RU2685492C1 - Method of prevention of dental caries in young children by impact on controllable risk factors of development thereof - Google Patents

Abstract

FIELD: medicine; dentistry.SUBSTANCE: invention relates to medicine, dentistry, microbiology. Used to prevent dental caries in young children. Achieved by the implementation of the main and additional programs of prevention. Main program includes counseling and educational work with parents. Additional program uses gel applications with colloidal silver Ag + 30 ppm according to the scheme for 6 months in the S. mutans source biotopes on the lingual surfaces of the lower jaw teeth and the back of the tongue mucosa 1–2 times a day on an empty stomach. Use natural non-carbonated mineralized oxygen water 2 times a day. Use freshly squeezed carrot juice, or carrot puree, or ready-made carrot puree "FrutoNyanya" 2 times a day. Apply dental floss. Water “Wave of Baikal” with a neutral pH and bioavailable ions of calcium, magnesium and silver in the morning on an empty stomach 20–30 minutes before meals and in the evening before going to bed according to the scheme before applying the gel with colloidal silver is used, at one time for children from 6 to 12 months – 20–30 ml each, from 1 to 2 years old – 30–40 ml each, from 2 to 3 years old – 40–50 ml each or for individual needs. Juice / puree is prepared from organic carrots, given within the age norm, 2 times a day with meals from 12.00 to 18.00 according to the regimen: children from 6 to 12 months – 20.0 ml / 1 tbsp. l.; from 1 to 2 years – 40.0 ml / 2 tbsp. l.; from 2 to 3 years – 40.0–60.0 ml / 2–3 tbsp. l. Basic course includes the use of carrot juice / puree for 7 days, 7 days break, just 3 months, alternating: 7 days natural water and colloidal silver, 7 days natural water and carrot juice / puree; supporting course of 3 months, drinking carrot juice / puree 1 time a day until 18.00, water 2 times a day, colloidal silver 1 time before going to bed 14 days, and 14 days break, dental floss is used waxed, bulky, once or twice a day before going to bed or after each meal, if it is possible.EFFECT: method provides for the management of factors: cariogenicity of dental plaque, the titer of cariogenic bacteria Streptococcus mutans, the cleansing properties of saliva, histadragous and coadhesive ability of the oral microbiome, dehydration of the oral tissues, stimulation of specific immunity.1 cl, 20 dwg, 5 ex, 3 tbl

Description

The invention relates to the field of medicine - dentistry / pediatric dentistry and microbiology / bacteriology and can be used for non-standard non-specific prophylaxis of dental caries in young children and enter into the complex treatment of caries of temporary and permanent teeth, the effect on controlled cariogenic factors: cleansing properties, viscosity and saliva pH, reduction of dental plaque and titer of cariogenic bacteria Streptococcus mutans in the oral cavity, histadastic and coadhesive ability of the oral microbiome, stimulus factors of species immunity.

In recent years, there has been an increase in interest in the fundamental issues of medical microbiology and immunology, in which the section on indigenic / resident microflora of the oral cavity (Zelenova EG, Zaslavskaya MI, Salina EV and Oral microflora of the oral cavity: norm and pathology (2004). Today, the leading role of microflora in the occurrence of a carious process has been proved (Knest S., Maslak E., Tsarev R.I. Biologic and social risk factors for the occurrence of early children's caries. Modern dentistry, 2011. No. 1. P. 62-65) .

The prevalence of caries in our country reaches 95-98%. (Kuzmina EM. Stom. The incidence of the population of Russia. M. 2009. 236 c). At the same time, tooth decay of the teeth among young children increased by 3 times (Kiselnikova L.P., Tokareva A.V. Caries of early childhood and its complications. 9th Congress of the European Academy of Pediatric Dentistry. Dubrovnik. 2008. p . 107). Knowledge of oral ecology, mechanisms of formation of normal microbial flora, regulation of ecosystem homeostasis is essential for pathogenetic substantiation of the primary program for preventing caries in young children by preventing the formation of selective conditions for Streptococcus mutans cariogenic dental plaque bacteria by affecting certain controllable risk factors for caries.

The value of the oral microbial flora is twofold: on the one hand, the role of the biological barrier / provision of colonization resistance as a factor of species immunity, on the other - a permanent reservoir of opportunistic bacteria with genetic potential that determines the risk of autoinfection under favorable conditions. The manifestation of protective or pathogenic properties by resident microbes depends on the microorganism and on the state of the tissues of the oral cavity.

The main regulator of the total number of microorganisms in the oral cavity is saliva (A.Yu. Tomnikov, VI Korzhenevich. The microflora of the oral cavity, 1996) and in modern dentistry, its role in the development of dental caries is of great importance (Barer G.M. Crystal variability aggregates of oral fluid in norm. Growth. Journal. 2003 No. 1. P. 31-35; Simonova M., Vasilyev V. Dental status and condition of the salivary glands in patients with Sjogren's disease during the development of lymphoproliferative complications. Dental education. 2011. No. 38. pp. 38-42; Hedman, J., Sjoma Caries Res. 2006. Vol. 40 - No. 2, P. 158-162). Mixed saliva consists of 99% water, organic and inorganic substances, being a multicomponent system, possessing bicarbonate and phosphate buffers. Saliva electrolytes play a primary role in remineralization processes: the salivary function of saliva is due to its oversaturation with calcium ions, phosphates and fluorides. And the degree of its saturation determines the pH of the medium. The main component of dentin, up to 70% and tooth enamel, up to 97% is hydroxyapatite, biological calcium phosphate and the third largest component of our body after water and collagen. Human saliva is a saturated solution of hydroxyapatite; protects teeth by neutralizing plaque acids and replenishes mineral loss during demineralization. After the ingestion of sugar into the oral cavity, the bacteria of dental plaque turn sugar into acid, the pH of the plaque sharply decreases. As long as this indicator remains in the acid range, and the plaque fluids are undersaturated in comparison with the tooth minerals, the acids produced by bacteria diffuse through the plaque and into the tooth, leaching calcium and phosphorus from the enamel. Demineralization occurs. Between the periods of formation of acids, alkaline buffers present in saliva diffuse into the plaque and neutralize the acids present, which stops the loss of calcium and phosphorus. Remineralization occurs. (Electronic resource: http://www.tusheflora.ru/products/powders/functional-powders/hydroxyapatite/, the date of circulation is 11/22/17). Hydroxyapatite - a component of natural enamel naturally alkalinizes the environment of oral fluid. In saliva, the pH varies significantly - from 6.0 to 8.0. With a decrease in pH, the degree of supersaturation of saliva with hydroxyapatite decreases sharply and its remineralizing activity decreases. In individuals with chronic diseases of the salivary glands, the secretion level decreases by 40%, the pH reaches 6.98 ± 0.05, and its composition drastically increases the concentration of sodium and potassium, which is accompanied by a sharp increase in the incidence of caries. The protective function of saliva is associated with its mechanical, immunological and antibacterial factors. Constant flow of saliva, moistening the mucous membrane with it helps to preserve the organs of the oral cavity in an active functional state, prevents the mucous membrane from drying out and the development of inflammatory processes. Mucoproteins of saliva / mucin reduce friction of the organs of the oral cavity, give the necessary viscosity to saliva. The salivary glands provide an adequate amount of secretion and the quality of saliva necessary for the formation of a food lump convenient for chewing and ingestion (EV Borovsky, VK Leontyev. Oral cavity biology. M. Med. Book, 2001). The mineral balance in the hard tissues of temporary teeth is determined not only by the activity of the controlled aggression factors, but also by the objective determinants of the carious process: reserves of mineral tissues, as well as the quality of saliva available to the tooth. The activity of the salivary glands is minimal during sleep, labile glands have the lowest ability to clear food and neutralize acids; effects of saliva are limited for the proximal surfaces in the zone of tight interdental contact, for enamel pits and fissures. Reducing the level of secretion of saliva leads to deterioration of the mechanical and chemical cleansing of the oral cavity from food debris, detritus, microbial mass. A rare lesion of the lower incisors in case of caries is explained by better self-cleaning due to the position of the tongue and abundant washing with saliva (Kuzmina E.M. Prevention of dental diseases. M. Medicine. 2001. 32 p.). Thus, in children with a compensated course of dental caries, the optimal rate of salivation is 0.43 ± 0.02 ml / min., And in children with decompensated caries, the rate of salivation is reduced to 0.27 ± 0.01 ml / min. An increase in the viscosity of mixed saliva is noted in both groups of up to 3.59 and 3.01 units, which impairs the oral cavity self-cleaning and is one of the biological risk factors for the development of caries in children (TE Yavorovskaya. Comparative characteristics of the composition and properties of mixed saliva in school-age children Acta medica Eurasica, 2016. - № 1. - p. 36-40). The deterioration of self-cleaning of the oral cavity leads to a decrease in mineralization in the oral cavity and the creation of favorable conditions for the development of microflora in it. With insufficient salivation, bacteria accumulate on the surface of the mucous membrane of the oral cavity and hard tissues of teeth, and saliva loses its antimicrobial, buffer, mineralizing and cleansing functions. With an insufficient volume of saliva and oral fluid, in conditions of chronic dehydration and poor oral hygiene, plaque forms (TP Vavilova, OO Yanushevich, IG Ostrovskaya. Saliva. Analytical possibilities and prospects. M., 2014. - p. 273-277).

Great importance in the development of caries is assigned to the sediment of the oral fluid, consisting of microflora, cellular elements, detritus, food debris, acid phosphatase, lactic and pyruvic acid. The liquid phase of saliva does not have a pronounced metabolic activity, leading to acid production and decalcification. More dangerous sediment, which due to proteolytic activity adversely affects the protective function of enamel. In caries-resistant individuals, the amount of sediment is 30% lower compared to caries-bearing individuals. Disruption of the mineralization processes in the oral cavity is determined by the mineralizing potential of saliva and directly depend on the active calcium concentration, total phosphorus content and pH of the medium, against the background of a decrease in total protein in saliva, changes in viscosity, which leads to the development of caries .G. Methods of research of oral fluid and the state of hard tissues of teeth, literature review, part 1, 2. Institute of Dentistry, 2013).

In the literature of recent years, there is convincing evidence of the influence of mucosal microbiocenosis on the mucosal immune response and, as a result, the realization of inflammation (Saavedra), Mechanisms of Action, and Practical Application. Saavedra. Nutr. Clin. Pract. 2007. 351-365). Low concentrations of secretory immunoglobulins serve as a predisposing factor for the development of inflammatory reactions of infectious etiology, and a significant increase in their content indicates the presence of an active inflammatory process (Lundell AG, Anderson K., Josefsson E. Soluble CD14 and CD83 from human neonatal antigen-presenting cells are inducible by commensal bacteria and human neonatal Th2 differentiation. Infect. & Immunity. 2007. 4097-4104). One of the most important humoral factors of protection of the oral cavity are immunoglobulins: IgA, IgG, IgM. They enter the saliva as a result of local synthesis by plasma cells and from the blood through extravasation through the gingival groove (Denisov, AV, The salivary glands. Saliva. TH. Publishing House of the Russian Academy of Medical Science. 2003. p. 136). The core of the oral cavity is secretory immunoglobulin A / sIgA, which is synthesized by epithelial cells of the excretory ducts of the salivary glands and is considered the most effective in providing local antimicrobial protection of the oral cavity (Radish, IV, Torshin VI, Papilko IV, Daurova FJ, Nikulina GV) Bulletin RUFP. 2007. N. 6. P. 75-79. Bacteria colonization of the infant’s oral cavity is easier than in adults, due to the functional immaturity of the immunological mechanisms of secretory immunity and the low level of immunoglobulin sIgA, which is destroyed by enzymes of a number of pathogens that contaminate the oral cavity, increasing the risk of developing caries in early childhood (L. P. Kiselnikova. , Vagemans N.V. Modern opportunities for the prevention of dental caries in young children. Pediatrics. 2010. 89 (5): 130-136).

In addition to immunoglobulins, lysozyme is important in the mechanism of protection, along with antibacterial properties, it has the ability to stimulate the nonspecific reactivity of the organism, to have anti-inflammatory and mucolytic effects (Amerongen, AVN, Ligtenberg AJM, Veerman ECI Ann. NY Acad. Sci. 2007. V. 1098. N1. P. 1-6).

