pastes:

– fluorides

– connections of calcium

– phosphates

– complexes mіcro- and makroelements

– antiinflammation agents

– styptic agents

– biologically active matters

– enzymes

– antimicrobial agents

– mineral salts

– inhibitors of crystallization

– connections which reduce the sensitiveness of hard fabrics of teeth.

Fluorides

A fluorine is one of basic operating matters, the mechanisms of influencing of which are related to diminishing of solubility of minerals of enamel, inhibition of formation of acids the bacteria of dental raid and participating in the processes of remineralization. Even the small concentrations of fluorine reduce the degree of demineralization enamel considerably, and that is why the frequent repeated use of preparations with the low concentration of fluorine is one of the most effective facilities of prophylaxis of caries.
A table of contents of fluorine in tooth-pastes, intended for the use children, must be not less 0,1% ions of fluorine that a considerable anticarious effect was attained. On the bristle of tooth brush part is squeezed out from a tube to pasture, on volume proper the size of pea. Paste is spread for the surfaces of teeth before the beginning of their cleaning. During cleaning of teeth paste aim not spitting and after cleaning during one minute teeth are rinsed paste which remained in a company, and two-bit of water.
After cleaning of teeth it is not recommended to rinse the cavity of mouth and also it follows during one hour to avoid adopting a meal and drink.
Thus concentration of fluorine in saliva and in interdental intervals remains on possibility high that reduces the increase of proksimal caries in same queue. It follows to consider multiplying an amount the lack of this technique to pasture, that swallow.

Triklozan

Triklozan creates the antimicrobial influencing in a wide spectrum. He is already a long ago used in different cleansers as addition. The most frequent concentration of triklozan in tooth-pastes is 0%. Triklozan multiplies permeability of shells of bacterial cages, that in same queue results in the exit of cytoplasm from a cage and its death. In the low concentrations of triklozan do inhibition synthesis of protein and metabolism of glucose ofbacteria.
Triklozan owns a antiinflammation action also. In researches, conducted on a present tense, it was not marked considerable effects of sides of triklozan.

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All tooth-pastes must satisfy such requirements.

– to be characteristics (to clear ability the surface of teeth from a soft dental deposit and food tailings) of abrasives, it can be attained due to mechanical, washings or combination those and other properties.

– it is not enough to influence on physiology floraof cavity of mouth.

– during two years after an issue must not contain pathogenic microorganisms and be a nourishing environment for the vital functions of bacteria which will be able to penetrate to pastes in the process of the use.

– not to have sharp and chronic toxicness, irritating actions.
Now perfume – cosmetic industry makes the considerable enough assortment of tooth-pastes which it follows to divide into two large groups. Basic part of industrial production is made by hygienical tooth-pastes, intended for cleaning of teeth and cavity of mouth from tailings of meal and soft deposit. The second group is made by medical – prophylactic tooth-pastes to which as additional components enter useful biologically-active preparations. To pasture these except for a cleansing and refreshing action have favourable enough influence on fabrics of teeth, mucus shell of cavity of mouth, complementing medical measures.

Classification of tooth-pastes.

I. On the method of action

1. Hygienical — intended exceptionally for the delete of dental deposits.

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2. Medical – prophylactic — that take off those or other factors which are instrumental in the origin of diseases of teeth and fabrics of paradontium.

3. Medical are including active components which influence directly on a certain pathological process in the cavity of mouth.

II. For belongings

1. Child (from 1 year to 6)

2. Child – juvenile from 6

3. Juvenile (from 9)

4. Mixed

5. Adult

III. On the degree of suds education

1. Not foamy

2. Poorly foamy

3. Moderately foamy

4. Strongly foamy

IV. On maintenance of elements

1. Without active elements

2. With active elements:

a) fluorine containing

b) calcium containing

c) mixed

d) salts

e) anthiseptic

f) extracts of herbages

V. On maintenance of connections of fluorine

1. Fluorine free

2. Fluorine containing

a) one connection of fluorine

b) different connections of fluorine (is mixed fluorine and calcium containing)

VI . On concentrations

1. With the very low concentration of fluorine

2. With the low concentration of fluorine

3. With a moderate concentration

4. With high

VII. On the actions of abrasives tooth-pastes subdivide into 3 basic a kind:

1. Anti-Plaque: middle degree of abrasive which hinders education
dental deposit.

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2. Type of “Sensitive”: owns very much the low degree of abrasive for an account low dispersion of particles (children and juvenile). Used people with the promoted sensitiveness of teeth.

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3. Type of “Smokers”: high and ever-higher degree of abrasive. Them it is impossible to apply often, no more 1st time per a week. Mainly they are used for professional cleaning of teeth.

