American Journal Of Social Sciences And Humanity Research
122
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VOLUME
Vol.05 Issue05 2025
PAGE NO.
122-125
10.37547/ajsshr/Volume05Issue05-29
Improvement of Caries Prevention Methods for Children
with Mental Retardation
INDIAMINOVA Gavkhar Nuriddinovna
Doctor of Philosophy medical sciences (PhD), Samarkand State Medical University, Uzbekistan
Received:
28 March 2025;
Accepted:
24 April 2025;
Published:
26 May 2025
Abstract:
In modern society, diseases of the oral cavity are of humanitarian, socio - economic significance. Today,
tooth decay and periodontal disease remain the most common dental disease not only among adults, but also
among younger populations around the world. According to recent epidemiological studies conducted on healthy
children, the incidence of dental pathology is high, with the prevalence of caries among healthy age groups 12-15
years old is 63.3-83 years, 4% and 81.7-88.7%, intensity 3.02 -3.75 and 4.6-5.73, and the prevalence of periodontal
tissue diseases in the group of healthy 12-year-old children ranged from 37.8% to 50%, in the 15-year-old group
of children it ranged from 57.7% to 84, 7%. The prevalence of caries is also high in children with mental retardation
of preschool and school age, while the intensity of caries is higher in children aged 13
–
18 years with mild mental
retardation (MAD). These indicators increase with age and depend on the severity of the underlying disease.
We carried out a program for the prevention of dental diseases in children with disabilities, however, most of
them were focused on children with mild and moderate mental retardation, where not only the degree of mental
retardation was taken into account, but also teaching them oral care skills, the degree of socialization and the
child's diet.
Keywords:
Dental caries, periodontal disease, epidemiological study, caries intensity, mental retardation.
Introduction:
The purpose of the study: To increase the
effectiveness of providing therapeutic and preventive
dental care to children with mental retardation based
on the implementation of a program for the prevention
of dental diseases, taking into account their limited
capabilities in the Samarkand region.
Research objectives:
1. To study the actual state of dental care for children
with intellectual disabilities living in orphanages in the
Samarkand region.
2. To study the level of dental morbidity in children with
mental retardation living in orphanages and to identify
its dependence on some external factors (Samarkand
region).
3. To conduct a microbiological examination of plaque
to assess the risk of dental diseases in mentally
retarded children.
4. To analyze the dynamics of caries intensity during 3
years in mentally retarded children suffering from
Down syndrome
5. Develop and implement a dental disease prevention
program for mentally retarded children living in a
boarding school, taking into account their limited
health opportunities, using a differentiated approach in
teaching oral hygiene.
METHODS
This study is conducted at the specialized boarding
school No. 62 for children with mental retardation
located in the city of Samarkand, including between 6,
9 and 12-year-old boarding school students. Depending
on the age, gender, diet, type of major neurological
diseases, the presence of Down syndrome and the
degree of socialization of the children accepted in the
study, it is planned to study the hygienic condition of a
special program used for a certain period of time aimed
at the prevention of dental diseases, the level of their
effectiveness is determined. In groups of 6, 12, and 15-
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
year
–
olds, the distribution was as follows: 15, 20, and
25 children aged 6, 12, and 15 were assigned to
subgroup 1 (socialized children + conditionally free
meals), respectively; 15, 30, and 25 children were
assigned to subgroup 2 (unsocialized children +
regulated meals). 6, 12, and 15 years old, respectively
(Table -1).
Prevalence of dental caries in subgroups of 6, 12, and
15-year-old mentally retarded children (Table -1)
The following indicators were evaluated:
-prevalence of caries;
-the intensity of caries of permanent teeth according to
the KPU index; -the clinical condition of periodontal
tissues was assessed by the PMA index in the Parma
modification. -hygienic condition of the mouth (using
the simplified index of hygiene of the mouth according
to Green
–
Vermillion).
(Table -2)
Indicators of gingivitis (RMA) severity in subgroups of mentally retarded children with different
socializations (Table -2)
Age
the subgroup
РМА
р
6
1п
5,0 [0,0;12]
0,004—
2п
27 [4,0;33]
12
1п
25,5 [9,0;35,8]
0,002—
2п
48,5 [26;67,8]
15
1п
25,0 [6,8;36,3]
0,005—
2п
42,0 [25,8;65,3]
Note:
1p – Socialized children + conditionally free meals;
2p – Unsocialized children + regulated meals;
1pD – Socialized children + conditionally free meals +with-m Down;
2pD – Unsocialized children + regulated nutrition+with-m Down
To assess the risk of dental diseases, a microbiological
study of plaque was conducted, for which 26 children
from subgroup 1 and 24 people from subgroup 2 were
randomly selected. For microbiological examination,
dental supragingival plaque was collected by scraping
with a sterile excavator.