The state of the immune system and resistance to various infections, including diseases of the oral cavity, largely depend on human nutrition (Leontyev VK, Kiselnikova LP. Pediatric therapeutic dentistry. National leadership. M .: GEOTAR-Media, 2017, 952 with.). In addition, the qualitative composition of the resident microflora depends on the length of intervals between meals, its consistency and nutritional characteristics. For example, an excess of sucrose in food contributes to the proliferation of yeast-like fungi Candida albicans; when it is replaced with glucose, they decrease or disappear. Of all carbohydrates, sucrose is the most significant aggressive factor, since it converts non-cariogenic / anticariogenic products into cariogenic / cariogenic. Sucrose contributes to an increase in the proportion of Streptococcus mutans and lactobacilli and simultaneously decreases the level of Streptococcus sanguini. (Douglass JM); 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). Sugar plays a significant role in the mechanism of plaque formation (EF), its adhesion to enamel and the activity of various microbes, among which resident bacteria, S. mutans gram-positive cocci, are the most important, they actively form ZN on any solid surfaces. The hypothesis about the role of streptococci in the development of caries has been adopted in the United States since 1960 after research in the country since the 40s of the 20th century (Shafer WG, A textbook of oral pathology, 1974). S. mutans due to the anaerobic glycolysis of sucrose and other simple carbohydrates, forms organic acids lactate and pyruvate, which, upon prolonged exposure, demineralize hard tooth tissues and develop caries (Seow KW. Dent Oral Epidemiol. 1998). S. mutans are tolerant to acids: they can exist when the pH shifts to the acidic side to a pH <5.5 level, and other oral microbes die under such conditions (Ovrutsky GD, Leontyev VK 2010). A decrease in pH in the dental plaque accompanies each meal containing fermentable carbohydrates: the Stefan curve reaches perigee in 5–20 minutes and returns to its original level by 30–60 minutes after food enters the oral cavity (Stephan. RM). on tooth surfaces and in caries lesion. JADA 1940. Vol. 27. P. 718-720). The membrane of S. mutans contains ATP-ase, which removes H ⁺ ions from the cell, which allows bacteria to grow in an acidic environment inaccessible to acid-sensitive microorganisms, which promotes the colonization of various biotopes of the child's oral cavity by S. mutans streptococci: these are the back sections of the mucous membrane shell of the back of the tongue, gingival sulcus and plaque (V.S. Kramar, et al., 1992; Zelenova, E.G. et al. Oral microflora: norm and pathology. N. Novgorod. 2004. 158 p.).

For a child, the source of a cariogenic infection is more often the mother, less often other adult family members. Infection can be direct and indirect. Direct infection involves close physical contact when microorganisms immediately transfer from one host to another (Skripkina GI, Smirnov SI A model of caries development in children. Pediatric dentistry and prevention. 2012. No. 3. P. 3- 7). In the case of indirect infection, microorganisms enter the child’s mouth through objects that have been in the mouth of another person, where they survive outside the body for up to 7 hours. The ability of S. mutans to colonize the oral cavity is determined by the number of transmitted individuals, the frequency of contacts, the ability of microbial cells to adhere, "age", and the occupancy of the tooth, carbohydrate load and body properties that determine sensitivity to microorganisms (Borutta A., Wagner M., Kneist S. Early Childhood Caries: A Multi-Factorial Disease. OHDMBSC. 2010. Vol. IX, No. 1. P. 32-38.). A mother with a high concentration of S. mutans in the oral fluid with each sample of the baby’s food with a spoon transmits to him several hundred colonizing units of S. mutans, which is a hundred times more than what happens with a low concentration of microorganisms in the mother’s mouth (Berkowitz RJ Causes, treatment microbiologic perspective, J. of Canad. Dent. Assoc. 2003. Vol. 69. (5). P. 304-307. 8. 168 p. If the sugar-containing food enters the child’s diet, one more “requirement” of streptococci for colonization of the oral cavity is fulfilled.

The disease does not develop because of the presence of S. mutans in the oral cavity, but because of the ecological shift in the biocenosis of the dental biofilm in favor of this microorganism and the acidophilic microflora as a whole. This shift is the result of the adaptation of the multicomponent biocenosis of the dental biofilm to the specific conditions of the oral cavity. Selective condition for acidophilic microflora is an acidic environment, which is supported by the intake of carbohydrate-containing foods and the saccharolytic activity of acidophilic / acidogenic microflora, which can ferment sucrose, fructose, glucose and starches that have been heat treated to acids. The predominance of S. mutans among acidophilus is established using several mechanisms, in particular: a. colonization of free niches, implemented with early infection of the child; free niches can appear at any age of the child; b. high competitiveness of S. mutans among other acidophilic microorganisms in the stressful conditions of the oral cavity: S. mutans has several means for attaching to smooth surfaces of the tooth, is able to synthesize energy reserves, allowing it to survive with occasional food intakes and fluctuations in the pH of the medium, with substrate deficiency synthesizes bactericidal mutations for suppression of other acidophiles, has the highest tolerance to acidic medium, does not suffer at pH = 5.5 (Leontyev V.K. Ivanova GG Methods for the study of oral fluid state hard tissues of teeth literature review, part 1, 2. The Institute of Dentistry, 2013).

The bioactivity of S. mutans increases with frequent and long-term intake of appropriate food, with the consumption of sticky products, with low clearance of the products from the near-tooth environment. From here you can clearly see the need to use a thread in order to prevent food debris between the teeth. Bacteriological studies have confirmed that in children with early childhood caries, with a high carbohydrate load and poor oral hygiene, the proportion of S. mutans in the plaque exceeds 30% of the microflora of dental plaque, while in children with healthy teeth it does not exceed 0.1% (Leontyev V.K., Kiselnikova L.P. Pediatric Therapeutic Dentistry .National Leadership. M .: GEOTAR-Media, 2017. 952 p.). The consumption of carbohydrate foods does not in all cases lead to a significant decrease in the pH of the plaque. The pH dynamics are determined by the ability of plaque to efficiently utilize carbohydrates, i.e. the presence and amount of cariogenic microflora in the plaque. In the classic experiment Stephan it is shown that the carbohydrate load, made after mechanical cleaning of the teeth, does not lead to a critical decrease in the pH in the near-tooth environment. With good mechanical or pharmacological control of plaque, sugar can become less dangerous.

Based on the above, in our opinion, the family should receive from the doctor a clear idea of the nature of the potential or already existing problem of dental caries and, accordingly, take on specific obligations to maintain the health and preventive treatment of the teeth of their child.

For several minutes, teeth that have cut through or have undergone professional hygiene are covered with a layer of proteins and glycoproteins of saliva / pellicle. It is this film, not the tooth enamel, that is the substrate for the adhesion of bacteria (Aik and Pg. Periodontology 2000). In modern interpretation, bacterial plaque is called “biofilm”, which is a specialized bacterial ecosystem that ensures the viability and preservation of its constituent species of microorganisms and an increase in the general population (Caufield PW, Cutter GR, Dasanayake A.P .: evidence for a discrete window of infectivity. J DentRes 1993; Leus PA, Communal Dentistry, 2000). According to Jill S. Nield-Gehrig, a conceptual model of a dental biofilm (2003), it consists of bacteria, microcolonies, microcolony aggregates of bacteria, an extracellular polysaccharide matrix of EPS substance, epithelial cells, components of saliva, food and blood cells. The biofilm associated with caries / Disease-associated dental plaque has impaired microbial homeostasis: the dominance of acidogenic and acid-tolerant Streptococcus spp. and Lactobacillus spp., loss of dominance of the main symbiotic and increase in the role of transient microflora (OS Gileva, “Ahead of the Future”, conference materials. Endodontia tudey. 2012). Pathogenic bacteria do not show aggressiveness against the host organism until the number and degree of virulence reaches a critical mass / necessary level in order to effectively overcome the defense of the host organism. For example, in vitro resistance of a biofilm to antibiotics is 500–1000 times higher than the similar capacity of individual bacteria in planktonic form (Allais G. Oral biofilm, New in Dentistry. 2006).

Bacteria in the biofilm are metabolically active, causing fluctuations in the pH of saliva. It is known that in the metabolism of simple food sugars, dental plaque bacteria secrete large amounts of lactic and other organic acids. Studies by Robert Stephen, conducted in the 1940s, showed the importance of acid dental plaque in the development of caries. Thus, in the absence of caries, the pH of the plaque is about 7.2, and with the development of severe caries it decreases to 5.5. This researcher also showed that after rinsing the mouth with glucose solution, the pH of dental plaque changes from 10 values to values much lower than 5, caused by metabolism of carbohydrates with the formation of organic acids. Such a shift has a great impact on the plaque ecology. With frequent consumption of foods rich in carbohydrates, the content of bacteria sensitive to the action of acids decreases and acid-resistant increases, which leads to acidification of the plaque and an increase in its cariogenic action.

The microbial flora of ZN is variable in quantitative and qualitative terms. Differences in the composition of microflora in different people depend mainly on the absence of violations of the secretion of saliva. In the absence of hygienic oral care, the number of non-spore-forming anaerobes increases. In the saliva itself, the number of bacteria ranges from 43 million to 55 billion in 1 ml, i.e. an average of 750 million in 1 ml. The microbial concentration in dental plaque / plaque and gingival sulcus is almost 100 times higher, about 200 billion cells per gram of sample, in which 80% of water. According to L.N. Rebreeva and V.F. Kuskovaya (1967), in 1 mg of the substance of the NN, there are 500 × 10 ⁹ microbial cells. Different subjects have different amounts of microorganisms. Epidemiological studies have established a high correlation between EF and caries. People with a high ZN index increase KPU 3 times faster than people with a low index. However, some villagers and ethnic groups of ZN are many, and caries susceptibility is low. In the study of ZN of these people in an electron microscope, it was found that the microorganisms were in an inactive state, which explains the low incidence of tooth decay in caries. In addition, the rate of formation of ZN matters. It has been established that the higher the speed, the more pronounced the cariogenic property of HF is. Both the diet and chewing intensity influence the formation of MN.

When planning preventive measures, it should be borne in mind that the factors of food are divided into aggressive: a significant content of sugar and other carbohydrates, a dense texture, high stickiness and protective: saliva and detergent effects, buffer properties, the presence of calcium ions, phosphates and fluorides. Factors of human behavior matter: food choices, frequency and sequence of meals. For products that contribute to the development of dental caries are characterized by such properties as acidogenicity and cariogenicity. The properties of a food product as a substrate for microbial glycolysis determine its acidogenicity — the ability to “transform” into acid. The combination of properties that determine the ability of the product to stimulate the growth of caries with long-term consumption in real diets, combine the concept of cariogenic. Thus, acidogenicity reflects the potential danger of the product to enamel, and cariogenicity - its real, manifested properties. Acidogenicity and cariogenicity do not always coincide. Due to the powerful protective forces of the oral cavity and reasonable human behavior, the cariogenic effects of highly acidogenic sugar can be reduced from 100% to 6%, and, conversely, the breach of infants feeding with breast milk with low acidogenic potential can cause the destruction of temporary incisors (TV Popruzhenko, TN Terekhova, 2008).

The unique for the representative of food products protective factors, minerals, vitamins, amino acids, all necessary for young children and applicable from 6 months of age, has carrots and freshly squeezed carrot juice.

For the first time about carrots are mentioned about 2 thousand years BC. Homeland main varieties of the root is Afghanistan and the Mediterranean coast. People who eat carrots their whole lives live long, in particular Tibetan monks. Organic compounds in carrots are excellent mineral antioxidants. Carrots are the king of vegetables for the balanced content of vitamins and trace elements in it. Regardless of the variety, 20 grams of raw carrots contain carotene, which is converted into vitamin A in the body, covering its daily intake. Vitamin A contributes to the normal metabolism, physical and mental development of the body, increases resistance to colds, provides normal function of the organs of vision. It is necessary for the normal growth of bones and teeth of a child, supports skin, hair and mucous membranes in a healthy state. Therefore, carrots are valued not only as a food product, but also as a useful therapeutic agent. Carrots retain carotene during long-term storage. It has vitamins, thanks to which carrots have a beneficial effect in case of their insufficiency, fatigue, and loss of strength. Carrot roots are rich in carotenoids: α-, β-, γ-carotenes, phytofluene, phytoen, etc., and vitamins of group B: B ₁ , B ₂ , B ₅ , B ₆ , B ₉ , as well as C, K, H, A , E, PP, etc. Vitamins E and A have regenerating properties, and therefore have a positive effect on the condition of the skin and mucous membranes. Vitamin A is necessary for growth and normal development of the body, therefore, carrots are a necessary part of the diet of children and pregnant women (electronic resource: http://sostavproduktov.ru/produkty/ovoshchi/morkov, the date of circulation is 03.11.17). Carrots and juice are used in diseases associated with impaired mineral metabolism: cholelithiasis, polyarthritis. Raw carrots are useful and necessary for people whose eyesight requirements are increased. Carrot roots of the first and second year, carrot juice are used in traditional medicine. Juice with honey is useful for colds, grated carrots are used as an analgesic, anti-inflammatory agent; for the treatment of kidney disease, it is applied to burned areas of the body, non-healing wounds, ulcers or wash them with carrot juice. Infusion is used to treat hemorrhoids. Dry tops brew and drink like tea. Fruits of carrots are included in some anthelmintic fees. Carrots are contraindicated in gastric and duodenal ulcers, enteritis and inflammatory processes of the rectum (electronic resource: http://www.webfazenda.ru/carrots.html, the date of circulation is 03.11.2017).

