Isikhathi sokwethula ingane yakho kudokotela wamazinyo ngasiphi iminyaka? Kungani ngisho nezingane ezineminyaka emithathu zithola ukubola kwamazinyo? Kungani uphatha amazinyo obisi, ngoba azophuma vele? I-Wday.ru ibuze imibuzo ethandwa kakhulu kusuka kubazali kuya kudokotela wamazinyo ohamba phambili wezingane eRussia.
Indondo yegolide yomncintiswano othi "Pediatric Dentistry" weRussia Dental Excellence Championship 2017, oyinhloko yomnyango wamazinyo ezingane we-AGF Kinder
1. Kufanele ibonwe nini ingane okokuqala ngqa kudokotela wamazinyo?
Ukuvakashelwa kokuqala nengane kwenziwa kangcono kakhulu lapho inezinyanga eziyi-9 kuya onyakeni owodwa, lapho amazinyo okuqala eqala ukuphuma. Udokotela uzohlola i-frenum yolimi nezindebe, ahlole amazinyo okuqala. Lokhu kuzokwenza ukuthi ukwazi ukubona nokuvimbela noma ukulungisa izifo zokuluma, ukukhubazeka kwenkulumo, nokuphazamiseka kobuhle ngesikhathi. Ngaphezu kwalokho, kungcono ukuvakashela udokotela wamazinyo wezingane ukuze uvikeleke kanye ngekota.
2. Ungayifundisa kanjani ingane ukuxubha amazinyo? Yini ebaluleke kakhulu - ibhulashi noma unama?
Ngokuvela kwezinyo lokuqala, usungakwazi ukufundisa ingane yakho ukuhlanzeka. Kuyafaneleka ukuqala ngebhulashi lomunwe elithambile lamanzi namanzi abilisiwe. Kancane kancane shintshela ebhulashi lamazinyo lengane ngamanzi. Uma kungekho okubonisa umuthi wokuxubha, ungaxubha amazinyo akho ngamanzi kuze kube unyaka nohhafu. Ngemuva kwalokho, shintshela ezintweni zokuxubha. Ukukhetha phakathi kokunamathisela nebhulashi akulungile ngokuphelele. Isikhathi esithile, ibhulashi libaluleke kakhulu, ezimweni ezithile - unamathisela. Isibonelo, uma ingane inesifiso sokubola kwamazinyo, udokotela uzokunika umuthi we-fluoride noma ukwelashwa okuqinile. Futhi i-European Academy of Pediatric Dentistry itusa ukusetshenziswa kwama-fluoride pastes avela ezinyweni lokuqala.
3. Kungani kusalungiswa amazinyo ezingane? Ziba mnyama, lokhu akuhambisani nomqondo, ingane ikhathazekile.
Ukuxubha amazinyo akuyona indlela yokwelapha amazinyo obisi, kepha kuphela ukulondolozwa kokutheleleka (ukumisa ama-caries), ngoba isiliva linempahla enhle yokubulala amagciwane. Ukuhlungwa kwamazinyo kuyasebenza lapho inqubo ingajulile, ngaphakathi koqweqwe lwawo. Uma inqubo ibanzi futhi ifaka izakhiwo zamazinyo ezinjenge-dentin, ukusebenza kwendlela yesiliva kuzoba phansi kakhulu. Indlela yesiliva ikhethwa lapho, ngasizathu simbe, ingekho indlela yokwelashwa okugcwele.
4. Indodakazi ineminyaka emithathu. Udokotela uphakamise ukuthi kwelashwe amazinyo ama-3 ngasikhathi sinye lapho ulele ngokwelashwa. Kodwa phela i-anesthesia iyingozi empilweni futhi ifushanise impilo, inemiphumela eminingi! Ikakhulukazi enganeni.
