caries in children
Introduction
Introduction to Pediatric Rickets Dental cary (children's disease) is a disease in which the hard tissue of the tooth is gradually destroyed. The disease is initially in the crown. If it is not treated in time, the lesion continues to develop, destroying the surface of the crown and forming a cavity, called a molar, and finally to the crown. Complete destruction, leaving only the roots. Untreated cavities do not heal by themselves, and the end result of their development is tooth loss. Rickets is a bacterial disease, so it can be secondary to pulpitis or periapical periodontitis, and even cause alveolar bone and jaw inflammation. Secondary infections of dental caries can form focal lesions that can cause or exacerbate many other diseases such as arthritis, endocarditis, chronic nephritis or eye diseases. basic knowledge The proportion of illness: 3% Susceptible people: children Mode of infection: non-infectious Complications: pulpitis acute apical periodontitis
Cause
Causes of rickets in children
Bacterial factors (25%):
In the pathogenesis and development of caries, there must be bacteria, and there are many types of cariogenic bacteria. Modern research has confirmed that the most important are Streptococcus mutans and Lactobacillus, which are mixed with mucin and food debris in saliva. Firmly adhered to the tooth surface and pit and groove. This kind of adhesive is called dental plaque or plaque. The large amount of bacteria in the plaque causes the food debris or sugar to ferment and produce acid, which causes the teeth under the plaque. The surface of the enamel is demineralized and dissolved, forming a cavity. Clinical investigations have confirmed that there are many caries in children with many plaques.
Dietary factors (15%):
In the process of caries formation, diet is an important role of bacteria. Food contains a lot of carbohydrates and sugars. These substances not only supply the energy of bacterial activity in plaque, but also cause glycolysis to produce organic acids through bacterial metabolism. It stays on the surface of the teeth and in the pits and pits, causing demineralization of the enamel. Following some bacteria, the protein is dissolved, forming a cavity, and many sugars are caused, mainly sucrose.
During the tooth development period, nutrition determines the biochemical structure of the tooth tissue, and the mineralized tooth has high resistance to mites, indicating the importance of nutrition during tooth development. If the food contains mineral salts, major vitamins and trace elements such as calcium and phosphorus. Insufficient vitamin B1, D and fluoride, the dental resistance is low, and it is prone to rickets.
The deciduous teeth have already occurred in the fetal period, development and calcification, maternal nutrition during pregnancy, although there is no decisive influence on the development of fetal deciduous teeth, but strengthening maternal nutrition is still beneficial to the mineralization of deciduous teeth, unless the mother suffers from severe metabolic disorders or genetic diseases. Generally, deciduous teeth are not easily affected seriously.
Dental factor (15%):
The shape, structure and position of the teeth are obviously related to the incidence of dental caries. The pits and grooves of the tooth surface are defects left in the development process. The deep pits are prone to retain bacteria and food debris, and are not easy to remove, which is easy to induce dental caries. Insufficient mineralization, especially in calcified teeth, the density of enamel and dentin is not high, the resistance to mites is low, and it is prone to sputum. Although the content of fluorine in the mineralized structure of teeth is very small, it is resistant to strengthening teeth. Sex is very important. It is not easy to cause rickets in the teeth with proper amount of fluoride. The structure and mineralization of deciduous teeth and young permanent teeth are not mature enough, so it is easy to be affected by cariogenic factors and the rate of caries is high.
Saliva is the external environment of the teeth. It acts as a buffer, rinse, antibacterial or antibacterial. The saliva can wash the surface of the teeth and reduce the accumulation of bacteria and food debris. The small amount of thick saliva is easy to stay, and the bacteria are prolonged. The plaque forms and adheres to the surface of the tooth. The nature and composition of the saliva affect its buffering capacity and also affect the living conditions of the bacteria.
Prevention
Pediatric rickets prevention
The basic principle of preventing dental caries is to focus on the factors of the disease and take corresponding measures. It is a very important child health work.
1. Enhance the resistance of teeth
It mainly increases the fluoride in the teeth by fluoridation, changes the structure of the surface or surface of the enamel, and enhances its resistance to mites. The methods that are considered to be better in modern times are: central water fluoridation, school School water fluoridation, topical fluoridation, fluoride toothbrushing, fluoride toothrinse, and the like.
(1) Tap water fluoridation and anti-mite: It is a suitable method for automatically adjusting the fluorine content of water by adding sodium fluoride to the water supply center. It has been considered as the best method for the fluorination of tap water in the international There are two opposite views in China. Therefore, only a few countries and regions have adopted it. Guangzhou, China has tried the observation of tap water fluoridation in the experimental area to study the feasibility and appropriate concentration of local tap water fluoridation.
China is located in three zones, with many high-fluorine areas. The water content, climate, crops and other fluorine content in different regions are different. The types and habits of diets are not the same. Therefore, it is unrealistic to emphasize tap water and fluoride in China. .
(2) Fluorine solution gargle method: It is suitable for kindergartens and middle schools. Under the supervision of medical staff or teachers, it is recommended to use 0.2% neutral sodium fluoride aqueous solution to rinse mouth every week or every 2 weeks. 1min, no swallowing, one mouthful every six months, is a more feasible method.
(3) Fluoride toothpaste brushing method: the general concentration does not exceed 0.4% sodium fluoride, children brushing teeth once a day, every morning, have a certain effect of reducing dental caries, but in theory, toothpaste fluoridation should be selective, It varies from person to person.
The fluorination method has an effect on the teeth that have not yet erupted during development and the erupted teeth. Any method of fluorination and anti-caries can only be used in the fluorine-free or low-fluorine zone of the water source, and the high-fluorine zone cannot be used. It should not be used.
2. Reduce or eliminate pathogen irritants
Reducing or eliminating plaque, changing the oral environment, creating clean conditions is an important part of flood control. The most practical and effective way is to brush your teeth and rinse your mouth. It is necessary to strengthen publicity and education so that children can develop oral hygiene habits from a young age and learn how to brush their teeth properly. Brushing your teeth can remove most of the bacteria in your mouth and reduce the formation of plaque. Children can use their soft towels or flannel to scrub their teeth. Children can start to brush their teeth after 3 years old. Try to brush them as soon as possible, and rinse your mouth after meals. It is more important to brush your teeth before going to bed. Because the interval between nights is long, the bacteria are easy to multiply. It is necessary to brush, that is, the upper teeth are brushed from top to bottom, and the lower teeth are brushed from bottom to top. Also pay attention to brushing the back teeth
Face, so that the teeth and the food residue on each tooth surface can be cleaned as much as possible. After brushing the teeth, rinse the mouth, do not cross the brush, the horizontal brush is easy to damage the gums, and the residue in the teeth is not cleaned. 1975 The Ministry of Light Industry and the Ministry of Commerce jointly held a national toothbrush conference and formulated the Provisional Specifications for Health Care Toothbrushes. The toothbrushes used by young children should not exceed two rows, each row of 5-6 bundles, the hair quality should be soft, and the toothbrush used by primary school students. The hair bundle does not exceed three rows, with 6 to 7 bundles per row.
Should pay attention to children's eating habits, eat more rough, hard and fiber-containing foods, have a frictional cleansing effect on the tooth surface, reduce the accumulation of food debris, hard food needs to be fully chewed, both to enhance the periodontal tissue, but also Rubbing the tooth surface may make the pits shallower, which is beneficial to reduce the pit and fissure.
3. Reduce or control the sugar in the diet
China is a country with cereals as the main food. It is difficult to control carbohydrates in the diet. However, in recent years, the consumption of sugar has increased, and the number of sugar-based foods and various beverages has increased significantly. The habit of eating snacks and confectionery, do not eat sugar before going to bed, pay attention to the quality and quantity of children's three meals, from the young children to grow more vegetables, fruits and foods containing calcium, phosphorus, vitamins, etc., eat as much as possible These coarse grains should pay attention to breast-fed infants. Recently, the international promotion of carbohydrates in diets and the use of sugar substitutes to reduce dental caries are currently unrealistic and uneconomical in China. A commonly used sugar substitute contains toxicity and has attracted international attention.
In short, the incidence of dental caries is complicated. At present, there is no single effective method to prevent the occurrence of new caries. Therefore, prevention of dental caries should prevent and control the combination of new caries, early detection, early treatment, and Leading, organizing oral health care, regular preventive and early treatment in nurseries, kindergartens, primary schools and junior high schools, while strengthening maternal and child health and nutrition and health work, to ensure the health of the body and teeth, can reduce the incidence of dental caries.
Complication
Pediatric rickets complications Complications, acute apical periodontitis
It can be secondary to pulpitis or periapical periodontitis, and even cause alveolar bone and jaw inflammation. Secondary infection of dental caries can cause or aggravate arthritis, endocarditis, nephritis or eye diseases.
Symptom
Pediatric rickets symptoms common symptoms toothache enamel corrosion teeth cold and hot pain allergies
Caries are most likely to occur in the molars of the molars and bicuspids, in the fissures, and in the contact surfaces of adjacent teeth. The former is called the fissure sulcus, the latter is called the adjacent sputum, and the child is in the sac of the tooth neck. Less, in severe malnutrition or some systemic diseases make the body extremely weak, according to the degree of caries destruction, the clinical can be divided into shallow, middle and deep.
1. Shallow sputum: Below, the sulcus and fissures begin to be in the ditch, which is not easy to see in the early stage. It can only be seen when it occurs at the sulcus. However, it is easy to have pigmentation of food at the mouth of the child's teeth. The doctor does not check carefully. Misdiagnosis or missed diagnosis, initial symptoms or shallow sputum have no symptoms.
2. Lieutenant: The eclipse has reached the dentin, forming a shallow cavity in the dentin. The child is cold, cold or sweet. The acid food will feel tooth pain, but after the stimuli are removed, the symptoms disappear immediately. This is because dentin For the reason that the sensation is allergic to the stimuli, the sputum is well treated in time.
3. Squat: The eclipse has reached the deep layer of dentin, close to the pulp, or has affected the pulp. At this time, the cavity is deep and the damage is large. The sick child has a pain in cold, heat, acid and sweetness. Sensitive to heat, after the stimuli are removed, the pain will continue to disappear after a certain period of time. At this time, most of the need for endodontic treatment to preserve the teeth.
If the squat is untreated, it will continue to develop the infected pulp or necrosis of the pulp. The bacteria can reach the apical foramen through the root of the root, causing inflammation of the periapical period, which may form a lesion infection. If the crown is mostly destroyed or only remains When rooted, it should be removed.
Examine
Pediatric rickets check
Peripheral blood leukocyte counts and neutrophils were significantly increased in secondary infections.
If necessary, you can do X-ray examination to see if there is inflammation of the apical periodontitis.
Diagnosis
Diagnosis and diagnosis of rickets in children
According to the clinical manifestations and test results can be diagnosed.
When squat or secondary infection becomes a lesion, attention should be paid to the identification of complications.
