Aim. To substantiate the need for the use of digital systems to support medical decision-making in the diagnosis of diseases of the oral mucosa.Materials and Methods. The study was conducted by the method of anonymous questionnaires, dedicated to the evaluation of the use of digital systems to support medical decision-making in the diagnosis of diseases of the oral mucosa, on the basis of the Institute of Dentistry I.M. Sechenov First Moscow State Medical University (Sechenov University). The study analyzed 200 questionnaires of doctors aged 20 to 70 years. The main methods used in the study: statistical method using the Kruskal-Wallis test, followed by pairwise comparison using the Mann-Whitney-Wilcoxon test (with Benjamin-Hochberg correction for multiple comparisons), questionnaire.Results. It was revealed that dentists with a long experience of medical practice from 15 to 20 years (77,8%) more often detect manifestations of diseases of the oral mucosa at a medical appointment. When analyzing the diagnosis of oral mucosa diseases, depending on the specialization of the dentist, it was found that this group of pathologies is more often determined by orthodontists(68,8%). At the same time, for the majority of specialists (59%), the diagnosis of diseases of the oral mucosa is difficult. Dentists of various specializations in most cases noted difficulties in determining a presumptive diagnosis (59.5%). At the same time, most specialists associated this with a lack of knowledge and experience in working with patients with diseases of the oral mucosa (66.5%) and with a large variety forms of diseases of the oral mucosa (54%) and resorted to the use of additional sources of information from textbooks, manuals, information articles, as well as the help of colleagues (64.5%). However, at clinical appointments, many doctors faced a lack of time to use reference literature (48.5%). As a result of the survey, it was also revealed that the majority of respondents (64,5%) would like to use the medical decision support system integrated into the medical information system of a medical institution.
The prevalence and detection of cancer in the world is steadily increasing. The most common methods of treating malignant neoplasms are chemotherapy and/or radiation therapy. Patients undergoing this treatment often experience oral complications. The most common complication is oral mucositis. According to the literature, the probability of its occurrence is from 20 to 80% [2, 3]. Oral mucositis and other complications have a negative impact on the quality of life of cancer patients. They face pain, difficulty eating, swallowing, and damage to the oral mucosa increase the risk of secondary infection.Aim. Evaluation of the dental status of oncological patients starting chemotherapy treatment.Material and methods. The study involved 94 patients aged 45 to 59, who were divided into three groups: 1 – malignant neoplasms of the maxillofacial region (n = 23), 2 – gastrointestinal tract (n = 39), 3 – breast (n = 32). To determine the dental status, the values of the DFM, PMA, OHI-s indices, as well as local factors contributing to the aggravation of the oral cavity (metal structures, sharp edges of the teeth) were studied. To assess the awareness of patients about the rules and methods of maintaining an individual hygienic state of the oral cavity, a survey of patients was conducted.Results. The dental status of cancer patients was assessed. The average value of the DFM index in group I is 13.3 (high), in group II – 11.4 (high), in group III – 5.7 (medium). The average value of the OHI-S index in group I was 3.8 (poor), in group II it was 3.1 (poor), in group III it was 1.7 (poor). The average value of the PMA index in group I was 67 (severe degree of inflammation), in group II – 55.6 (moderate degree of inflammation), in group III – 30.8 (moderate degree of inflammation). According to the survey, low awareness of patients about the means and methods of monitoring individual oral hygiene was revealed. Risk factors have been identified in the form of sharp edges of teeth and metal structures that can contribute to the development of severe complications from the oral cavity during chemotherapy treatment.Conclusion. According to the results of the study, an unsatisfactory dental status of patients with oncological diseases of various localization was revealed. The need for control by dentists is shown.
An increase in diagnostic capabilities contributes to the early detection of oncological diseases, which is statistically reflected in the number of detected pathologies. The prevalence of cancer is increasing every year. Chemotherapy is one of the leading methods of treatment in oncology. According to the literature, from 20 to 80% of cancer patients experience complications of chemotherapy treatment from the organs and tissues of the oral cavity. The most common complication is oral mucositis. Such damage to the oral mucosa causes discomfort, pain, difficulty in eating, swallowing, and interferes with speech function. In advanced cases, oral mucositis leads to extreme weight loss, sepsis, and premature death. The development of oral mucositis is a complex multi-step process. Despite the fact that it is based on damage to the DNA structure of the cells of the oral mucosa, the microflora of the oral cavity plays an important role in the further development of the process. The influence of representatives of the microflora on the development of inflammatory processes is enormous. In the oral cavity, microorganisms are presented in the form of microbial communities - biofilms. Biofilm management is the basis for preventing inflammation of the oral mucosa and destruction of hard dental tissues. Due to the negative effect of chemotherapeutic drugs on the local immunity of the oral cavity, on salivation, there is a deterioration in the hygienic status of cancer patients. Taking into account the available data, we decided to conduct a study on the effect of mechanical action on oral biofilms in order to prevent complications from the organs and tissues of the oral cavity during chemotherapy treatment. The obtained results demonstrate the influence of the hygienic protocol on the state of the oral cavity of cancer patients during chemotherapy.
Aim: analysis of medical and social characteristics and assessment of the dental status of geriatric patients with cognitive impairment.Materials and methods. The study was carried out at the Department of Therapeutic Dentistry. We analyzed the responses and laboratory results of 43 patients aged 60–92 years. The main methods used in the study were: questioning (Fox test), sialometry, saliva pH determination, microbiological analysis (of the upper respiratory tract) for fungal microflora.Results obtained showed that an objective study of the secretory function of the salivary glands according to the method of M.M. Pozharitskaya found that the average rate was 0.2 ± 0.004 ml/min, and the average saliva pH was 5.7 ± 0.04. The medical and social portrait of a geriatric patient indicates that mainly patients with impaired cognitive functions seeking dental treatment and prophylaxis were women, whose average age was 76.03 ± 2.8 years, as a rule, they were representatives of the humanitarian and natural-scientific professions, 75% are married. According to the results of the Fox test, it was found that 60% of patients complained of dry mouth of a different nature. The perception of dry mouth was statistically significantly dependent on gender (P = 0.025) and the presence of chronic diseases (P = 0.004). Women (OR = 1.17, P = 0.026) with chronic diseases (OR = 2.97, P = 0.002) were more likely to suffer from dry mouth.
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