GENERAL CHARACTERISTICS OF THE CONDITION OF HARD TISSUES OF TEETH AND ORAL MUCOSA IN CHILDREN AGAINST THE BACKGROUND OF CHEMOTHERAPY

Abstract

Damage to the oral mucosa and hard tissues in children with various systemic diseases, in particular oncological pathology, is one of the most important and at the same time the least studied sections of modern Pediatric Dentistry. In Ukraine, in recent years, there has been a tendency to increase the prevalence of various forms of oncohematological, bone, nervous system, brain and other diseases. One of the leading factors of damage to the oral mucosa is the inability of the child’s body to be exposed to various opportunistic microorganisms, when as a result of changes in their species composition, both general and local nonspecific resistance of the child’s body changes. The purpose of this study. Study of clinical manifestations of dental complications of chemotherapy in childhood on the basis of modern guidelines and reviews. Research materials and methods. For general characterization, a structural analysis of the prevalence of dental disease in children treated with chemotherapy, we examined 98 children with acute lymphoblastic leukemia aged 2 to 18 years. All examined children were treated in the oncohematology department of the Regional Medical Center of Family Health, Dnipro. Among them – 37 girls, which is 37.8% and 61 boys, which corresponds to 62.2%. All examined patients were divided into 3 subgroups depending on the clinical course of acute lymphoblastic leukemia (ALL): 1 subgroup is 46 children (46.9%) with the first acute period of ALL; Subgroup 2 comprised 27 children (27.6%) with ALL in remission and subgroup 3 comprised 25 patients (25.5%) with relapse of ALL. In each subgroup, patients studied the indicators of the state of hard tissues of the teeth, periodontal tissues by means of an index assessment and manifestations on the oral mucosa. Research results. The main complaints in children about changes in the maxillofacial area in all groups of patients with acute lymphoblastic leukemia included: enlargement of the lymph nodes, soreness in the oral cavity, bleeding gums when brushing teeth and eating food, the presence of gum hypertrophy, dry mouth, plaque on the tongue. Children with acute lymphoblastic leukemia complained of impaired taste, bad breath, as well as a feeling of numbness in the area of intact teeth and tongue. Conclusions. Changes in the mucous membrane of the oral cavity are of important diagnostic and prognostic importance, since they can be early manifestations of oncohematological diseases, as well as reflect the course of the pathological process and the effectiveness of the treatment. Timely diagnosis of dental lesions in children with acute leukemia and their comprehensive prevention and treatment is an important component of a multidisciplinary approach to the management of this category of patients and contributes to improving their general condition and quality of life.