A.N. Pavlov, T.P. Sabgayda
¹Municipal establishment of Public Health “Dental Clinic”, Nizhnevartovsk city
²Federal Research Institute for Health Organization and Informatics of Ministry of Health and Social Development of the Russian Federation, Moscow

Summary. The hypothesis about existence of an influence of concomitant somatic pathology on dental morbidity and cost of treatment of oral diseases has been under investigation. A comparative analysis was performed based on data of the mandatory health insurance in areas that differ in terms of health financing and development of dental care: the Khanty-Mansijsk Autonomous District, Samara and Kaliningrad regions.

The study showed that the presence of systemic diseases affect the development of dental problems since childhood. The levels of funding of health and development of dental care did not affect the pattern of influence of concomitant somatic pathology on dental diseases. The ratios between the shares of dental disease of people of the same age group with different concomitant diseases and without them are about the same in the Khanty-Mansijsk Autonomous District, Samara and Kaliningrad regions.

There are an age specifics in the spectrum of opportunistic diseases as well as in their impact on the spread of dental diseases. In the Khanty-Mansijsk Autonomous District the frequency of all kinds of cavities in young children is by 1.5 -5 times more in case of presence of infectious diseases or diseases of the respiratory or diseases of digestive system. The frequency of all dental diseases in school-age children is more in case of any somatic pathology: in 1.2-1.7 times for tooth enamel, in 1.3-1.9 - for acute apical periodontitis, in 1.4-1.7 times for chronic apical periodontitis. The main somatic pathology among population of working age affects on the incidence of pulpitis, raising it in 1.2-1.4 times, among female - also on chronic periodontitis (1.2-1.4 times). