Prevention of hard dental tissues diseases in children

Zubni karijes kronična je bolesti koju uzrokuju mnogi čimbenici. Ona predstavlja jednu od najraširenijih bolesti kojoj je suvremeni čovjek podložan tijekom čitavog života. Razvoj bolesti započinje nakupljanjem bakterija na zubnoj površini prekrivenoj glikoproteinskim naslagama iz hrane. Fermentacijom ugljikohidrata u obliku zubnog plaka bakterije stvaraju kiselinu. Snižavanjem pH vrijednosti dolazi do demineralizacijskog procesa na površini zuba. Preventivnim postupcima moguće je pravovremeno djelovati na očuvanje oralnog zdravlja i spriječiti razvoj karijesne lezije. Preventivne metode iziskuju suradnju i roditelja i djeteta. U izboru preventivnih metoda nužno je procijeniti rizik od razvoja karijesa za pojedinca, kao i obaviti detaljan klinički pregled i dijagnostiku. Najraširenija metoda prevencije zubnog karijesa je topikalna fluoridacija. Značaj topikalne fluoridacije leži u sprječavanju nastanka demineralizacije zubne cakline. Njome se potiče remineralizacija površine koja postaje otporna na kiseli medij i djelovanje bakterijskih enzima. Fluor se primjenjuje u obliku gelova i lakova koji se nanose na zubnu površinu, dodatka zubnim pastama i žvakaćim gumama te restaurativnim materijalima koji otpuštaju fluor. Preventivni postupci, poput pečaćenja fisura, sprječavaju prodor bakterija i hrane u fisure i jamice zubi s ciljem zaštite fisurnog sustava i omogućavanja lakše provedbe oralne higijene. Antimikrobna sredstva pomažu u kontroli plaka suprimirajući patološko djelovanje bakterija i koagregaciju biofilma na površini zubne cakline. Najčešće primjenjivana sredstva su klorheksidin i ksilitol. Preventivni programi educiraju djecu i roditelje o važnosti brige o oralnom zdravlju i pomažu u smanjenju straha od dentalnih zahvata.Dental caries is a chronic multifactorial disease. It is one of the most widespread diseases affecting people at every stage of life. The disease develops due to accumulation of bacteria on the surface of the tooth covered with glycoproteins from food. Cariogenic bacteria create acids by metabolizing fermentable carbohydrates. The process of demineralization starts on the tooth surface due to lowering of pH values. The use of preventive procedures helps preserve oral health and prevent development of caries lesions. Cooperation between parents and children is necessary for good prevention of dental caries. Preventive methods are based on individual cavity risk assessment, clinical examination and diagnosis. Topical fluoridation is one of the most commonly used preventive methods. Fluoride prevents dental caries by inhibiting demineralization of the tooth enamel and enhancing remineralization. The remineralized surface is resistant to acids and bacterial enzymes. Fluorides come in professionally applied fluoride compounds such as gels and varnishes which are applied on the tooth surface, toothpastes and chewing gums together with fluoride-releasing restorative materials. Pit and fissure sealants protect the tooth surface from bacterial accumulation and by filling morphological irregularities it allows patients to take better care of their oral hygiene. Antimicrobial agents help with plaque control by blocking bacterial metabolism and adherence on the tooth surface. The most frequently used agents are chlorhexidine and xylitol. Prevention programs educate children and their parents on the importance of oral hygiene and are a great help with reducing fear of dental procedures