RU2661612C1 - Method of non-specific donozological prophylaxis and treatment of dental caries in children of tender age - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, in particular to dentistry/pediatric dentistry and microbiology/bacteriology, and can be used for non-specific prophylaxis and enter a complex treatment of milk tooth caries by impact on cariogenic S. mutans in the tongue microbiome and dental plaque of the lingual surface of teeth in young children. Method includes conducting a dental examination of children and diagnosing the contamination by S. mutans bacteria of the lingual surface of the milk teeth of the lower jaw and the mucosa of the middle third of the tongue, use of colloidal silver applications in the form of a gel with a concentration of silver Ag⁺ nanoparticles 30 ppm. Application of the gel is carried out in the most abundant biotopes of S. mutans – on the lingual surfaces of the teeth of the lower jaw and on the mucosa of the middle third of the back of the tongue. During the three-month basic course, the application is carried out 2 times a day in the morning on an empty stomach and in the evening before going to bed for 7 days, the next 7 days break, the three-month maintenance course includes the application once a day before going to bed for 14 days, the next 14 days break. In this case, before carrying out the treatment of biotopes with a gel with Ag⁺ nanoparticles pre-hygienic cleaning of teeth, give the child 30.0–50.0 ml of clean water.

EFFECT: invention ensures the harmlessness of the use, the possibility of indirect non-specific treatment and prevention of dental caries, and the impact of Streptococcus mutans in the sites of donation by using colloidal silver.

1 cl, 1 dwg, 2 tbl, 5 ex

Description

The invention relates to the field of medicine - dentistry / pediatric dentistry and microbiology / bacteriology, and can be used for non-specific prophylaxis and enter into the complex treatment of decay of deciduous teeth by exposure to cariogenic Streptococcus mutans as part of the tongue microbiome and plaque of the lingual surface of the teeth in young children.

Caries is an infectious disease that does not threaten life, but significantly affects the functional properties of the body, the growth of the child and reduces the quality of his life (American Academy of Pediatric Dentistry. Symposium on the prevention of oral disease in children and adolescents. Chicago. 2005: Conference papers. Pediatr Dent 2006.196-198).

und Gesundheits

derung. 2009. 4. P. 119-123).Despite measures aimed at reducing the level of caries in children, the prevalence and severity of the carious process in various regions of our country remains at a high level (Kiselnikova L.P., Tokareva A.V. Caries of early childhood and its complications. 9-th Congress of the European Academy of Pediatric Dentistry, Croatia, Dubrovnik, 2008, p. - 107 .; Skripkina GI, Smirnov SI The model of development of the carious process in children // Pediatric Dentistry and Prevention. 2012. No. 3. S. 3-7). At the same time, the decay of decay of deciduous teeth among children of early and preschool age has increased almost 2.5-3 times (Kharitonova T.L., Lebedeva S.N., Kazakova L.N. Early prevention of dental caries in children // Saratov Scientific medical journal. 2011. Volume 7 No. 1. Appendix. P. 260 .; Shakovets N.V. et al. Risk factors for the occurrence of early childhood caries according to the results of three countries // Pediatric Dentistry and Dental Disease Prevention: Collected Works VII scientific -practical conference with international participation / Moscow, Sank .Petersburg, May 16, 2011, under the editorship of prof. Kiselnikova LP, LN Drobotko S. 213-215). According to foreign authors, the greatest increase in the prevalence and intensity of caries is observed in the age category from 2 to 5 years (Borutta A., Wagner M., Kneist S. Early Childhood Caries: A Multi-Factorial Disease // OHDMBSC; Splieth C.H. , Treuner A., Berndt C. Oral health in toddlers.

und gesundheits

derung. 2009.4. P. 119-123).

In Belterami G (ed). La

infantile. Marseille: Leconte 1952).Due to the high prevalence of this pathology, a special term has been proposed: “Early Childhood Caries”, which describes the presence of one or more carious surfaces removed due to complicated caries or filled in any temporary tooth in children aged 71 months and earlier (Milnes AR Description and Epidemiology of nursing caries. J Public Health Dent 1996; 56: 38-50; Tinanoff N, Kaste LM, Corbin SB. Early childhood caries: positive beginning. Comm Dent Oral Epidemiol 1998; 26: 117-119). Early caries has long been recognized by the clinical syndrome described by Belterami in the 1930s as “Les dents noire de tout-petits” (Belterami G. Les dents noires de tout-petits.

In Belterami G (ed). La

infantile. Marseille: Leconte 1952).

In early childhood caries, temporary teeth are affected almost immediately after eruption. The carious process is characterized by the speed of the course, spreading in width, multiple lesions of the teeth in the order of their eruption, except for the incisors of the lower jaw. A rare lesion of the lower incisors is explained by better self-cleaning due to the position of the tongue and the abundant washing of their saliva (Kuzmina EM. Prevention of dental diseases. - M .: Medicine. 2001. 32 p.). The child’s teeth especially need careful and effective care during the first year after teething, as well as during the period of mineral maturation of enamel, from 2 to 5 years (Kharitonova T.L., Lebedeva S.N., Kazakova L.N. Early caries prevention teeth in children // Saratov Scientific and Medical Journal. 2011. T. 7, No. 1 adj. S. 260-262).

Teeth that have erupted or undergone professional hygiene are covered for several minutes with a layer of saliva proteins and glycoproteins / pellicle. It is this film, and not tooth enamel, that is the substrate for bacterial adhesion (Asikainen S, Chen C: Oral ecology and person to person transmission of Aa and Pg. Periodontology 2000). In the modern interpretation, bacterial plaque is called a “biofilm”, which is a specialized bacterial ecosystem that ensures the viability and preservation of its constituent species of microorganisms and increases the general population (Caufield PW, Cutter GR, Dasanayake A. P .: Initial a cquisition of mutans streptococci by infants: evidence for a discrete window of infectivity. J DentRes 1993, Leus P.A. Communal dentistry, 2000). According to the conceptual model of dental biofilm according to Jill S. Nield-Gehrig (2003), it consists of bacteria; microcolonies, aggregates of microcolonies of bacteria, extracellular polysaccharide matrix of EPS substance, epithelial cells, components of saliva, food and blood cells. Biofilm associated with dental health and periodontal / Health-associated dental plaque. Microbiological portrait of a healthy film: S. sanguinis, S. mitis, S. orates, S. salivarium, Veillonella, Actinomycetaceae, Haemophilus, Bacteroides. The biofilm associated with caries, periodontitis, periimplantitis / Disease-associated dental plaque is represented by a violation of microbial homeostasis: the dominance of acidogenic and acid tolerant Streptococcus spp. and Lactobacillus spp., the loss of dominance of the main symbiont and the increasing role of transient microflora (O.S. Gileva, conference “Ahead of the future”, Moscow, 2012, Endodontia tudey. - 02.2012).

Pathogenic bacteria do not show aggressiveness against the host organism until the amount and degree of their virulence reaches the necessary level in order to effectively overcome the defense of the host organism. In vitro antibiotic resistance of the biofilm is 500-1000 times higher than that of individual bacterial colonies (Allais G. Oral Biofilm, New in Dentistry. 2006).

Microflora as the most important structural component of a multicomponent oral system is an indicator of dental and systemic health, environmental conditions (OS Gileva, conference “Ahead of the future”, Moscow, Endodontics tudey. 2012). Normal oral flora is involved in the formation of plaque / plaque. It is known that more than 800 species of the studied microorganisms inhabit the oral cavity of a healthy person, preserving the ecosystem and not disrupting homeostasis (Slavkin, 1999, Tchaikovskaya I.V., 2002, Zelenova E.G. et al., 2004, Tets V.V., 2008). To date, the leading role of microflora in the occurrence of the carious process has been proved (Kneist S., Maslak E., Tsare R., Berzina S., Skrivele S., Terekhova T., Shakovets N., Wagner M., de Mura-Sieber V. , de Mura R., Berutta A. Biological and social risk factors for early childhood caries // Modern Dentistry. 2011. No. 1. P. 62-65). The hypothesis about the role of streptococci in the development of caries has been accepted in the USA for practical guidance since 1960 after studies conducted in the country since the 40s of the XX century (Shafer W. G., A textbook of oral pathology, 1974).

Gram-positive streptococci of the species Streptococcus mutans initiate the formation of plaque / biological film on the tooth surface and provide, due to coadhesion, the accumulation of other representatives of the pathogenic flora (Kuznetsov E.A., Tsarev V.N. et al., 1996; Burt and Pai, 2001; Tchaikovskaya I.V., 2002; Berkowitz R., J. Causes. 2003, Tets V.V., 2008, Skripkina G.I., 2014; Khavkin A.I., Ippolitov Yu.A., Aleshina E .O., Microbiota and oral diseases, 2015. 78-81). Streptococci constitute a significant proportion of the microflora of dental plaque, up to 80% of the total number of microorganisms of the oral cavity (Weiilherell I.A. Composition of dental enamel // Brit. Med. Bull. 1975. - Vol. 31, No. 2. P. 1415-1420 ; Maksimovsky Yu.M. et al., 2009). The most important factor in the virulence of Streptococcus mutans is their prosperity in an acidic environment (Ovrutsky G.D., Leontiev V.K., 2010). Fermentation of carbohydrates causes cariogenic plaque bacteria to produce organic acids that act on susceptible tooth enamel and develop caries (Seow KW. Biological mechanisms of early childhood caries. Community Dent Oral Epidemiol. 1998. 26. 1 Suppl: 8-27) . These properties allow streptococci to be the first to populate various biotopes of the child's oral cavity (V.S. Kramar et al., 1992)

The main biotopes of the oral cavity are the mucous membranes, the back of the tongue, gingival sulcus, oral fluid and plaque (Zelenova E.G. Zaslavskaya M.I., Salina E.V., Rassanov S.P. Microflora of the oral cavity: norm and pathology: Educational allowance N. Novgorod: Publishing House of the Russian National Academy of Medical Sciences, 2004. 158 pp.) There are conflicting data on the seeding of streptococci of individual biotopes (Zelenova E.G. et al., 2004, Skripkina G.I., 2014). Various types of oral streptococci selectively colonize certain areas: S. mitior - buccal mucosal epithelial cells; S. mutans - adsorbed on the hard surface of the teeth. The detection rate of S. mutans in saliva and gingival pockets is 100%, in 1 ml of saliva - 1.5⋅10 ⁵ . The number of oral streptococci is variable, but it is an informative indicator, reflecting the degree of homeostatic disorders (Razzhivin, A.P. Dysbiotic conditions in children: clinic, diagnosis and treatment: study guide. N. Novgorod: NGMA. 1999. 123 p.).