Root crops are rich in mineral salts of sodium, potassium, calcium, magnesium, iron, phosphorus, iodine, silicon. Its content in 100 g of carrots reaches 25 mg. Silicon (Si) - together with protein structures promotes the formation of enzymes, amino acids, hormones; necessary for human absorption of calcium, phosphorus, fats, chlorine, fluorine, sodium, sulfur, manganese, molybdenum, cobalt, and many other elements; affects the conductivity of nerve fibers, energizes the cerebellum, it is necessary for normal growth of bones and teeth of a child, keeps skin, hair and mucous membranes healthy. The composition of carrots includes volatile, killing pathogenic flora and harmful bacteria. Its use stimulates salivation, the number of harmful microbes in the oral cavity is significantly reduced, the gums and oral mucosa are strengthened. Carrots are used as a natural abrasive, which helps to clean the teeth after a meal (Electronic resource: http://chem-polezno.com/ovoshchi/morkov, date of treatment 04.11.17)

Carrots are rich in macronutrients related to the health of the oral cavity and teeth: calcium, magnesium, sodium, potassium, chlorine, phosphorus, sulfur. Content per 100 grams of carrot calcium reaches 51 mg. The daily intake of calcium for children under 3 years of age according to WHO recommendations is 600 mg. Calcium (Ca) from the Latin calce - lime, known as calcium carbonate or chalk. About 1 kg, 98% of calcium is in the bones and only 1% in the teeth. Calcium is important for cardiac activity, protects the body from infections, is used in the processes of information exchange between cells (electronic resource: https://www.fat-down.ru/table/table_calcium, the date of circulation 23.11.2017). Calcium is well absorbed with a sufficient amount of vitamin C, which is about 5 mg per 100 g of carrots.

The magnesium content in 100 g of carrots is 38 mg, which is 9.5% of the daily requirement (Electronic resource: http://health-diet.ru/base_of_food/sostav/804.php, the date of circulation is 11/23/2017). Magnesium (Mg) functions powerfully as a cofactor in more than 300 enzymatic reactions, in the process of metabolism. Energy generation, glucose utilization, fatty acid oxidation, activation of amino acids - magnesium is required everywhere. He is involved in the biosynthesis of protein, the transfer of genetic information, the formation of cAMP. It is important for the regulation of the cardiovascular system, strengthening and growth of bones and teeth. Magnesium helps to eliminate toxins from the body, the absorption of calcium, B vitamins and minerals, the restoration of gastric acidity, the regulation of blood sugar levels, the splitting of carbohydrates, and the strengthening of the immune system (Electronic resource: http://vitaminas.ru/magnesium.html; http: //alter-zdrav.ru/magnij-v-kakih-produktah-soderzhitsya-magnij-simptomy-nedostatka-magniya/, circulation date 23.11.2017).

Content per 100 grams of carrot phosphorus reaches 55 mg. Phosphorus (P) - part of the phospholipid membrane structures of the cell; is a component of the blood buffer system, provides support for acid-base balance. Phosphorus in the form of salts and phosphoric acid is present in both muscle and bone tissues, promotes skeletal development, increases tooth resistance to caries, is necessary for the central nervous system, is involved in intracellular metabolism. Phosphorus in the form of phosphates is a part of nucleic acids and nucleotides (DNA, RNA), participates in the processes of coding and storage of genetic information. Phosphorus compounds are involved in energy metabolism.

Also in carrots a large number of trace elements: iron, zinc, iodine, copper, manganese, selenium to 0.1 mg, chromium, fluorine to 55 mg.

Fluoride (F) - is responsible for strengthening the bone skeleton and tooth enamel; ensuring the normal growth of nails and hair; stimulation of blood formation processes; immunity strengthening; removal of heavy metals and radicals from the body; prevention of osteoporosis; suppressing the activity of acid-forming bacteria; prevention of periodontal disease and caries. At the same time, the daily rate of fluoride for children under 1 year old is 0.5 mg, for children from 1 to 3 years old 0.7 mg (Electronic resource: http://kakievitaminy.ru/vitaminy-i-mineraly/ftor, the date of circulation is 21.11. 2017), that is, about 100 grams of raw carrots or juice per day, comparable to a child's consumption.

Also carrots contain boron, molybdenum, vanadium, cobalt. Boron (B) is a mineral metabolism conductor, its content in 100 g of carrots reaches 200 mg, which is necessary in micro doses to maintain healthy bones, metabolism of calcium, phosphorus and magnesium, lithium, aluminum, and nickel.

Molybdenum (Mo) contains 20 mg per 100 g of carrot, it participates in the processes associated with tissue respiration and the synthesis of ascorbic acid. Without them, normal growth and development of the whole organism is impossible. Thanks to this trace element, fluoride is worse excreted from the body, which contributes to the strengthening of tooth enamel and allows you to fight against caries. Molybdenum is involved in the processes responsible for the metabolism of proteins, fats and carbohydrates, in the synthesis of hemoglobin, a cofactor of most enzymes that provide for the metabolism of purines and pyrimidines, sulfur-containing amino acids. Thus, it is a regulator of metabolic processes (Electronic resource: http://edaplus.info/minerals/products-containing-molybdenum.html, circulation date 26.11.2017). In this case, the rate of consumption of Mo for children from birth to 10 years is 15-150 mg.

Nutritional value of 100 grams of carrots: calories 35 kcal, proteins 1.3 g, fats 0.1 g, carbohydrates 6.9 g, water 88 g, mono- and disaccharides 6.7 g. The chemical composition of carrots per 100 grams product (electronic resource: http://www.webfazenda.ru/carrots.html, the date of circulation 03.11.2017). In carrots there are most essential amino acids that can be obtained only with food, and their lack leads to metabolic disorders: arginine, valine, histidine, isoleucine, leucine, lysine, methionine, threonine, tryptophan, phenylalanine, 100 g of raw carrots replace from 3 up to 12% of the daily intake. Replaceable amino acids: aspartic acid, alanine, glycine, alanic acid, proline, series, tyrosine, cysteine (Electronic resource: http://www.intelmeal.ru/nutrition/foodinfo-carrots-raw.php appeal date 21.11.2017 ).

In terms of carbohydrate content, carrot ranks 311 among all products. In terms of digestible carbohydrates, carrots are products with a very low carbohydrate content, up to 9.58 g per 100 g of carrots, including polysaccharides: fiber 2.8 g and starch 1.43 g, as well as 4.74 g of sugar, of which monosaccharides - glucose 0.59 g, fructose 0.55 g, from disaccharides - sucrose 3.59 g. Traces of essential oil, phospholipids, sterols were detected (Electronic resource: https://fitaudit.ru/food/120821/carbohydrate, date appeals 21.11.2017). Thus, carrots are an affordable and balanced food for young children, in which minerals and vitamins are in a bioavailable state, easily digested, with no contraindications to use, dose limiting, and allergic reactions are rare. Allergy to carrots develops very rarely, only cross-allergy in children who already have food allergies and pollinosis with sensitization to weeds. In the case of overeating of carrots and / or juice by children, the skin of the palms of the face and face is orange, which does not threaten the health and is leveled by restriction of consumption per kilogram of the child’s weight.

The risk of developing caries in children does not increase due to the presence of a particular disease, but depending on the degree of immunodeficiency state. Immunopathological mechanisms act synergistically with other uncontrolled or relatively manageable cariogenic risk factors: deviations from the physiological course of pregnancy, illness of the child in the first year of life, artificial feeding, impaired salivation, and adverse environmental background, which leads to the formation of reduced resistance of dental tissues. Currently, dental caries are classified as controlled diseases. It is possible to change the situation, both at the population and individual levels, by controlling the main cariogenic factors: insufficient provision of children and adults with fluoride, poor hygienic care of teeth, frequent use of sugar-containing foods and beverages (Leontyev V.K., Pakhomov G. N. Prevention of dental diseases. M. KMK-INVEST. 2006. 410 p.).

The question of the influence of water and electrolyte balance on the development of caries in young children remains little studied. Water is a universal biological solvent and only in the aquatic environment all the most complex biochemical processes in a living organism can occur. Water performs a transport function, transferring substances through the body, participating in the elimination of the end products of metabolism from the body, is the main plastic material and takes an active part in thermoregulation. Osmotic movement of water through the membrane is able to generate hydroelectric energy, which is converted and stored in energy reservoirs in the form of ATP / adenosine triphosphate and GTP / guanosine triphosphate - the two most important systems, chemical energy sources in the body, used in the simplest exchanges, especially in the process of neurotransmission. In solutions of a high degree of viscosity, in the state of dehydration, the effectiveness of proteins and enzymes decreases, water itself regulates all the functions of the body, including the activity of dissolved substances that it carries (F. Batmanghelidj. Vienna). Global Health Solutions. 2001 ).

Water-salt balance is a fundamental component of human health, providing the basic mechanisms of functioning of the macroorganism. The needs of the newborn baby in water for growth and development are met first by the water contained in the milk, and then by the consumption of pure water itself. The factors that regulate the water balance during a child’s growth include growth hormone and other related hormones and neurotransmitters, such as histamine, that trigger the mechanism of thirst. The process of growing and dividing cells requires a lot of water. Water is 75% of the composition of each cell. The body of a growing child constantly needs water and demands it; otherwise growth will not be possible (F. Batmanghelidj, M.D. For health, for healing, Thirsty! N. N. Y. 2003).

Low-level dehydration, as opposed to acute and clinical dehydration, is chronic, this widespread problem has a huge impact on health, energy levels, appearance and resistance to external influences. Chronic dehydration is not as obvious as acute, and is disguised as various diseases. For adequate digestion of food, secretion of gastric juice in the volume of 80-100 ml / h is needed, with a decrease in this indicator, food lasts longer in the stomach, which leads to problems such as heaviness after eating, nausea, heartburn and pulling pain. In addition, the liquid is part of the epithelium that lines the cavity of the stomach and intestines, creating a gel immiscible layer of bicarbonate, which protects the walls from the aggressive effects of hydrochloric acid. Water helps the regular enrichment of the circulatory system. The blood volume of a healthy person is about 5 liters of blood, 60% of this amount is plasma, which in turn is 90% water. With chronic dehydration, the volume of fluid in the blood decreases, which leads to its thickening. This entails either hypotension - as a small amount of blood is not enough to fill all the arteries and veins, or hypertension, due to the additional load on the heart muscle.

Disruption of the acid-base balance of the body can also be caused by chronic dehydration. An insufficient amount of water in the body slows down the production of enzymes, which leads to an increase in blood acidity. This process significantly affects the functioning of the whole organism, worsening the processes of enzymatic and metabolic reactions, which leads to the formation of kidney stones, weakened immunity, damage to the nervous system.

To ensure that the required amount of ions is supplied to the body, part of the water consumed per day must be mineral. Christopher Vasya, ND, a Swedish naturopath and author of Water Treatment (Healing Arts Press, 2006) believes that most people are constantly suffering from chronic dehydration due to the inappropriate use of food and drinks. The body needs constant water consumption in order to function effectively. In 2004, the Institute of Medicine (IOM), a division of the National Academy of Sciences, established normal water consumption per day: 3.7 liters for men, and 2.7 liters for women. These numbers refer to total water consumption, including all food and beverages. Products such as chips and crackers do not contain moisture and, like dry sponges, absorb water as they move through the digestive tract. Drinks containing caffeine, sugar and alcohol, contain harmful chemicals or cause chemical reactions, for processing and excretion of which requires a large amount of fluid, create an acidic environment in the body that interferes with the functioning of enzymes and hinders the kidneys. Artificially sugared drinks add a toxic load to the body.

Thus, the properties of a dental biofilm, which is an ecosystem sensitive to external factors and its cariogenic potential, can depend on the effect of the carbohydrate factor, nutritional structure, mineral saturation, acidity and viscosity of saliva, the volume of fluid consumed. It is known that affecting mature biofilms, using antibiotics, antiseptics that hardly penetrate into microbial structures, is problematic, especially in the conditions of reducing the influence of antibodies and macrophages on them - factors of local humoral and cellular immunity.

The medical control of non-specific biofilm is simple and effective in the treatment of caries and periodontal diseases (Kuzmina EM. Prevention of dental diseases: a textbook. Moscow, 2001., Socranssky SS, Haffajee AD: Dental Biofilms:: Period. Periodontology 2002) . In dental practice, antiseptics are widely used for these purposes. Typical agents are chlorhexidine, alexidine, diacid (Trykovski J., 1981; Petrikas A.Sh., Rumyantsev V.A., 1984). 0.1-0.2% solutions have a specific antimicrobial effect, inhibiting the growth and development of microflora. Chlorhexidine, used in the form of gargles and toothpaste. When it is applied, the amount of microflora inducing caries decreases by 80-90%, the formation of plaque is reduced (Giermo, 1975; Svatun B.I. Et al., 1981). Fungicidal properties are manifested at a chlorhexidine concentration of more than 0.05%, virucidal - at 1% and higher. Irrigation of the mucous membranes should be carried out 2-3 times a day, with an exposure of the solution for 2-3 minutes, which is problematic for young children who do not tolerate the bitter taste of the drug. The solution can change the color of the tongue (black), contributes to the desquamation of the epithelium in the oral cavity, changes in taste sensitivity, and with prolonged use, cocarcinogens are formed. A significant drawback is the inability of young children to rinse their mouths.

