Kodi ndi zaka zingati zomwe mungadziwire mwana wanu kwa dokotala wa mano? N’chifukwa chiyani ngakhale ana a zaka zitatu amawola mano? N'chifukwa chiyani mano mkaka, chifukwa iwo adzagwa mulimonse? Wday.ru adafunsa mafunso otchuka kwambiri kuchokera kwa makolo kupita kwa dokotala wamano wabwino kwambiri wa ana ku Russia.
Wopambana mendulo ya golide pampikisano wa "Pediatric Dentistry" wa Russian Dental Excellence Championship 2017, wamkulu wa dipatimenti ya ana a AGF Kinder.
1. Kodi ndi liti pamene mwanayo ayenera kuwonedwa koyamba kwa dokotala wa mano?
Ulendo woyamba ndi mwana umachitika bwino ali ndi miyezi 9 mpaka 1 chaka, pamene mano oyambirira amayamba kutuluka. Dokotala adzayang'ana frenum ya lilime ndi milomo, fufuzani mano oyambirira. Izi zipangitsa kuti zitheke kuzindikira ndikuletsa kapena kukonza matenda oluma, zolakwika zamalankhulidwe, ndi zovuta zokongoletsa pakapita nthawi. Kupitilira apo, ndikwabwino kukaonana ndi dotolo wamano wa ana kuti apewedwe kamodzi pa kotala.
2. Kodi mungaphunzitse bwanji mwana kutsuka mano? Chofunika kwambiri ndi chiyani - burashi kapena phala?
Ndi maonekedwe a dzino loyamba, mukhoza kale kuphunzitsa mwana wanu ukhondo. Ndikoyenera kuyamba ndi burashi yofewa ya silicone ndi madzi owiritsa. Pang'onopang'ono sinthani msuwachi wamwana wokhala ndi madzi. Ngati palibe chisonyezero cha mankhwala otsukira mano, mukhoza kutsuka mano anu ndi madzi kwa chaka chimodzi ndi theka. Pambuyo pake, sinthani ku mankhwala otsukira mano. Kusankha pakati pa phala ndi burashi sizolondola kwathunthu. Kwa zaka zingapo, burashi ndi yofunika kwambiri, pazochitika zina - phala. Mwachitsanzo, ngati mwanayo ali ndi chiwopsezo cha kuwola kwa dzino, dokotala amamupatsa phala la fluoride kapena mankhwala ochiritsira. Ndipo European Academy of Pediatric Dentistry imalimbikitsa kugwiritsa ntchito phala la fluoride kuchokera pa dzino loyambirira.
3. N'chifukwa chiyani kupukuta mano a ana kukugwiritsidwabe ntchito? Amasanduka akuda, izi sizowoneka bwino, mwanayo ali ndi nkhawa.
Mano a siliva si njira yothandizira mano a mkaka, koma kuteteza matenda (kusiya caries), popeza siliva ali ndi katundu wabwino wa antiseptic. Kupanga siliva kwa mano kumakhala kothandiza ngati njirayo ndi yosazama, mkati mwa enamel. Ngati ndondomekoyi ndi yochuluka ndipo imaphatikizapo mapangidwe a mano monga dentini, mphamvu ya njira ya silvering idzakhala yochepa kwambiri. Njira ya silvering imasankhidwa pamene, pazifukwa zina, palibe kuthekera kwa chithandizo chokwanira.
4. Mwana wamkazi ali ndi zaka zitatu. Dokotala anaganiza zochiza mano atatu nthawi imodzi pogona mankhwala. Koma pambuyo pa zonse, opaleshoni ndi yowopsa kwa thanzi ndipo imafupikitsa moyo, imakhala ndi zotsatirapo zingapo! Makamaka kwa mwana.
Dokotala akufuna kuchiza mano mu sedation (chidziwitso chochepa) kapena pansi pa anesthesia (anesthesia, mankhwala ogona) kwa makolo a odwala aang'ono, chifukwa, mwatsoka, ali ndi zaka 3-4, ana oposa 50% amavutika kale. kuchokera ku caries. Ndipo chidwi cha ana chimakhala chochepa, nthawi yokhala pampando ndi pafupifupi mphindi 30. Iwo amatopa, amwano ndi kulira. Nthawiyi sikokwanira ntchito zapamwamba ndi kuchuluka kwa ntchito. M'mbuyomu mu zamankhwala, osati mankhwala otetezeka kwathunthu a anesthesia adagwiritsidwa ntchito. Panalinso osafunika zimachitikira: kusanza, kumverera kufupika, mutu, yaitali kufooka. Koma tsopano mankhwala ikuchitika pansi opaleshoni ambiri ntchito mankhwala sevoran (sevoflurane) moyang'aniridwa ndi gulu la opaleshoni ndi dokotala wa ana. Ndi mankhwala otetezeka kwambiri pokoka mpweya. Idapangidwa m'bungwe la ku America ndipo yakhala ikugwiritsidwa ntchito bwino kwa zaka zopitilira 10 ku USA, Japan ndi Western Europe. Sevoran amachitapo kanthu mwachangu (wodwalayo amagona atapuma koyamba), sizimayambitsa ziwengo. Wodwalayo amadzuka mosavuta kwa mphindi 15 atazimitsa sevoran, mankhwalawa amatuluka mwachangu komanso popanda zotsatirapo, samavulaza ziwalo ndi machitidwe. Komanso, palibe contraindications ntchito sevoran odwala matenda aakulu monga khunyu, matenda a ubongo, mtima kupunduka, chiwindi ndi impso kuwonongeka.
Oposa 50% ya ana a zaka 3-4 zaka kale akudwala matenda kuwola. Pofika zaka 6, 84% ya odwala achichepere amawola mano.