Infection with cariogenic species S. mutans and their colonization in grooves of the tongue are possible even before teething (Berkowitz 2003), which confirms the route of transmission of Streptococcus mutans from mother to child (Kuzmina EM Dental disease prevention: study guide. Moscow, 2001; Kuzmina EM Prevention of dental caries as the most important aspect of preserving the dental health of children. // Russian pediatrician. Zhurn. - 2006. - No. 6). Studies (Thorhild I, Lindau-Johnson B, Twetman S, 2002, Berkowitz, 2003, Shakovets H.V., 2009, Caufield, Ratanapridakul et al, 1988, Loveren, Buijsetal, 2000; Kuzmina E.M., I . I. Lysenkova, Prevention of dental caries as the most important aspect of preserving the dental health of children, // Russian Pediatrician Zhurn. 2006. No. 6; Kiselnikova LP Individual prevention of caries in school children / Clinical Dentistry. 2006). Children attending a kindergarten have identical strains of bacteria in saliva (Berkowitz, 2003), and children who are at home raising have identical strains of streptococci and their titer with their mother and father, which confirms the horizontal transmission of cariogenic streptococci (Seow K W., Biological mechanisms of early childhood caries. Community Dent Oral Epidemiol. 1998; 26: 8-27; Caufield P. W, Griffen A L. Dental Caries. An infectious and transmissible disease. Pediatr Clin North Am. 2000; 47: 1001-19). The earlier the oral cavity is populated by 5. mutans, the higher the prevalence of caries by 4 years of life (American Association of Pediatric Dentistry (AAPD). Dental care for your baby. 2009). The age at which a child becomes infected with S. mutans is very important and determines the risk of developing caries. Historically, the idea that a child is infected occurs between 19 and 31 months. into the so-called discrete infection window. However, it has now been proven that this type of infection can occur at an earlier age. Thus, the identification of S. mutans in one-year-old children was the most effective prognostic criterion for caries diagnosed in the same children of 3.5 years. According to modern concepts, the average age of infection is 15.7-16.0 months; by this time 84% of children have a high level of colonization of the oral cavity S. mutans. Clinical studies conducted in recent years have shown that S. mutans are found in the mouth of toothless infants up to 6 months. Their ecological niche is located in the grooves of the back of the tongue.

Bacteriological studies have shown that in children with early caries S. mutans account for 30% of the cultivated dental plaque flora. Such a high density of contamination of tooth surfaces with this type of bacteria is associated with carious lesions, chalk stains and intact tooth surfaces adjacent to carious areas. In contrast, in dental plaque in children with low caries activity, S. mutans typically make up less than 0.1% of the microflora. V.G. Korchagin in his study conducted on patients 12-14 years old, showed reliably that in children with a higher incidence of plaque S. mutans there is a high intensity of caries of 6.57 ± 0.63, while in children with a low intensity of caries 3.30 ± 0.66 - S. mutans in dental plaque less. The author associates the level of plaque contamination with bacterial microflora with the body's resistance. Studies by Alaluusua S. and Renkonen O. showed that children whose dental plaque already had S. mutans at the age of 2 years old suffered from active caries by 4 years old, with CPI values of 10.6, while in children in whom colonization of the oral cavity occurred later, the CPI index was within 3.4. Similar data are presented by V. Kohler et al.

This suggests that the sooner S. mutans colonizes the oral cavity of the child, the higher the chance of immature enamel of recently erupted teeth being coated with plaque, the properties of which will depend very much on the food consumed, especially if it contains easily fermentable carbohydrates. Of all carbohydrates, sucrose is the most significant aggressive factor, since it converts non-cariogenic / anticariogenic products into cariogenic. Sucrose contributes to an increase in the proportion of Streptococcus mutans and lactobacilli, while the level of Streptococcus sanguini decreases. (Douglass JM Response to Tinan off and Palmer: Dietary determinants of dental caries and dietary recommendations for preschool children. J Public Health Dent 2000; 207-209; Paes Leme, H. Koo, C. M. Bellato, G. The Role of Sucrose in Cariogenic Dental Biofilm Formation - New Insight. J Dent Res 2006, 878-887).

For such a multifactorial disease as dental caries, stereotypical preventive measures do not guarantee a high end result. It is necessary to abandon the stereotyped approach to the prevention of dental caries and to determine the individual individual predisposition to this disease (Puzikova O.Yu. Predicting the development of dental caries taking into account integrated indicators and mathematical modeling: diss. Candidate of medical sciences. Omsk, 1999. 183 p. ) It is important to carry out prophylaxis based on pre-nosological diagnosis and prognosis of the disease (Laurisch L. ZWR., 1990; Melnik A.I. abstract of thesis. 1991; Li Y., W. Wang J. Dent. Res., 2002; M. Fontana et al., J. Dent. Res., 2011; Prevention of Caries Today / New in Dentistry, 2011. No. 6. 178. C 6-15 .; Slayton R. Risk Assessment of Caries Development // Dental Maestro. 2007. No. 25. C 23-26; J. Tsubonchi et al. A study of dental caries and risk factors among Native American infants / // J Dent Child. - 1995. - Vol. 62. - P. 283-287).

The prenosological state - the transition from norm to pathology, called the “prenosological diagnosis”, is the basis for the formation of health groups and the development of primary preventive measures (Risik of aktoren ftirdas Nursingottle-yndrome / Ch. Hirsh et al. // Oralprophylaxe. 2000. Vol. 22. P. 103-107; Robko FJ Haufigkeit der Nuckelflaschen karies beiVorschulkindern in einer westdeutschen Grobstadt / FJ Robko, M. Buitkamp // Oralprophylaxe. 2002.Vol.24. P. 59-65; Sellmann HH Kariesrisikotest jetzt auch als DNSS Test // Dental Spigel. 2003. Vol. 1. P. 44-45; van Palenstein Helderman WH, W. Soe, MA van't H on Rise factors of early childhood caries in a Southeast Asian population. J. Dent. Res 2006. Vol. 85, No. 1. P. 85-88; Gorbunova I. L. Use DNA technologies for early detection of caries predisposition. Dentistry. 2006. No. 4. P. 18-19). Mass prenosological diagnosis should be one of the most important elements in the system of protecting children's health, since it is aimed not at finding a disease, but at establishing a level of health (V. Suntsov, Dental prophylaxis in children, Moscow, 2001. 344 p.). Early detection, elimination or attenuation of risk factors reduces the increase in caries in children. Prevention of dental caries is the key to dental health for life. Preservation of healthy temporary teeth until the physiological shift will avoid many problems in the future.

Thus, the issue of prevention of the risk of developing early childhood caries and the development of an individual approach to treatment and prevention methods of correction and, in fact, treatment, is very relevant.

Medical monitoring of non-specific biofilms is a simple and common effective tool in the treatment of caries and periodontal diseases (Kuzmina EM. Dental disease prevention: a training manual. Moscow, 2001., Socranssky SS, Haffajee AD: Dental Biofilms: difficult the rapeutictargets. Periodontology 2002 ) Treatment should cover the entire surface of the oral cavity and the adjacent surface of the pharynx, and not just the area of teeth and periodontium (Theilade E. Factors controlling the microflora of the healthy mouth. In: Human microbial ecology. Hill MJ, Marsh PD Boca Raton, FL, CRC Press 1990).

In connection with the foregoing, our studies are devoted to measures of nonspecific prenosological prophylaxis, treatment and medical control of the most vulnerable risk group for caries - young children by reducing the titer of Streptococcus mutans bacteria in oral biotopes, their adhesive and coadhesive ability in biotopes that are most contaminated with cariogenic microorganisms. - a microbiome of the back of the tongue and plaque of the lingual surface of milk teeth.

In our study, conducted from 2013 to 2015, certified colloidal silver preparations containing Ag ⁺ nanoparticles were used for use. Our selection of drugs for the non-specific prevention and treatment of dental caries in young children was due to the uniqueness of Ag ⁺ molecules. The most brief properties of silver as an antiseptic are presented in the article by the link in the Internet resource: http://www.o8ode.ru/article/tawa/bacterios.htm. The bactericidal properties of silver have been known since ancient times, since it, like gold, was found in a native state and did not have to be smelted from ore. Even in ancient India, with its help, water was disinfected, and the Persian king Cyrus kept the water in silver vessels. From ancient times, people ate from silver spoons, stored milk and water in buckets of silver. In religious Hindu books it is written about the disinfection of water by briefly immersing hot silver in it. Currently, water is disinfected with silver using the electrochemical method.

Silver is a very rare chemical element on our planet. The average content of this silver in the earth's crust is about 70 mg / t. Even in shales where its concentration is considered maximum, the silver content barely reaches 1 g / t. The chemical activity of silver is higher than gold, its concentration in the waters of the World Ocean is 10 times higher than that of gold, and is about 0.04 μg / L.

Silver has a bactericidal, antiviral, pronounced antifungal and antiseptic effect and serves as a highly effective disinfectant against pathogenic microorganisms that cause acute infections. The action of silver ions extends to more than 650 species of bacteria. For comparison - the spectrum of action of any antibiotic 5-10 types of bacteria.

