Gastroözofageal Reflü Nedeni ile Cerrahi Tedavi Yapılmış Çocuklarda Ağız Sağlığı ve Tükürük Pepsin Düzeylerinin Cerrahi Sonrası Değerlendirilmesi

Abstract

Gastroesophageal reflux disease (GERD) is characterized by the impact of gastroesophageal reflux on daily life and function, leading to troublesome symptoms and/or complications. The aim of this study is to evaluate the oral and dental health, certain salivary parameters and salivary pepsin concentrations of children undergoing surgery due to GERD, by comparing them with healthy children. Following approval from the Hacettepe University Non-Interventional Ethics Committee, data were collected, including demographic information of children and their families, systemic health status of children, dietary and tooth brushing habits through a questionnaire. Oral health assessment included evaluation of dental caries using dmft/DMFT and dmfs/DMFS indices, PUFA/pufa index, assessment of periodontal health using plaque index, gingival index, tooth discoloration findings, dental anomalies, soft and hard tissue findings, evaluation of dental erosion using the Basic Erosive Wear Examination (BEWE) index, and evaluation of salivary parameters including salivary flow rate, pH value, buffering capacity, and pepsin levels. Pepsin enzyme concentrations in saliva samples were analyzed using the sandwich ELISA method. The study included 16 children who underwent surgical operations due to GERD with a mean age of 7.19±4.651 and 26 healthy children with a mean age of 8±4.186, operated on in the Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, since 01.01.2018. Data were statistically analyzed using the Chi-square test, Fisher's exact test, T-test, Mann-Whitney U test, Pearson correlation test, and Spearman's correlation test (p<0.05). In the operated GERD group, 56.3% of children do not feed orally. The mean dmft/dmfs and indices of children in the operated GERD group are statistically significantly lower compared to healthy children, while plaque index and gingival index means are higher. BEWE index values in the maxillary anterior region in the operated GERD group are statistically significantly higher compared to other regions. In this group, children who do not feed orally have dmft/dmfs, DMFT/DMFS indices of zero. The salivary pepsin level was found to be 95.219±154.250 pg/ml in the operated GERD group and 104.923±193.869 pg/ml in the healthy group; however, no statistically significant difference was observed between the groups in terms of pepsin concentrations. In conclusion, in diseases where GERD is observed, it is important to have pediatric dentists among the team that follows up and evaluates the diagnosis, treatment, and control stages. Medical specialties responsible for the treatment of these children, families, and ultimately children themselves should be informed about the importance of oral health.