At home, the main method of preventing caries remains regular and thorough cleaning of the teeth using toothpaste with fluoride. The variety of fluorine-containing means necessitates the use of a differentiated approach in choosing the means for conducting preventive measures in young children. Of all the possible forms of using fluoride for the prevention of caries, toothpastes occupy a leading place. The use of fluoride-containing pastes provides a constant long-term presence of fluorides on the enamel surface, in the oral fluid and dental plaque (Izotova, EA, Petrova, AP, A Differentiated Approach to Recommended Personal Hygiene Products for Children, Internet Medical Conferences, 2014 Volume 4. Number 5).

Not enough attention is paid to the use of dental floss in young children, their use is not included in the standard prevention regimen. Depending on the presence of the coating, floss waxed and unwaxed. Due to wax impregnation of the dental floss, particles of the material are not stratified during the cleaning of the oral cavity and makes it possible to extract food fragments even from tightly spaced teeth. Due to this, the probability of cleaning all areas increases. Waxed thread is a safe accessory for those who are just learning how to handle it. Therefore, when operating the floss, there is no risk of injury to the QVR. Dental floss can be bulky - increase in section when in contact with moisture. They have the softest structure, which allows for delicate care of interdental spaces. That is why we recommend waxed and, preferably, bulky dental floss for use in young children. Biorepair Espandibile dental floss, Swiss Smile tape, Riser Floss (Italy) or Splat waxed dental floss (Italy) are suitable. Dentists of the University of New York have proven the effectiveness of dental floss: dental floss better than a toothbrush saves the oral cavity from bacteria and significantly reduces their level in a short period. The two-week study involved 51 pairs of twins from 12 to 21 years. Dental floss is an essential tool for proper oral hygiene, which is recommended to be used after each meal (The Journal of Periodontology). Young children are almost completely dependent on adults, on the level of parents' sanological culture, the degree of their motivation, and only a handful of oral hygiene is carried out correctly and regularly for children. It has become necessary to propose a preventive scheme that would influence some of the managed risk factors for caries, to reduce the virulence of plaque, would include non-standard approaches along with the classical ones: topically applied gel with colloidal silver, fresh carrot juice inside, natural mineral water from Lake Baikal inward, use waxed dental floss at least once before bedtime. In this regard, our studies are devoted to measures of non-specific prophylaxis, treatment and therapeutic control of the most vulnerable risk group for developing caries - young children by reducing the dental plaque on temporary teeth in general and the titer of Streptococcus mutans in oral biotopes, adhesion and adhesion in most seeded with cariogenic microorganisms biotopes - microbiome of the back of the tongue and plaque on the lingual surface of temporary teeth, in particular.

In our study, implementing a prevention program in young children, we included non-claimed xylitol containing, in concentrations of 20–40%, Spiffies Tooth Wipes hygiene wipes for children up to a year into the main scheme. Wipes Spiffies non-woven material / based on polypropylene, do not leave the fibers, do not irritate and do not injure the mucous membrane of the child. Invented in the USA by Dr. Ray Wagner, a member of the American Academy of Pediatrics and a practicing dentist. Spiffies act in two directions: mechanically removing plaque from the teeth and creating an environment in the oral cavity that inhibits the development of bacteria causing caries. It was recommended to use, from the age of 3-4 months, to wipe the gums and tongue of the baby after each feeding, before the eruption of the first tooth, since xylitol inhibits the growth of microorganisms and promotes the remineralization of the tooth enamel by increasing the buffer capacity of saliva. The best way to prevent tooth decay is to start caring for your teeth before they erupt. As a means of preventing caries, xylitol CH2OH (СНОН) 3CH2OH is a good natural sweetener (edited by prof. Kuzmina E.M.). M., Poly Media Press Publishing House 2001. 216 p.). Xylitol is a natural substance that is present in nature in vegetables and fruits and is in the human body. It has a sweet taste, but unlike conventional sugars (present in milk, juice, as part of most infant formula mixes) containing six carbon atoms, xylitol has five carbon atoms. Xylitol inhibits the growth and reproduction of S. mutans, since S. mutans uses carbohydrates with six carbon atoms as an energy source. Consumption of xylitol does not reduce the pH of plaque (Kuzmina EM The prevalence of dental diseases among the population of different regions of Russia. Problems of neurotomatology and dentistry. 1998. №1. P. 68-69). Xylitol competes with hexatomic sugars in the process of transmembrane transfer and in metabolic processes inside the cell. In contrast to the metabolism of hexatomic sugars, which leads to the release of energy and contributes to bacterial growth, the splitting of S. mutans xylitol energy is only consumed, but not released. During xylitol metabolism, intermediates that are sources of energy are absorbed, but not reproduced (Lukinsky LM, Gazhva SI, Kazarina LN Dental caries: etiology, clinic, treatment. Nizhny Novgorod: NGMA Publishing House, 1996. 126 p.). Xylitol reduces the production of a bacterial cell and the concentration of dextran in the saliva, which ensures the attachment of the bacterial cell to the tooth surface. Xylitol inhibits the transfer of bacteria from mother to child more effectively than chlorhexidine (Medical and social prevention of dental caries: Method. Recommendations. A.N. Galiullin and others. M., 1990. 57 p.). Studies at the Harvard School of Dentistry have shown that xylitol is more effective in preventing caries than combining xylitol with sorbitol (Monitoring and Evaluation of the Health of the Cavity: Report of the WHO Expert Committee. M .: Meditsina, 1991. 73 p.). Spiffies wipes allow unobtrusively to teach young children to oral hygiene, which is very important for his overall health. This significantly reduces the amount of plaque on the front temporary teeth and significantly reduces the contamination of the mouth S. mutans. Before use, we recommended putting the napkin for a while in the fridge: holding the baby with a cooled napkin for the parents will help with teething, reducing itching and unpleasant, and sometimes painful sensations, also improves blood circulation in periodontal tissues. Regular hygienic care at the age of three years later forms in the child a strong habit of such procedures and a desire to follow them throughout their lives. Spiffies wipes are recommended by the American Academy of Pediatrics. Clinical trials have shown that Spiffies wipes effectively remove plaque and are perceived by children more positively than a toothbrush (Prevention of dental diseases (edited by prof. Kuzmina EM, Poly Media Press, 2001, 216 p.). Recommended method of application: wrap the napkin around the index finger and hold it with your thumb. This reduces the risk of wipes slipping in the baby's mouth. Systematic oral care is necessary after the appearance of the first tooth and the beginning of complementary feeding. But it is important to clean the oral cavity when complementary food is introduced into the child's diet. The tiniest milk residues from the milk mixture or solid food are a substrate for the growth of microorganisms that cause caries (Borovsky EV, Leus PA Caries of the teeth. M., “Medicine ", 1979. 256 pp .; Drescher VL Medico-social substantiation of the criteria for the quality of primary prevention of dental caries in the population of the Republic of Tatarstan. Author's abstract for candidate of medicine, Kazan, 2003. 24 pp .; Leontyev V.K. On the etiology of dental caries. Dentistry 1994. №3. Pp. 19-21). It is rational, in our opinion, to recommend the use of napkins up to 18 months. Normally, 8 front teeth are erupting by the year, which are easy to clean, but this is not enough for other groups of teeth.

In our study, conducted from 2013 to 2015, we used ready-to-use certified natural water from Lake Baikal containing silver Ag ⁺ . The composition of the water also includes ions of natural magnesium, potassium, sodium, chlorine. The pH of the water is 7.3-7.8, close to the normal pH of healthy saliva with a shift to the alkaline side. The choice for non-specific prevention and treatment of dental caries in young children was due to a balanced mineral composition and the unique Ag ⁺ molecules. Most briefly, the properties of silver as an antiseptic are set out in the article at the link in the Internet resource: http://www.o8ode.ru/article/tawa/bacterios.htm. Silver has a bactericidal, antiviral, pronounced antifungal and antiseptic effect and serves as a highly effective disinfectant against pathogenic microorganisms. Silver in various dosage forms is used in surgical practice: for lesions, muscles, joints, lymph nodes; in ophthalmology, in an ENT-practice (Bezlepko AV. The efficacy and safety of the use of collargol in the treatment of non-atopic bronchial asthma. Diss. Candidate of Medical Sciences. M. 1999). Apply silver / silver water for bathing children, with dermatosis, children's eczema, burns. Used in the practice of internal diseases: in the treatment of gastritis, viral enteritis and colitis, with endocrinological diseases and metabolic disorders: diathesis; in the practice of infectious diseases: in the treatment of dysentery, scarlet fever, diphtheria; in obstetric and gynecological practice, in the treatment of various inflammatory processes of the mucous membrane, nipple cracks, see RF Patent 2411951, 2011; practice of skin diseases: in the treatment of furunculosis and fungal infections of the skin; in dental practice: in the treatment of stomatitis, gingivitis and other oral diseases.

Silver ions are actively involved in the immune function of the body. Under the influence of silver, the number of immunoglobulins of classes A, M, G increases, the percentage of absolute number of T-lymphocytes increases. However, it has long been noted that silver really helps one person for one week, another for months does not help another, and a third one can cause an allergic reaction. It has been proven that colloidal silver preparations with a concentration of Ag ⁺ 30 ppm ions in the form of a gel interferes with the reproduction of S. mutans, which is assigned the main role in the development of caries. According to the instructions, it is applied topically for erosion / damage to the mucous membrane of the oral cavity, aphthous stomatitis, for diseases of the gums, unpleasant smell from the mouth, prevention of caries. However, there is a significant drawback in the instructions for use: it is proposed to use gel in caps for caries prevention, which is unacceptable for young children who actively resist foreign objects in the oral cavity, in addition, a large consumption of gel is assumed for use throughout the cap volume .

We used colloidal silver preparations with a concentration of Ag ⁺ 30 ppm ions in the form of a gel according to the scheme developed by us (Application for the invention “Method for non-specific prenosological prevention and treatment of dental caries in young children” No. 2017128961/15 dated August 14, 2017, positive result formal examination of 15.09.17) and “Wave of Baikal” water with natural silver. The plant “Baikal-Incom” LLC is the largest enterprise in the region for bottling drinking artesian water, which is located next to the oldest lake on the planet - Baikal. The well from which water is extracted is located at the foot of the Khamar-Daban ridge, on the southern shore of Lake Baikal, and has a depth of over 70 meters. Melt glacial water is mixed with the unique water of Lake Baikal and comes to the surface of high quality; no additional measures are required to clean it from extraneous chemical elements. It is enriched with silver, has a neutral pH and very weak mineralization - from 70-80 mg per liter, it is maximally saturated with oxygen, 12 mg / l, its molecular structure and isotopic composition are not artificially synthesized (Electronic resource: http: //www.voda -nasha.ru/catalog/voda-volna-bajkala/voda-volna-bajkala-negazirovannaya-1.5-litra.html, circulation date November 27, 2017). According to the information on the label: Artesian drinking water, natural non-carbonated “Baikal Wave”. Solzansky water intake. Well number 4. The first category. Mineralization, mg / l, not more than: 100. Ag: 0.002; I: 0.01; Mg ²⁺ : no more than 10; Ca ²⁺ : not more than 40; Na ⁺ : no more than 5; K ⁺ : no more than 5; Cl ^- : not more than 3; HCO ₃ : not more than 50; pH: 7.3-7.8. See FIG. 1, FIG. 2 which show photos of the label of natural water "Wave of Baikal" in a 1.5 liter bottle.

In the literature available to us there is no description of how to prevent dental caries in young children using topical colloidal silver preparations on the mucous membrane of the tongue and on the lingual surface of the teeth, natural non-carbonated oxygen mineral water with ions of silver, calcium and magnesium / mashed in age doses, using waxed bulk dental floss to care for interdental spaces in children.

There are numerous methods of complex and multifactorial and monofactor prevention and treatment of dental caries in adults and children, but all of them have two significant drawbacks: they are of little use for young children and do not take into account the child’s complete dependence on parent / caregiver’s compliance with all types of prophylaxis. Thus, it is important not only to select early-acting drugs and individual methods of prevention, but also to educate parents about their use and convince the latter to carry out a range of activities on an ongoing basis, regularly, for a long time, while simultaneously teaching the child oral hygiene, healthy nutrition, and drinking regime, and, thus, gradually forming a correct outlook on the child and a healthy lifestyle.

For such a multifactor disease as dental caries, the implementation of stereotypical preventive measures does not guarantee a high end result (Puzikova O.Yu. Prediction of the development of dental caries with regard to integrated indicators and mathematical modeling. Omsk. 1999. 183 p.). It is necessary to abandon the standard approach to the prevention of dental caries (Laurisch L. ZWR., 1990; Melnik, AI, 1991; Li Y., W. Wang, J. Dent. Res., 2002; M. Fontana et al., J Dent. Res., 2011; Prevention of dental caries today. New in dentistry. 2011. No. 6. 178. C 6-15; J. Tsubonchi et al. A study of dental caries and risk factors among Native American infants. J Dent Child 1995. P. 283-287). Early detection, elimination or weakening of risk factors reduce the growth of caries in children. Prevention of dental caries is the key to dental health for a lifetime. Thus, the issue of prevention of the risk of caries development in young children and the development of an individual approach to treatment-and-prophylactic methods of correction and treatment is highly relevant.

