| Abstract | CILJ ISTRAŽIVANJA:
Autizam je neurobiološki razvojni poremećaj mozga koji se očituje teškoćama u socijalnim interakcijama, teškoćama u verbalnoj i neverbalnoj komunikaciji, kao i neuobičajenim ponašanjem. Osobe oboljele od autizma imaju i ograničene aktivnosti i interese te različite motoričke smetnje i stereotipije. Oralno zdravlje u takvoj populaciji često zna biti zapostavljeno zbog ostalih zdravstvenih teškoća kroz koje prolaze stoga je cilj ovog istraživanja ustanoviti oralni status oboljelih osoba koji su štićenici Centra za autizam u
Splitu te ga usporediti sa sveukupnom populacijom u Republici Hrvatskoj.
MATERIJALI I METODE:
U istraživanje je uključeno ukupno 37 osoba (6 ženkog i 31 muškog spola). Dob ispitanika se kreće u rasponu od 7. god do 33. god. Zbog velikog raspona u dobi ispitanici su podijeljeni u dvije skupine. Prvu skupinu čine djeca u dobi od 7. do 12. godine. Tu skupinu čini ukupno 7 osoba (0 djevojčica i 7 dječaka). Kriterij za svrstavanje u prvu skupinu je dentalni status mješovite denticije. Drugu skupinu čine osobe od 13. do 33. godine života te se u njoj nalazi ukupno 26 osoba (5 ženskog i 21 muškog spola). Svi ispitanici u drugoj skupini u dentalnom statusu imaju zabilježenu trajnu denticiju. Postupak se provodio u prostorijama Centra za autizam u razdoblju od dva mjeseca. Pregledom smo utvrđivali KEP indeks u ispitanika, procjenjivali smo gingivalni indeks i educirali ispitanike o održavanju oralne higijene.
REZULTATI:
Populacija osoba oboljelih od autizma koja je sudjelovala u istraživanju bila je u omjeru muškaraca naspram žena 5:1. Prema kriterijima SZO prva skupina ispitanika (djeca u dobi od 7. do 12. godine) nalazi se u vrlo visokom riziku intenziteta karijesa, dok druga skupina ispitanika (osobe u dobi od 12. do 33. godine života) spada u skupinu s visokim rizikom. Gingivitis, koji je tretiran po kriteriju gingivalnog indeksa po Loe and Silnessu [27] pokazao nam je veće probleme u vidu upale i krvarenja u osoba starije životne dobi nego u osoba mlađih od 12 godina. U prvoj skupini 43 % ispitanika imalo je lagano upaljenu gingivu (stupanj 1) , dok je u drugoj skupini ispitanika njih 65,3 % imalo gingivitis. Kep indeks u prve skupine, djeca s mješovitom denticijom, iznosi 5,71, a SIC za istu skupinu 13. U druge skupine ispitanika zabilježen je nešto veći KEP indeks 7,07, dok je SIC jednak kao i u prvoj skupini i iznosi 13. Samo 14 % ispitanika mlađe životne dobi imalo je kep indeks 0, a 28 % imalo je kep indeks veći od 10. U starijoj skupini ispitanika samo 7,6 % ispitanika imalo je indeks 0, dok je čak 30,7 % ispitanika imalo KEP indeks veći od 10.
ZAKLJUČAK:
Visoki intenzitet karijesa koji je zabilježen na području cijele Hrvatske, kao i visoka, odnosno vrlo visoka prevalencija karijesa zabilježena u našoj ispitivanoj skupini, upućuju na veoma veliku problematiku koju je potrebno riješiti. Potrebno je pomno isplanirati programe i akcije promicanja oralnog zdravlja i prevencije karijesa koji će se početi provoditi na nacionalnoj razini. Takvi programi trebali bi omogućiti promjene, upozoriti na važnost
preventivnih djelovanja te potaknuti na revitalizaciju preventivne dentalne zaštite kako u općoj populaciji tako i u osoba oboljelih od autizma. Potrebno je u sklopu Specijalističkih dentalnih ustanova osigurati posebno odjeljenje za osobe oboljele od autizma te zajedno
sa stručnim timom, uz dugotrajne i strpljive metode edukacije i prilagodbe, osigurati kvalitetnu dentalnu skrb. |
| Abstract (english) | OBJECTIVES:
Autism is a neurobiological developmental brain disorder that presents in social interactions, difficulty in verbal and non verbal communication and overall untypical behavior. People affected by autism also have limited activity and interests as well as varying degrees of motor problems and steretypies. Oral health in the autism population can often be neglected in overview of other health difficulties these patients go through, so the purpose of this research is to determine the oral health status of those patients that are listed in the “Center for Autism” in Split and to compare it to the status of the general population in Croatia.
MATERIALS AND METHODS:
The research includes total of 37 people (6 female and 31 male). The age of the examinees is from 7 to 33 years old. As a result of the wide span of age the examinees are divided in two groups. First group contains children ages 7 to 12. This group makes 7 people in total (0 female and 7 male). The criterion for placement into the first group is mixed stage dental status. Second group contains people ages 13 to 33. This group makes 26 people in total (5 female and 21 male).The dental status of all examinees in the second group is only permanent teeth. The procedures were carried out on location in the “Center for Autism” in the span of two months. With the examinations we ascertained examinees DMFT index, Gingival index and educated the examinees in maintaining oral hygiene.
RESULTS:
The proportion, of the population of people with autism that participated in the study, men to women was 5:1. According to the WHO criteria; first group of examinees (children ages 7 to 12) is in a very high risk of intensive caries, while the second group of examinees (people age 12 to 33) falls under high risk. Gingivitis, which was treated in accord to the gingival index by Loe and Silness [27], has indicated larger problems evident in inflammations and bleeding more so in those of older age than in those younger than 12 years. In the first group 43 % of examinees had a mild gingiv inflammation (level 1), while in the second group of examinees 65.3 % had gingivitis. DMFT index in the first group with mixed stage teeth development is 5,71, and SIC for the same group 13. In the second group of examinees there is a somewhat higher DMFT index of 7,07 while the SIC is, the same as for the first group, 13. Only 14% of examinees of young age had DMFT index 0, and 28 % had DMFT index higher than 10. In the older age group only 7,6 % examinees had DMFT index 0, while as high as 30,7 % had DMFT index over 10.
CONCLUSIONS:
High intensity of caries which was recorded across the territory of Croatia, along with high (that is, very high) prevailing caries in our examined groups indicates a very problematic situation that needs to be resolved. There need to be diligently planed programs and campaigns of promoting oral health and caries prevention that should run on a national level. Such programs should facilitate change, illuminate the importance of preventive acting and motivate revitalization of preventive dental protection in general population, as well as in people with autism. We need to provide a specialized department for people with autism within the dental specializing institutions; and together with a professional team with long lasting and patient methods of education and adjustments assure the best quality of dental care possible. |
