Nagehan Aktaş, Neşe Akal, Yasemin Akın, Azime İlknur Moğulkoç

Çocuklarda tedavi edilmemiş diş çürüklerinin PUFA indeksi ile değerlendirilmesi

Amaç: Diş çürüğü özellikle gelişmekte olan ülkelerde ciddi bir sağlık problemi olarak karşımıza çıkmaya devam etmektedir. Tedavi edilmemiş diş çürüklerinin yol açtığı apse, ülserasyon ve fistül gibi komplikasyonların prevalansını araştıran sınırlı sayıda araştırma bulunmaktadır. Bu çalışmanın amacı, bir grup çocukta tedavi edilmemiş diş çürüklerinin klinik sonuçlarının prevalansının araştırılmasıdır. Gereç ve Yöntem: Çalışma 1-31 Mart 2012 tarihleri arasında Gazi Üniversitesi Diş Hekimliği Fakültesi Pedodonti Anabilim Dalı Kliniğinde yaşları 5-12 arası olan 1200 çocuk üzerinde yürütüldü. Daimi ve süt dişlerinde diş çürükleri DMFT/dmft ve PUFA/pufa indeksleri ile skorlandı (D/d: çürük, M/m: kayıp, F/f: dolgulu diş, P/p: pulpayı içeren çürük lezyonu, U/u: kök parçalarından dolayı mukozanın ülserasyonu, F/f: fistül, A/a: apse). Bulgular: Çocuklarda DMFT indeksi 2.34 ± 1.37 ve dmft indeksi 4.25 ± 3.46 olarak bulundu. Daimi ve süt dişleri için PUFA/pufa prevalansı sırasıyla %2.30 ve %22.25 olarak belirlendi. Hem süt hem daimi dişlerde en yüksek skoru pulpayı içeren diş çürüğü oluşturdu (süt dişlerinde %11.24 ve daimi dişlerde %1.67). Bunu apse ve fistülizasyon izledi. Sonuç: Seçilen popülasyonda tedavi edilmemiş süt dişi çürüklerinin ve yumuşak dokudaki klinik sonuçlarının prevalansı yüksek bulundu. PUFA/pufa indeksi diş çürüklerini değerlendirmek amacıyla var olan çürük indekslerini tamamlayıcı bir epidemiyolojik araç olarak görülmektedir.

Anahtar Kelimeler:

Apse, çocuk, diş çürükleri, DMF indeksleri, fistül

Evaluation of untreated dental caries in children with PUFA index

Objective: Tooth decay continues to come up as a serious health problem particularly in developing countries. Limited number of studies investigated the prevalence of complication of untreated dental caries as abscess, fistula and ulceration. The purpose of the present study was to investigate the prevalence of the clinical consequences of untreated dental caries among a group of children. Materials and Method: The study was conducted on 1200 children with ages between 5-12 years in the Department of Pedodontics, Faculty of Dentistry, GaziUniversity between the dates 1-31 March 2012. Caries in deciduous and permanent teeth were scored using DMFT/dmft and PUFA/pufa indexes (D/d: decayed, M/m: missing, F/f: filled, P/p: carious lesion with pulpal involvement, U/u: ulceration of the mucosa due to root fragments, F/f: fistula, A/a: abscess). Results: DMFT index was 2.34 ± 1.37 and dmft index was 4.25 ± 3.46. The prevalence of PUFA/pufa for permanent and deciduous teeth was 2.30% and 22.25%, respectively. The highest score in both permanent and deciduous teeth was caries lesions with pulpal involvement (%11.24 for deciduous teeth and %1.67 for permanent teeth). This was followed by abscess and fistula formation. Conclusion: The prevalence of clinical consequences of untreated dental caries was high for deciduous teeth in the selected population. The PUFA/pufa index is seen as an epidemiological tool complementary to the existing caries index aimed to assess dental caries.

