DENTAL AND PERIODONTAL HEALTH STATUS IN CHILDREN: A NEW PROPOSAL OF EPIDEMIOLOGICALEXPERIMENTAL PROTOCOL AND STUDY

Recent epidemiological studies indicate a reduction in the occurrence of caries in Italy, which is in line with the trend observed in industrialized countries in the last decades. Despite this reduction, a polarized distribution of the disease has been observed. In order to create prevention programs specific to each area, it is necessary that have specific data of territory. The aim of this study was to determine the oral health situation of the Campanian children, Italy. The final aim is to establish an oral health baseline prior to introducing promotion and prevention strategies and appropriate health care for specific groups, and to provide the starting point for monitoring the time evolution according to the World Health Organization 2020 global goals for oral health in Campania region, Italy. This study analysed in the first instance dental and periodontal health status of Campanian schoolchildren (Group I). In order to facilitate the identification of subgroups with increate risk of oral disease, this study investigated the group of population which required oral care like children who every day belong to Paediatric Dentistry Department of “Federico II” University of Naples (Group II). Simultaneously, this study investigated groups of children who, because of serious systemic diseases, may present increased risk of tooth decay and periodontal diseases [children undergoing liver transplantation (Group III), children with respiratory problems such as children with asthma (Group IV) and children affected by cystic fibrosis (Group V)]. This research provides important data about dental and periodontal health status in campanian children. This way, this study established an oral health baseline prior to introducing promotion and prevention strategies and appropriate health care for specific groups, and provided the starting point for monitoring the time evolution according to the World Health Organization 2020 global goals for oral health in Campania region, Italy. Additionally, the results of this study showed particular considerations for each group; Group I: The goal of WHO nearly exhausted in campanian children. Dental health behaviour is associated with lifestyle as well as demographic factors. All these factors are relevant to a high caries prevalence and demonstrate the importance of a preventive educational programme for children with a comprehensive caries prevention schedule to obtain caries decrease. Group II: There is an urgent need to strengthen the effectiveness of proven preventive actions in order to prevent the further deterioration of oral health. Today available preventive systems (fluoride prophylaxis; fluoride toothpastes; control of oral hygiene; sealing), despite being partly responsible for the reduction of the prevalence disease, haven’t succeeded in penetrating effectively this social layers of population. Our findings showed the important relationship among caries experience and socio-economic and cultural family level. Therefore, new prevention programs must involve the entire family. Group III: It is important that dentists, as a member of a team for liver transplantation, monitor the dental health of patients. Routine dental care and caries prevention programs need to be planned for those children during pre-liver or post-liver transplantation in order to reduce the risk of systemic infection arising from the oral cavity. Oral hygiene instructions to parents should begin as early as possible before liver transplantation. Group IV: Children affected by mild intermittent and mild persistent asthma, despite its disease status and its pharmacotherapy, do not seem to be more susceptible to caries diseases than children belonging to healthy control group. In addition, this subjects are similar to healthy subjects for periodontal health status and for the presence of dental enamel defects. For this reason, there is no need of including paediatric patients affected by mild intermittent and mild persistent asthma in particular preventive dental programs. Group V: Cystic Fibrosis patients, have a significantly lower caries experience than control subjects, but it was statistically significant only for deciduous teeth (p<0.001). Besides, it showed that in CF group there is an higher prevalence of enamel defects and low presence of calculus with a good periodontal health. Developmental defects in the enamel present important clinical significance since they are responsible for aesthetic problems, with subsequent psychological discomfort for the patients. This emphasises the need for a paediatric dentist to be a member of the multi-professional team involved in the care of children with CF with the aim of establishing priority programs of prevention to improve their health-related quality of life