SAİD KARABEKİROĞLU, NİMET ÜNLÜ

Toplum Bazlı Koruyucu Ağız Diş Sağlığı Programlarında Erken Dönem Koruyucu Uygulamaların Yeri ve Önemi

Diş çürükleri birçok ülkede önemli bir halk sağlığı sorunudur. Çürük ağızda klinik olarak görülebilir hale gelmeden uzun süre önce başlayan kronik bir hastalıktır. Bu nedenle çürük çalışmalarının odak noktası diş çürüğünün önlenmesi ve başlangıç çürüklerinin remineralizasyonuna doğru yönelmiştir. Çürüğe sebep olan etkenlerin bilinmesi bu sorunun önüne geçilmesini tam olarak önleyememektedir. Bu derlemenin amacı toplum bazlı koruyucu ağız diş sağlığı programlarında erken dönem koruyucu uygulamaların yeri ve önemini anlatmaktır. Bu makale, tüm çocuklar ve özellikle de diş çürüğü riskinde olan çocuklar için sözlü sağlık sonuçlarını iyileştirmek için tasarlanmış pratik tabanlı koruyucu-önleyici ağız sağlığı programlarını anlamak ve uygulamak için gereken güncel kavramları ve bilimsel kanıtların bir derlemesidir.

The Importance and Role of Early Prevention Practices in Community-Based Preventive Oral Health Programs

Dental caries is a major public health problem in most countries. Caries is a chronic disease starting long before it clinically become visible in mouth. For this purpose, the focus in caries research has recently shifted to prevention of dental caries and remineralization of initial carious lesion. Knowing the causes of it cannot fully prevent it to occur. The aim of this review is to present the importance and role of early prevention practices in community-based preventive oral health programs. This article is a compilation of current concepts and scientific evidence required to understand and implement practice-based preventive oral health programs designed to improve oral health outcomes for all children and especially children at significant risk of dental caries.