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In same queue modern medical– prophylactic tooth-pastes on the orientation of action and on composition it is possible to subdivide into the followings groups:

1. That influence on mіneralіzation of fabrics of tooth contain:

a) connection of fluorine

b) connection of calcium

c) phosphates (in particular hydroxide apatites)

d) complexes macro- and microelements (remodent, egg-shell, complexes of salts).

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2. That influence on fabrics of paradontium and mucus shell of cavity of mouth contain:

a) antiinflammation agents

b) styptic agents,

c) biologically active matters (vitamins, extracts of medical plants)

d) enzymes

e) antiseptics

f) mineral salts.

3. That reduce formation of dental name-plate contain:

a) antiseptics

b) mineral salts

c) enzymes

d) connection of fluorine.

4. That reduce education a tooth a stone contain:

a) inhibitors of crystallization

b) matters of abrasives.

5. That reduce the sensitiveness of hard fabrics of tooth contain:

a) connections to potassium

b) connections of strontium

c) formalin

6. Those, that bleaching contain:

a) inhibitors of crystallization

b) matters of abrasives

c) peroxides connections.

All bleaching tooth-pastes can be divided into two groups:

– to pasture, that chemical matters contain bleaching, for example, of peroxides connection, acids or enzymes.

– to pasture, that provide the high-quality delete of superficial dyes and polishing an effect due to the increase of abrasive. To pasture these does not operate at a good hygiene. That, if there is not a raid on teeth, and a dark color is a color of enamel, abrasive paste will not help. To pasture such good for smokers, for example.

Who suffers the disease of paradontium, pasturing such is better not to apply. They also contra-indicated persons with a hypersensitiveness and pathological abrasion.

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On the method of application medical – prophylactic tooth-pastes can be subdivided on:

1. To pasture for the daily cleaning of teeth.

2. To pasture and gels for valid for one occasion application in the certain intervals of time.

3. Gels are for appliques or easy embrocation after cleaning of teeth.

Children’s tooth-pastes

From adults they differ the less concentration of active components, low abrasive and also taste. Unlike adults which give advantage mint taste, for children he causes vomit reflex often. That is why in tooth-pastes of children’s more frequent use neutral or fruit aromatizators. Tooth-pastes of children’s are subdivided into two groups: for children to 6, which the concentration of fluorides is reduced in; and for children from 6 to 12-14, in which the concentration of fluorid is close to adult tooth-paste and an abrasive is saved reduced.

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Tooth-pastes with soda

It is the special group of pastes they contain a food soda (from 7 to 10%). Its properties: promotes clearing property to pasture, being not an abrasive; creates a weak alkaline environment in the cavity of mouth approximately on 20 minutes after cleaning of teeth; antiseptic action; creates a hypertensive environment, as a result takes off an edema from gums (well during pregnancy, in complex therapy of paradontitis); causes death of microbes, accountable for the origin of caries.

For associative perception between taste and color, there are the followings conformities to the law:

a) green color – moderately mentol;

b) the brilliant is saturated dark blue – as a mint;

c) navy blue mat – as salt;

d) green dark – as vegetable;

e) orange-gold – as calendulas;

f) rose – as strawberry;

g) red – raspberry – as a raspberry and etc

Optimum, if you will choose paste on a reception for dentistry. It is possible to lick this problem, remembering that cheap pastes from unknown producers not so good, as firms. Tooth-pastes it follows to be on duty. Yes, at propensity to the caries and paradontitis it follows to apply anticarious paste in the morning, and in the evening – antiinflammation. It is important here to observe the correct technique of cleaning of teeth.

All measures on the prophylaxis of caries of teeth it is possible to divide into state, social, medical, hygienical and educating. The system of state preventives includes measures on the health protection mother and child, guard of environment. Realization of the state system of measures of health protection population is directed foremost on the antenatal prophylaxis of diseases, on forming and development of healthy child, on support of health of the grown man is basis of prophylactic direction of health protection in our country.

The system of social measures on the prophylaxis of caries is related to providing of healthy way of life is observance of the rational mode of labor, rest, scientifically grounded norms of feed, personal hygiene.

To the hygienical measures hygienical education of population from the questions of dentistry, control after the state of environment and feed, belong on the prophylaxis of caries. By introduction of hygienical measures (fluorination of drinking-water, control after high-quality and quantitative composition of meal and water) the necessity of children and adults is provided in the valuable factors of health of organism and organs of cavity of mouth.

Educating measures on the prophylaxis of caries of teeth are taken to diffusing learning about the healthy way of life, inoculating of skills of care of organs of cavity of mouth and support them in the healthy state. These tasks are decided by doctors, middle medical personnel teachers and parents.

