
ISSN: 2637-4692
Chaizhunusova N Zh*1, Berekenova GA2, Shabdarbayeva DM3, Rakhimzhanova FS4, Momynzhanov AT5, Sailaugalieva SS6 and Salimbekov7
Received: February 01, 2021 Published: April 8, 2021
Corresponding author: Chaizhunusova N Zh, Semey Medical University, Non-Commercial Joint-Stock Company. Kazakhstan
DOI: 10.32474/MADOHC.2021.04.000196
It is noted that the presence of neglected and long-term
untreated periodontitis can lead not only to the aggravation of
dental problems, in the form of complicated caries, loss and loss of
teeth, but also to an increased risk of gastrointestinal diseases and
diseases of the cardiovascular system. [1] It should be recognized
that the literature data on post-traditional changes in the oral mucosa
are generally sporadic. Thus, in the publications of Belarusian
scientists after the accident at the Chernobyl nuclear power plant,
frequent lesions of the mucous membrane in the form of dryness,
swelling, and hyperemia were reported. The same study reported
a high incidence of caries compared to control areas. In addition,
the authors noted an increased incidence of aphthous stomatitis
and recurrent herpes in the exposed population. [2] The work of
other researchers noted an increase in the incidence of periodontal
diseases in the population of Belarus, especially in areas affected
by the Chernobyl accident. [3] In the region of the Semipalatinsk
nuclear test site, dental morbidity in children and adults was also
studied. The most extensive comprehensive examination of the
affected population of the Semipalatinsk region with the study
of the course, treatment and prevention of periodontal and oral
mucosa diseases is given, where it is convincingly shown that in the
mechanism of development of oral mucosa candidiasis and chronic
recurrent aphthous stomatitis, the leading role belongs to changes
in immune parameters, salivary dysfunction and microcirculation
disorders.
As risk factors, such as radiation dose, somatic diseases,
dysfunction of salivation, and local immunodeficiency are listed. At
the same time, over the years that have passed since the publication
of this work, the doses of ionizing radiation that affected the exposed
population have been clarified. Despite the fact that dosimetric
studies in the territories adjacent to the SNTS were started back in
1953, that is, 52 years ago, there are still a lot of disagreements and
contradictions in their assessment. From a historical point of view,
two mutually opposite tendencies constantly existed in assessing
the doses of ionizing radiation received by the population living in
radiation-contaminated areas. One of these tendencies, put forward
and defended mainly by employees of the military-industrial
complex, was the desire to underestimate the amount of absorbed
and effective equivalent doses received by the population as much
as possible. A striking example of this is the adjustment of the dose
to the city of Semipalatinsk for the entire existence of the nuclear
test site, that is, from 1949 to 1989, in the amount of 0.03cSv.
The opposite tendency was an attempt by some researchers to
exaggerate the doses received by force, which in some publications
turned out to be equal to or exceeding 400-500cSv. At present, it
has been reliably established that the number of atmospheric
explosions carried out between 1949 and 1989 was 166. There is
some disagreement about the number of underground explosions,
but at present most scientists are inclined to admit that there were
about 500. [4] In recent years, considerable attention has been
paid to the effect of ionizing radiation on the reproductive health of
women and their offspring. In this regard, studies were carried out
within the framework of two programs to assess the consequences
of radiation exposure among children born to irradiated parents.
Single reports are devoted to the study of the dental status
of people exposed to factors associated with the consequences of
the explosions at the Semipalatinsk test site. When analyzing the
literature data on the influence of the radiation factor on the state
of the oral cavity, it should be borne in mind that numerous data
indicate the role of odontogenic foci of infection on the development
of a number of general somatic diseases of pathological conditions.
On the other hand, diseases of the internal organs contribute to
the development or aggravate the course of various pathological
processes of the dentoalveolar system, the occurrence of which
is preceded or accompanied by a violation of the homeostasis of
the oral cavity. [5] When examining the state of the oral cavity
and periodontal tissues in patients with diseases of the digestive
tract exposed to ionizing radiation as a result of accidents at the
Chernobyl nuclear power plant, it was found that congestive
hyperemia and edema of the mucous membrane of the lips were detected in atrophic and ulcerative gastritis of varying severity - in
60%, and cracks, erosion, dryness, peeling on the red border of the
lips and in the corners of the mouth in 35%. Glandular cheilitis,
resistant to the applied therapy, was noted in 10% of the examined
patients.
In 73% of patients, catarrhal gingivitis was detected,
hypertrophic - in 12%. In ulcerative lesions, 100% of the periodontal
tissues were affected. In persons exposed to ionizing radiation,
the pathological process involved the most radiosensitive areas
of the oral mucosa - the lateral surface and tip of the tongue, the
floor of the mouth, soft palate, cheeks, gingival margin and gingival
papillae. [6] Moreover, the radiosensitivity increased in the case of
insufficient hygiene - in the unsanded oral cavity, with the already
existing caries. In children with an increased content of radioactive
cesium and nitrates in the body, an increase in the activity of salivary
amylase was found. It was noted that in the examined persons
exposed to ionizing radiation, in almost all cases early symptoms
of periodontal diseases were detected, and the periodontal index
characterizing the severity of periodontitis or predisposition to
it was higher than in people from “clean” areas. In patients with
periodontitis, the manifestation of changes in local factors of
nonspecific protection of the oral cavity depended on the degree
of remoteness from the focus of nuclear damage. Dysfunctions of
salivation, the local immune system, changes in the microelementenzymatic
composition of saliva and the cellular composition of the
gingival fluid were the priority in the pathogenesis of periodontal
diseases. One of the main criteria for the hygienic assessment
of the radiation situation caused by global fallout is the data
characterizing the strontium-90 content in human bone tissue.
[7] It is known from the literature that patients with practically all
forms of cancer in the head and neck area treated with radiation
exposure develop radiation mucositis. Its cause is the selective
death of the most rapidly multiplying cells of the oral epithelium.
This condition significantly reduces the quality of life of the sick
and is accompanied by pain and discomfort, reduces the available
dose of radiation, negatively affecting its effectiveness. The pain can
be so severe that narcotic analgesics are required to control it. The
condition of patients is usually assessed by such clinical parameters
as weight loss, difficulty in swallowing and speech.
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