Maria Borysewicz-Lewicka

Oral manifestations of primary immune deficiencies in children

An important task for both dentists and pediatricians dealing with patients manifesting different oral lesions is to be able to differentiate changes signaling systemic disease from those appearing without any concomitant serious health problem. In this article, symptomatology of selected primary immune deficiency diseases are discussed with particular emphasis on oral manifestations reported in this group of disorders. Facial, dental, and oral findings compose a constellation of symptoms observed in immunodeficiency diseases. Predisposition to bacterial invasion, cytokine dysregulation, tissue inflammatory process, and necrosis lead to early-onset oral lesions and periodontitis. Developmental abnormalities, periodontal disease, and oral lesions may accompany immunodeficiency and require particular awareness directed toward diagnosis of an underlying disease of the immune system.

Child sexual abuse as an etiological factor of overweight and eating disorders — considerations for primary health care providers

Despite the recognition of the clinical importance of child sexual abuse, primary health care providers are often not ad-equately prepared to perform medical evaluations and diagnose child sexual maltreatment. Paper presents basic symptoms and signs of CSA, which may suggest the need for further patients diagnosis and referral. Since the great majority of sexually abused children do not have any abnormal physical findings, special attention is paid to the silent warning signs of CSA, such as changes in attitude towards own body and eating habits. Numerous studies suggest that victims of CSA may develop obesity or eating disorders of various forms and intensities.

The relationship between oral hygiene level and gingivitis in children

BACKGROUND The condition of the teeth, periodontium and oral mucosa determines directly and indirectly the general health of the organism and, therefore, requires to be monitored. Childhood, especially the first years of life, is the time when proper health-promoting behaviors are formed, allowing the future prevention of such diseases as dental decay and gingivitis. Studies concerning the gingival status and bleeding in children are scarce, although such knowledge can be useful in planning preventive programs. OBJECTIVES The aim of the study was to determine the relationship between oral hygiene level and the likelihood of gingival bleeding. MATERIAL AND METHODS The examined group comprised 2,856 children aged 7 years, living in an urban area in western Poland. The hygiene status was evaluated according to the simplified Debris Index (DI-S) criteria and the periodontal status was evaluated according to the Community Periodontal Index (CPI) criteria. Logistic regression analysis was used to determine the predictors of gingival bleeding. RESULTS The average value of DI-S was 0.91; it was not significantly different between girls and boys. In more than a half of the studied subjects (59.10%), oral hygiene was fair, in 12.46% - poor. Clinically healthy periodontium was observed in 91.32% of cases, bleeding on probing was present in 7.46% of cases. Calculus was detected in 1.22% of the children. Logistic regression analysis of the predictors of gingival bleeding showed that children with fair and poor oral hygiene were respectively 6 and 25 times more likely to show bleeding on probing compared to the children with very good oral hygiene. CONCLUSIONS In the studied group, it was noted that there is a need to promote oral hygiene, as it contributes to the fall in gingivitis prevalence among school children.

Enamel defects and dental cariesamong children attending primary schools in Poznań, Poland

BACKGROUND Both positive and negative associations between developmental enamel defects (DED) and dental caries have been reported in the literature. OBJECTIVES The aim of this study was to assess the prevalence of DED of permanent dentition and its association with dental caries in schoolchildren living in Poznań (Wielkopolskie Voivodeship, Poland). MATERIAL AND METHODS A total of 2,522 6th grade children and 3,112 1st grade children were examined. Developmental enamel defects were described using the modified Developmental Defects of Enamel Index. Dental caries experience was assessed in accordance with the number of decayed, missing and filled teeth (DMFT). RESULTS The study revealed 475 children (9.6%) to have at least 1 enamel defect of permanent dentition. In 6th-graders, statistical analysis confirmed significant differences between DMFT, DT (decayed teeth) and FT (filled teeth) numbers of various DED groups with subjects affected by diffuse opacities having generally the lowest caries indices and subjects with enamel hypoplasia and/or demarcated opacities having the highest caries indices. In both age groups, dental caries prevalence was statistically significantly higher in subjects with hypoplasia and/or demarcated opacities as compared to subjects without DED or with diffuse opacities (p < 0.05). CONCLUSIONS The prevalence of DED in the examined population was low and comparable to those reported in regions without fluoridated water. The study confirmed that children affected by diffuse enamel opacities were less susceptible to dental caries, while demarcated opacities and hypoplasia should be considered important dental caries risk factors.