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dc.contributor.advisorATAÇ, ATİLLA STEPHAN
dc.contributor.authorŞENER, MÜNEVVER
dc.date.accessioned2017-06-13T10:55:05Z
dc.date.available2017-06-13T10:55:05Z
dc.date.issued2016
dc.date.submitted2016-09-22
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dc.identifier.urihttp://hdl.handle.net/11655/3509
dc.description.abstractŞener, M. The effect of inhaled corticosteroids on oral health in pre-school children, 2 to 6 years of age, with asthma. Hacettepe University, Faculty of Dentistry, Specialty Thesis in Pediatric Dentistry, Ankara, 2016. Asthma is a growing public health problem affecting over 300 million people worldwide. Although individuals from all age groups are affected by asthma, the disease usually begins in childhood. Depending on the increase in the prevalence of asthma, oral problems arising from the use of asthma medications have become a major health problem all over the world. The children, aged 2 to 6 years, who referred to Hacettepe University Medical Faculty Allergy and Asthma Unit were included in this study. 115 children, who have been treated with inhaled corticosteroids for at least 6 months and did not have any other systemic health problems, were examined. After approval of the Local Ethics Committee of Hacettepe University, a questionnaire was conducted to the parents before oral examination. Written informed consents were obtained from the parents and the children were examined using dental mirror and probe under dental unit lighting after air-drying the teeth. Oral health status was evaluated with dmft-dmfs, DMFT-DMFS, ICDAS II, plaque index and gingival index. Furthermore posterior, anterior and canine occlusal relationships were also evaluated. The average duration of inhaler use in children was 19.84 ± 11.46 months. The use of budesonide+lactose inhaler resulted in higher prevalence of caries in permanent teeth than that of fluticasone propionate inhaler (p=0,046). Increased inhaled corticosteroids use was associated with high dmft-dmfs/DMFT-DMFS, plaque and gingival index without statistically difference (p>0,05). However, increased inhaled corticosteroid use was associated with oral candidiasis and it was statistically significant (p=0,027). As a result; inhaled corticosteroid is an important risk factor for tooth decay and gum disease. In addition, due to the effect of immunosuppression, increased usage of inhaled corticosteroid increases the risk of developing opportunistic pathogen candida. Families should be educated about the effects of asthma medications on oral health and should be encouraged for attending to regular dental visits. Also patients should be advised to rinse their mouths after inhaler use.tr_TR