The effectiveness of the bactericidal action of silver ions is explained by their ability to suppress the work of the enzyme, with the help of which oxygen exchange is provided in simple organisms. As soon as silver ions are adsorbed on the surface of the microbial cell, they penetrate into the cell and inhibit the enzymes of the respiratory chain, separating the processes of oxidation and oxidative phosphorylation in microbial cells, as a result of which the cell dies. There is evidence of the formation of nucleic acid complexes by silver ions, as a result of which DNA stability and bacterial viability are impaired. One of the reasons for the wide antimicrobial effect of silver ions is the inhibition of the transmembrane transport of Na + and Ca ++.

Silver has a more powerful antimicrobial effect than penicillin, biomycin and other antibiotics, and has a detrimental effect on antibiotic-resistant strains of bacteria. On Staphylococcus aureus, Proteus vulgaris, Pseudomonas aeruginosa and Escherichia coli, which are of particular interest to clinicians, silver ions have various antimicrobial effects - from bactericidal to bacteriostatic. See additional materials for documented experiment data on the effects of silver ions of the Elena and Prince of Silver drugs on several types of ATCC strains of opportunistic bacteria from the microflora of the human body. Silver is superior to antibiotics in relation to Staphylococcus aureus and most cocci (Bryzgunov V.S., Lipin V.N., Matrosova V.R. Comparative evaluation of the bactericidal properties of silver water and antibiotics on pure microbial cultures and their associations. Scientific tr. Kazan honey Inst., 1964. T 14. 121-123). A number of researchers have found that silver ions have a pronounced ability to inactivate vaccinia viruses, influenza strains A-1, B, some entero and adenoviruses, and even the HIV virus (Valikhova S.S., Volsky N.N. et al. -infected patients. Ross. Patent. 2192870).

The effect of the destruction of bacteria by silver preparations is extremely large. It is 1750 times stronger than the action of the same concentration of carbolic acid and 3.5 times stronger than the action of mercuric chloride. Only 1 mg / l of silver within 30 minutes causes the complete inactivation of influenza A, B, Miter and Sendai viruses. Already at a concentration of 0.1 mg / l, silver has a pronounced fungicidal effect. With a microbial load of 100,000 cells per liter, the death of Candida albicans mushrooms occurs 30 minutes after contact with silver (Golubovich V.N., Rabotnova I.L. Kinetics of suppression of Candida udlus growth by silver ions. Microbiology. 1974. 43).

The rate of destruction depends on the concentration of silver ions in the solution: for example, E. coli dies after 3 minutes at a concentration of 1 mg / l, after 20 minutes at 0.5 mg / l, after 50 minutes at 0.2 mg / l, after 2 hours at 0.05 mg / l. At the same time, the disinfecting ability of silver is higher than that of carbolic acid, mercuric chloride and even such strong oxidizing agents as chlorine, bleach, sodium hypochloride.

When using acceptable concentrations, silver ions, killing all pathogenic and conditionally pathogenic flora of the body, remain safe for the body's own beneficial flora / saprophytes. An interesting fact: while treating an infection due to the formation of antibiotic-resistant forms of bacteria, you have to change the drug every 5 days, then no bacteria or virus will form stable forms of silver ions. Silver ions have a detrimental effect on antibiotic-resistant forms (Belevantsev VI, Bondarchuk. IV Institute of Inorganic Chemistry SB RAS. Essay on the properties of silver and its compounds. The use of silver preparations in medicine. Novosibirsk, 1994).

It has been established that silver solutions are the most effective means in direct contact with surfaces that are festering and inflamed due to bacterial infection. The results of the use of silver water indicate its effectiveness in gastrointestinal diseases, cholecystitis, infectious hepatitis, cholangitis, pancreatitis, duodenitis, any intestinal infections without fear of ruining their own beneficial microflora and causing dysbiosis. The gastric ulcer and 12 p.c. are successfully treated, since Helicobacter bacteria - pylori and campylobacter, which constantly live on the mucous membranes of the stomach and intestines and actively support erosive and ulcerative processes in the gastrointestinal tract, are destroyed.

Typical silver nanoparticles are 25 nm in size. They have an extremely large specific surface area, which increases the contact area of silver with bacteria or viruses, significantly improving its bactericidal action.

At the same time, silver is not just a metal that can kill bacteria, but also a trace element, which is a necessary component of the tissues of any living organism. A person’s daily diet should contain an average of 80 micrograms of silver. When ionic silver solutions are used, not only pathogenic bacteria and viruses are destroyed, but also metabolic processes in the human body are activated, immunity increases.

Silver ions take part in the metabolic processes of the body. Depending on the concentration, its cations can both stimulate and inhibit the activity of a number of enzymes. Under the influence of silver, the intensity of oxidative phosphorylation in the mitochondria of the brain is doubled, and the content of nucleic acids is also increased, which improves the function of the brain. Silver in various dosage forms is used in surgical practice: for damage to bones, muscles, joints, lymph nodes due to strepto-staphylococcal pneumococcal infection, tuberculosis bacillus; in ophthalmology, in ENT practice (Bezlepko A.V. Effectiveness and safety of using collargol in the treatment of non-atopic bronchial asthma. Diss. ... Ph.D. in medical sciences, M. 1999. in pediatrics). Apply silver / silver water for bathing children, with dermatoses, childhood eczema, burns. They are used in the practice of internal diseases: in the treatment of gastritis, viral enteritis and colitis, with endocrinological diseases and metabolic disorders: sugar disease, diathesis; in the practice of infectious diseases: in the treatment of dysentery, typhoid fever, scarlet fever, diphtheria; in obstetric and gynecological practice: in the treatment of various inflammatory processes of the mucous membrane of the gynecological sphere and nipple cracks, see Ross. Patent 2411951, 2011; practice of skin diseases: in the treatment of furunculosis and fungal skin lesions; in dental practice: in the treatment of stomatitis, gingivitis and other diseases of the oral cavity; external use: purulent wounds, pustular skin diseases, burns, dermatoses, eczema. Domestic use of silver / silver water: conservation of drinks, juices, compotes, disinfection of drinking water in epidemiologically unfavorable areas; watering indoor plants to disinfect the earth from microorganisms, molds, fungi, disinfection of dishes, vegetables, fruits, disinfection of underwear and bed linen.

The Faberlic website has an online resource: http://shop.faberlic.com/index.php?option=com_catalog&view=goods&id=1000142308855&idcategory=1000111369973; Toothbrushes with silver ions are proposed for use, which prevents the growth of bacteria on the bristles.

The site of the company "Coral Club" posted preparations of colloidal silver in the form of a solution of "Colloidal silver", 118 ml. Next text is placed. Colloidal silver is a new silver solution that is completely safe for the human body. This solution has a powerful antibacterial effect, so it can be used in the fight against bacteria and yeast. Colloidal silver was used for clinical research by scientists from the Department of Microbiology at Brigham Youth University. They came to the conclusion that this solution is an excellent antiseptic, which has a powerful antifungal effect, it can be used both internally and externally, and in large doses, since it contains no toxic substances. This solution can also be used to prevent numerous diseases. Source: http://www.tiensmed.ru/news/post_new7409.html

The website “Healthy Lifestyle” link: https://zdips.ru/, and further: https://zdips.ru/zdorovoe-pitanie/mineraly/1652-serebro-v-organizme-heloveka.html. Silver (Ag) is a chemical element with atomic number 47. In its elementary form, silver is a silver-white metal. Silver is ductile, malleable, quite resistant to corrosion and therefore belongs to noble metals. Its density is 10.5 g / cm ³ , which is about one and a half times more than that of iron.

Silver ions adversely affect pathogens, it is used to disinfect water. Silver nitrate (lapis, "hell stone") is a powerful antiseptic that can protect a person even from blood poisoning as a result of cadaveric poison entering the wound. The main thing is to treat the wound as quickly as possible. Silver nitrate and its colloidal solutions are used as an astringent. Silver is used as a food additive and has an E174 marker. Silver is found in many living organisms. In mammalian tissues, its concentration is about 0.02 mg / kg body weight. The biological role of silver in the human body is not fully understood. Its highest concentration was found in the brain, more precisely, in the nuclei of neurons - up to 0.08% of dry matter.

The author writes about the properties of silver at the link in the Internet resource: http://forum.guns.ru/forummessage/15/4669.html. The active - the most active elements of silver are ions, which, due to the functional features of the electrons of the five level orbits of the silver atom, enter into a constantly unstable relationship with the fragments of the water molecule, as a result of which the water molecules form a stable shell around the silver ion, preserving the active state of the silver ion in the form of a stabilized hydrated complex. Under the protection of the water membrane, silver ions easily penetrate into the tissues of a living organism and freely circulate in the bloodstream and tissue fluids, meeting with pathogenic microbes, viruses and fungi, easily penetrate their outer shell, and then combine with the respiratory enzyme and, blocking the respiratory function, lead to their death. At the same time, pathogenic microorganisms cannot develop resistance to the destructive action of silver ions, as with antibiotics. Silver ions do not affect the beneficial intestinal flora, helping to combat dysbiosis, stimulating the growth of bacteria that work on humans.

The main way that silver ions enter the human body remains the intestines. Known methods of introducing silver water intravenously through the skin. Therefore, any contacts with silver already enrich the human body with silver ions and the usefulness of silver jewelry is based on this.

Due to the high activity of the bactericidal properties of silver water, only domestic and American astronauts, sailors in submarines, on long voyages and other extreme situations drink it. And therapeutic concentrations of silver ions, which are orders of magnitude higher than their concentration in silver water, have been able to destroy even AIDS viruses, cancer metastases and severe tuberculosis infiltrates. It has already been established that the amount of silver in the tissues of our body reaches 20 μg per 100 g of dry matter. Most silver is found in the human brain, in the nuclei of nerve cells, in the glands of the endocrine system, the iris of the eyes and in the bones. Therefore, silver is a necessary structural element of the tissues of our body. The stimulating effect of silver ions on the blood-forming organs was also noted, with a doubling of the oxidative processes of the brain, which improves its function. Participating in the metabolic processes of the body, silver is consumed, and to replenish it, it needs to be supplied from the outside, while the daily requirement of a person reaches 88 micrograms of silver. Today, silver is regarded as a necessary trace element that ensures the health of our body by replenishing the structural reserves of silver in the body and the bactericidal properties of silver, which protect us from infection. There are reports of anti-inflammatory properties of silver, which manifest themselves like powerful immunomodulators, comparable to steroid hormones. Under the influence of silver, the number of immunoglobulins of classes A, M, G increases, the percentage of the absolute number of T-lymphocytes increases. Silver ions are actively involved in the immune function of the body and can increase immunity. However, it has long been noted that silver really helps one person in a week, does not help another in months, and in a third one it can cause an allergic reaction.