PDF

___

1. Fejerskov O. Changing paradigms in concepts on dental caries: consequences for oral health care. Caries Res 2004;38:182-191.
2. Zero D, Fontana M, Lennon AM. Clinical applications and outcomes of using indicators of risk in caries management. J Dent Educ 2001;65:1126- 1132.
3. Saydam G, Oktay İ, Möller, I. Türkiye' de Ağız Diş Sağlığı Durum Analizi. Dünya Sağlık Örgütü Avrupa Bölgesi -Sağlık Bakanlığı, Ankara, 1990.
4. Gökalp S, Güçiz Doğan B. Türkiye Ağız-Diş Sağlığı Profili, 2004. T.C. Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Basımevi, 2006.
5. Çubukçu ÇE. Neden Koruyucu Diş hekimliği? Toplum Hekimliği Bülteni 2003;1: 22-31.
6. Akar Ç. Türkiye'de Ağız-Diş Sağlığı Hizmetlerinin Strateji Değerlendirmesi, Türk Diş Hekimleri Birliği Yayınları, Araştırma Dizisi: 9, Ankara, 2014.
7. Horowitz HS. The water fluoridation and other systemic fluorides. J Dent Res 1990;69:760-4.
8. Küçükeşmen Ç, Sönmez H. Diş hekimliğinde florun, insan vücudu ve dişler üzerindeki etkilerinin değerlendirilmesi. S.D.Ü. Tıp Fak. Derg. 2008:15(3):43-53.
9. Nizel AE. Nutrition in Preventive Dentistry: Science and Practice. Chapter 13: Fluoride metabolism, safety and role in caries. Philadelphia, London, Toronto, W.B. Saunders Company 1972: 194-218.
10. Şahin E. Başlangıç mine lezyonlarının tedavisinde fluorid ilave edilmiş kazein fosfopeptid amorfoz kalsiyum fosfat (CPP-ACP) ile fluoridli süt ve suyun etkinliğinin karşılaştırılması. Doktora Tezi, Ankara Üniv., Sağlık Blimleri Enstitüsü, 2011.
11. Chen MS. Oral health of disadvantaged populations. In: Cohen LK, Gift CH, ed: Disease Prevention and Oral Health Promotion. Copenhagen: Munksgaard, 1995:152-212.
12. Burt BA: Prevention policies in the light of the changed distribution of dental caries. Acta Odontol Scand 1998;56:179-86.
13. DePaola PF, Soparkar M,Van Leeuwen M, DeVelis R: The anticaries effect of single and combined topical fluoride systems in schoolchldren. Arc Oral Biol 1980;25:649-53.
14. Featherstone JD: Caries Prevention and reversal based on the caries balance. Pediatr Dent 2006;28:128-32.
15. Marinho VCC, Higgins JPT, Logan S, Sheiham A: Systematic review of controlled trials on the effectiveness of fluoride gels for the prevention of dental caries in children. J Dent Educ 2003;67:448-58.
16. Ashley PF, Attrill DC, Ellwood RP, Worthington HV, Davies RM. Toothbrushing habits and caries experience. Caries Research 1999;33:401-412.
17. Adair SM. Risks and benefits of flüoride mouthrinsing. Pediatrician 1989;16:161-169
18. James D. Bader, Daniel A. Shugars and Arthur J. Bonito: A systematic review of selected caries prevention and management methods. Community Dent Oral Epidemiol 2001;29: 399-411.
19. Ripa LW: Review of the anticaries effectiveness of professionally applied and self-applied topical fluoride gels. J Public Health Dent 1989;49:297- 309.
20. Ferrazzini G. Prevention in the schools of Massagno, Ticino: Results after 8 years. SSO Schweiz Monatsschr Zahnheilkd 1979;89:147-50.
21. Ercan E, Dülgergil ÇT, Yıldırım I, Dallı M, Arcak R. İç Anadolu Bölgesi Şehir Merkezinde Yaşayan Çocuklarda, Farklı Koruyucu Uygulamaların Çürük Oluşumu Üzerine Etkisinin Değerlendirilmesi: 12 aylık çalışması sonuçları. Ankara Diş hekimleri Odası Klinik Bilimler Dergisi 2008;2:218-223.
22. Dülgergil, ÇT, Soyman M, Civelek A, Ercan E, Ercan M. Güneydoğu Anadolu kırsalında yaşayan çocuklarda değişik koruyucu uygulamaların değerlendirilmesi: 24 aylık saha çalışması sonuçları. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 2006;16:26-32
23. Horowitz HS, Heifetz SB, McClendon BJ, Viegas AR, Guimaraes LOC, Lopez ES: Evalution of selfadministrated prophylaxis and supervised toothbrushing with acidulated phosphate fluoride. Caries Res 1974; 8:39-51.
24. Marinho VC, Higgins JP, Logan S, Sheiham A: Topical fluoride (toothpastes, mouthrinses, gels or varnishes) for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2003, CD002782.
25. Beltran-Aguilar ED, Goldstein JW, Lockwood SA. Fluoride varnishes: A review of their clinical use, cariostatic mechanism, efficacy and safety. J Am Dent Assoc 2000; 131:589-96.
26. Bawden JW. Fluoride varnish: a useful new tool for public health dentistry. J Public Health Dent 1998;58(4), 266-269.