dc.description.tableofcontentsONAY SAYFASI iii TEŞEKKÜR iv ÖZET v ABSTRACT vi İÇİNDEKİLER vii SİMGELER ve KISALTMALAR x ŞEKİLLER xii TABLOLAR xiii 1. GİRİŞ 1 2. GENEL BİLGİLER 3 2.1. Tarihçe 3 2.2. Tanım 3 2.3. Epidemiyoloji 5 2.4. Sınıflandırma 6 2.4.1. Etiyolojik Faktörlere ve Çeşitli Kliniklere Göre Sınıflandırma 6 2.4.2. Klinik Bulgular ve Şiddetine Göre Sınıflandırma 8 2.4.3. Kontrol Durumuna Göre Sınıflandırması 9 2.5. Etiyolojisi ve Risk Faktörleri 10 2.5.1. Konağa Ait Faktörler: 10 2.5.2. Çevresel Faktörler 13 2.6. Astım Tanısı 17 2.6.1. Anamnez: 17 2.6.2. Klinik Bulgular 18 2.6.3. Laboratuvar Testleri: 19 2.6.4. Ayırıcı Tanı: 22 2.7. Patogonez 22 2.8. Tedavisi 25 2.8.1. Tıbbi Tedaviler 25 2.9. Ağız Sağlığına Etkileri 31 2.9.1. Çürük 31 2.9.2. Periodontal Problemler 33 2.9.3. Dental Erozyon 35 2.9.4. Oral Kandidiyazis Gelişimi 36 2.9.5. Dentoalveolar Anomaliler 37 3. BİREYLER VE YÖNTEM 39 3.1. Araştırmanın Zamanı ve Yeri 39 3.2. Araştırmanın Tipi 39 3.3. Evren ve Örneklem 39 3.4. Değişkenler 40 3.5. Terim, Sınıflama, Kriterler 40 3.6. Veri Toplama Aracı 41 3.7. İnsan Gücü 41 3.8. Veri Toplama Şekli 42 3.8.1. Anket Uygulanması 42 3.8.2. Ağız İçi Muayenelerinin Yapılması 42 3.9. Verilerin Analizi 48 3.10. Etik Kurul Onayı ve Gerekli İzinler 48 3.11. Zaman Çizelgesi 49 3.12. Bütçe 49 4. BULGULAR 50 4.1. Çocuğa ve Velilerine Ait Bazı Sosyo-Demografik Özellikler 50 4.2. Çocuğun Doğumuna İlişkin Bazı Özellikler 51 4.3. Çocuğun Anne Sütü Alma, Biberon ve Emzik Kullanımına İlişkin Özellikler 52 4.4. Velilerin Çocuklarının Ağız Diş Sağlığına İlişkin Şikayetleri 54 4.5. Çocukların Beslenme Alışkanlıklarına Ait Özellikleri 55 4.6. Çocukların Diş Fırçalama Alışkanlıkları ve Diş Hekimine Gitme Durumlarına İlişkin Özellikleri 56 4.7. Çocuğun Ağız Sağlığı Yönünden Kötü Alışkanlıkları 58 4.8. Çocuğun Astım Hastalığına İlişkin Bazı Özellikleri 59 4.9. Çocuğun Kullandığı İlaca İlişkin Bazı Özellikleri 60 4.10. Çocukların Ağız ve Diş Muayene Bulguları 61 4.10.1. dmft-dmfs/DMFT-DMFS İndeksleri 61 4.10.2. ICDAS II İndeksi 62 4.10.3. pufa İndeksi 65 4.10.4. Oklüzyon 65 4.10.5. Gingival İndeks ve Plak İndeksi ile İlgili Bulgular 66 4.10.6. Yumuşak Dokular 67 4.10.7. dmft-dmfs/DMFT-DMFS, Gingival İndeks ve Plak İndeksi Bulgularının Bazı Değişkenlere Göre Karşılaştırılması 67 4.10.8. İnhale Kortikosteroid Kullanım Süresi Ve Oral Kandidiyazis Meydana Gelme Şikayatine İlişkin Bulgular 78 5. TARTIŞMA 79 6. SONUÇ ve ÖNERİLER 90 7. KAYNAKLAR 92 EKLER Ek-1 Etik Kurul Onayı Ek-2 Aydınlatılmış Onam Formu Ek-3 Astımlı Çocuklarda Diş Sağlığı Projesi EK-3 Astım Hastası Olan Çocukların Ağız-Diş Sağlığının Belirlenmesine Ait Anket ve Muayene Formu Ek-4 Ağız İçi Muayene Formutr_TR
dc.language.isoturtr_TR
dc.publisherSağlık Bilimleri Enstitüsütr_TR
dc.rightsinfo:eu-repo/semantics/openAccesstr_TR
dc.subjectÇocuktr_TR
dc.subjectAstım
dc.subjectİnhaler Kortikosteroid
dc.subjectAğız Diş Sağlığı
dc.titleOkul Öncesi Dönemde Astım Tanısı İle İzlenen 2-6 Yaş Arası Çocuklarda İnhale Kortikosteroidlerin Ağız-Diş Sağlığı Üzerine Etkilerinin Belirlenmesitr_TR
dc.typedentThesisen
