Evaluation of the effectiveness of complex treatment of patients with gastroesophageal reflux disease on the state of oral hygiene

Abstract

Summary. Various changes in the digestive system affect the condition of the oral cavity. The duration and severity of the underlying disease reflect the severity of pathological processes. This is explained by the close morphofunctional dependence between different parts of the alimentary canal and oral cavity, including the mucous membrane. This area is also subject to reflex effects of the gastrointestinal tract, and SORP receptors affect the secretory and motor functions of the gastrointestinal tract.

The aim of the study – to study the dynamics of indicators of the state of the oral cavity according to the OHI-S oral hygiene index, according to the index of plaque on the tongue (WTC), acid-alkaline balance before and after the treatment.

Materials and Methods. 30 patients were examined for gastroesophageal reflux disease (15 of them with increased acidity of gastric juice and 15 with decreased acidity). The oral hygiene index was determined using Green-Vermilion according to the generally accepted method. The index of plaque on the tongue was evaluated by WTC (Winkel Tongue Coating). This index takes into account the thickness of the coating. The acidity of saliva depends on the rate of salivation. Determination of the pH of the oral fluid was performed on an empty stomach using a universal indicator paper impregnated with a special substance (litmus). The pH measurement range is from 0 to 14. The ratio of acid and alkali in the oral fluid is called acid-base balance. Statistical data processing was carried out using the Microsoft Excel program by calculating the arithmetic mean value.

Results and Discussion. Evaluating the state of oral hygiene, it should be noted that overall hygiene was satisfactory in the pre-treatment examination group. According to the results of the study of the indicators of oral hygiene in the examined patients, positive dynamics can be traced after the proposed treatment and prevention complex. In patients with gastroesophageal reflux disease, attention was drawn to the unsatisfactory level of tongue hygiene, depending on the type of acidity. The level of tongue hygiene was determined by the degree of plaque coverage - the W.T.C index. Thus, after the treatment and prevention complex proposed by us, an improvement in the tongue hygiene index by 3.2 times was noted compared to before treatment. The acid-alkaline balance (pH) of the oral fluid is important for metabolism in the oral cavity. Normally, the acidity of human saliva varies from 6.8-7.4 pH, and with a high rate of salivation it can reach 7.8 pH. With gastroesophageal reflux, which reaches the oral cavity, a decrease in the pH of saliva leads to pathological changes in the organs of the mouth. Thus, the proposed treatment-prophylactic complex has a positive effect on the acid-alkaline balance of the oral fluid in GERD patients with an acid-dependent state. The pH of saliva tends to a neutral environment.

Conclusions. The results of our study indicate a positive effect of the therapeutic and preventive measures proposed by us on the condition of the oral cavity in patients with GERD. Medically, a prophylactic complex must be introduced into the treatment of this contingent of patients in order to prevent the manifestations of GERD in the oral cavity and the occurrence of complications.