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PREVENTION OF ORAL CAVITY IN APHTHOUS STOMATITIS
Eshmurodov F.A.
Samarkand State Medical University
https://doi.org/10.5281/zenodo.13340917
Pain in the oral cavity when talking and eating has a pronounced effect on
the psychoemotional sphere, somatic health, limits communication, and reduces
the quality of life. Viral turn in some patients with chronic aphthous stomatitis
confirms latent herpesvirus infection of the examined patients. Aphthous rashes
in the oral cavity with parasitic invasions against the background of secondary
immunodeficiency also have a similar clinical picture and require differentiation.
To establish a trusting relationship, we conducted a conversation about the
causes of the disease, possible complications, the need to adhere to the
treatment and health regimen, and motivated long-term interaction with each
patient.
Scheme of examination and treatment of a patient with recurrent oral
aphthae:
• assessment of dental status;
• ultrasound of internal organs, laboratory tests: general clinical blood test,
biochemical parameters, immunogram, ELISA of blood serum for antibodies to
food allergens, herpes viruses, bacteriological culture of oral fluid,
determination of sensitivity of microflora to antibiotics and antimycotics;
according to indications - ELISA of blood serum for antibodies to echinococcus,
toxocara, helminths of marine fish, etc.;
• consultation of a therapist, gastroenterologist, immunologist, infectious
disease specialist, nutritionist, physiotherapist - based on the results of the
study;
• a set of sanitation, treatment, health and rehabilitation measures. Neglect of
any aspect of treatment led to a sharp decrease in its effectiveness. To limit the
damaging effect on the weakened oral mucosa, it was recommended to stop
smoking, drinking alcohol and carbonated drinks, spicy and sour foods, long-
term storage products containing preservatives and antioxidants, and to
eliminate traumatic factors in the oral cavity. Of particular importance for the
recovery of individuals with reduced immunobiological indicators was the
regulation of the diet, work, and rest regimen.
Oral health improvement:
• as indicated: dental sanitation, removal of dental plaque, polishing of tooth
surfaces, smoothing of sharp cusps, jagged edges of teeth due to abrasion,
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polishing of rough fillings (or their replacement), prosthetics (or replacement of
dentures) with restoration of bite height; • refusal from long-term use of
fermented toothpastes, mouthwashes with increased content of antiseptics (for
example, 0.2% solution of chlorhexidine bigluconate), sodium lauryl sulfate.
General health measures:
• To restore salivation, cleanse the gastrointestinal tract, increase daily water
intake (from 1.5 liters for women, 2.5 liters for men) in the first half of the day in
the form of unsweetened berry fruit drinks. Diet therapy: for 1-3 months, the
diet was based on natural plant and fermented milk products, excluding hot,
sour, spicy foods, meat and bone broths, long-term storage products, including
bakery and confectionery products packed in celluloid, due to the inclusion of
preservatives; grated hard vegetables and fruits, especially carrots and
pumpkin, raw, baked or steamed, in soups - up to 350 g per day, dried apricots,
figs, 1-2 sprouted nuts (almonds, walnuts, hazelnuts) per day. To correct the
content of vitamin PP (nicotinic acid) and thiamine, baker's bran was introduced
into the diet (1 teaspoon - in vegetable and cereal dishes).
• To increase tone, depending on age and physical condition, light or moderate
physical activity was recommended (calculated for up to 25 years - 2 hours per
day, 25-40 years - 1.5 hours, 45 and older - 1 hour, retirement age - 45 minutes)
in the form of gymnastics, walks, dancing, active housework, etc. The health-
improving effect of the daily routine, work and rest, adequate sleep, nutrition,
regulation of water-salt and vitamin balance, plant-based and fermented milk
diet, dosed light or moderate physical activity led to an improvement in well-
being within 5-7 days, increased physical activity, contributed to the
normalization of weight, and increased motivation to continue treatment.
• Drug therapy, depending on the severity of clinical manifestations and
duration of the disease, was carried out differentially:
1. To correct the vitamin balance, after determining tolerance, milgamma B was
prescribed parenterally - 2 ml intramuscularly once every 3 days, No. 5, or
cocarboxylase - 2 ml intramuscularly every other day, No. 5, 1-2 courses per
year; orally - ferroplex, angiovit - 1 tablet 2 times a day, from 10 to 14 days,
locally - "Aevit" - the capsule was asked to dissolve in the mouth after rinsing the
mouth, 2 times a day, for 7-10 days.
2. In case of severe inflammation along the periphery of extensive aphthae or
ulcers, Biseptol-480 tablets were prescribed — 1 tablet 1 time, in severe cases
— 2 times a day after meals, for 5-10 days; as prescribed by a rheumatologist in
case of permanent cicatricial aphthae, as well as against the background of
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nonspecific ulcerative colitis, sulfasalazine 0.5 tablets were prescribed — 1
tablet 3-4 times a day, for 5-7 days.
3. Corticosteroid ointments were used locally for extensive or ulcerative lesions.
In case of permanent cicatricial Setton aphthae, depending on the severity of
clinical manifestations, together with a rheumatologist, corticosteroids were
prescribed orally: 5-10 mg of prednisolone per day, for 2 weeks to 3 months,
with a subsequent reduction in the dose of the drug. In case of generalized
Touraine's aphthosis, in a hospital setting, parenteral administration of sodium
succinate methylprednisolone (methylprednisolone) up to 200 mg per day was
performed, followed by a reduction in the dose of the drug, and detoxification
measures.
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развития непрерывного образования: вызовы цифровой экономики. –
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