Medical measures on the prophylaxis of caries of teeth are directed for development and introduction etiologic and the nosotropic grounded facilities and methods of influence on an organism and organs of cavity of mouth for the increase of their firmness to the caries, and also on the decline of cariogenicity of unfavorable factors of environment on the cavity of mouth.

It follows to begin the prophylaxis of teeth decay in a period forming of organic matrix of the temporal and second teeth, their mіneralіzation and continue after teething to the complete ripening of enamel.

PROPHYLAXIS OF CARIES OF TEETH

Without medical prophylaxis of caries of teeth

Rational feed.

The process of forming and mіneralіzation of teeth begins in the embryo period of life of child and proceeds after its birth that is why for forming of teeth resistance to the caries there is important the high-quality feed of expectant mother and child.

The necessity of pregnant makes: to the 1,5 g calcium, 2,5 g phosphorus, 3 mg fluorine, 2,5 mg vitamin of B 5000—10000 МО of vitamin D, on days. The necessity of consumption of these matters especially grows during the second half of pregnancy. In this period and in a period feeding of child a woman must use milk products — curd (no less as 200 g on a day), kefir, sour milk thick. Oligoelementss are contained in a beet, cabbage, nuts, oarweed, meat of rabbit, saltwater fish.

During all pregnancy the organism of woman needs the doubled amount of vitamins. The vitamin of C is especially important, vitamins of group B, A, D, E. Vitamin D takes part in formation of bone skeleton, regulating acalcium and phosphoric exchange, activity of ductless glands. At insufficiency of him a mineral exchange is violated in an organism, the amount of calcium and phosphorus diminishes in bone fabric, teeth cut throughlately, put must propensity to the caries. Day’s necessity of pregnant in the vitamin D is 500,0 МО. Vitamin A assists to correct development of bone fabric, provides normal activity of organ of sight, promotes firmness in relation to the diseases of mucus shells. Day’s dose of vitamin A — 2 mg.

For the children of 1st life milk of mother is an ideal product. It contains in optimum amounts and correlations biologically valuable albumens, fats, carbonhydratess, vitamins, mineral matters, hormones, immune bodies, enzymes antimicrobial and

bifidogenous factors.

A necessity in salts of calcium grows as far as growth and development of organism of child, vitamins, albumens, fluorine, which can be satisfied by the increase in the ration of milk products, green-stuffs, fruit.

Strengthening of somatic health.

It is assumed that under act of commons diseases the terms of forming and ripening of hard fabrics of tooth change in the first turn of enamel which does them less proof in relation to influencing of cariogenic factors.

At the children of different age, burdened by the carried or concomitant diseases of internalss caries of teeth develops especially often. Thus a process is characterized by sharp motion. Practically the defeats of any organs and systems of child’s organism are extrapolated on hard fabrics of teeth. That is why it is needed with the purpose of prophylaxis of dental diseases, on possibility, to treat be – what somatic pathology.

Intensive mastication.

The large value in a prophylaxis has active mastication, valuable loading on a maxillufacial area. It is expedient to promote physiology activity of organs and fabrics of cavity of mouth, especially at children, by multiplying a number and varieties of natural irritants, which at the permanent use of the treated meal becomes all less. The amount of children which are characterized by untrained of masseters through protracted their underloading under act of the developed “lazinesses of mastication”. As a result putting such is renounced hard meal, is chewed languidly and slowly. Such children cost to recommend the use of products without previous culinary treatment (raw green-stuffs, fruit).

Medical prophylaxis

A medicinal prophylaxis is divided into general (endogenous) and local (exogenous). The endogenous in the turn is specific and heterospecific. At a specific prophylaxis preparations of fluorine are used and at heterospecific are vitamins, calcium containing preparations, roborants. The local consists in introduction to the cavity of mouth or directly on the surface of tooth of preparations of fluorine or remineralization solutions.

Preparations of fluorine now are basic facilities of prophylaxis of teeth decay. The mechanism of protective action of fluorine on enamel consists in the assistance to the delay of phosphoric-calcium connections in an organism and processes of remіneralіzation of hard fabrics of tooth and also braking of activity of bacterial enzymes in the cavity of mouth and dental deposit.

Modern information show that the favourable action of fluorine is predefined by a few mechanisms:

1. Fluorine, uniting from a hydroxide apatites enamel, substituting for ОН – groups, forms a fluorapatites, doing an enamel more strong and more proof to the action of acids. This connection reduces permeability of enamel.

2. The mechanism of anticarious action of fluorides is related also to their oppressive influence on growth and exchange of matters of microflora of cavity of mouth.