In this connection, many countries have developed acceptable standards for the silver content in drinking water. WHO allows up to 0.1 mg / l, Euro-Standard and in Russia 0.01 mg / l. At the same time, well-known silver-containing drugs (colloidal silver, silver nitrate) used in medicine for more than a hundred years, contain silver 3-4 orders of magnitude more, given that the time of their use is short-lived.

In drugs, silver has a destructive effect on microbes at an ion concentration of more than 150 μg / L. It is toxic to humans. So much is not required for the antibacterial effect. Information on the website of the Sokolinsky Center, Internet pecypc: https://www.pobedi2.ru/natural_products/imunitet/kolloidnoe-serebro/. Silver ions are in suspension in water, forming a gel with tiny particles. 95% of nanosilver particles are 3-5 nm in size. The concentration of ordinary nanosilver is 10 ppm, respectively, for nanosilver 30-30 ppm. The concentrated substance is applied externally and for inhalation to the posterior pharyngeal wall, to the nose. Immunomodulating colloidal solution of nanosilver 10 mg / l - Nasisol 10 ppm, 100 ml, with high composition stability and the ability to penetrate into tissues, was developed by employees of the Physicotechnical Institute in St. Petersburg and put into practice (Vladimir Sokolinsky Health Recipes Center. Medical Systems LLC, St. Petersburg). It can be used externally and internally. Use by adults inside 1 teaspoon 1 time per day, preferably on an empty stomach; children under 6 years old, 2-3 drops 2 times a day for no more than 3 consecutive weeks, 1 month break. There is also an NASiSOL antiseptic for external and internal use, 30 in the form of a spray, an antiseptic solution of colloidal silver with a content of silver particles of 30 ppm, that is, 30 mg / l. Nasisol 30 ppm is a concentrated substance for external use only and on the mucous membranes: with angina, sinusitis, periodontosis, colpitis, fungal skin lesions. A more active natural antimicrobial agent is not found. It can only be compared with 100% tea tree oil. But oil is harder to use in children due to the strong smell. Making inhalation of nanosilver is easy. The bottle is equipped with a spray. One bottle contains 100 ml of safe colloidal silver.

We first used nanosilver in the form of a gel, for external use, “NAno SILver SOL” cleaning gel, 30 ppm, manufacturer of Resbio LLC, St. Petersburg, by order of NPO Zvezda, St. Petersburg for 3 children years. According to the instructions, the gel can be used for antiseptic treatment of hands.

Later, NPO Zvezda in St. Petersburg expanded its assortment of various forms containing silver nanoparticles: Septic Dentamine gel, with nanosilver, 15 ppm, 30 ml. Dentamine gel contains silver nanoparticles with a concentration of 15 ppm, a dimension of 2-5 nm (85% of all particles) and neutral, non-ionic gelling agents that are approved for use on the skin and mucous membranes. It has local immunomodulating, antiseptic, antiviral, anti-inflammatory, oncoprotective effects. It has been proven to inhibit the propagation of S. mutans, streptococcus, which is assigned a major role in the development of caries. According to the instructions, it is applied topically for erosion / damage to the oral mucosa, aphthous stomatitis, gum disease, halitosis, and caries prophylaxis (when used in burls). Apply to the affected areas of the mucosa 3-6 times a day until the result is achieved. For the prevention of caries and bad breath: fill gel caps (individual or purchased at the pharmacy) with gel, apply at night, after brushing your teeth, before going to bed for an hour (the duration of the course is not limited). The gel with nanosilver suppresses the activity of the “bad” bacteria S. mutans, which cover the tooth enamel in the form of the finest biofilms and produce acids that corrode the enamel and cause tooth decay. However, there is a significant drawback in the instructions for use: it is proposed to use the gel in the mouthguards for caries prevention, which is unacceptable for young children who actively resist the presence of foreign, foreign objects in the oral cavity, in addition, a large consumption of the gel for use over the entire mouthguard volume is assumed .

There is a method of prevention and treatment of caries of children as a general hygiene / sanological method - regular brushing. The main goal of mechanical plaque removal is to reduce the total number of bacteria and modify the composition of the biofilm.

The following methods for the professional prevention of caries are known. Remineralizing prevention of dental caries. The directed use of the effect of remineralization to increase the resistance of tooth enamel. Penetration and sedimentation in various enamel layers of calcium, phosphate and fluorine leads to a gradual normalization of permeability due to the formation of new hydroxyapatite crystals (Johanson, 1965; Silverstone, 1972; Kocherzhinsky V.V., 1973). The work of a number of authors (Lenz, 1967; Frank, 1967; Vahl, 1968; Watherell et al., 1974; Woltgens et al, 1976) noted that, during remineralization, intercrystalline spaces are filled with new crystals other than healthy enamel (Gustafson, Sundstrom , 1975). The main components of such mixtures should be calcium salts, phosphates and fluorides in ionized form (Borovsky E.V., Leus P.A., 1972; Prokhonchukov A.A., 1977; Pakhomov G.N., 1982; Leontyev V.K. ., 1984). The creation of such preparations encounters serious technological difficulties associated with the chemical incompatibility of these ions in one solution; they quickly interact with each other and precipitate. For remineralization of enamel, artificially created solutions have been proposed (Andersen, 1921). According to Pigman er al. (1964) Sobel solution containing in mmol / liter Ca - 2.5; phosphate - 1.6; sodium - 97; K - 5; NSO, - 22; at pH 7.3 and a temperature of 37 ° C, with remineralization does not cause complete hardening of the enamel without additional fluorine treatment. These data were confirmed in studies by Muhlemann et al. (1964). In 1960, Koulourides, Pigman described a metastable solution of calcium phosphate to restore enamel, softened with acid. However, when checking this Levine (1980) solution, significant shortcomings were noted: instability during storage and low mineralizing ability due to the difficult solubility of calcium phosphate. In experimental studies (Silverstone, 1971), a solution containing 200 mmol / L sodium chloride, 1.8-, 9-phosphate, and 1-calcium (Ca / P -1.63) was used. The addition of sodium chloride prevented spontaneous precipitation of the remineralizing solution. The studies revealed that for remineralization under experimental conditions, not only the presence and optimal ratio of Ca and P ions in solution, but also the pH value is essential (Koulourides et al, 1965; Gonzales et al., 1975; Silverstone, 1977). In domestic practice, a remineralizing solution was proposed containing in its composition compounds of calcium, phosphate, fluorine, zinc and magnesium (Borovsky EV, Leus P.A., 1972). Using successively applications of a 10% solution of calcium gluconate (5-10 min) and a 2% aqueous solution of sodium fluoride, E.V. Borovsky, P.A. Leus (1976) received a good therapeutic effect in the treatment of caries in the stage of a white spot. They noted a positive result of treatment in 88.4% of cases after 15-20 applications. The erosion surface acquires a fine-grained relief, the structure remains stable for 12 months. Using the method of E.V. Borovsky with preventive goals in children of Moscow (Borovsky E.V., Leus P.A. et al., 1977; Borovsky E.V., Terentyeva T.E. et al., 1978; Borovsky E.V., Kuzmina E.M., Vasina S.A., 1980) reduced the increase in caries of permanent teeth by 29-44%. The disadvantage of this method is the inconvenience in use (two solutions) for young children, in addition, calcium gluconate is difficult to dissociate into ions, which weakens the therapeutic and prophylactic effect. Application for the treatment of focal demineralization of enamel (Axamit L.A., 1978) only a calcium gluconate solution does not give a positive effect.

Remineralizing composition, known as “Remodent”, was proposed by G.N. Pakhomov (1974), contains minerals extracted from bones and teeth during their chemical treatment. The use of "Remodent" for early treatment of focal enamel demineralization (Pakhomov G.N., Leus P.A., 1979) made it possible to achieve the disappearance of spots with a slow-flowing form in 75% of cases. After experimental and clinical verification of a number of drug modifications, the industrial production of Remodent in the form of toothpaste and powder based on a synthetic solution has begun (Luste A.Ya., Lasovsky II, 1984). However, the method of using “Remodent” in the form of applications is time-consuming, requires a lot of time for the doctor and patient, its composition is inevitably a large number of foreign ions, foreign antigens, and the remineralizing potential is reduced due to the deposition of Ca or P during cooking, which is not applicable for young children .

Omsk school of dentists (Leontiev V.K., 1978; Suntsov V.G., 1987) for a long time developed a new class of remineralizing agents. Remineralizing calcium-phosphate-containing gels (A.S. 1114221) were used as prophylactic and treatment tools for initial caries, which simulate enamel and saliva of a healthy person and have different pH values based on the calcium phosphorus coefficient and degree of oversaturation of Ca and P. The gels are oversaturated with calcium and phosphate ions relative to their concentration in saliva. This increase increases the mineralizing potential of prevention and treatment compared to the potential of healthy saliva many times over. To prevent dental caries in children, gel cleaning is prescribed in courses of 2-3 times a year for 10-15 days per course. However, young children do not brush their teeth on their own, and the dosage of ions on them is not designed.