27. Fure S, Lingström P. Evaluation of different fluoride treatments of initial root caries lesions in vivo. Oral Health Prev Dent 2009;7:147-54.
28. van 't Hof MA, et al., The atraumatic restorative treatment (ART) approach for managing dental caries: a meta-analysis. Int Dent J 2006;56(6):345- 51.
29. Roshan NM, Sakeenabi B, Survival of occlusal ART restorations in primary molars placed in school environment and hospital dental setup-one year follow-up study. Med Oral Patol Oral Cir Bucal 2011;16(7): 973-977.
30. Ercan E, et al, A field-trial of two restorative materials used with atraumatic restorative treatment in rural Turkey: 24-month results. J Appl Oral Sci 2009;17(4):307-14.
31. Hatibovic-Kofman S, Koch G. Fluoride release from glass ionomer cement in vivo and in vitro. Swed Dent J 1991;15(6):253-8.
32. Songpaisan Y, Bratthall D, Phantumvanit P, Somridhivej Y. Effects of glass ionomer cement, resin-based pit and fissure sealant and HF applications on occlusal caries in a developing country field trial. Community Dent Oral Epidemiol 1995;23(1):25-9.
33. Wendt LK, Koch G, Birhed D. On the retention and effectiveness of fissure sealant in permanent molars after 15-20 years: a cohort study. Community Dent Oral Epidemiol 2001;29(4):302- 307.
34. Arrow P, Riordan PJ. Retention and caries preventive effects of a GIC and a resin-based fissure sealant. Community Dent Oral Epidemiol 1995;23:282-5.
35. Colak H, Dülgergil CT, Dalli M, Hamidi MM. Early childhood caries update: A review of causes, diagnoses, and treatments. J Nat Sci Biol Med 2013;4(1):29-38.
36. Tinanoff N, Reisine S Update on early childhood caries since the surgeon general's report. Acad Pediatr 2009;9(6):396- 403.
37. Reisine ST, Psoter W. Socioeconomic status and selected behavioral determinants as risk factors for dental caries. J Dent Educ 2001;65(10):1009-1016.
38. Reisine S, Douglass JM. Psychosocial and behavioral issues in early childhood caries. Community Dent Oral Epidemiol 1998;26(1 Suppl):32-44.
39. American Academy Of Pediatric Dentistry. Guideline on management of the developing dentition and occlusion in pediatric dentistry. Pediatr Dent 2012;34:239-251.
40. Yıldırım I, Dülgergil ÇT, Serdaroğlu İ. Aile Hekimliği Uygulamalarında Erken Dönem Koruyucu Diş Hekimliği. Uygulamalarının Önemi. Sağlıkta Performans ve Kalite Dergisi 2010;2(1):21-39.
41. Rozier RG, Sutton BK, Bawden JW, Haupt K, Slade GD, King RS. Prevention of early childhood caries in North Carolina medical practices: implications for research and practice. J Dent Educ 2003;67(8):876-885.
42. Nowak AJ, Casamassimo PS. Using anticipatory guidance to provide early dental intervention. J Am Dent Assoc 1995;126:1156-1163.
43. Savage MF, Lee JY, Kotch JB, Vann WF Jr. Early preventive dental visits: effects on subsequent utilization and costs. Pediatrics 2004;114:418-423.
44. Volpato FC, Jeremias F, Spolidório DMP, Silva SRCd, Valsecki Junior A, Rosell FL. Effects of oral environment stabilization procedures on Streptococcus mutans counts in pregnant women. Brazilian dental journal 2011;22(4):280-284.
45. Gomez S, Weber A. Effectiveness of a caries preventive program in pregnant women and new mothers on their offspring. International Journal of Paediatric Dentistry 2001;11(2):117-22.
46. Güler E, Köprülü H. Preventive measures to reduce the transfer of Streptococcus mutans from pregnant women to their babies. Journal of Dental Sciences 2011;6(1):14-8.
47. Brambilla E, Felloni A, Gagliani M, Malerba A, Garciía-godoy F, Strohmenger L. Caries prevention during pregnancy: results of a 30- month study. The Journal of the American Dental Association 1998;129(7):871-7.
48. Pienıhäkkınen K, Söderlıng E, Ostela I, Leskelä I, Tenovuo J. Comparison of the efficacy of 40% Chlorhexidine varnish and 1% ChlorhexidineFluoride gel in decreasing the level of salivary mutans streptococci. Caries Res 1995;29(1):62-67.
49. Gripp VC, Schlagenhauf U. Prevention of early mutans streptococci transmission in infants by professional tooth cleaning and chlorhexidine varnish treatment of the mother. Caries Res 2002;36(5):366-372.
50. Kohler B, Andréen I. Mutans streptococci and caries prevalence in children after early maternal caries prevention: a follow-up at 19 years of age. Caries Res 2012;46(5):474-480.