3. Connections of fluorine in saliva inhibit the transport of glucose in the cages of pathogenic bacteria and formations of for cellular polysaccharidess, which form the matrix of dental deposit.

4. Fluorides violates absorption of microorganisms on-the-spot cages of tooth, absorb albumins of saliva, glycoproteins, as a result of what prevent growth of dental name-plate.

5. And finally, at internal introduction the fluorides normalize an albuminous and mineral exchange.

Fluorides present in enamel and in the dental deposit catalysis «proceeding» in the early carious defeats due to remіneralіzation of crystals of enamel, multiplies the size of crystals of hydroxide apatites.

From modern international data days’ even receipts of fluorides are distributed thus:

– very low = 0,1-0,6 milligrams;

– low =0,7-1,4 milligram;

– optimum = 1,5-4,0 milligrams;

– high (impertinent fluorosis) = 5-12 milligrams;

– ever-higher = 20 milligrams and more (at treatment of osteoporosis of bones by fluorines preparations).

The amount of fluorine in an organism depends on his maintenance in water and food products.

ENDOGENOUS PROPHYLAXIS

A specific endogenous prophylaxis provides for:

1. Fluorination of drinking-water

2. Fluorination milk

3. Fluorination salts

4. Adopting the pills of fluorides of sodium

FLUORINATION OF WATER

One of the acknowledged methods of prophylaxis of caries there is fluorination of drinking-water is controlled addition of connections to the fluorine to water of sources of water-supply with the purpose of leading to the concentration of ions of fluorine in a drinking-water to the level, which is sufficient for the effective prophylaxis of teeth decay and at the same time does not have an unfavorable influence on functional possibilities of organism of man, physical development and health of population.

First artificial enriching of tap water by fluorine it is carried out in 1945 and since got distribution more than in 35 countries in which over 150 million persons now use fluorination water.

For artificial fluorination to water add the followings connections to the fluorine: fluoride of sodium. This process is carried out to the step waterworks. It is rotined that for achieving maximal efficiency fluorination water, it follows to consume from birth, but some researches rotined efficiency of this method of prophylaxis and at patients which got the optimum concentrations of fluorides upon termination of odontosis.

Presently about 5% all population of earth (approximately 260 million persons) drink fluorination water. In spite of numerous objections of opponents of fluorination, the presence of undesirable effects is not well-proven, and although every objection must be explored, safety of fluorination of water can be considered set.

The optimum concentration of fluorine in a drinking-water is 1,0 mg/l. Expedience of fluorination of water in every case is set by the organs of sanitary-epidemiology service. To fluorination of water low KF” is a testimony in water and considerable staggered of population by the caries of teeth. In theory at any KF”, less than optimum, it is expedient fluorination water, but practically in the first turn it needs to be done on those plumbings in which water contains less after 0,3…0,5 mg/l to the fluorine.

Fluorination of water remains the advantageous and cheap method of prophylaxis. Most influencing of fluorination water shows up on smooth surfaces, in more small degrees on proximal, cheeks and figures. For frontal teeth, influencing of fluorinating water shows up in more small degrees that for masticatory.

Fluorination of drinking-water allows get reduction of increase of baby teeth permanent decay on 40-50% — on 50-60%.

Efficiency of fluorination is estimated by the dynamic supervision during 10—15 years after morbidity by the teeth caries of population which uses fluorinating water. It is possible also to compare findings to the indexes of morbidity by the caries of population of neighbouring settlement which uses water with small maintenance of fluorine (more small after 0,2 mg/l). For the estimation of anticarious action of fluorine use two indexes: prevalence of caries and his intensity (CSR and cs). About satisfactory efficiency it is possible to talk in that case, when in 7—8 years after the beginning of fluorination of water the index of CSR of children 7—8 years went down on 40—50%, about good — on 50—60%, about excellent — on 65—80%.

FLUORINATION OF MILK

The use of fluorinating milk is the alternative and effective method of prophylaxis.

Milk a long ago brings over to itself attention of researchers on a number of reasons, so as:

– it is the necessary component of feed of child, especially in the first years of life;

– owns valuable nourishing properties necessary for child’s organism;

– it is the basic source of calcium and phosphorus, fabrics of bones and teeth necessary for the structure;

– contains the high level of calcium, phosphorus and lactose which laminates carbonhydratess also.

Similar composition allows to milk to bring in the payment in the process of remіneralіzation of enamel of teeth and in its defence.

For successful introduction of method of fluorination of milk certain terms are needed:

– high dental morbidity of population is in a region;

– low maintenance of fluorides is in a drinking-water;

– absence of other sources of system receipt of fluorides.