Fluoroprophylaxis. Fluorine preparations are one of the main means of prevention of dental caries, although much remains unclear in the mechanism of caries static action. A large number of works devoted to the disclosure of the mechanisms of action of fluorine (Pakhomov G.N., Leus P.A., 1972); Fedorov Yu.A. et al., 1974; Palazzi, 1975; Gulzov, 1976) allows us to identify three main areas. First, fluorine, interacting with enamel hydroxyapatite, replaces the hydroxyl or carbonate group with the formation of a less soluble form - hydroxyfluoroapatite (Wefel and Harless, 1981; Ogaard et al., 1983). Secondly, fluorides have a depressing effect on the growth and metabolism of the microflora of the oral cavity through an active inhibitory effect on phosphoenolpyruvate kinase, which reduces the intensity of carbohydrate breakdown and acid production (Hardwick, 1963; Edgar et al., 1970; Myers and Handelman, 1971) . Rinsing with fluoride affects the colonization of bacteria on the surface of the enamel (Tinanoff et al., 1976) by changing the adhesion. Thirdly, the works (Brudevold et al., 1961; Kolesnika A.G., 1967; Silverstone, 1971; Gonsales et al., 1975) proved the effect of fluorine, along with the mineral, on the protein phase of enamel, which affects the formation of teeth and their resistance to caries. In the teeth treated with fluoride paste, there is an increase in the intensity of radioactive Ca and P inclusion (Kolesnik A.G., 1964; Pakhomov G.N. et al., 1971; Maksimovskaya L.N., Sherman L.V., 1980). For the prevention of caries, various fluorine compounds are used, which are usually divided into groups of inorganic and organic substances. Most often, sodium and potassium fluoride are used (Ibragimov AM, 1981), tin fluoride (Svatun B., 1981; Tinanoff et al., 1983), aminofluoride (Künzel V., 1980; Pipa, 1982), monofluorophosphate (Ekstrand, 1979) zirconium fluoride (Horowitz, Bitler, 1976). Numerous studies to identify the most active anti-caries fluoride compounds have not allowed to answer this question with certainty. Most compounds have a similar anti-carious effect, although the data are rather contradictory. At the same time, for fluoride practical use, the optimal concentration of fluoride for local use was revealed: no more than 1-2% per fluorine ion, since a further increase in the content of this element does not affect the effectiveness of prevention (Driscol et al., 1982). When selecting fluoride agents and compositions, it is necessary to take into account the possibility of binding fluorides, for example, with calcium, as a result of which they can lose their activity (Pakhomov G.N. et al., 1975; Morozova N.V., Morozova L.V., 1975; Hesselgren, 1980). Fluorides for the prevention of dental caries should be prescribed depending on the fluoride content in drinking water and food, otherwise their use will be ineffective (Pashaev K.P., Voronina L.A., 1984). The forms of use of fluorine compounds for the prevention of dental caries are diverse. In areas where the fluorine content is below 0.7 mg / l, fluoridation of drinking water is used for mass prevention (Gabovich R.D., Minkh A.A., 1979; Petrikas A.Sh., 1981; Timonov M.A., 1985) by increasing the concentration of fluorine to 0.8-1.2 mg / L. There is evidence of a pronounced prophylactic effect (reduction of caries up to 50%) when children use fluorinated salt (Regolati, 1975; Toth, 1977; Toth et al., 1980). milk in Transcarpathia, Smolensk and other cities of the country (P.I. Gorzov, A.G. Kolesnik, A.G. Shargorodsky et al., 1995). For collective and individual prevention of caries, rinses with 0.02-0.2% fluoride solutions are used (Smolyar N.I., Masny Z.P., 1985), applications of 1-2% fluorine solutions and gels (Morozova N.V., 1975; Kolesnik L.G. et al., 1975; Leontyev V.K. et al., 1977; Prokhonchukov A.A., 1977; Chekmezova I.V., 1983), toothbrushing with fluoride pastes (Pakhomov G.N. ., 1975; Morozova N.V., 1975; Klimm V., 1980), the introduction of fluorides by electrophoresis (Opalko et al., 1978), the application of fluoride varnish (Lagutina N.Ya., Stepanov A.V., 1980 ; Sinitsin R.G. et al., 1980; Kosenko K.N. et al., 1984; Borovsky E.V. et al. Tue., 1985), chewing fluoride tablets (Driscoll, 1974, 1978; Horowitz, 1979, 1984; Weatherell et al., 1984), giving sodium fluoride tablets inside (Berner et al., 1975; Ahrens, 1976; Anke, 1979 ; Driscoll et al., 1979; Klimek, 1982) and vitafluore (Pashaev K.P., 1981; Petrushenko O.E., Zhedik A.N., 1985). Analysis of the effectiveness of these types of fluoride prophylaxis of dental caries shows that the reduction of caries in the vast majority of cases does not exceed 50%. The action of fluorine is not long, which is probably due to its washing out of enamel (K. Alkalaev, 1964; Brudevold et al., 1965; Mechin, 1975). However, modern studies identify fluoride as a poison when it is used in water and salt, in this case, the use of these obsolete methods is not applicable to young children and is a significant drawback.

Methods of using fluoride varnishes: Duraphat (Woelm) Duraphat (Colgate) Fluor Protector Stand-Gard Fluoride Radogel F (VladMiVa) Rainbow (Rainbow-R) Fluradent (Rainbow- R). Professional oral hygiene is carried out; teeth isolation, dried with warm air; fluoride varnish is applied with a thin layer on all surfaces of teeth with a brush or wooden stick, avoiding the drug getting on the mucous membrane of the oral cavity. Within 3-5 minutes, the varnish is dried, the patient sits with his mouth open. After the patient is recommended not to eat for 2 hours, to use only liquid and soft food during the day, teeth should not be brushed for 12-24. A 3-fold coverage of the teeth with an interval of 1-2 days is recommended.

Deep fluorination is the formation of submicroscopic crystals (50A) of CaF2 and MgF2, which has even greater solubility than CaF2 in the pores of the loosened zone of the solid substance of the tooth. Preparations for deep fluoridation: “Enamel-sealing liquid”, “Gluftored”. Deep fluorination occurs as a result of successive wetting of enamel with a weakly acid solution of magnesium fluoride silicate (MgSiF6) and subsequent quenching with an alkaline suspension of copper-calcium hydroxide. The solutions penetrate deep into the funnel of the enamel and the reaction proceeds both on the surface of the enamel and inside the funnel / dentinal tubules. As a result, calcium and magnesium fluorides are formed, as well as silicic acid MgSiF6 + 2Са (ОН) 2 = 2 CaF2 + MgF2 + Si (OH) 4. The resulting silicic acid turns into a gel. The result is an alkaline gel-like substance with microcrystals of calcium, copper and magnesium fluorides. With an excess of Ca (OH) 2, the reaction proceeds without the formation of MgF2: MgSiF6 + 3Са (ОН) 2 = 2 CaF2 + Mg (OH) 2 + Si (OH) 4. Nanofluorides are stored in funnels from 0.5 to 2 years, gradually releasing fluoride.

The technique of conducting "deep fluorination" with the drug "Enamel-sealing liquid." Plaque is thoroughly removed from the teeth, including in the interdental space, dried for 0.5-1.0 minutes, the teeth are liberally moistened with a cotton swab soaked in the liquid for the first quenching, which is magnesium fluoride, for 30 seconds while blowing with warm air; then the surface of the teeth with pre-shaken preparation No. 1. After that, without making an intermediate mouth rinse, the tooth enamel is thoroughly moistened with a pre-shaken preparation No. 2. Only after this, the patient can rinse his mouth after 1-2 minutes. After two repetitions in 1-3 weeks, the procedure is subsequently carried out 1-2 times a year. It should be borne in mind that if you accidentally swallow a large amount of enamel-sealing liquid (more than 5 ml), it is recommended to drink a large amount of water or milk. In the doctor’s office, it can be recommended to use liquid gypsum milk as an antidote: 1 teaspoon per 1 glass of water.

The technique of "deep fluoridation" drug "Gluftored." Plaque is thoroughly removed from the teeth, including in the interdental space and dried; the teeth are liberally moistened with a cotton swab soaked in a liquid for the first stewing, which is magnesium fluoride silicate for 1 minute, while blowing with warm air; then the surface of the teeth is moistened with a suspension of copper-calcium hydroxide in water for 1 minute; rinse with water. A significant drawback is the laboriousness of both methods, the large time costs, the high likelihood of swallowing fluoride preparations, which is difficult to prevent when working with young children.

Fluoride applications are possible. For this purpose, 1-2% solutions of sodium fluoride or fluoride gels are used. They are used in the form of tooth-gingival applications. The surfaces of the teeth before application are thoroughly cleaned by cleaning with hygienic toothpastes, isolated from saliva and dried. The solution is applied on cotton swabs for 3-4 minutes or in the form of a cap. Fluoride solution cannot be swallowed. The presence of foreign objects and a large temporary exposure exclude the use of the above methods in children under 3 years of age.

Professor V.K. Leontiev for application proposed 1-2% gel of sodium fluoride on 3% agar. Before use, after brushing your teeth, the gel warmed up on the spirit lamp is applied with a brush to the teeth, where it touches in the form of a thin film upon contact with them. After this, the patient is released home with a recommendation not to eat food for 3 hours. This method is also laborious and of little use for young children, which in this case reduces its value.

In dental practice, the use of antiseptics is known. Typical and most studied agents are chlorhexidine, alexidine, diacid (Trykovsky Y., 1981; Petrikas A.Sh., Rumyantsev V.A., 1984). These substances in low concentrations (0.1-0.2% solutions) have a strong and specific antimicrobial effect, inhibiting the growth and development of microflora. Chlorhexidine as the most widely used tool for the prevention of caries (Giermo, 1975; Svatun B. et al., 1981) is used in the form of rinses and toothpaste. With its use, the amount of microflora that induces caries in the oral cavity is reduced by 80-90%, and the formation of plaque is reduced. For rinsing, a 0.05-0.2% solution is used 1-2 times a day after meals. The solution has a bitter taste, the color of the tongue can change (blackens), with prolonged use it helps to desquamate the epithelium in the oral cavity, and change the taste sensitivity. A significant drawback is the inability of young children to rinse their mouths and a bitter-tasting drug. In addition, there is evidence that with prolonged use, carcinogens can form in the oral cavity, therefore, only freshly prepared chlorhexidine solutions are used.