The prevention program included teaching children
oral hygiene and health education with the staff of the
institution and the parents of some of the students who
attended the boarding school. Individual prevention
methods were also carried out:
Professional oral hygiene;
Remineralizing therapy- applying fluoride-containing
varnish to teeth;
Sealing the fissures of permanent teeth.
RESULTS
:
It is known from the literature that children with Down
syndrome are less at risk of developing dental caries,
therefore, a division was carried out within subgroups
with different socializations, taking into account the
presence of this syndrome. Thus, within the subgroups
of 6, 12, and 15-year-old socialized children, children
without Down syndrome were identified
—
10, 32, and
40 children, respectively, and children suffering from
Age
Prevalence of caries (%)
1п
1пД
2п
2пД
6
33,0
0,0
0,0
0
12
64,0
20,0
17,0
0
15
85,0
33,0
22,0
0
Note*:
1p- socialized children + conditionally free meals;
2p- unsocialized children + regulated nutrition.
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
this syndrome
—
12, 8, and 5 children, respectively.
Among the 6, 12, and 15-year-old unsocialized children,
subgroups of children without Down syndrome were
also identified
—
11, 30, and 15 children, respectively,
and children with Down syndrome
—
4, 6, and 13
children, respectively. The prevalence and intensity of
caries were assessed in these subgroups.
To assess the risk of dental diseases, a microbiological
study of plaque was conducted, for which 23 children
from subgroup 1 and 21 people from subgroup 2 were
randomly selected. For microbiological examination,
dental supragingival plaque was collected by scraping
with a sterile excavator No. 2.
The third stage of our research was the development,
implementation and evaluation of the effectiveness of
a dental disease prevention program adapted for
mentally retarded children in the conditions of DDI.
The prevention program included teaching children
oral hygiene and health education with the staff of the
institution and the parents of some of the students who
attended the boarding school. Individual prevention
methods were also carried out: occupational hygiene,
applying fluoride-containing varnish to teeth, sealing
fissures.
The effectiveness of the implemented adapted
prevention program, which takes into account the
medical, psychological and pedagogical characteristics
of children, was assessed by the hygiene index (IGY-Y)
and the condition of periodontal tissues (PMA index)
initially, 1,2,3 years after the start of training.
The data obtained from 9 and 12-year-olds served as
internal control for groups of children who entered the
prevention program at the ages of 6-8 and 9-11 before
the program was implemented. At the same time, the
group of 9-year-olds is the comparison group for the
other groups of 9-year-olds and becomes the main
group three years after these children reach the age of
12. For children who entered the prevention program
at the age of 12, 15-year-old children previously
examined served as a control group
The prevalence and intensity of dental caries in
mentally retarded children depended on socialization,
which determines lifestyle and diet, as well as on the
presence of Down syndrome.
The incidence of dental caries in mentally retarded
children living in orphanages depends on their
socialization, which determines certain lifestyle and
nutrition features. The risk group consists of socialized
children without Down syndrome: the prevalence of
caries was 31.0, 62.0 and 83.0% with intensity
0[0;1,17], 2[0;4], 4[3;5] 6, 12, and 15-year-olds,
respectively. In unsocialized children without Down
syndrome, the prevalence of caries was low
–
0, 18.0,
and 22.5% in 6, 12, and 15-year-olds, respectively,
while children with Down syndrome had no dental
caries. Mild gingivitis prevailed in socialized children
(55, 50, and 50% among 6, 12, and 15-year-olds,
respectively), moderate gingivitis prevailed in
unsocialized children (47.1 and 41.6% in 6 and 15-year-
olds, respectively) and severe gingivitis (38.6% in 12-
year-olds). 45[26;67,5]. The inability to take full-
fledged oral care on their own makes this group of
children particularly vulnerable to periodontal
diseases.
CONCLUSIONS
A differentiated approach to teaching oral hygiene
based on the possibilities of developing self-service
skills in mentally retarded children, taking into account
their mental and physical capabilities, can significantly
improve oral hygiene and the condition of periodontal
tissues. The PMA index decreased from 15% [0;25.6] to
0% [0; 2.6] in group I, from 14%[0; 29] to 0%[0; 4] in
group II, from 35% [15.1; 64.5] to 6% in group III.[0; 11].
The prevalence of children with healthy periodontitis
increased from 19% to 56.5%.
During the three years of the prevention program, the
reduction in the increase in the hygiene index
amounted to 71.0% in the first group of training
(independent care and control of staff), 65.7% in the
second group of training (independent care and
assistance of staff) and 70.0% in the third group (staff
care). In 9, 12, and 15-year-old socialized children, the
prevalence of caries after three years was 13.5, 43.4,
and 63% with intensity 0[0;0], 0,5[0;4], 3[0;4,5],
respectively, which is lower than the control group
(42.9, 60 and 76% at intensity 0[0;3,25], 3[0;4,5],
4[1,5;5], respectively).
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