The following methods for the prevention of dental caries are known. Endogenous prevention. Systemic methods of fluoride use are indicated when the content in the drinking water is less than 0.5 mg / l of fluoride ion and the high prevalence of dental caries in the population. The programs of “automatic provision of the population with fluorides”: fluoridation of water, salt or milk is beneficial for people with low socioeconomic status, who have difficult access to dental care, as well as for people leading lifestyles that are favorable for the development of caries. The effectiveness of the use of systemic fluorides is 30-80%, depending on the type of fluoride supplements, the regularity and duration of their use (Hamadeeva AM, Maslak EE Preventive materials. In the book. Pediatric therapeutic dentistry. National leadership. M: GEOTAR- Media, 2010. Chapter 33. p. 689-711). In our country, the program of fluoridation of water, salt or milk, the use of tablets of sodium fluoride are used limitedly. At the same time, purchase of fluorinated salt at home, tapes for fluoridation of drinking water at home, bottled fluorinated water, and pharmacies - Sodium fluoride tablets, 1.1 mg or 2.2 mg for children 2-14 years old, which are sold without a prescription, are available to the public. The consumption of fluoride-enriched products and fluoride preparations by the population is not controlled, the market is developing spontaneously. Fluoridation of milk. Milk fluoridation projects have been introduced in England, Bulgaria, China, Russia, Thailand and Chile. In Russia, milk fluoridation at the suggestion of the World Health Organization, was launched almost simultaneously in several cities: Voronezh (Zimina VI. The effectiveness of the prevention of dental caries in children using fluoridated milk: Abstract of dissertation in medical sciences. M., 1997 23 p.), Maykop and Smolensk in 1994. In 2002, milk fluoridation was introduced in the city of Nizhnekamsk, in Zelenodolsk in 2004 (Pakhomov GN, Shaimieva NI, Kolesnik AG Monograph. Milk fluoridation for the prevention of dental caries in children. Kazan. 2013. 255 p. ., practical dentistry Shaimieva NI Kazan Medical Academy, 6.82, 2014) The use of substances that prevent the development and reproduction of the microflora of the oral cavity. Reducing the pathogenic properties of microflora, reducing its quantity, a favorable change in the species composition plays a significant role in primary prevention, first of all, dental caries. For this there are a number of antibacterial, bacteriostatic agents.

Antibiotics. Possess the most powerful antibacterial action. However, many years of experience has shown that local application of them in the oral cavity is not rational, as they can cause: a) the strongest allergic reactions, even death; b) dysbacteriosis phenomena; c) microflora resistance to them; d) weakening of immune defense factors; e) formation of antibiotic resistant strains and transmitting this property to other microorganisms. Therefore, local use of antibiotics in dentistry is severely limited (Fitzgerald, 1973; Jordan, 1973, 1974), although there are observations about the anti-caries effect when using vancomycin (De Paola, 1974) by temporarily suppressing the growth and development of streptococci.

Antiseptics. Over the past decades, a number of antimicrobial agents have been synthesized, which, with low toxicity, have a broad spectrum of action and do not develop an addictive microbial flora. Typical and most studied agents are chlorhexidine, alexidine, diacid (Trykovski J., 1981; Petricas A.Sh., Rumyantsev VA, 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. A significant disadvantage is their ability to be adsorbed on enamel and oral tissues.

Substances based on various herbal preparations. This group of substances includes a number of preparations from onions and garlic, which contain bactericidal preparations - phytoncides, which have bacteriostatic and bactericidal action.

Remineralizing therapy. Penetration and sedimentation in different layers of enamel calcium, phosphate and fluorine leads to a gradual normalization of permeability due to the formation of new hydroxyapatite crystals (Johanson, 1965; Silverstone, 1972; Kocherzhinsky VV, 1973). A number of authors (Lenz, 1967; Frank, 1967; Vahl, 1968; Watherell et al., 1974; Woltgens et al., 1976) noted that during the remineralization, intercrystalline spaces are filled with new crystals that are different from healthy enamel (Gustafson, Sundstrom, 1975). The main components of such mixtures are calcium salts, phosphates, and fluorides in ionized form (Borovsky EV, Leus PA, 1972; Prokhonchukov AA, 1977; Pakhomov GN, 1982; Leontyev VK, 1984). The creation of such drugs encounters serious technological difficulties associated with the chemical incompatibility of these ions in the same solution, they quickly interact with each other and precipitate. For remineralization of enamel, artificially created solutions were proposed (Andersen, 1921). According to Pigman er al. (1964) Sobel solution containing Ca – 2.5 mmol / liter; phosphate - 1.6; sodium, 97; K - 5; NSO, - 22; at pH 7.3 and a temperature of 37 ° С, during remineralization, it does not cause complete hardening of the enamel without additional fluorine treatment. These data were confirmed in studies of Muhlemann et al. (1964). In 1960, Koulourides, Pigman described a metastable solution of calcium phosphate for the recovery of acid-softened enamel. However, when testing this Levine solution (1980), significant drawbacks were noted: storage instability and low mineralization capacity due to difficult solubility of calcium phosphate. In experimental studies (Silverstone, 1971) a solution was used containing 200 mmol / l sodium chloride, 1.8-, 9 -phosphate and 1-calcium (Ca / P - 1.63). The addition of sodium chloride prevented the spontaneous precipitation of the remineralizing solution. In studies, it was found that for remineralization under experimental conditions, not only the presence and optimal ratio of Ca and P ions in solution, but also pH (Koulourides et al., 1965; Gonzales et al., 1975; Silverstone, 1977) . In domestic practice, a remineralizing solution containing calcium, phosphate, fluorine, zinc and magnesium compounds was proposed (Borovsky EV, Leus PA, 1972). Using successively applications of 10% calcium gluconate solution (5-10 min) and 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 white spots. They noted a positive result of treatment in 88.4% of cases after 15-20 applications. Using the method of E.V. Borovsky with preventive purposes in children of Moscow (Borovsky EV, Kuzmina EM, Vasina SA, 1980) allowed to reduce the growth of caries of permanent teeth by 29 - 44%. A significant disadvantage of this method is the inconvenience of consistently using 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 enamel demineralization (Aksamit LA, 1978) only calcium gluconate solution does not give a positive effect.

The Omsk School of Dentists (Leontyev, VK, 1978; Suntsov, VG, 1987) for a long time developed a new class of remineralizing agents. As a means of preventing and treating the initial caries, remineralizing calcium phosphate-containing gels (A.P. 1114221) were used, simulating the phosphor-calcium coefficient and the degree of oversaturation of Ca and P enamel and saliva of a healthy person and having different pH values. Gels are supersaturated with calcium and phosphate ions relative to their concentration in saliva. This increase increases the mineralizing potential of the means of prevention and treatment compared to the potential of healthy saliva many times. For the prevention of dental caries in children, gel cleaning courses are prescribed 2-3 times a year for 10-15 days per course. However, there is a significant drawback: young children do not brush their teeth on their own, and the ion dosage is not designed for them.

Fluoroprophylaxis. Fluorine preparations are one of the main means of prevention of dental caries, although the mechanism of the cariesstatic action remains a lot unclear. A large number of works devoted to the disclosure of the mechanisms of action of fluorine (Pakhomov GN, Leus PA, 1972); Fedorov Yu.A. et al., 1974; Palazzi, 1975; Gulzov, 1976) allows us to distinguish three main directions. First, fluorine, interacting with enamel hydroxyapatite, replaces a hydroxyl or carbonate group to form a less soluble form, hydroxyfluoroapatite (Wefel, Harless, 1981; Ogaard et al., 1983). Secondly, fluorides inhibit the growth and metabolism of oral microflora through active inhibitory effects on phosphoenol pyruvate kinase, resulting in a decrease in the intensity of carbohydrate breakdown and acid production (Hardwick, 1963; Edgar et al., 1970; Myers, Handelman, 1971) . Fluoride rinsing affects the colonization of bacteria on the enamel surface (Tinanoff et al., 1976) by altering the adhesion. Third, works (Brudevold et al., 1961; Kolesnik, AG, 1967; Silverstone, 1971; Gonsales et al., 1975) proved the effect of fluorine, along with mineral, on the protein phase of enamel, which affects the formation of teeth and their resistance to tooth decay. In the teeth treated with fluoride-containing paste, there is an increase in the intensity of incorporation of radioactive Ca and P (Kolesnik AG, 1964; Pakhomov G.N. et al., 1971; Maksimovskaya LN, Sherman LV, 1980). For the prevention of dental caries, various fluorine compounds are used, which are usually divided into groups of inorganic and organic substances. Sodium fluoride and potassium fluoride (Ibrahimov AM, 1981), tin fluoride (Svatun B., 1981; Tinanoff et al., 1983), aminofluoride (Künzel V., 1980; Pipa, 1982), monofluorophosphate (Ekstrand, 1979) are most commonly used. , zirconium fluoride (Horowitz, Bitler, 1976). For local use: no more than 1-2% in terms of fluoride 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 fluoride binding to calcium, as a result of which they may lose their activity (Pakhomov, G.N. et al., 1975; Morozova, NV, Morozova, LV, 1975; Hesselgren, 1980). Fluorides for the prevention of dental caries should be appointed depending on the fluorine content in drinking water and food, otherwise their use will be ineffective (Pashayev KP, Voronina LA, 1984). The forms of application 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 prophylaxis (Gabovich RD, Minh AA, 1979; Petrikas A.Sh., 1981; Timonov MA, A. 1985) by increasing the concentration of fluorine to 0.8-1.2 mg / l. There is evidence of a pronounced preventive effect (reduction of caries up to 50%) when fluorinated salt is used in children (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 and others, 1995). For collective and individual prophylaxis of caries, rinsing with 0.02-0.2% fluoride solutions is used (Smolyar N.I., Masnyi ZP, 1985), applications of 1-2% solutions and fluorine 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), cleaning teeth with fluoride-containing 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 (Kosenko KN et al., 1984; Borovsky E B et al., 1985), chewing fluoride tablets (Driscoll, 1974, 1978; Ho rowitz, 1979, 1984; Weatherell et al., 1984), giving inside tablets of sodium fluoride (Berner et al., 1975; Ahrens, 1976; Anke, 1979; Driscoll et al., 1979; Klimek, 1982) and Vitafluoro (Pashaev KP, 1981; Petrushenko O.E., Zhedik A.N., 1985). Analysis of the effectiveness of the listed types of dental caries prophylactics shows that the reduction of caries in most cases does not exceed 50%. The action of fluorine is not long, which is probably due to its leaching from enamel (Alkalayev KK, 1964; Brudevold et al., 1965; Mechin, 1975). However, modern research has identified sodium fluoride as a poison when it enriches water and salt. The countries of Europe, Japan, have abandoned this practice, the use of these outdated methods is unsafe and not applicable for young children, which is a significant drawback.

Fluoride varnish application technique: “Duraphat” (Colgate) “Fluor Protector” “Stand-Gard” “Fluorlak” “Radogel F” (VladMiVa) “Raduga” (Raduga-R) “Fluradent” (Raduga-R) Conducted professional oral hygiene; isolation of teeth, dried with warm air; A fluoric lacquer is applied with a thin layer on all surfaces of the teeth with a brush / wooden stick, avoiding contact with the mucous membrane of the oral cavity. Within 3-5 minutes the lacquer is dried, the patient sits with his mouth open. After the patient is advised not to eat for 2 hours, use only liquid and soft food for a day, do not brush your teeth for 12-24 days. Recommended 3-fold coverage with an interval of 1-2 days.

Deep fluoridation is the formation of submicroscopic (50A) crystals of CaF2 and MgF2, which is even more soluble than CaF2, in the pores of the loosened zone of the solid substance of the tooth. Preparations for deep fluoridation: “Enamel-sealing liquid”, “Glufored”. Dental plaque is carefully removed from the teeth, dried; teeth are abundantly moistened with a cotton swab soaked in a liquid for the first brushing for 1 minute, while blowing warm air; then the surface of the teeth is moistened with a suspension of copper-calcium hydroxide in water for 1 minute; rinsing with water. A significant drawback is the laboriousness of both methods, time consuming, high probability of swallowing fluoride drugs, which is difficult to prevent when working with young children.

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

Substances that prevent the accumulation of plaque on the teeth and facilitate its removal. This group of substances is widely used for the prevention of dental diseases. The most common representatives of this group are the so-called surface-active substances (surfactants) (Fedorov Yu.A., Koren VN, 1978; Levitsky AP, et al., 1979; Mizina IK, Mezinova L. G., 1980). In the mechanism of their preventive effects lie: a) an antimicrobial effect on the microflora of the oral cavity; b) the obstacle to the settling of microbes and metabolites on the enamel surface and the formation of a soft plaque on it. As a result of this complex effect, the ability of the plaque to adhere to the enamel is lost and the rapid leaching and removal of the microbial substrate from its surface is ensured. As a surfactant, a large group of substances is used - sodium lauryl sarcolysate, cetavlon, sodium oleate, cetylpyridine and others. In practical application, they are used in two dosage forms for rinsing the oral cavity as part of various elixirs and in toothpastes (Yu.A. Fedorov, 1984). A significant drawback is the high probability of ingestion of chemically active drugs with surfactants, which is difficult to prevent when working with young children.