Except for it, at introduction of similar project striving to is the necessary mortgage of success collaborate from the side of regional administration and organs of health protection, as necessary refinancing for the production and organizational measures at the division and delivery of milk in the organized collectives.

For fluorination of milk more frequent fluoride of sodium is used. The table of contents of fluoride in milk concernes for help fluoride of selective electrode. Technology of fluorination of milk is simple and does not present difficulties.

The amount of fluoride, which must be added to milk, is guilty to take into account age of child and receipt of fluoride from other products and water. Yes, coming recommendations of WOHP from, for children from 3 to 7 years day’s receipt of fluoride makes 0,87-1,75 milligrams.

For the children of preschool age the concentration of fluoride in milk, even 2,5 mg/l, is optimum, as 1,0-1,15 milligrams of fluoride provide the daily total receipt in days.

At the use of fluorinating milk it is necessary to adhere to the followings recommendations:

– effectively to use this method at children from 3 to 12 years

– daily a child must use a 1 glass of milk from 0,5 mg of fluoride

– during a year a child must drink milk not less 250 days.

ADOPTING PILLS OF FLUORIDE OF SODIUM

The doses of fluoride of sodium are recommended in pills

AGE

AMOUNT OF PILLS ON DAYS

FLUORINE, MG

2-4

0,5

0,25

5-6

0,5

7-14

Pills are effective during development and ripening of teeth. Using it is needed 200-250 days in a year from 2 to 15 years. In this case effect from their use it is possible to compare to influencing of fluorinating water. It is the best to accept in the morning and chew pills. It is thus provided as general so local effect of fluorine. Adopting the pills of fluorine it is possible to be on duty with adopting the drops of Vitaftorum.

Pills are appointed daily to 14-15-years-old age. Contra-indication to setting of pills:

– table of contents of fluorine in an environment more than 50% from optimum;

– any another ways of adopting a fluorine inward.

By major advantage of adopting the pills of fluoride of sodium inward there is «flexibility» of method at the prophylaxis of teeth caries, that allows to bring a fluorine exactly into those periods, when this more expedient in all, and also exactly to measure out a microelement taking into account age and features of organism. However much this way has failings: difficulty of organization of adopting pills, and, in addition, he appeared more dearst than other methods of bringing fluorine are into an organism.

Experience of the use of pills of fluorides of sodium rotined that only high responsibility of parents, pills constantly tracker after the regular reception by children, can provide a high enough prophylactic effect.

Vitaftorum (Vitaftorum) is the combined fluorine containing preparation. Contains in the composition of fluoride of sodium, vitamins A,D,C.

Pharmacological properties of Vitaftorum are conditioned by combination in him of vitamins A also D₂ with a fluorine which favourably influences on the maintainance and forming of fabrics of teeth. Vitamin A assists to the normal odontogeny and correct forming of skeleton. Vitamin D regulates the exchange of phosphorus and calcium in an organism, is instrumental in suction them in an intestine and timely laying in a new formed bone.A fluorine finds out the anticarious action, is well sucked in, accumulates in bones, in teeth, by a less measure — in cartilages. Vitamin C limits the deposit of fluorine in fabrics and the same prevents intoxication by fluorine.

It is used under time or after-meal during a month inward with an interval in 2-4 weeks each 3 months in locality, where maintenance of fluorine in a drinking-water is minimum. To the children from 1 year to 6 years preparation is appointed for ? of tea-spoon 1 time per a day; from 7 to 14 years — for 1 tea-spoon 1 time per a day during a month. After a 2-a week interruption a course is repeated. In a year 4-6 courses of prophylaxis are conducted with an interruption on summer months.

Not specific endogenous prophylaxis provides for:

1. The reception of the calcium of containing preparations

2. The reception of vitamins

3. The reception of roborants.

CALCIUM CONTAINING PREPARATIONS

Calcemin is adopted on a chart, depending on age of child. It is recommended to the use to pregnant, women in the period of lactation, to the children from 5 to 12 years of 1 pill 1 time per a day, after 12 years -1 pill on a day.

Calcium D₃ Nicomed – is accepted for 1 pill 2 times per a day in the second half of day – 10 days; 20 days – for 1 pill in a day in the evening. On the average course of treatment by preparations of calcium of makes 1month.

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In a mouth liquid the use of preparation of CALCINOVA which contains a calcium and phosphates necessary for mіneralіzation of bones and teeth, and also complex of vitamins, including the vitamin of D₃, which is instrumental in absorption of these minerals in the organs of digestion and their division in the organs of digestion, is the alternative method of increase of maintenance of calcium and phosphorus. Preparation contains a calcium, phosphorus, vitamins A, D, B₆, C. In connection with that pills it is needed well to chew, in a mouth liquid the considerable increase passes the concentrations of minerals, which promote mіneralіzation and remіneralіzation of teeth.

