Improvement Of Methods Of Providing Dental Care For Children With Mental Delayed Development

In modern society, diseases of the oral cavity are of humanitarian, socio - economic significance. Today, tooth decay and periodontal disease remain the most common dental disease not only among adults, but also among younger populations around the world. According to recent epidemiological studies conducted on healthy children, the incidence of dental pathology is high, with the prevalence of caries among healthy age groups 12-15 years old is 63.3-83 years, 4% and 81.7-88.7%, intensity 3.02 -3.75 and 4.6-5.73, and the prevalence of periodontal tissue diseases in the group of healthy 12-year-old children ranged from 37.8% to 50%, in the 15-year-old group of children it ranged from 57.7% to 84, 7%. The prevalence of caries is also high in children with mental retardation of preschool and school age, while the intensity of caries is higher in children aged 13 – 18 years with mild mental retardation (MAD). These indicators increase with age and depend on the severity of the underlying disease. We carried out a program for the prevention of dental diseases in children with disabilities, however, most of them were focused on children with mild and moderate mental retardation, where not only the degree of mental retardation was taken into account, but also teaching them oral care skills, the degree of socialization and the child's diet.


RESEARCH OBJECTIVES
1. To study the actual state of the organization of dental care for children with mental retardation living in orphanages in the Samarkand region. 2. To study the level of dental morbidity in children with mental retardation living in boarding schools and to identify its dependence on some external factors (Samarkand region). 3. Conduct a microbiological study of dental plaque to assess the risk of developing dental diseases in mentally retarded children. 4. To analyze the dynamics of the intensity of caries within 3 years in mentally retarded children suffering from Down syndrome 5. To develop and implement a program for the prevention of dental diseases for mentally retarded children living in an orphanage, taking into account their disabilities, using a differentiated approach to teaching oral hygiene.

MATERIAL AND RESEARCH METHODS
This study is carried out in a specialized boarding school No. 62 for children with mental retardation located in the city of Samarkand, including between 6, 9 and 12 year olds from boarding schools. Depending on the age, gender, diet, type of major neurological diseases, the presence of Down syndrome and the degree of socialization of children taken in the study, it is planned to study the hygienic state of a special program used for a certain period of time aimed at preventing dental diseases, their level is determined efficiency. In the groups of 6, 12 and 15-year-old children, the distribution was carried out as follows: subgroup 1 (socialized children + conditionally free food) included 15, 20 and 25 children of 6, 12 and 15 years, respectively; to subgroup 2 (non-socialized children + regulated meals) -15, 30 and 25 children 6, 12 and 15 years old, respectively (table -1). 1n -socialized children + conditionally free food;

Indicators of the prevalence of dental caries in
2p -non-socialized children + regulated meals.
The following indicators were evaluated: To assess the risk of developing dental diseases, a microbiological study of dental plaque was carried out, for which 26 children from subgroup 1 were randomly selected and 24 people from subgroup 2. To conduct a microbiological study, supragingival plaque was collected by scraping with a sterile excavator.
The prevention program included teaching children oral hygiene and health education with the staff of the institution and the parents of some of the inmates who attended the boarding school. Individual prevention methods were also carried out: Professional cavity hygiene Demineralizing therapy -application of fluoride-containing varnish to teeth; Fissure sealing of permanent teeth.

RESULTS
It is known from the literature that children with Down syndrome are less at risk of developing dental caries, therefore, within subgroups with different socialization, a division was made taking into account the presence of this syndrome. Thus, within the subgroups of 6, 12, and 15-year-old socialized children, children without Down's syndrome were identified -10, 32, and 40 children, respectively, and children with this syndrome -12, 8, and 5 children, respectively. Among 6, 12, and 15-year-old non-socialized children, subgroups of children without Down syndrome were also identified -11, 30 and 15 children, respectively, and children with Down syndrome -4, 6 and 13 children, respectively. In these subgroups, the prevalence and intensity of caries were assessed.
To assess the risk of developing dental diseases, a microbiological study of dental plaque was carried out, for which 23 children from subgroup 1 were randomly selected and from subgroup 2 -21 people. To conduct a microbiological study, dental supragingival plaque was collected by scraping with a sterile excavator No. 2.
The third stage of our research was the development, implementation and evaluation of the effectiveness of a program for the prevention of dental diseases adapted for mentally retarded children in conditions of preschool education.
The prevention program included teaching children oral hygiene and health education with the staff of the institution and the parents of some of the inmates who attended the boarding school. Also, individual methods of prevention were carried out: professional hygiene, application of fluoride-containing varnish to teeth, sealing of fissures.
The effectiveness of the implemented adapted prophylaxis program, which takes into account the medical, psychological and pedagogical characteristics of children, was assessed by the hygiene index (IGR-U) and the state of periodontal tissues (PMA index) initially, 1.2.3 years after the start of training.
The data obtained from 9 and 12-year-old children, before the implementation of the program, served as internal control for groups of children who entered the prevention program at the age of 6-8 and 9-11 years. At the same time, the group of 9-year-old children is a comparison group for the other groups of 9year-olds and becomes the main one three years later after these children reach the age of 12. For children who entered the prevention