Udokotela uhlongoza ukwelapha amazinyo ngesilonda (ukungazi kahle) noma ngaphansi kwe-anesthesia (i-anesthesia, ukulala ngemithi) kubazali beziguli ezincane, ngoba, ngeshwa, eneminyaka engama-3-4, izingane ezingaphezu kuka-50% sezivele zihlupheka kusuka ku-caries. Futhi ukunakwa kwezingane kuncane, isikhathi esichithwa esihlalweni cishe imizuzu engama-30. Bayakhathala, bagangile bese bekhala. Lesi sikhathi asanele umsebenzi osezingeni eliphakeme ngomthamo omkhulu womsebenzi. Ngaphambili kwezokwelapha, akuzange kusetshenziswe izidakamizwa eziphephe ngokuphelele ze-anesthesia. Kwakukhona nokusabela okungathandeki: ukuhlanza, ukuzwa uphefumula kanzima, ikhanda elibuhlungu, ubuthakathaka obude. Kodwa manje ukwelashwa kwenziwa ngaphansi kwe-anesthesia ejwayelekile kusetshenziswa i-sevoran yezidakamizwa (sevoflurane) ngaphansi kweso lethimba lodokotela ababulala izinzwa nodokotela wezingane. Kuyinto ephephile yokuphefumula yokubulala izinzwa. Yakhiwa enhlanganweni yaseMelika futhi isetshenziswe ngempumelelo iminyaka engaphezu kwengu-10 e-USA, Japan nase Western Europe. I-Sevoran isebenza ngokushesha (isiguli silala ngemuva kokuphefumula kokuqala), asibangeli ukungezwani komzimba. Isiguli sivuka kalula emizuzwini engu-15 ngemuva kokucisha ukunikezwa kwe-sevoran, umuthi uyashesha futhi ngaphandle kwemiphumela ekhishwe emzimbeni, awulimazi noma yiziphi izitho nezinhlelo. Futhi, akukho okuphikisana nokusetshenziswa kwe-sevoran ezigulini ezinesifo esibi njengesifo sokuwa, ukukhubazeka kobuchopho, ukukhubazeka kwenhliziyo, ukulimala kwesibindi nezinso.
Izingane ezingaphezu kuka-50% ezineminyaka engama-3-4 ubudala sezivele zinenkinga yokubola kwamazinyo. Ngeminyaka engu-6 ubudala, ukutholakala kwamazinyo aqothulayo kutholakala ku-84% weziguli ezisencane
5. Udokotela wancoma ukuthi ingane yasenkulisa inikezwe i-fluoridation, uphawu lwe-fissure, i-remineralization. Yini? Ingabe ukuvimbela noma ukwelapha nje? Kungani ukufakwa kwe-fissure kwenzeka kuphela ngemuva nje kokuqhuma, futhi hhayi ngemuva kwesikhathi eside?
Ngemuva kokuqhuma, amazinyo angapheli awakakhiwa ngokuphelele, koqweqwe lwawo alunamaminerali, futhi kunengozi enkulu yokutheleleka. Imifantu iyimigodi yemvelo emazinyweni. Ukubeka uphawu kusiza ukuvala imigodi ukuze uqweqwe lokudla okuthambile lunganqwabeli kuyo, okunzima ukususa ngesikhathi senhlanzeko yansuku zonke. Ama-caries amazinyo wesithupha unomphela kumacala angama-80% enzeka ngonyaka wokuqala, ngakho-ke, kuyasebenza kakhulu ukuwavala ngokushesha ngemuva kokuqhuma. Ukwelashwa kwe-remineralization kungumuthi ophethe izidakamizwa ze-fluoride noma i-calcium. Zonke izinqubo zihloselwe ukuqinisa amazinyo nokuvikela ukubola.
6. Indodakazi yesaba udokotela wamazinyo (kanye kabuhlungu faka ukugcwaliswa). Ungamthola kanjani udokotela ozokusiza unqobe ukwesaba kwakho?
Kungathatha isikhathi eside ukuthi ingane ivumelane nokuqokwa kwamazinyo. Qhubeka kancane kancane, tshela ingane yakho ukuthi kungani ufuna ukuya kudokotela, ukuthi kuzohamba kanjani. Emtholampilo, akukho lapho ingane kufanele iphoqwe ukuba yenze noma yini. Ekuhambeleni kokuqala, isiguli esincane singahlala ngisho nasesihlalweni, kepha sizomazi udokotela, sikhulume naye. Ngemuva kohambo oluningana, ungakhulisa kancane kancane isihlalo. Uma ukwesaba kunganqotshwa nakancane, ukuthula kwengqondo kwengane nabazali, kungahle kube nengqondo ukukhetha ukwelashwa ngaphansi kwesilaliso noma i-anesthesia ejwayelekile.