Keywords:

Abscess, child, dental caries, DMF indexes, fistula,

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Antunes JL, Peres MA, de Campos Mello TR, Waldman EA. Multilevel assessment of determinants of dental caries experience in Brazil. Community Dent Oral Epidemiol 2006;34:146-52.
Martins-Júnior PA, Oliveira M, Marques LS, Ramos-Jorge ML. Untreated dental caries: impact on quality of life of children of low socioeconomic status. Pediatr Dent 2012;34:49-52.
Ashkanank F, Al-Sane M. Knowledge, attitudes and practise of caregivers in relation to oral health of preschool children. Med Princ Pract 2013;22:167-72.
Bönecker M, Abanto J, Tello G, Oliveira LB. Impact of dental caries on preschool children's quality of life: an update. Braz Oral Res 2012;26:103-7.
Gökalp SG, Doğan BG, Tekçiçek MT, Berberoğlu A, Unlüer S. National survey of oral health status of children and adults in Turkey. Community Dent Health 2010;27:12-7.
Filstrup SL, Briskie D, da Fonseca M, Lawrence L, Wandera A, Inglehart MR. Early chilhood caries and quality of life: child and parent perspectives. Pediatr Dent 2003;25:431-40.
Leal SC, Bronkhorst EM, Fan M, Frencken JE. Untreated cavitated dentine lesions: impact on children's quality of life. Caries Res 2012;46:102-6.
Benzian H, Monse B, Heinrich-Weltzien R, Hobdell M. Untreated severe dental decay: a neglected determinant of flow Body Mass Index in 12-year-old Filipino children. BMC Public Health 2011;11:558.
Gradella CM, Bernabé E, Bönecker M, Oliveira LB. Caries prevalence and severity, and quality of life in Brazilian 2- to 4- year-old children. Community Dent Oral Epidemiol 2011;39:498-504.
Baginska J, Stokowska W. Pulpal involvement-roots-sepsis index: a new method for describing the clinical consequences of untreated dental caries. Med Princ Pract 2013;22:555-60.
Bagińska J, Rodakowska E, Wilczyńska-Borawska M, Jamiołkowski J. Index of clinical consequences of untreated dental caries (pufa) in primary dentition of children from north-east Poland. Adv Med Sci 2013;58:442-7.
Leake J, Jozzy S, Uswak G. Severe dental caries, impacts and determinants among children 2-6 years of age in Inuvik Region, Northwest Territories, Canada. J Can Dent Assoc 2008;74:519.
Murthy AK, Pramila M, Ranganath S. Prevalence of clinical consequences of untreated dental caries and its relation to dental fear among 12-15-year-old schoolchildren in Bangalore city, India. Eur Arch Paediatr Dent 2014;15:45-9.
Monse B, Heinrich-Weltzien R, Benzian H, Holmgren C, van Palenstein Helderman W. PUFA-an index of clinical consequences of untreated dental caries. Community Dent Oral Epidemiol 2010;38:77-82.
Usha M, Deepak V, Venkat S, Gargı M. Treatment of severely mutilated incisors: a challenge to the pedodontist. J Indian Soc Pedod Prev Dent 2007;25:34-6.
Slabsinskiene E, Miciuviene S, Narbutaite J, Vasiliauskiene I, Andruskeviciene V, Bendoraitiene EA, et al. Severe early childhood caries and behavioral risk factors among 3-year-old children in Lithuania. Medicina (Kaunas) 2010;46:135-41.
Ferraz NK, Nogueira LC, Pinheiro ML, Marques LS, Ramos-Jorge ML, Ramos-Jorge J. Clinical consequences of untreated dental caries and toothache in preschool children. Pediatr Dent 2014;36:389-92.
Alkarim HA, Watt RG, Pikhart H, Sheiham A, Tsakos G. Dental caries and growth in school-age children. Pediatrics 2014;133:616-23.
Pinkham JR, Casamassimo PS, Fields WH Jr, Mc Tigue DJ, Novak AJ. Pediatric dentistry: infancy through adolescense, 4th. edn. St.Louis, Missouri: Elsevier Saunders; 2005. p. 69-71.
World Health Organization. Oral health surveys: basic methods, 5th edn. Geneva: WHO Press; 2013.
Oziegbe EO, Esan TA. Prevalence and clinical consequences of untreated dental caries using PUFA index in suburban Nigerian school children. Eur Arch Paediatr Dent 2013;14:227-31.
Figueiredo MJ, de Amorim RG, Leal SC, Mulder J, Frencken JE. Prevalence and severity of clinical consequences of untreated dentine carious lesions in children from a deprived area of Brazil. Caries Res 2011;45:435-42.
Mehta A, Bhalla S. Assessing consequences of untreated carious lesions using pufa index among 5-6 years old school children in an urban Indian population. Indian J Dent Res 2014;25:150-3.
Shanbhog R, Godhi BS, Nandlal B, Kumar SS, Raju V, Rashmi S. Clinical consequences of untreated dental caries evaluated using PUFA index in orphanage children from India. J Int Oral Health 2013;5:1-9.
Armfield JM, Stewart JF, Spencer AJ. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health 2007;7:1.