These methods and the means used for its implementation are taken as the closest analogue prototypes. However, all of the above methods have significant drawbacks. All of them are of little use for direct exposure to cariogenic flora in young children, from birth to 3 years, do not provide affordable, safe, accurate and easy to use methods of prenosological non-specific prevention and, at the same time, treatment of dental caries, using / application of colloidal silver preparations in bacteriologically identified, most active biotopes as a model system for the donation / source of cariogenic S. mutans, in order to suppress their growth and / or reduce titer with modern, safe to use, tasteless and transparent gels containing silver nanoparticles. Also, the disadvantage of the above analog prototypes is: time-consuming, long-term manipulation, high cost of specialized labor. The above methods have other significant drawbacks, because they do not take into account protective factors of saliva, do not affect its cleansing properties, do not offer available useful products that are suppliers of organic vitamins and minerals that are applicable to young children, do not take into account the importance of mechanical food removal from the interdental spaces of children before bedtime. Due to the peculiarities of the psychosomatic status of young children, their restlessness, the performance of examination by a specialist and the use of complex manipulations is inconvenient. It is necessary to choose the optimal method, which assumes minimal time costs for the implementation of 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, giving consent to the use of carrot juice and natural water with proven quality certificates.

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

The test strip "Dentocult SM Strip mutans" is pressed against the child's tongue, on which saliva is present. On the test strips with a square end put a plaque from the enamel of the teeth. Then the strips are placed in selective nutrient saliva, for S. mutans. The quantitative composition is characterized by the density of their attachment and is compared with the reference map / scheme in the instructions for use.

The objective of the invention is to propose a method of non-standard non-specific prevention of dental caries in young children, which is part of a comprehensive - basic and additional program for the prevention and treatment of dental caries of temporary teeth in children under 1 year old, from 1 to 2 years old, from 2 to 3 years old, by exposure on some controlled cariogenic factors through the influence on the cleansing properties, viscosity and pH of saliva, reducing the amount of plaque and titer of cariogenic bacteria Streptococcus mutans in the oral cavity, histodiages and coadhesivity and microbiome of the tongue and mouth, stimulation of factors of specific immunity, by applying colloidal silver on the mucous membrane of the back of the tongue and lingual surface of temporary teeth, using ready-made preparations of nano-silver, regular use of natural non-carbonated low-mineralized artesian water daily organic carrots and the use of waxed bulk dental floss, devoid of the above listed disadvantages.

The technical result is that along with the stages of the main program for the prevention of caries in young children in age groups up to 1 year, from 1 to 2 years, from 2 to 3 years, a gentle and painless preventive or therapeutic procedure is performed, with the possibility of direct influence active in relation to cariogenic bacteria by Ag ⁺ silver nanoparticle ions to highly disseminated Streptococcus mutans oral biotopes in young children as important sources of infection, as well as reducing the number / titer of pathogenic caries S. mutans gene microorganisms, from among the indigenous microflora of the human oral cavity, available in the treatment of the mucous membrane of the dorsum of the tongue, lingual surfaces of temporary teeth as areas with a probable function of donation, using non-claimed preparations of colloidal silver with the concentration of Ag ⁺ 30 ppm ions in the form of a gel, also reducing the process of microorganism histadhesia to tissue cells, and coadhesion, that is, the adherence of microbial cells to each other for the formation of biofilm. Simultaneously with the local processing of the back of the tongue and teeth, non-declared natural non-carbonated deep-well artesian oxygen water with low mineralization and neutral pH is introduced into the child's drinking regime with a shift to the alkaline side of the “Baikal Wave” containing unique minerals in a balanced form, including calcium and potassium ions , magnesium, silver. Daily use of natural water with minerals ions useful for the composition of teeth in a bioavailable form and pH close to healthy pH saturated with hydroxyapatite leads to a decrease in saliva viscosity, improving its rheological properties and, thus, increasing its cleansing, protective, remineralizing ability, which leads to a decrease in the rate of plaque formation and a decrease in the cariogenicity of plaque, thereby achieving the goal of preventing the accumulation of a critical mass of cariogenic microorganisms in the organ biofilms, to prevent the actual organization of biofilms, in favorable conditions which they have the ability and are able to show their pathogenic / cariogenic properties. In saliva with sufficient water, enzymes work best, nonspecific factors of local immunity: phagocytes, lysozyme, secretory sIgA. At the same time, freshly squeezed carrot juice / organic carrot puree is injected into the child’s diet, 2 times a day at the age dose, and if it is impossible to prepare, unclaimed carrot puree for children from 4 months old “Fruto Nanny” (Lipetsk, Russia) see fig. 3, FIG. 4, taking into account supplementary food and complementary foods for children from 6 to 12 months and the diet of children from 1 to 3 years. Carrot juice supplies the growing set of the child the necessary set of vitamins B, A, E, C, PP, H, rich in composition of macronutrients and microelements, among which are minerals directly involved in building quality dentin, strengthening the enamel of the teeth, enhancing the remineralization of enamel , improving the state of local immune protection: Ca, P, F, Mg, B, Si, Se, Mo, etc. A wide range of essential and non-essential amino acids contributes to a balanced metabolism and functioning of the nervous, endocrine, immune systems. Phytoncides of carrots kill pathogenic bacteria, salivation is stimulated, local immunity is stimulated, the number of cariogenic microbes in the oral cavity is significantly reduced, the adhesive and co-adhesive properties are weakened, the gums and mucous membrane are strengthened. Along with a decrease in the titer of pathogenic bacteria, carrot juice helps cleanse the oral cavity, decreases the rate of plaque formation and its cariogenicity due to the low content of fast-absorbing organic sugars. As a daily procedure, use of an undeclared volumetric waxed dental floss of the Splat type is introduced at least once before going to bed, and if possible, after a nap and every meal, for mechanical cleansing of interdental spaces of temporary teeth, reducing the accumulation of food residues for a long time, which split by enzymes of saliva and oral microbes, increasing the acidity of saliva, cariogenic plaque, so the risk of decomposition of food remains on the surface of the tooth enamel is reduced, the risk of long duration is reduced effect of organic acids on the tissues of the teeth, provoking the blooming of cariogenic bacteria in favorable conditions of the acidic environment.

Thus, the application of an additional program to the main / classical program, as a nonspecific non-standard prophylaxis of the above listed colloidal silver gel preparations, undeclared natural water “Baikal Wave”, freshly squeezed carrot juice / puree and waxed bulk dental floss, improves the quality of nonspecific prevention and treatment of caries with the possibility of repeated treatment of the back of the tongue and the lingual surface of the teeth in children as a method of direct bactericidal effects on cariesogen s the bacteria Streptococcus mutans in the habitats, the possibility of repeated bacteriological and microscopic control over the results of ongoing prevention and treatment. The absence of obstacles to access to the surface of the tongue and lingual surfaces of the teeth at the reception of a dentist or other specialist allows to widely use the effect of Ag ⁺ silver nanoparticles on the pathogenic flora as part of the tongue microbiome and lingual surfaces of the teeth directly, in different concentrations of the active substance on the donation / source Streptococcus model mutans, significantly preventing their reproduction and spread to other biotopes, as well as the weakening of the processes of adhesion and coadhesion of oral microbes. Consumption of natural water and carrot juice / puree can vary, depending on the child’s preferences, the minimum suggested dose can be increased, taking into account the season of the year, the child’s physical activity, health status, and the need at a particular point in time. For children from 2 to 3 years old, instead of juice and mashed potatoes, there is a whole carrot root crop in the age dose. This will contribute to the self-cleaning of the oral cavity and the development of the maxillofacial system. The parents' activity in the implementation of the prevention program will lay the foundation for a healthy lifestyle, both in the child and in the mother and father.

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 correcting these procedures in children. Early non-specific non-standard prevention of caries in children under 3 years of age, along with the basic classical prevention program, 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 the parents received informed consent in accordance with Art. 20, No. 323 - FZ of 11/21/2011. All children are undergoing a comprehensive dental study: assessment of the dental implants, hygiene index (GI) and cariogenicity of dental plaque (KZN). The intensity of caries lesion is determined using the cpu 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 by E.M. Kuzmina, 2000. They determine the cariogenicity of MN according to the method of Hardwick JL, Manley E.V. in modification of T.G. Petrova et al. Microbiological testing of young children is carried out, the presence and density of seeding of Streptococcus mutans bacteria on the mucous membrane of the dorsal surface / back of the tongue and temporary teeth are determined. The intake 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 sterile tuffer. The degree of colonization is assessed by the presence and quantitative content of Streptococcus mutans using the non-claimed microbiological test Dentocult SM Strip Mutans manufactured by Vivadent, Liechtenstein. A selective nutrient medium is used for cariogenic streptococci and test strips with a square end and a rough surface, taking into account the natural adhesion ability of S. mutans. The strip with the applied biological material is immersed, in selective for Streptococcus mutans nutrient broth with the antibiotic bacitracin, to which they are resistant, is incubated for 48 hours at 37 ° C. Evaluation of results is carried out according to the instructions reflecting the number / density of colonies of Streptococcus mutans, the titer was assigned to one of four classes: the 0th class corresponds to less than 10,000 colonies (CFU <10 ⁴ / ml), the 1st class, 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. Microscopy of the tongue root scraping is performed with staining of a fixed native smear by the Gram method. This simple non-invasive method allows you to get information about the presence and quantity of microorganisms, their belonging to gram-positive or gram-negative bacteria, the presence of leptotrichia, Candida, their adhesive activity: consider the coefficient of histadhesion with respect to epithelial cells, on which microbes are adhered, and coadhesion coefficient, adhesion of bacteria to the surface of long large sticks, leptotrichia (Methodical recommendations "Assessment of the adhesive and coadhesive properties of Leptotrichia" Strelnikova N.V., Koltsov I.P., Anto ova AA / Khabarovsk .: DVGMU, 2010. 15 pp.). Investigate the presence of accumulations of microbes of the type of balls and / or shapeless formations, as signs of chronic dehydration of the tissues of the oral cavity (Application for the invention “Microscopic method for determining the dehydration of tissues of the oral cavity on the language microbiome model” №2017130096 / 14 of 08.24.2017, positive result formal examination of 12.09.17).

Children were divided into three research groups: up to 1 year, 15 children, from 1 to 2 years old 18 children, from 2 to 3 years old 26 children, and one control group: 36 children from 2 to 3 years old. Identified the CPU, IG, KZN, proposed the main developed program, including classical approaches to the prevention and treatment of dental caries in children's dentistry, and, along with the main, additional non-standard non-specific prophylaxis with non-claimed colloidal silver, non-claimed natural carbonated oxygen water "Baikal Wave", fresh carrot juice / puree from organic carrots, or non-declared carrot puree for children from 4 months "Fruto Nanny" (Lipetsk, Russia), using non-announced waxed th volume of floss type Splat. The multiplicity and dose of the drug silver, water, juice, the multiplicity of the use of dental floss are summarized in the scheme. The data of the additional basic program are presented in table 1.

The technical result of the proposed method is directly achieved by the fact that the main / classical and additional prevention programs under the scheme, depending on the age of the child. The entire main prevention program is conditionally divided into 2 blocks. The first block includes counseling and educational work with parents, questioning and interviewing conducted by a specialist - children's dentist, the second - work with young children, conducted by a specialist - children's dentist in a dental office and parents at home. The main program of prevention: the first unit is aimed at working with parents to enhance their compliance with the program for the prevention of caries in children.

Block 1 - Improving the level of hygienic knowledge of parents: 1. Primary questionnaires and interviews of parents; 2. Demonstration of a training presentation on the meaning of temporary teeth, oral hygiene and the nature of nutrition; 3. Demonstration of samples with grown colonies of pathogenic bacteria to increase motivation up (see Fig. 5, Fig. 6); and after conducting a comprehensive prevention program (see Fig. 7, Fig. 8); 4. After demonstration of samples with growing colonies of pathogenic bacteria to increase motivation, parents were trained in oral hygiene using dental floss. Parent training in application of colloidal silver with Ag ⁺ nanoparticles according to the scheme; 5. Repeated survey of parents to control the level of knowledge; 6. Distribution of notes on the care of teeth and oral hygiene.

The main program of prevention: the second unit is aimed at working with children in groups and individually, including the provision of specialized dental care.