Silvering method (Saforayt, Japan), which halts the development of caries by chemical modification of carious tissues. The method consists in sequentially applying a solution of silver and a reducing agent (ascorbic acid, hydroquinone) to the carious tissue. After that, the silver goes into a metal form and is deposited on the surface in the form of finely dispersed crystals. The method contributes to the coloring of tooth tissues in black, which parents do not like and can contribute to the social maladaptation of the child. This method robs the child of an aesthetic smile.

These methods and the means used for its implementation are accepted as the closest prototype analogues. However, all of the above methods have significant disadvantages. All of them are of little use for a direct effect on the cariogenic flora in young children, from the moment of birth to 3 years old, and they do not provide an accessible, safe, accurate and easy-to-use method of prophylactic prophylaxis and, at the same time, treatment of dental caries, with application / application colloidal silver preparations in bacteriologically identified, most active biotopes as a model system for donation / source of cariogenic S. mutans, in order to suppress their growth and / or decrease titer using modern Certified and safe to use, tasteless and clear gels containing silver nanoparticles. Also a disadvantage of the above prototype analogues is: time costs, lengthy manipulation, high cost of specialized labor. Due to the peculiarities of the psycho-somatic status of young children, their restlessness, the examination by a specialist and the use of complex manipulations are inconvenient. In this regard, it is necessary to choose the optimal method, which involves minimal time costs for performing preventive and therapeutic procedures, is convenient, harmless, and easily accessible in young children. In addition, the proposed method is easily mastered by parents or people caring for children.

There is no evidence in the available scientific literature on the relationship between the high dissemination of cariogenic flora of biotopes of the mucous membrane of the back of the tongue and plaque from the lingual surfaces of the teeth in young children and the possibility of direct exposure to colloidal silver directly in these biotopes.

In the course of our study, it was found that the density of contamination with the cariogenic flora of the lingual surface of the teeth and the mucous membrane of the back of the tongue is statistically significantly identical, while their seeding is significantly higher than all other biotopes of the oral cavity, where Streptococcus mutans can be detected.

Currently, for studies of the microbial composition of the oral cavity and saliva, methods are used that are simple and convenient for children when applied directly to the dental office. For microbiological testing for Steptococcus mutans, we used in vitro diagnostic tests in children: “Dentocult SM Strip mutans” (Vivadent, Liechtenstein).

For the Dentocult SM Strip mutans rapid test, the rough surface of the test strip with a rounded end is pressed against the tongue of the child in which saliva is present. Test strips with a square end have a rough surface on which plaque is applied from tooth enamel. Then the strips are placed in selective nutrient saliva in a vial with a previously dissolved disk of the antibiotic bacitracin, which inhibits the growth of bacteria, except for S. mutans. The bottle is placed in an incubator for 48 hours at a temperature of 37 ° C. After the incubation, the presence of bacteria is detected by growth on the rough surface of the test strip of colonies having a color ranging from dark blue to blue. The quantitative composition is characterized by the density of their attachment and is compared with a reference card / diagram in the instructions for use.

An analysis of the colonization density of saliva, various tooth surfaces, the interdental space and the mucous membrane of the tongue back by pathogenic streptococci is presented in FIG. 1, he showed the predominance of Streptococcus mutans on the lingual surface of the teeth and the mucous membrane of the back of the tongue, with the lowest concentration of microorganisms on the vestibular surface of the teeth (p <0.01).

Object of the invention: to propose a method for non-specific pre-nosological prophylaxis and treatment of dental caries in young children to reduce the contamination of Streptococcus mutans with cariogenic microorganisms for dental plaque of deciduous teeth and the back of the tongue by using colloidal silver, and its direct effect on the mucous membrane of the back of the tongue and lingual surface of milk teeth as the most active donor biotopes, using ready-made nanosilver preparations, devoid of the above disadvantages.

The technical result consists in the fact that a gentle and painless prophylactic or therapeutic procedure is performed for young children, with the possibility of direct influence of Ag ⁺ silver nanoparticles active against cariogenic bacteria on the most highly seeded oral biotopes of Streptococcus mutans in young children as the most significant sources infection, as well as reducing the number / titer of pathogenic cariogenic microorganisms S. mutans, from among indigenous microflora of the human oral cavity, available treating the mucous membrane of the back of the tongue, lingual surfaces of milk teeth as areas with a probable donation function, using undeclared colloidal silver preparations with an ion concentration of Ag ⁺ 30 ppm in the form of a gel.

The quality of non-specific pre-nosological prophylaxis and treatment of caries is improved with the advent of the possibility of repeated rapid treatment of biotopes of the mucous membranes of the back of the tongue and lingual surface of the teeth in children as a way of direct bactericidal exposure to cariogenic bacteria Streptococcus mutans in biotopes, the possibility of repeated bacteriological monitoring of the results of the prevention and treatment. Development of an individual program for the prevention of dental caries by increasing or decreasing the dose, the frequency of administration and / or the course of prevention and treatment with the possibility of correction of these procedures in children. The absence of barriers to access to the surface of the tongue and lingual surfaces of the teeth at the appointment with a dentist or other specialist makes it possible to widely use the proposed method of exposure of Ag ⁺ silver nanoparticles to the pathogenic flora as a part of the microbiome of the tongue and lingual surfaces of the teeth directly, in different concentrations of the active substance, on the donation model / the source of Streptococcus mutans, significantly preventing both their reproduction and distribution to other oral biotopes in young children. Early non-specific prevention of caries in children plays an important role in maintaining dental health.

The technical result is achieved by the fact that before the start of preventive and therapeutic measures from parents received informed consent in accordance with Art. 20, No. 323 - Federal Law of 11/21/2011. All children undergo a comprehensive dental study: assessment of dental prosthetics, hygiene index (GI) and cariogenicity of dental plaque (KZN). The intensity of tooth decay with caries is determined using the kpu index: the number of carious, filled and removed temporary teeth due to complicated caries. To calculate the hygienic condition of the oral cavity, an index for young children according to E.M. is used. Kuzmina, 2000. The cariogenicity of ST is determined by the method of Hardwick J.L., Manley E.V. in modification Nedoseko VB Microbiological testing of young children is carried out, the presence and density of the bacteria of Streptococcus mutans being seeded by the mucous membrane of the dorsal surface / back of the tongue and all the surfaces of milk teeth examined are determined. The fence is carried out from the intact / non-carious area of the enamel of the teeth of the lower jaw and from the entire surface of the mucous membrane of the middle third of the back of the child’s tongue with a sterile tuffer. The degree of colonization of streptococcus mutans is assessed by the presence and quantitative content of Streptococcus mutans using the undeclared microbiological test "Dentocult SM Strip Mutans" manufactured by "Vivadent", Liechtenstein. The test is based on the use of a selective nutrient medium for cariogenic streptococci and a test strip with a square end and a rough surface, based on the natural ability of Streptococcus mutans bacteria to adhere.

The strip with the applied biological material is immersed, according to the manufacturer’s instructions, in a Streptococcus mutans selective nutrient broth with the antibiotic bacitracin, to which S. mutans are resistant. The vial is incubated for 48 hours at a temperature of 37 ° C. After the incubation, the presence of bacteria is detected by the growth density of the colonies towering on the rough surface of the test strip in the form of small blue balls with a diameter of 0.1-0.5 mm. Evaluation of the results is carried out according to the attached standard scheme in the instructions for use, reflecting the number / density of Streptococcus mutans colonies, the titer was assigned to one of four classes: class 0 corresponds to less than 10,000 colonies (CFU <10 ⁴ / ml), class 1 , less than 100,000 colonies (CFU <10 ⁵ / ml), 2nd class - from 100,000 to 1,000,000 (CFU10 ⁵ / ml - CFU10 ⁶ / ml), 3rd class -> 1,000,000 colonies (CFU> 10 ⁶ / ml) . The results are recorded in the register of selected strains. The number / density / contamination / titer of S. mutans revealed in the microbiome of the mucous membrane of the back of the tongue statistically significantly corresponds to the titer of Streptococcus mutans in the plaque of the most colonized biotope of the lingual surface of the lower jaw milk teeth. The data are presented in table 1. Therefore, the data obtained can be used as a prognostic model for determining the biotopes most seeded with cariogenic bacteria Streptococcus mutans hard tissues of milk teeth in young children with the aim of further processing them with colloidal silver.

After determination of CPU, IG, CZN, children were divided into two clinical groups: 15 children of 3 years of age with low activity and caries intensity, and 20 children of 3 years of age with high activity and intensity of carious process, which / both groups along with us developed prevention received colloidal silver preparations. The third control group had medium and high caries activity, where 18 children underwent a preventive scheme developed by us, but they did not receive silver preparations. The technical result of the proposed method is directly achieved by the fact that for children under 3 years of age from the clinical groups, against the background of the prophylaxis scheme proposed by us for all subjects, we additionally applied gel colloidal silver with a concentration of silver nanoparticles Ag ⁺ 30 ppm according to the scheme for 6 months . After 3 months and 6 months after the end of the course, the current and control dental and microbiological studies of children under 3 years old were performed in all groups. Gel for external use, “NAno SILver SOL” cleaning gel, 30 ppm, manufacturer of Resbio LLC, St. Petersburg, by order of NPO Zvezda, St. Petersburg, was used for 35 children up to 3 years of 2 experimental groups with acute and chronic caries. The course of application of the gel directly to the Streptococcus mutans source biotopes was carried out with a viscose tampon applicator in the amount of 2 drops: the first drop of the gel was squeezed out of the bottle with a diameter of 2.5-3 mm, first it was applied to the lingual surfaces of the teeth of the lower jaw on the left and then, on the right, the second a drop was applied to the mucous membrane of the middle third of the back of the tongue in circular motions from left to right, capturing the entire surface of the mucous membrane of the middle third of the back of the tongue from the center to the periphery. The whole procedure took no more than 30-40 seconds. The course of treatment was carried out as follows. An application of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm was carried out by parents 2 times a day in the morning and evening. It is recommended that in the morning on an empty stomach, pre-hygienic brushing of the teeth, give the child 30.0-50.0 ml of clean water and after 5-7 minutes, sequential treatment of biotopes of the lingual surfaces of the teeth and back of the tongue, applying an undeclared gel with Ag ⁺ nanoparticles at a concentration of 30 ppm. You can take food no earlier than after 20-30 minutes. It is recommended in the evening before going to bed, to carry out hygienic brushing of teeth beforehand, to give the child 30.0-50.0 ml of clean water, and after 5-7 minutes to conduct sequential treatment of biotopes of the lingual surfaces of the lower teeth jaws and backs of the tongue, applying an undeclared gel with Ag ⁺ nanoparticles at a concentration of 30 ppm. The application can be done no earlier than an hour after eating and / or drinks. The scheme is designed for two courses over 6 months. The basic course includes the application of colloidal silver 2 times a day for 7 days, the next 7 days, a break, only 3 months. The maintenance course includes the application of colloidal silver once a day at bedtime for 14 days, the next 14 days, a break, only 3 months.