VITAMINS PREPARATIONS

Videcholum is preparation of vitamin of D₃. It is appointed 1 time per a year in a winter period.

Vitrum – calcium – for children after 12 years for 1 pill in a day during 1-2 months; to the adults – 1-2 pills in days 3-6 months.

ROBORANTS (ADAPTOGENS)

Adaptogens are preparations, mainly vegetable origin, what have general stimulant operating on the basic functions of the system and promote resistance of body to the unfavorable actions.

Ascorbic acid – from 7 to 13 years – for 250 milligrams, from 14 to 17 years – for 750 milligrams of ? 1 time per a day during three days, 1 time on year.

Vitamin Е- to pregnant on 7-10 and 30-32 weeks pregnancies – on a 1 capsule (0,1) or on a 1 tea-spoon 2 times per a day, during 2-3 weeks.

EXOGENOUS PROPHYLAXIS

It follows to take to facilities of exogenous prophylaxis:

– fluorine containing facilities for local application

– remineralization solutions

– encapsulants

FLUORINE CONTANING FACILITIES

At the use of fluorine it is needed to take into account the following:

1. The concentration of fluorides not must exceed for a local prophylaxis
1-2% (calculating on a fluorine), as with the increase of concentration efficiency does not grow.

2. Efficiency of influencing is conditioned by their concentration in the free ionized kind.

3. It is necessary to take into account in this connection fastening possibility fluoride ions with the ions of calcium.

4. Fluorides is appointed taking into account maintenance of fluorine in a drinking-water and climatic factors.

Tooth-pastes

Presently became obviously, that the decline of morbidity by caries is explained to the wide uses of fluorine containing of tooth-pastes.

Pastes are given recommended to the use from 3-4 years. Cleaning is necessary 2 times per a day for 3 minutes, consistently clearing all surfaces of tooth.

Fluorine containing varnishes

One of widespread facilities of local prophylaxis there are varnishes which use for the prolonged period of influencing of fluoride on enamel. They form tape adjoining to the enamel, and which remains on teeth during a few hours and in fissures a few days and even weeks.

A fluorine – varnish shows itself composition of natural resins of vegetable origin. At the market presented: „Ftorlac” (Kharkiv), varnish „Duraphat”, „Belac” (Vladmiva).

A method is given recommended at the moderate or high level of intensity of caries of teeth, to the children and young people with the high risk of origin of caries. Frequency of causing of varnish is 2-4 times per a year, depending on activity of caries.

BELAK – F

Method: the surface of teeth is purged from the deposit and is dried out. Then by the special brush varnish is inflicted by a skim on the surface of tooth. At the same time it is possible to cover all teeth on one jaw or 3-5 teeth. For getting dry of varnish it is needed about 2-3 minutes. It is possible to dry the varnish by the compressed air. After coverage of teeth by fluorine varnish it is impossible to use the meal of 1-3 hours and in future the desired only spoon-meat. It is not recommended to clean teeth 24 hours. Varnish is contained on-the-spot tooth not less 12 hours and for this time his ions penetrate on a depth to 100 mcm of healthy enamel.

To cover teeth by varnish it follows depending on activity of cariosity: at a 1 degree — 2 times per a year, at 2 — 4 times per a year, at 3 — from 6 to 12 times per a year. Triple coverage of teeth is recommended with an interval 1-2 days.

It is set that in a year after application of fluorine containing varnish second caries of teeth goes down on the average on 50%.

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Fluorine containing gels and solutions for the professional use

Gels and solutions of fluoride of sodium 1% and 2% are used for appliques and electrophoresis. A doctor-dentist conducts procedure in the conditions of policlinic. Remineralization action of gels is based on diffusion of matters from gel in saliva and from her in the enamel of tooth.

BELAGEL – F

Method: teeth preliminary clear, dry out and impose the wadding tampon well moistened by solution of fluoride of sodium on 3- 5 minutes. At first assess the masticatory surfaces of teeth, and then – labial and cheeks on both jaws. If gel is used, he is inflicted by heated by a brush and give to dry out. After procedure does not recommend eat and drink during 2 hours.

As a rule conduct 3-5 appliques by solution twice on a year and 2-6 appliques by gel on a year.