5. Dokotala analimbikitsa kuti mwana wa sukulu aperekedwe fluoridation, kusindikizidwa kwa fissure, remineralization. Ndi chiyani icho? Ndi kupewa kapena kuchiza chabe? Kodi nchifukwa ninji kutseka kwa zipsera kumatheka pokhapokha kuphulika, ndipo pasanapite nthawi yaitali?
Pambuyo pa kuphulika, mano osatha sanapangidwe bwino, enamel yawo si mineralized, ndipo pali chiopsezo chachikulu cha matenda. Zipsera ndi maenje achilengedwe m'mano. Kusindikiza kumathandiza kusindikiza maenje kuti plaque yofewa ya chakudya isaunjike mmenemo, zomwe zimakhala zovuta kuchotsa paukhondo wa tsiku ndi tsiku. Caries ya mano achisanu ndi chimodzi osatha mu 80% ya milandu imapezeka m'chaka choyamba, choncho, ndi bwino kusindikiza mwamsanga pambuyo pa kuphulika. Remineralization therapy ndi zokutira ndi fluoride kapena calcium mankhwala. Njira zonse zimapangidwira kulimbitsa mano ndikuletsa caries.
6. Mwana wamkazi amaopa dokotala wa mano (kamodzi mopweteka kuika kudzazidwa). Kodi mungapeze bwanji dokotala kuti akuthandizeni kuthetsa mantha anu?
Zimatenga nthawi kuti mwana azolowere kukaonana ndi dokotala wa mano. Pitirizani pang'onopang'ono, auzeni mwana wanu chifukwa chake mukufuna kupita kwa dokotala, momwe zidzakhalire. Kuchipatala, palibe vuto kuti mwanayo akakamizidwe kuchita chilichonse. Pa maulendo oyambirira, wodwala wamng'onoyo sangakhale pampando, koma adzadziwana ndi dokotala, kulankhula naye. Pambuyo maulendo angapo, mukhoza kuwonjezera pang'onopang'ono kusintha kwa mpando. Ngati mantha sakugonjetsedwa konse, chifukwa cha mtendere wamaganizo wa mwanayo ndi makolo, zingakhale zomveka kusankha chithandizo chamankhwala pansi pa sedation kapena anesthesia.
7. N’cifukwa ciani tiyenela kucitila caries pa mano a ana? Zimatuluka zodula, koma zimagwerabe.
Kusachiza mano a ana chifukwa choti agwa n'kulakwitsa. Mwana amafunikira mano athanzi kuti athe kutafuna chakudya bwino ndi kuphunzira kulankhula bwino. Inde, mano amkaka akutsogolo amatuluka mwachangu, koma gulu lotafuna la mano limatha mpaka zaka 10-12. Ndipo mano amwanawa amalumikizana ndi amuyaya. Pofika zaka 6, 84% ya odwala amawola mano owonongeka. Pamsinkhu uwu, mano oyamba okhazikika okhazikika, "sakisisa", amayamba kuphulika. Ndipo ziwerengero zimatsimikizira kuti caries okhazikika mano achisanu ndi chimodzi mu 80% ya milandu kumachitika chaka choyamba. Kuwola kwa mano ndi matenda omwe amachulukana ndikuwononga minofu yolimba ya mano. Imafika ku mitsempha ya dzino, pulpitis imapezeka, mano amayamba kupweteka. Pamene matendawa akupita mozama, chiwombankhanga cha dzino lokhazikika chingathenso kukhudzidwa ndi kutupa, pambuyo pake amatha kutuluka ndi mawonekedwe osinthidwa kale a enamel kapena kuchititsa imfa ya rudiment.
8. Mwa mwana wamkazi (wazaka 8) ma molars amatuluka mokhota. Dokotala wathu akunena kuti ngakhale mbale zokha zikhoza kuikidwa, ndi molawirira kwambiri kuti muyike zingwe. Ndipo mnzake wazaka 12 wapeza kale zingwe. Kodi pali kusiyana kotani pakati pa mbale ndi zomangira? Momwe mungamvetsetse - mano osatha a mwanayo akuwongoka kapena ndi nthawi yoti muthamangire kukonza kuluma?
Panthawi yogwira ntchito ya kuphulika kwa mano okhazikika (zaka 5,5 - 7), zonse zimadalira ngati pali malo okwanira m'nsagwada za mano atsopano. Ngati ndikwanira, ndiye kuti ngakhale mano okhotakhota okhazikika omwe amatuluka adzayimirira mofanana pambuyo pake. Ngati palibe malo okwanira, ndiye kuti simungathe kuchita popanda kuwongolera occlusion ndi zomangamanga zilizonse za orthodontic. Mbale ndi chipangizo chochotsamo chomwe chimapangidwa payekha. Mbale ntchito pamene wathunthu kusintha mkaka mano sichinachitike, ndipo padakali kukula madera nsagwada. Mothandizidwa ndi mbale, kukula kwa nsagwada kumalimbikitsidwa, ndipo pali malo a mano osatha. Ndipo zomangira zimagwiritsidwa ntchito ndi kusintha kwathunthu kwa mkaka kukhala mano okhazikika. Ichi ndi chipangizo chosachotsedwa chomwe zida zapadera zokonzera (zingwe) zimamangiriridwa ku dzino ndipo, mothandizidwa ndi arc, zimagwirizanitsidwa ndi unyolo umodzi ngati mikanda. Mano akayamba kusintha, ndi bwino kupita kukawonana ndi a orthodontist ndikuwunika momwe zinthu ziliri. Mwamsanga mutayamba kukonza occlusion, njirayi idzakhala yosavuta ndipo zotsatira zake zidzakwaniritsidwa.