After carrying out the proposed treatment and preventive measures scheme, including: sanitation of the oral cavity, normalization of the nature and diet with the elimination of the carbohydrate factor, topical application of fluorides once every 3 months, consultation with a pediatrician. After demonstrating samples with grown colonies of pathogenic bacteria to increase motivation, parents were taught oral hygiene using dental floss. In three groups, statistically significant results were obtained to reduce plaque formation on tooth surfaces, and to reduce the titer of cariogenic Streptococcus mutans in the studied oral biotopes. Kpu growth did not occur in the 1st experimental group, insignificantly in the 2nd group, in the control group against the background of the prophylaxis developed by us, there was an increase in kpu in 7 out of 18 children. Dynamics of the tooth kpu index in 3-year-old children during preventive measures (M ± m) are presented in table 2

The advantages of the proposed method are:

- harmlessness, reduction of time costs, profitability;

- the availability of biotopes of the lingual surface of the teeth of the lower jaw and the biotope of the back of the tongue in children;

- sparing diagnostic procedure for young children; simplicity and speed of use;

- the possibility of indirect non-specific treatment and prevention of dental caries, reduction of dental plaque caries in young children, effects on cariogenic microorganisms, including indigenous microflora of the human oral cavity, Streptococcus mutans, mucous membrane of the back of the tongue and soft plaque of hard lingual surfaces of the teeth directly in their biotopes -sources;

- improving the quality of pre-nosological prophylaxis and treatment, with the advent of the possibility of repeated bacteriological monitoring of the contamination of the mucous membranes of the back of the tongue and the lingual surface of the teeth of the lower jaw as an indicative way to detect cariogenicity of dental plaque as a result of a set of preventive measures;

- prevention of dental caries in young children through the use of colloidal silver with immunomodulating properties;

- improving the quality of treatment / preventive measures and the possibility of correcting therapeutic and preventive procedures with safe drugs with silver nanoparticles for children of early age;

- the absence of barriers to access to the surface of the back of the tongue at the appointment of a dentist or other specialist, makes it possible to widely use the proposed method for reducing the titer of cariogenic flora in the microbiome of the root and hard tissues of the teeth on the model of donation of cariogenic bacteria into other biotopes of the oral cavity in young children;

- after completing the course of the complex of treatment and prophylactic measures, in the absence of contraindications, it is possible to conduct a repeated course of applying colloidal silver to the surface of the back of the tongue and lingual surface of the teeth at the discretion of the attending physician;

- resistance to silver in cariogenic bacteria was not found;

- high parental compliance with the proposed method of prevention and treatment

Example 1

Child A., 2 years 11 months, during the initial treatment revealed: lack of sanitation - teeth CPD was 7, poor oral hygiene / GI - 0.74 and pronounced cariogenic plaque - 2 points. In the oral cavity: 53, 52, 51, 61, 62, 63, 64 teeth: acute course of caries, decompensation: deep carious cavities, wet dentin, bright. The child was examined microbiologically, according to the proposed method. The biomaterial was taken from 4 biotopes: plaque from the vestibular and lingual surfaces of the teeth, the interdental space and from the mucous membrane of the back of the tongue. It was found that the contamination of the mucosa of the back of the tongue and lingual surface of the teeth with cariogenic bacteria Streptococcus mutans corresponds to the 3rd class / CFU> 10 ⁶ / ml; No statistically significant differences were found. The seeding of the vestibular surface of the tooth is 1 class / CFU <10 ⁵ / ml, interdental space - 2 class, which corresponds to CFU 10 ⁵ / ml - CFU 10 ⁶ / ml. Thus, during the initial examination revealed a high contamination of cariogenic bacteria. A high titer of pathogenic microflora is due to the lack of sanation, poor oral hygiene and pronounced cariogenic plaque. A complex of treatment and preventive measures was prescribed, including: sanitation of the oral cavity, normalization of the nature and diet with the elimination of the carbohydrate factor, topical application of fluorides once every 3 months, consultation with a pediatrician. After demonstrating samples with grown colonies of pathogenic bacteria to increase motivation, parents were taught oral hygiene using dental floss and applications of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm according to the scheme below.

An application of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm was carried out by parents 2 times a day in the morning and evening. In the morning on an empty stomach, after preliminary hygienic brushing of the teeth, the child was given 30.0-50.0 ml of pure water and after 5-7 minutes the biotopes of the lingual surfaces of the teeth and back of the tongue were sequentially treated, an undeclared gel with Ag ⁺ nanoparticles at a concentration of 30 ppm was applied. They took food no earlier than 20-30 minutes. In the evening before going to bed, we preliminarily carried out hygienic brushing of the teeth, gave the child 30.0-50.0 ml of clean water, and after 5-7 minutes, the biotopes of the lingual surfaces of the teeth of the lower jaw and back of the tongue were sequentially treated, an undeclared gel with Ag ⁺ nanoparticles in a concentration 30 ppm. The application was performed no earlier than an hour after eating and / or drinks. The scheme was performed in two courses for 6 months. The basic course included the application of colloidal silver 2 times a day for 7 days, the next 7 days, a break, only 3 months. The maintenance course included the application of colloidal silver once a day at bedtime for 14 days, a break of the next 14 days, a total of 3 months.

After 3 months, after a complex of treatment and prophylactic measures using a gel with colloidal silver, the dental status and the seeding rate of cariogenic microorganisms were re-evaluated. For all indicators received a significant improvement. The value of kpu remained the same - 7, but the component “k” - “0”, “p” - 7 changed in the structure of the index. Analysis of the results showed a significant decrease in GI - 0.24, the values of dental plaque cariogenicity improved to 1 point. It was found that the contamination of the mucosa of the back of the tongue and lingual surface of the teeth with cariogenic bacteria Streptococcus mutans corresponds to the 1st class / CFU <10 ⁵ / ml; No statistically significant differences were found. The seeding of the vestibular surface of the tooth is 1 class / CFU <10 ⁵ / ml, interdental space - 1 class, which corresponds to CFU <10 ⁵ / ml. During the follow-up observation, no new foci of carious lesions were revealed in the child.

Example 2

Child S., 2 years old, 4 months old, tooth CPR was 0. Oral hygiene / GI - 0.18, the value of cariogenic plaque - 1 point. The child was examined microbiologically, according to the proposed method. The biomaterial was taken from 4 biotopes: plaque from the vestibular and lingual surfaces of the teeth, the interdental space and from the mucous membrane of the back of the tongue. It was found that the contamination of the mucous membrane of the back of the tongue and lingual surface of the teeth with cariogenic bacteria Streptococcus mutans was - class 2, which corresponds to CFU 10 ⁵ / ml - CFU 10 ⁶ / ml; No statistically significant differences were found. The seeding of the vestibular surface of the tooth is class 0, which corresponds to CFU <10 ⁴ / ml, interdental space - 1 class / CFU <10 ⁵ / ml. We carried out a set of treatment and preventive measures that we developed, including: sanitation of the oral cavity, normalization of the nature and diet with the elimination of the carbohydrate factor, topical application of fluorides once every 3 months, consultation with a pediatrician. After demonstrating samples with grown colonies of pathogenic bacteria to increase motivation, parents were taught oral hygiene using dental floss and applications of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm according to the scheme below.

The application of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm was carried out by parents 1-2 times a day in the morning and evening. In the morning on an empty stomach, they preliminarily carried out hygienic brushing of teeth, gave the child 30.0-50.0 ml of clean water, and after 5-7 minutes, the biotopes of the lingual surfaces of the teeth and back of the tongue were sequentially treated by applying an undeclared gel with Ag ⁺ nanoparticles at a concentration of 30 ppm. They took food no earlier than 20-30 minutes, in the evening before going to bed, pre-carried out hygienic brushing of teeth, gave the child 30.0-50.0 ml of clean water, and after 5-7 minutes, the biotopes of the lingual surfaces of the teeth of the lower jaw were sequentially treated and the back of the tongue, an undeclared gel was applied with Ag ⁺ nanoparticles at a concentration of 30 ppm. The application was performed no earlier than an hour after eating and / or drinks. The scheme consisted of two courses for 6 months. The basic course included the application of colloidal silver 2 times a day for 7 days, the next 7 days, a break, so in turn, only 3 months. The maintenance course included the application of colloidal silver once a day at bedtime for 14 days, a break of the next 14 days, a total of 3 months.