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Causing of fluorides by a spoon:

1. To choose the spoon of the proper size

It must be the covered is all dental row, including the areas of retraction and it follows to provide access of gel to the contact with the structure of teeth. The ends of spoon (peripheral areas) must be closed in order that gel did not flow down in the cavity of mouth sick. Ideally spoons befit with coverage from the made foam material, as they fit snugly dental row of patient and allow to gel to achieve all surfaces

2. To place gel in a stretcher.

3. To insert a spoon in the mouth of patient.

4. To insert between the spoons of saliva ejector, making sure, that to the patient comfortably (at this method for balance of bite from opposite sides necessary wadding rollers)

5. To bring a spoon out of mouth sick.

6. To ask a patient to spit out immediately after the delete of spoon.

After procedure, at a necessity the delete of superfluous fluoride, to apply the intensive sucking

7. To warn a patient that during 30 minutes after procedure it is impossible to eat or drink

Fluorine containing solutions for the independent use

The wide use in the prophylaxis of caries was found by solutions with the low concentrations of fluoride.

The rinses begin to use, when the first second teeth cut through at children. The method of prophylaxis is given does not need considerable expenses of time and financial resources, and that time is effective enough.

Amount of rinses makes:

– by a 0,05% solution -1 once on a day

– by a 0,1% solution -1 once in a week

– by a 0,2% solution – 1 one time in two weeks

For the improvement of co-operation of fluorine with an enamel preliminary it follows well to clean teeth and rinse a mouth by alkaline water for the change of рН environment. In addition it is necessary to teach a child to rinse a mouth by ordinary water by energetic motions by cheeks.

Method: depending on age of child give to rinse the mouth of 5-10 ml solution. The rinse lasts 1-3 minutes, and for the children of junior age more expedient double rinse on 1 minute. After it a mouth is rinsed by clean water.

Application by the children of rinses by solution of fluorine sodium gives reduction to the caries 30%, upon termination of rinses an effect lasts yet in 2-3.

At casual swallowing of fluoride of sodium it is necessary to give to the child to take an a swig at the soupspoon of solution of chloride of calcium, which, linking a fluorine will not give him to be sucked in.

Application of fluorine containing disks

Fluorine containing disks (paper and paraffins) are produced in packing for 10 things. The expense of material is a 1 disk on procedure. The disk of «Ftorglicofoskal’» contains the followings ingredients:

– neurosin — 8-16 g

– fluoride of sodium — 0,5-2 g

– superficial matters — 0,5-2,0 g

– beeswax — 4,5-6,5 g

– paraffin.

A disk is fixed in an angular tip by a mandrel. A fluorine is rubbed in hard fabrics of tooth on minimum speed with the use of three types of motions: recurrently-forward, up-down, circles.

As usual, before treatment by fluorine containing disks the professional hygiene of cavity of mouth is conducted, whereupon by disks at first the vestibular surfaces of all teeth of maxilla are processed from left to right, then lower — from right to left. After it the palatal surfaces of teeth of maxilla and languages surfaces of teeth of lower jaw are processed, farther are masticatory surfaces of teeth of overhead and lower jaws with the use of only circular motions clockwise. At a variable bite process by fluorine containing disk only the second teeth. It is recommended 2-3 multiple treatment of teeth with an interval 1-2 days, in a year 2-4 courses.

In practice of therapeutic dentistry fluorine containing disks found large popularity not only at the prophylaxis of teeth decay but also at treatment of hyperesthesia of hard fabrics of teeth.

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Remineralization solutions

At application of remineralization matters it is expedient to heat them to 40-45⁰C, taking into account that the increase of temperature of solution on 10 strengthens precipitation of ions on-the-spot enamel on 1 %.

Choosing the concentration of remineralization solution, it should be remembered that the high concentration of calcium conduces only to mіneralіzation of superficial layer of enamel, while the low concentrated solutions are instrumental in remineralization on all depth of enamel.

In behalf of the combined application of remineralization solutions and solutions of fluorine the fact of assistance of ions to the fluorine testifies to the acceleration of plugging in the net of enamel of calcium and phosphorus.

Borovskij’s – Leus’s method

Teeth carefully purge from the dental raid by ordinary pastes, dry out.

Consistently conduct appliques by a 10% solution of glucoside of calcium during 15 minutes(3 times for 5 minutes) and 2% by water solution of fluoride of sodium during 3 minutes. Duration of course on the average 10-15 procedures every day or in a day.

Borovskij’s – Leus’s method

(with electrophoresis)

This chart foresees electrophoresis of a 10% solution of glucoside of calcium (3—5 minutes) and applique of a 2% soluble- fluoride of sodium (1—2 minutes) 3 times in a week.