dc.description.ozetŞener, M. Okul öncesi dönemde astım tanısı ile izlenen 2-6 yaş arası çocuklarda inhale kortikosteroidlerin ağız diş sağlığı üzerine etkilerinin belirlenmesi. Hacettepe Üniversitesi Diş Hekimliği Fakültesi, Çocuk Diş Hekimliği Uzmanlık Tezi, Ankara, 2016. Astım, dünya çapında 300 milyondan fazla insanın etkilendiği ve gün geçtikçe artış gösteren toplumsal bir sağlık problemidir. Her yaş grubundan bireyler astımdan etkilenmesine karşın, bu hastalık genellikle çocukluk çağlarında başlamaktadır. Astım hastalığının sıklığındaki artışa bağlı olarak, astım ilaçlarının kullanımından kaynaklanan ağız içi problemler de tüm dünyada önemli bir sağlık sorunu haline gelmiştir. Bu çalışmada, Hacettepe Üniversitesi Tıp Fakültesi Çocuk Alerji ve Astma Ünitesi’ne başvuran astım teşhisi koyulmuş, en az 6 ay boyunca inhale kortikosteroid kullanan ve başka herhangi bir sistemik sağlık sorunu bulunmayan, 2-6 yaş arası koopere 115 çocuğun ağız diş sağlığı durumları incelenmiştir. H.Ü. Girişimsel Olmayan Araştırmalar Etik Kurulu Başkanlığı’ndan onay alındıktan sonra, inhale kortikosteroid kullanan astım hastası çocuklar, araştırmacı tarafından H.Ü. Diş Hekimliği Fakültesi Çocuk Diş Hekimliği Anabilim Dalı Kliniği’ne çağırılmış ve veriler hastaların velilerine uygulanan bir anket formu aracılığıyla toplanmıştır. Velilerden yazılı onam alındıktan sonra, çocukların ağız diş muayeneleri ayna, sond ve ünit ışığı altında; hava-su spreyi ile dişler kurutularak yapılmıştır. Diş çürükleri; dmft-dmfs/DMFT-DMFS ve ICDAS II indeksleri ile, diş eti sağlığı ve plak durumu ile ilgili kayıtlar ise gingival ve plak indeksleri kullanılarak değerlendirilmiş ve kaydedilmiştir. Buna ek olarak, çocuklarda posterior, anterior ve kanin diş ilişkileri değerlendirilmiştir. Araştırmaya katılan çocukların ortalama inhaler kullanım süreleri 19,84±11,46 aydır. Budesonid+laktoz içeren inhaler kullanan çocukların daimi dişlerindekideki çürük prevelansı, flutikazon propiyonat içeren inhaler kullanan çocukların daimi dişlerindeki çürük prevelansına göre daha yüksektir (p=0,046). İnhaler kortikosteroid kullanım süresi arttıkça diş çürüğü prevelansında, plak ve gingival indekslerinde artış gözlenirken bu fark istatistiksel olarak anlamlı değildir (p>0,05). Ancak inhaler kortikosteroid kullanım süresi arttıkça oral kandida enfeksiyonu gelişmesindeki artış istatistiksel olarak anlamlı bulunmuştur (p=0,027). Sonuç olarak; inhaler kortikosteroid kullanımı diş çürüğü ve diş eti hastalıkları üzerinde önemli bir risk faktörüdür. Ayrıca steroidlerin immünsüpresyon etkilerinden dolayı inhaler kullanım süresi arttıkça fırsatçı patojen olan kandida enfeksiyonunun gelişim riski de buna paralel olarak artmaktadır. Aileler astım hastalığının ve tedavide kullanılan ilaçların ağız içi etkileri konusunda eğitilmeli ve düzenli diş hekimi kontrollerine gidilmesi için teşvik edilmelidir. Ayrıca inhaler kullanım sonrası hastalara ağız çalkalama tavsiye edilmelidir.tr_TR
dc.contributor.departmentÇocuk Diş Hekimliğitr_TR
dc.contributor.authorIDTR200836tr_TR


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