After 3 months, after a complex of treatment and prophylactic measures using a gel with colloidal silver, the dental status and the seeding rate of cariogenic microorganisms were re-evaluated. For all indicators received a significant improvement. The value of kpu remained the same - 0. Analysis of the results showed the previous value of GI - 0.1, and cariogenicity of plaque up to 0 points. It was found that the contamination of the mucous membrane of the back of the tongue and lingual surface of the teeth with cariogenic bacteria Streptococcus mutans corresponds to class 0 CFU <10 ⁴ / ml; No statistically significant differences were found. The seeding of the vestibular surface of the tooth is class 0, which corresponds to CFU <10 ⁴ / ml, interdental space is class 0, which corresponds to CFU <10 ⁴ / ml. During the follow-up observation, no new foci of carious lesions were revealed in the child.

Example 3

Baby O., 2 years, 9 months, tooth CPD is 1. Good oral hygiene / GI - 0.14, the value of cariogenic plaque - 0 points. In the oral cavity: 64 tooth - a chronic course of caries, compensation: medium carious cavity, dense dentin, pigmented. The child was examined microbiologically, according to the proposed method. The biomaterial was taken from 4 biotopes: plaque from the vestibular and lingual surfaces of the teeth, the interdental space and from the mucous membrane of the back of the tongue. It was found that the seeding of the mucous membrane of the back of the tongue and lingual surface of the teeth with cariogenic bacteria Streptococcus mutans in the 2nd class, which corresponds to CFU <10 ⁵ / ml; No statistically significant differences were found. The seeding of the vestibular surface of the tooth is class 2 / CFU <10 ⁵ / ml, the interdental space is class 2, which corresponds to CFU <10 ⁵ / ml. A complex of treatment and preventive measures was prescribed, including: sanitation of the oral cavity, normalization of the nature and diet with the elimination of the carbohydrate factor, topical application of fluorides once every 3 months, consultation with a pediatrician. After demonstrating samples with grown colonies of pathogenic bacteria to increase motivation, parents were taught oral hygiene using dental floss and applications of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm according to the scheme below.

An application of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm was carried out by parents 2 times a day in the morning and evening. In the morning on an empty stomach, after preliminary hygienic brushing of the teeth, the child was given 30.0-50.0 ml of pure water and after 5-7 minutes the biotopes of the lingual surfaces of the teeth and back of the tongue were sequentially treated, an undeclared gel with Ag ⁺ nanoparticles at a concentration of 30 ppm was applied. They took food no earlier than 20-30 minutes. In the evening before going to bed, we preliminarily carried out hygienic brushing of the teeth, gave the child 30.0-50.0 ml of clean water, and after 5-7 minutes, the biotopes of the lingual surfaces of the teeth of the lower jaw and back of the tongue were sequentially treated, an undeclared gel with Ag ⁺ nanoparticles in a concentration 30 ppm. The application was performed no earlier than an hour after eating and / or drinks. The scheme was performed in two courses for 6 months. The basic course included the application of colloidal silver 2 times a day for 7 days, the next 7 days, a break, only 3 months. The maintenance course included the application of colloidal silver once a day at bedtime for 14 days, a break of the next 14 days, a total of 3 months. After a complex of treatment and preventive measures using a gel with colloidal silver, indicators of dental status improved. The value of kpu remained the same - 1, but the component “k” - “0”, “p” - 1 changed in the structure of the index. Analysis of the results showed the previous value of GI - 0.14, and cariogenicity of plaque to 0 points. It was found that the contamination of the mucosa of the back of the tongue and lingual surface of the teeth with cariogenic bacteria Streptococcus mutans corresponds to the 1st class of CFU <10 ⁵ / ml .; No statistically significant differences were found. The seeding of the vestibular surface of the tooth is 0 class, which corresponds to CFU <10 ⁴ / ml., Interdental space - 1 class, which corresponds to CFU <10 ⁵ / ml. During the follow-up observation, no new foci of carious lesions were revealed in the child.

Example 4

Child S., 2 years, 10 months, tooth CPD equal to 8. Poor oral hygiene / GI - 0.68, the value of cariogenic plaque - 2 points. In the oral cavity: 54, 53, 52, 51, 61, 62, 63, 64 teeth: acute course of caries, decompensation: carious cavities are deep, the dentin is moist, light. The child was examined microbiologically, according to the proposed method. The biomaterial was taken from 4 biotopes: plaque from the vestibular and lingual surfaces of the teeth, interdental space and from the mucous membrane of the back of the tongue. It was found that the contamination of the mucous membrane of the back of the tongue and lingual surface of the teeth with cariogenic bacteria Streptococcus mutans was - Grade 3, which corresponds to CFU> 10 ⁶ / ml; No statistically significant differences were found. The seeding of the vestibular tooth surface is grade 3 CFU> 10 ⁶ / ml, the interdental space is grade 3, which corresponds to CFU> 10 ⁶ / ml. In this clinical case, we did not prescribe the application of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm. A child underwent a set of treatment and preventive measures that we developed, which included: sanitation of the oral cavity, normalization of the nature and diet with the elimination of the carbohydrate factor, topical application of fluorides once every 3 months, consultation with a pediatrician. After demonstrating samples with grown colonies of pathogenic bacteria to increase motivation, parents were taught oral hygiene using dental floss. After a complex of treatment and prophylactic measures without the use of gel with colloidal silver, the indicators of dental status also improved, the contamination of cariogenic bacteria decreased. The value of kpu remained the same - 8, but the component “k” - “0”, “p” - 8 changed in the structure of the index. Analysis of the results showed a significant decrease in GI - 0.28, the values of dental plaque cariogenicity improved to 1 point. It was found that the contamination of the mucous membrane of the back of the tongue and lingual surface of the teeth with cariogenic bacteria S. mutans corresponds to the 1st class / CFU <10 ⁵ / ml; No statistically significant differences were found. The seeding of the vestibular surface of the tooth is 1 class / CFU <10 ⁵ / ml, the interdental space is 1 class, which corresponds to CFU <10 ⁵ / ml. During the follow-up observation, an increase in one focus of carious lesions of the teeth was revealed.

Example 5

Child R., 2 years 11 months, tooth CPD is 4. Poor oral hygiene / GI - 0.62 and pronounced cariogenic plaque - 2 points. In the oral cavity: 52, 51, 61, 62 teeth — a chronic course of caries, compensation: carious cavities made by dense, pigmented dentin. The child was examined microbiologically, according to the proposed method. The biomaterial was taken from 4 biotopes: plaque from the vestibular and lingual surfaces of the teeth, the interdental space and from the mucous membrane of the back of the tongue. It was found that the contamination of the mucous membrane of the back of the tongue and lingual surface of the teeth with cariogenic bacteria Streptococcus mutans was in the 3rd class, which corresponds to CFU> 10 ⁶ / ml; No statistically significant differences were found. The seeding of the vestibular surface of the tooth is 1 class / CFU <10 ⁵ / ml, the interdental space is 1 class, which corresponds to CFU <10 ⁵ / ml. In this clinical case, we did not prescribe the application of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm. A child underwent a set of treatment and preventive measures that we developed, which included: sanitation of the oral cavity, normalization of the nature and diet with the elimination of the carbohydrate factor, topical application of fluorides once every 3 months, consultation with a pediatrician. After demonstrating samples with grown colonies of pathogenic bacteria to increase motivation, parents were taught oral hygiene using dental floss. After a complex of treatment and prophylactic measures without the use of gel with colloidal silver, the indicators of dental status also improved, the contamination of cariogenic bacteria decreased. The value of kpu remained the same - 4, but the component “k” - “0”, “p” - 4 changed in the structure of the index. Analysis of the results showed a significant decrease in GI - 0.20, the values of dental plaque cariogenicity improved to 1 point. It was found that the contamination of the mucosa of the back of the tongue and lingual surface of the teeth with cariogenic bacteria Streptococcus mutans corresponds to the 1st class / CFU <10 ⁵ / ml; No statistically significant differences were found. The seeding of the vestibular surface of the tooth is 1 class / CFU <10 ⁵ / ml, the interdental space is 1 class, which corresponds to CFU <10 ⁵ / ml. During the follow-up observation, an increase in one focus of carious lesions of the teeth was revealed.

Colonization of Streptococcus mutans vestibular and lingual surfaces of the teeth, interdental space and mucous membrane of the back of the tongue

The dynamics of the index of tooth kpu in children of 3 years during preventive measures (M ± m)

Claims (1)

A method for non-specific pre-nosological prophylaxis and treatment of dental caries in young children, including a preliminary set of dental examinations and microbiological diagnostics of Streptococcus mutans bacteria colonizing the lingual surface of the temporary teeth of the lower jaw and mucous membrane of the middle third of the back of the tongue in children, using colloidal silver applications with a concentration of silver nanoparticles Ag ⁺ 30 ppm in gel form, characterized in that in the group with acute or chronic course caries ann the gel is mixed with nanosilver directly into biotopes - sources of Streptococcus mutans, with a viscose tampon applicator, each time in the amount of two drops: the first drop of the gel with a diameter of 2.5-3 mm is squeezed out of the bottle, sequentially applied to the lingual surfaces of the lower jaw teeth on the left and then on the right, the second drop is applied to the middle third of the back of the tongue in circular motions from the center to the periphery, from left to right, capturing the entire surface of the mucous membrane of the middle third of the back of the tongue, while apple is applied during the basic course ikation with colloidal silver 2 times a day in the morning on an empty stomach and in the evening before bedtime for 7 days, the next 7 days, a break of only 3 months, in the morning pre-conduct hygienic brushing of the teeth, give the child 30.0-50.0 ml of clean water and after 5- 7 min. Sequentially apply a gel with Ag ⁺ nanoparticles on the lingual surface of the teeth and back of the tongue, take food after 20-30 minutes; in the evening before going to bed, not earlier than an hour after eating and / or drinks, carry out hygienic brushing of the teeth, give the child 30.0-50.0 ml of clean water and after 5-7 minutes conduct sequential treatment of the lingual surfaces of the teeth of the lower jaw and backs of the tongue; apply a gel with Ag ⁺ nanoparticles; the maintenance course lasts 3 months, for 14 days they spend the application of colloidal silver 1 time a day before bedtime, the next 14 days, a break, this allows to achieve the absence of growth of caries at the stages of the follow-up.

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