Borovskij’s – Volkov’s method

Two-component solution which consists of a 10% solution of nitrate of calcium and 10% solution of hydrophosphate to the ammonium is used. Prepare teeth and consistently conduct appliques by each of these solutions for 3-5 minutes. Through 5-7 procedures on-the-spot enamel and in mіcro spaces under superficial layer the matter appear which is an ionogen phosphorus and calcium. This method is used for treatment of hyperesthesia.

Udovits’ka’s method

O. Udovits’ka recommends to apply at the children of 2—3 years of applique of a 10% solution of glucoside of calcium (3 minutes) and fluorine varnish 6 times per a week; course — 1 one time in a year during 3 years

Applique by solution „Remodent”

“Remodent” is the preparation synthesized from natural materials consists of complex of ions macro- and micrtoelements necessary for activating of process of remіneralіzation and prophylaxis of caries. Unlike fluorine preparation is instrumental in substituting for the ions of calcium and phosphorus in the crystalline grate of enamel of teeth.

On preliminary cleared (by a tooth brush and tooth-paste) and dried up teeth inflict the wadding tampon saturated by solution of “Remodent” on 15—20 minutes. During this time a tampon is changed twice. After an applique it is not recommended to rinse a mouth and adopt a meal during 2 hours. Next appliques conduct twice for a week after the same method. The course of treatment is 20—30 appliques.

In addition, with the purpose of prophylaxis of teeth decay it is possible to recommend the rinse of mouth by a 3% solution of “Remodent” by duration of 3—4 of minutes (1—2 times per a week) during 10 months on a year. On one rinse goes to 15—25 ml solution.

Vinogradova’s method

Purge teeth by hygienical tooth-paste, appliques dry out and conduct teeth by a 10% solution of glucoside of calcium on 2-4 minutes and mouths baths (washing) by a 0,2% solution of fluoride of sodium on 2-4 minutes. This complex is conducted 3-4 times per a year.

In the over concentrations fluorides is toxic.

Recommendations are on the hygienical care of cavity of mouth of children

Parents must begin the hygienical care of cavity of mouth of child from the moment of eruption of the first temporal tooth (in age 5-6 months).

This procedure needs to be executed 1 time per a day (in the evening before sleep). For the removal of dental deposit from every surface of tooth the special very soft tooth brush is recommended, what dressed on afinger. From gums to the cutting edge clear the teeth of child circular motions without application of tooth-paste.

To the moment of eruption for a child 8th teeth (as a rule, to one year) it is necessary to clear teeth parents already twice in a day (in the morning and in the evening) by soft child’s tooth brush (length of working part must not exceed 1,5 mm), also without application of some tooth-paste. Thus the special attentioeeds to be spared teeth which are in the stage of eruption the masticatory surfaces of which did not yet attain the level of occlusal plane.

Teeth it is recommended to purge thus:

1. To clear vestibular surfaces at serried jaws, here to set a tooth brush horizontally, athwart to the surface of teeth, carrying out only vertical motions in direction from gums to the cutting edge of teeth: on an overhead jaw – from top to bottom, on lower – from below to upwards .

To clear oral surfaces circular motions, here in the area of frontal teeth on an overhead and lower jaw to set a brush apeak.

It follows to delete a raid from the masticatory surfaces of teeth motions ahead-back.

It is recommended to use this technique in the period of eruption of all temporal teeth (to 2-2,5), when cleaning of teeth must become for a child by obligatory part of morning and evening rest room.

In 2-2,5 parents must clean teeth children by soft child’s brush twice on a day (in the morning – to breakfast and in the evening – before sleep) and to use child’s gel tooth-paste.

To prevent tooth decay:

· Brush your teeth at least twice a day with afluoride-containing toothpaste

. Preferably, brush after each meal and especially before going to bed.

· Clean between your teeth daily with dental floss or interdental cleaners, such as the Oral-B Interdental Brush, Reach Stim-U-Dent, or Sulcabrush.

· Eat nutritious and balanced meals and limit snacks. Avoid carbohydrates such as candy, pretzels and chips, which can remain on the tooth surface. If sticky foods are eaten, brush your teeth soon afterwards.

· Check with your dentist about use of supplemental fluoride, which strengthens your teeth.

· Ask your dentist about dental sealants (a plastic protective coating) applied to the chewing surfaces of your back teeth (molars) to protect them from decay.

· Drink fluoridated water. At least a pint of fluoridated water each day is needed to protect children from tooth decay.

· Visit your dentist regularly for professional cleanings and oral exam.

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Caries of deciduous teeth in children. Patterns of clinical manifestations and course. Diagnosis, differential diagnosis.

Caries of permanent teeth in children. Patterns of clinical manifestations and course. Diagnosis, differential diagnosis.