Block 2 - Primary and secondary prevention of dental caries in young children: 1. Conducting dramatized health lessons, teaching children the basics of oral hygiene (see Fig. 9, 10, 11, 12). Dental examination of children in a game form (see Fig. 13, 14, 15, 16). 2. Improving the hygienic condition of the oral cavity: controlled cleaning of the teeth. 2. Normalization of the nature and diet / elimination of carbohydrate factors. 3. Local antimicrobial therapy at home: 3.1 The use of applications of colloidal silver with Ag ⁺ nanoparticles according to the scheme. 3.2 Oral cleansing with unclaimed xylitol-containing Spiffies Tooth Wipes sanitary napkins for children up to 18 months. 4. Compliance with the drinking regime. 5. Apply fluoride locally once every 3 months by a doctor in a dental office. 6. Sealing the fissure of temporary molars, according to indications. 7. Examination by a pediatrician to identify general somatic pathology and possible hypocalcemia. 9. Dispensary observation.

An additional prevention program is carried out in parallel to the main one, consists of a basic and supporting course, and the technical result of the proposed method is directly achieved by the fact that children up to 3 years of the three groups, against the background of the main prevention scheme proposed for all subjects, additionally use colloidal silver in the form gel with the concentration of silver nanoparticles Ag ⁺ 30 ppm nezayavlyaemym «NAno sILver SOL» cleaning gel, 30 ppm, a manufacturer of "Resbio" St. Petersburg, commissioned by the NGO "Star" in St. Pete burg or equivalent scheme for 6 months. The course of application of the gel directly into Streptococcus mutans source biotopes is carried out by a viscose tampon applicator in an amount of 2 drops: the first drop of gel is first 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 mucous membrane of the middle third of the back of the tongue in circular motions from left to right. The whole procedure takes 30-40 seconds. The course of treatment is as follows. Application of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm is carried out by parents 2 times a day, morning and evening. It is recommended to carry out pre-morning fasting hygienic cleaning of the teeth, to give the child pure water and after 5-7 minutes a consistent processing biotopes lingual surfaces of the teeth and tongue of the back, causing nezayavlyaemy gel nanoparticles Ag ⁺ in a concentration of 30 ppm. Eating can be no earlier than 20-30 minutes. It is recommended in the evening before bedtime, to pre-hygienically clean the teeth, give the child clean water and after 5-7 minutes to carry out sequential processing of biotopes of the lingual surfaces of the teeth of the lower jaw and the back of the tongue, applying a non-declared gel with Ag ⁺ nanoparticles at a concentration of 30 ppm. It is possible to carry out the application no earlier than one hour after eating and / or drinks. The scheme is designed for two courses for 6 months. The basic course includes application of colloidal silver 2 times a day for 7 days, the next 7 days break, only 3 months. The supporting course includes application of colloidal silver 1 time a day before going to bed for 14 days, the next 14 days break, only 3 months. It is recommended to use clean water on an empty stomach - non-purged non-carbonated natural oxygen low-mineralized water “Wave of Baikal” LLC “Baikal-Incom”, Baikalsk, Irkutsk region, containing calcium, magnesium and silver ions, etc., according to the following scheme: in the morning on an empty stomach, for 20- 30 minutes before meals and in the evening before bedtime, after the hygienic cleaning of teeth, before applying the gel with colloidal silver, twice a day, children from the first group, from 6 to 12 months, are given 20-30 ml of water “Wave of Baikal” per one reception, children from the second group from 1 d 2 years, give 30-40 ml of water "Wave of Baikal" at one time, children from the third group from 2 to 3 years, give 40-50 ml of water "Wave of Baikal" at one time, or more, depending on the individual characteristics and needs. Freshly squeezed carrot juice / freshly prepared organic carrot puree or undeclared baby carrot puree / carrot with “Fruto Nanny” pulp in the age dose at lunchtime and in the evening from 12.00 to 18.00 hours, when vegetables are best absorbed: for children from 6 months to 12 months: 20.0 ml / 1 tablespoon 2 times a day with meals; from year to 2 years 40.0 ml / 2 tablespoons 2 times a day with meals; from 2 years to 3 years: 40.0-60.0 / 2-3 tablespoons 2 times a day with meals. Dosage / quantity in ml is set individually by parents, depending on the tolerance and taste sensations, on the child’s desire. If the child has not received additional carrot juice for up to 6 months, they begin to inject him, starting with 0.5 tsp, gradually increasing the dose to the required one within 5-7 days. The scheme is designed for two courses for 6 months. The basic course includes the use of carrot juice / puree 2 times a day for 7 days, the next 7 days break, just 3 months, alternating with application of colloidal silver: 7 days natural water and colloidal silver, the next 7 days natural water and carrot juice / puree . The maintenance course includes consuming carrot juice / mashed potatoes 1 time a day in the evening for 3 months, prior to application with colloidal silver gel. Natural water is consumed at the same age dosage, daily, 2 times a day. Uniform intake of moderate doses of carrot puree / juice ensures that the necessary amino acids, micro and macronutrients and vitamins and fiber are regularly added to a growing baby’s body. Eating vegetables preferably at lunchtime and in the evening for better absorption of bioavailable components from the unique composition of carrots. To reduce food debris and reduce plaque formation, Splat non-coaxial waxed dental floss was used at least once a day at bedtime or, if parents could, 2 times a day, before day and evening sleep, and / or after each meal.

6 months after the completed comprehensive prevention program, the end of the main and additional programs, after 3 months of the basic course and after 3 months of the supporting course, three times during the year, current and control dental and microbiological studies of children under 3 years old were conducted in all groups. After carrying out, according to the method, the main program of therapeutic and preventive measures, including: rehabilitation of the oral cavity, normalization of the nature and diet with the elimination of carbohydrate factor, application of fluoride locally 1 time in 3 months, consultation with a pediatrician and after the completion of an additional prevention program, including the use natural water, carrot juice / mashed potatoes, topical colloidal silver and oral hygiene using bulk waxed dental floss, we summarized. In three groups, compared with the control group, statistically significant results were obtained in reducing the formation of dental plaque on tooth surfaces, reducing the titer of cariogenic Streptococcus mutans in the studied biotopes of the oral cavity, reducing indices of hystergesis to epithelial cells and co-adhesion of microorganisms among themselves. KPU growth in the 1st, from 6 to 12 months, and in the 2nd, from 1 to 2 years, experimental groups did not occur, in the 3rd group - a slight increase, in the control group against the background of the main program only prevention of cpu increase in 7 children out of 18. The dynamics of cpu in children of groups 1, 2, and 3 during preventive measures (M ± m) are presented in Table 2.

Studies have shown the degree of positive impact of a comprehensive prevention program - the main and additional, taking into account individual characteristics, on the signs of chronic dehydration in 78% of children with caries and without caries, but with risk factors. After detecting microscopic signs of a lack of water in the tissues of the oral cavity, see FIG. 17, 18, medium and / or a high degree of microbial adhesion and coadhesion, for 3 months, the subjects studied took pure water in age doses as a baseline program, and further, up to 6 months, as a supportive prevention program. After 3 and 6 months of additional program, repeated microscopic examination was performed. The results demonstrate the elimination of signs of chronic dehydration of the tissues of the oral cavity, see FIG. 19, 20: a decrease in the coefficients of histadhesion and coadhesion to a low degree, that is, a variant of the norm. The data of the results of microscopic examination of the scraping of the back of the tongue, taking into account the signs of chronic dehydration of the tissues of the oral cavity before and after water intake, are presented in table 3.

The advantages of the proposed method are:

- improving the quality of non-standard non-specific prophylaxis and treatment, the possibility of repeated bacteriological monitoring of contamination of the mucous backs of the tongue and lingual surface of the lower jaw teeth as an indicative method for detecting cariogenicity of dental plaque and microscopic monitoring of signs of chronic dehydration, coefficients of histahesion and coadhesion as a result of the preventive measures performed;

- safety, reduction of time, cost;

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

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

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

- improving the quality of preventive measures and the possibility of correction of therapeutic and prophylactic procedures with safe preparations, natural water and organic carrot juice with bioavailable trace elements to young children;

- no obstacles to access to the surface of the back of the tongue at the reception of a dentist or other specialist, allows you to widely use the proposed method of preventing caries by reducing the titer of cariogenic flora in the composition of the root microbiome and hard tissues of the teeth on the model of donation of cariogenic bacteria to other biotopes of the oral cavity in children early age; bacterial titer and plaque congestion at the same time decreases;

- prevention of dental caries in young children through the use of natural non-carbonated mineralized oxygen water with calcium, magnesium and silver ions with immunomodulating properties; the use of water increases the cleansing and protective properties of saliva in a non-drug way, activates the factors of specific immunity in saliva;

- prevention of dental caries in young children by applying juice and / or mashed organic carrots with ions of calcium, magnesium, phosphorus, fluorine, silicon, boron, molybdenum, etc., a wide range of essential amino acids, vitamins C, A, E, groups B, increases the protective properties of dentin and saliva in a physiological way, activates factors of specific immunity, strengthens periodontal tissues and tooth enamel;

- prevention of dental caries in young children through the use of dental volume waxed thread additionally, allows you to achieve perfect purity of the interdental spaces and develop personal hygiene skills in the child;

- after the end of the main and additional program of prevention as a complex of therapeutic and preventive measures, in the absence of contraindications, it is possible to conduct a repeated course of application of colloidal silver on the surface of the back of the tongue and teeth, use natural water and carrot juice at the discretion of the attending physician;

- allergic reactions to carrots are very rare, as a rule, combined with pollinosis on weeds and food allergies;

- resistance to silver in cariogenic bacteria was not detected;

- high parental compliance to the proposed method of prevention and treatment.

Example 1

Child O., 1 year old, during the initial treatment, the following were revealed: delay in eruption periods: 51, 61, 71, 81, good oral hygiene / HI - 0.24. In the oral cavity: 51, 61, teeth - intact. The child was microbiologically examined, according to the plan. 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 revealed that the dissemination of the mucous membrane of the tongue and lingual surface of the teeth by cariogenic bacteria Streptococcus mutans corresponds to class 3 / CFU> 10 ⁶ / ml; no statistically significant differences were found. The infestation of the vestibular tooth surface is 1 class / CFU <10 ⁵ / ml, the interdental space is 2 class, which corresponds to a CFU 10 ⁵ / ml - CFU 10 ⁶ / ml. Thus, the primary examination revealed a high contamination with cariogenic bacteria. The high titer of pathogenic microflora is due to the lack of rehabilitation, poor oral hygiene and severe cariogenic dental plaque. According to a microscopic study of the scraping of the backs of the tongue, unexpressed signs of chronic dehydration were found by the presence of small clusters of microbes in irregularly shaped figures. The coefficient of low-degree gidadgezii, moderate coadhesia. The main and additional complex of treatment and preventive measures were appointed, according to the method after demonstration of samples with grown colonies of pathogenic bacteria to increase motivation.

Application of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm was carried out by parents 2 times a day, morning and evening. In the morning on an empty stomach after preliminary hygienic cleaning of teeth, a child was given 20.0-30.0 ml of water "Wave of Baikal" and after 5-7 minutes they performed a sequential processing of biotopes of the lingual surfaces of the teeth and the back of the tongue, applied an undeclared gel with Ag ⁺ nanoparticles ppm They took food not earlier than in 20-30 minutes. In the evening before bedtime, hygienic cleaning of the teeth was previously performed, the child was given 20.0-30.0 ml of Water "Wave of Baikal" and after 5-7 minutes they performed sequential processing of biotopes of the lingual surfaces of the teeth of the lower jaw and the back of the tongue, Ag non-claimed gel was applied ⁺ at a concentration of 30 ppm. Conducted the application no earlier than one hour after eating and / or drinks. The scheme was performed according to the method. The supporting course included application of colloidal silver 1 time a day before going to bed for 14 days, the next 14 days break, only 3 months. Additionally, they received carrot juice of 20.0 ml / 1 tablespoon 2 times a day with meals from 12.00 to 18.00, according to the method, for 7 days, the next 7 days break, and then according to the scheme. Dental waxed bulk thread used daily, 1 time before bedtime.

After 6 months, after carrying out a set of basic and additional therapeutic and preventive measures using a gel with colloidal silver, the dental status and the contamination class with cariogenic microorganisms were re-assessed. By all indicators received a significant improvement. The cpu value remained the same - 7, but the component “k” - “0”, “n” - 7 changed in the index structure. Analysis of the results showed a significant decrease in GI - 0.24, the cariogenic values of plaque improved to 1 point. It was revealed that the dissemination of the mucous membrane of the tongue and lingual surface of the teeth by cariogenic bacteria Streptococcus mutans corresponds to class 1 / CFU <10 ⁵ / ml; no statistically significant differences were found. The infestation of the vestibular tooth surface is 1 class / CFU <10 ⁵ / ml, the interdental space is 1 class, which corresponds to CFU <10 ⁵ / ml. Microscopic examination of the scraping of the back of the tongue showed no signs of chronic dehydration. The coefficients of low-grade and high-grade coadhesion. During the follow-up period of observation during one year, no new foci of carious lesions of the teeth were found in the child.