7. Kungani uphatha ama-caries emazinyweni ezingane? Iphuma ibize, kepha isawa.
Ukungawaphathi amazinyo ezingane ngoba nje ezowa kuzobheda ngokuphelele. Ingane idinga amazinyo ezingane aphilile ukuhlafuna kahle ukudla futhi ifunde ukukhuluma kahle. Yebo, amazinyo obisi angaphambili aphuma ngokushesha, kepha iqembu elihlafunayo lamazinyo ngalinye lihlala iminyaka eyi-10-12. Futhi la mazinyo ezingane athintana nalawo angunaphakade. Ngeminyaka engu-6 ubudala, ukutholakala kwamazinyo aqothulayo kutholakala ku-84% yeziguli ezisencane. Ngalesi sikhathi nje, amazinyo okuhlafuna okuhlala njalo, "ama-sixes", aqala ukuqhuma. Futhi izibalo ziqinisekisa ukuthi ukubola kwamazinyo wesithupha unomphela kuma-80% wamacala kwenzeka ngonyaka wokuqala. Ukubola kwamazinyo kuyisifo esandayo futhi sonakalise izicubu ezinzima zamazinyo. Ifinyelela emthanjeni wezinyo, i-pulpitis ivela, amazinyo aqala ukuqaqamba. Lapho ukutheleleka kujula ngisho nangokwengeziwe, ukuqhuma kwezinyo elihlala njalo nakho kungabandakanyeka kunqubo yokuvuvukala, ngemuva kwalokho kungaphuma nesakhiwo esivele sishintshiwe koqweqwe lwawo noma kuholele ekufeni kwe-rudiment.
8. Endodakazini (eneminyaka engu-8 ubudala) izinhlungu zomlomo ziphuma zigwegwile. Udokotela wethu uthi yize kungafakwa amapuleti kuphela, kusesekuseni kakhulu ukufaka izinsimbi. Futhi umngane wakhe oneminyaka engu-12 usevele unezinsimbi. Uyini umehluko phakathi kwamapuleti nezinsimbi? Ungakuqonda kanjani - amazinyo wengane ahlala eqondile noma sekuyisikhathi sokugijima ukulungisa ukuluma?
Esigabeni esisebenzayo sokuqhuma kwamazinyo waphakade (iminyaka engu-5,5 - 7), konke kuncike ekutheni kunesikhala esanele emhlathini wamazinyo amasha. Uma kwanele, khona-ke ngisho namazinyo asontekile ahlala njalo azophuma ngokulinganayo ngokuhamba kwesikhathi. Uma singekho isikhala esanele, lapho-ke awukwazi ukwenza ngaphandle kokulungisa ukuvalwa nganoma yikuphi ukwakhiwa kwe-orthodontic. Ipuleti liyisetshenziswa esikhiphekayo esenziwa ngawodwana. Amapuleti asetshenziswa lapho kungenzeki ushintsho oluphelele lwamazinyo obisi, futhi kusenezindawo zokukhula emhlathini. Ngaphansi kwethonya lamapuleti, ukukhula komhlathi kuyakhuthazeka, futhi kukhona indawo yamazinyo waphakade. Futhi ama-brace asetshenziswa ngokushintsha okuphelele kobisi emazinyweni angunaphakade. Le yidivayisi engasuseki lapho kufakwa khona izinto ezikhethekile zokulungisa (ama-brace) ezinyo futhi, ngosizo lwe-arc, zixhunywe kuketanga elilodwa njengobuhlalu. Lapho amazinyo eqala ukushintsha, kungcono ukuyobonana nodokotela wamazinyo futhi uhlole isimo. Ngokushesha lapho uqala ukulungisa ukuvalwa, le nqubo izoba lula futhi umphumela uzotholakala ngokushesha.