Clinical and Laboratory Evaluation of Dental Caries Prevention Efficacy of Permanent Teeth in 6-7 Years Old Children

The purpose of the study is to examine the dental caries prevention efficacy of permanent teeth in 6-7 years old children. Materials and methods. Сaries prevention complex for permanent teeth in 6-7 years old children was developed during the study. It consists of calcium containing tablets “CalciNova” (КRКА, Slovenia). This pills should be taken daily during 2 mouths in the morning and in the evening after meals and tooth brushing. In addition, antihomotoxic drops “Osteobios” (“Gunna”, Italy) for regulation of calcium-phosphate exchange should be taken in the amount of 6 drops diluted in 10-15 ml of water twice a day during one month semiannually. Moreover, the process should be accompanied by somatic diseases treatment and dispensary observation at the pediatrician. Local caries preventive measures included professional hygiene of oral cavity twice a year; fissure sealing in first permanent molars; sanitation of oral cavity and hygienic education of children. With the aim to examine the clinical efficacy of caries prevention complex 2 groups of children were formed. The main group included 40 6-year old children, control group – 30 children of the same age. In control group of children only local caries preventive measures were used, such as professional hygiene of oral cavity, fissure sealing and preventive filing in first permanent molars, operative treatment of caries in temporary teeth, hygienic education of children concerning oral hygiene. Evaluation of caries prevention complex efficacy was being carried out during two years using indices of intensity growth and reduction of dental caries. Structural and functional enamel resistance was examined using TER-test (R. Okushko, 1983). Laboratory assessment included studying the level of total calcium in saliva according to Karkashov and Vivchev method modified by V. Leontiev and V. Smirnova (1990). The level of ionized calcium in saliva was evaluated according to the method of direct ion-selective potentiometry, level of non-organic phosphorus – according to Bolts and Luic method modified by V. Convay (1990). Enzyme activity of alkaline phosphatase was examined with the Anderch method modified by T. Vavilov (1990). Results. After 12 month of caries prevention complex usage, index of dental caries intensity growth in permanent teeth in children of the main group was 0,25, in children of control group – 0,96. Reduction of caries intensity growth was 73,96%. After two years the increase in intensity of dental caries in children of the main group was 0,78, in control group it was three times higher – up to 2,47. Reduction of caries intensity growth after two years of observations was 68,42%. TER-test index, which characterizes the level of enamel resistance to caries, significantly increased in children of the main group: after one year – up to 5,24±0,21 (from 6,57±0,18), after 2 years – up to 4,96±0,25 and corresponded with the middle level of caries resistance of tooth enamel. Significant changes of TER-test in children of control group were absent. Efficacy of the suggested caries prevention complex was confirmed by laboratory studies. The level of total calcium in saliva in children of the main group increased to 1,33±0,08 mmol/l, ionized calcium – to 0,74±0,06 mmol/l, non-organic phosphorus – to 2,65±0,09 mmol/l. Alkaline phosphatase activity in saliva in children of main group increased to 7,27±0,53 U/l, in control group of children this index was 5,46±0,69 U/l. Conclusions. The usage of caries prevention complex during two years leads to significant decrease of dental caries intensity in permanent teeth in 6-7 years old children and contributes to the normalization of saliva mineralizing potential. This data confirms high clinical efficacy of the proposed caries prevention complex.