Example 2

Child S., 2 years 3 months, the cpu of the teeth was 0. Oral hygiene / GI - 0.18, the value of cariogenic dental plaque - 1 point. The child was examined microbiologically, according to the proposed method. A biomaterial from 4 biotopes was taken: plaque from the vestibular and lingual surfaces of the teeth, the interdental space and from the mucous membrane of the back of the tongue. Revealed that the infection of the mucous membrane of the tongue and lingual surface of the teeth by cariogenic bacteria Streptococcus mutans was - class 2, which corresponds to a CFU of 10 ⁵ / ml - CFU of 10 ⁶ / ml; no statistically significant differences were found. Seediness of the vestibular surface of the tooth - class 0, which corresponds to CFU <10 ⁴ / ml, interdental space - 1 class / CFU <10 ⁵ / ml. According to a microscopic study of the scraping of the backs of the tongue, unexpressed signs of chronic dehydration were found by the presence of small clusters of microbes in irregularly shaped figures. The coefficient of hisdesgeia average degree, coadhesia moderate. We carried out a complex of treatment-and-prophylactic measures developed by us according to the scheme, including: rehabilitation of the oral cavity, normalization of the nature and diet with the elimination of the carbohydrate factor, application of fluoride locally 1 time in 3 months, consultation with a pediatrician. After demonstration of specimens with grown colonies of pathogenic bacteria to increase motivation, parents were trained in oral hygiene using bulk waxed dental floss and applications of colloidal silver. Additionally, parents performed applications of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm 1-2 times a day, morning and evening. In the morning on an empty stomach hygienic cleaning of the teeth was carried out, a child was given 40.0-50.0 ml of water "Wave of Baikal" and after 5-7 minutes they carried out sequential processing of biotopes of the lingual surfaces of the teeth and the back of the tongue, applying Ag ⁺ undeclared gel. They took food not earlier than in 20-30 minutes, in the evening before bedtime, they preliminarily performed hygienic cleaning of the teeth, gave the child 40.0-50.0 ml of water "Baikal Wave" and after 5-7 minutes carried out sequential processing of biotopes of the lingual surfaces of the teeth the lower jaw and the back of the tongue, put the gel with Ag ⁺ , no earlier than one 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 break, so alternately, only 3 months. The supporting course included application of colloidal silver 1 time a day before going to bed for 14 days, the next 14 days break, only 3 months. Additionally, 3 months received carrot juice 40.0 ml / 2 tablespoons 2 times a day with meals from 12.00 to 18.00, according to the method, for 7 days, the next 7 days break, and further, according to the scheme. Dental waxed bulk thread was used daily, 2 times a day, before daytime and evening sleep.

After 6 months, after the complex of the main and additional program of therapeutic and preventive measures using the gel with colloidal silver, the dental status and the contamination class with cariogenic microorganisms were re-evaluated. By all indicators received a significant improvement. The value of cpu remained the same - 0. Analysis of the results showed the previous value of GI - 0.1, and the cariogenicity of plaque to 0 points. It was revealed that the infection of the mucous membrane of the tongue and lingual surface of the teeth with cariogenic bacteria S. mutans corresponds to 0 class of CFU <10 ⁴ / ml .; no statistically significant differences were found. Seediness of the vestibular surface of the tooth - class 0, which corresponds to CFU <10 ⁴ / ml., Interdental space - class 0, which corresponds to CFU <10 ⁴ / ml. Microscopic examination of the scraping of the back of the tongue showed no signs of chronic dehydration. The coefficients of low-grade and high-grade coadhesion. During the follow-up of new foci of carious lesions of the teeth in a child was not identified.

Example 3

Child O., 3 years 1 month, cpu of teeth is 1. Good oral hygiene / GI - 0.14, the value of cariogenic dental plaque - 0 points. In the oral cavity: 64 tooth - chronic course of caries, compensation: medium-sized 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 revealed that the dissemination of the mucous membrane of the tongue and lingual surface of the teeth by cariogenic bacteria Streptococcus mutans in grade 2, which corresponds to a CFU <10 ⁵ / ml; no statistically significant differences were found. Seediness of the vestibular surface of the tooth - 2 class / CFU <10 ⁵ / ml, interdental space - 2 class, which corresponds to CFU <10 ⁵ / ml. According to a microscopic study of scraping the backs of the tongue, unexpressed signs of chronic dehydration were found. The coefficient of low-degree gidadgezii, moderate coadhesia. A complex of treatment-and-prophylactic measures was appointed in accordance with the declared main and additional program. The application of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm was carried out by parents 2 times a day, morning and evening, according to the method, according to the scheme. In the morning on an empty stomach after preliminary hygienic cleaning of teeth, a child was given 40.0-50.0 ml of water "Wave of Baikal" and after 5-7 minutes they performed sequential processing of biotopes of the lingual surfaces of the teeth and the back of the tongue, applied an undeclared gel with Ag ⁺ nanoparticles ppm They took food not earlier than in 20-30 minutes. In the evening before bedtime, hygienic cleaning of the teeth was previously performed, the child was given 40.0-50.0 ml of water "Wave of Baikal" and after 5-7 minutes they performed sequential processing of biotopes of the lingual surfaces of the teeth of the lower jaw and the back of the tongue, Ag non-claimed gel ⁺ at a concentration of 30 ppm. Conducted the application no earlier than one hour after eating and / or drinks. The scheme was performed in two courses for 6 months, according to the description of the method. Additionally, we received carrot juice 40.0-60.0 / 2-3 tablespoons 2 times a day. The dosage was set individually by the parents, depending on the needs of the child, increased the dose to 3-4 tablespoons. Dental waxed bulk thread was used daily, before daytime and evening sleep.

After carrying out a complex of treatment-and-prophylactic measures, according to the main and additional program of prevention, the indicators of dental status improved. The cpu value remained the same as -1, but the component “k” - “0”, “n” - 1 changed in the index structure. Analysis of the obtained results showed the same GI value - 0.14, and the cariogenicity of plaque to 0 points. It was revealed that the dissemination of the mucous membrane of the tongue and lingual surface of the teeth by cariogenic bacteria Streptococcus mutans corresponds to class 1 CFU <10 ⁵ / ml .; no statistically significant differences were found. The infestation of the vestibular surface of the tooth is class 0, which corresponds to CFU <10 ⁴ / ml., The interdental space is class 1, which corresponds to CFU <10 ⁵ / ml. According to a microscopic examination of the scraping of the back of the tongue, signs of chronic dehydration were not detected. The coefficients of low-grade and high-grade coadhesion. During the dispensary observation for a period of 12 months, new foci of carious lesions of the teeth in a child were not detected.

Example 4

Child C, 2 years and 10 months, teeth cpu equal to 8. Poor oral hygiene / GI - 0.68, the value of cariogenic dental 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, dentine is moist, light. The child was examined microbiologically, according to the proposed method. The biomaterial was collected 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 revealed that the dissemination of the mucous membrane of the tongue and lingual surface of the teeth by cariogenic bacteria Streptococcus mutans was 3 class, which corresponds to a CFU> 10 ⁶ / ml; no statistically significant differences were found. Seediness of the vestibular surface of the tooth - 3rd class CFU> 10 ⁶ / ml, interdental space - 3rd class, which corresponds to CFU> 10 ⁶ / ml. According to a microscopic study of the scraping of the backs of the tongue, pronounced signs of chronic dehydration by the presence of accumulations of microbes in figures of the type of balls were found. The coefficient of hisdesgesia moderate degree, coadhesia high degree. In this clinical case, we did not use an additional prophylactic program, did not prescribe colloidal silver applications, Baikal Wave water, carrot juice, and waxed dental floss. The child was given a complex of treatment and preventive measures developed by us from the main prevention program, which includes: rehabilitation of the oral cavity, normalization of the nature and diet with the elimination of carbohydrate factor, application of fluoride locally 1 time in 3 months, consultation with a pediatrician. After demonstration of samples with growing colonies of pathogenic bacteria to increase motivation, parents were trained in oral hygiene without the use of dental floss. After carrying out a complex of treatment-and-prophylactic measures without using a gel with colloidal silver, the indicators of the dental status also improved, seeding with cariogenic bacteria decreased. The cpu value remained the same - 8, but the component “k” - “0”, “n” - 8 changed in the index structure. Analysis of the results showed a significant decrease in GI - 0.28, the values of cariogenic plaque improved to 1 point. It was revealed that the infection of the mucous membrane of the tongue and lingual surface of the teeth with cariogenic bacteria S. mutans corresponds to class 1 / CFU <10 ⁵ / ml; no statistically significant differences were found. The infestation of the vestibular tooth surface is 1 class / CFU <10 ⁵ / ml, the interdental space is 1 class, which corresponds to CFU <10 ⁵ / ml. According to a microscopic examination of the scraping of the back of the tongue, signs of chronic dehydration remain. The coefficients of low degree of hisdes and coadhesion of moderate. During the follow-up period of 12 months, revealed an increase in one focus of carious lesions of the teeth.

Example 5

Child R., 2 years 11 months, teeth cpu equals 4. Poor oral hygiene / GI - 0.62 and pronounced cariogenic dental plaque - 2 points. In the oral cavity: 52, 51, 61, 62 teeth - a chronic course of caries, compensation: carious cavities performed by dense, pigmented dentin. The child was examined microbiologically, according to the proposed method. It was revealed that the spread of the mucous membrane of the tongue and lingual surface of the teeth by cariogenic bacteria Streptococcus mutans was - in grade 3, which corresponds to CFU> 10 ⁶ / ml; no statistically significant differences were found. The infestation of the vestibular tooth surface is 1 class / CFU <10 ⁵ / ml, the interdental space is 1 class, which corresponds to CFU <10 ⁵ / ml. According to a microscopic study of the scraping of the backs of the tongue, moderate signs of chronic dehydration were found by the presence of microbial accumulations in figures of the type of balls. The coefficient of hisdesgeia average degree, coadhesia moderate. In this clinical case, we did not designate an additional prevention program: application of colloidal silver with Ag ⁺ nanoparticles at a concentration of 30 ppm, “Baikal Wave” water, carrot juice, and waxed bulk dental floss. The child was given a complex of treatment and preventive measures developed by us from the main prevention program, which includes: rehabilitation of the oral cavity, normalization of the nature and diet with the elimination of carbohydrate factor, application of fluoride locally 1 time in 3 months, consultation with a pediatrician. After carrying out a complex of treatment-and-prophylactic measures without using a gel with colloidal silver, the indicators of the dental status also improved, seeding with cariogenic bacteria decreased. The cpu value remained the same - 4, but in the structure of the index the component “k” - “0”, “n” - 4 changed. Analysis of the results showed a significant decrease in GI - 0.20, the cariogenic values of plaque improved to 1 point. It was revealed that dissemination of the mucous membrane of the tongue and lingual surface of the teeth by cariogenic bacteria Streptococcus mutans corresponds to class 1 / CFU <10 ⁵ / ml; no statistically significant differences were found. The infestation of the vestibular tooth surface is 1 class / CFU <10 ⁵ / ml, the interdental space is 1 class, which corresponds to CFU <10 ⁵ / ml. According to a microscopic examination of the scraping of the back of the tongue, signs of chronic dehydration remain. The coefficients of hisdes and coadhesia moderate. During the follow-up period of 12 months, revealed an increase in one focus of carious lesions of the teeth.

Claims (1)

A method for preventing dental caries in young children by affecting manageable risk factors for its development, achieved through the implementation of basic and additional prevention programs, where the main program includes counseling and educational work with parents, provide dental medical care for children with oral sanitation, while simultaneously carrying out an additional program gel applications with colloidal silver Ag + 30 ppm according to the scheme for 6 months in the S.mutans source biotopes on lingual languages teeth of the lower jaw and the mucous membrane of the back of the tongue 1-2 times a day on an empty stomach, using natural non-carbonated mineralized oxygen water 2 times a day, freshly squeezed carrot juice / freshly prepared carrot puree or ready-made carrot puree “FrutoNyanya” 2 times a day using dental floss , characterized in that water is used to drink "Wave of Baikal" with a neutral pH and bioavailable ions of calcium, magnesium and silver in the morning on an empty stomach 20-30 minutes before meals and in the evening before going to bed according to the scheme before applying the gel with colloidal silver, at one time for children from 6 to 12 months - 20-30 ml each, from 1 to 2 years old - 30-40 ml each, from 2 to 3 years old - 40-50 ml or for individual needs, juice / puree is prepared from organic carrots, given within the age norm 2 times a day with meals from 12.00 to 18.00 according to the schedule for one reception: for children from 6 to 12 months - 20.0 ml / 1 tablespoon; from 1 to 2 years - 40.0 ml / 2 tablespoons; from 2 to 3 years - 40.0-60.0 ml / 2-3 tablespoons; The basic course includes the use of carrot juice / puree for 7 days, 7 days break, just 3 months, alternating: 7 days natural water and colloidal silver, 7 days natural water and carrot juice / puree; supporting course 3 months, drinking carrot juice / puree 1 time per day until 18.00, water 2 times per day, colloidal silver 1 time before going to bed 14 days and 14 days break, dental floss using waxed, volume, once or twice a day before sleep or, if possible, after each meal.

Images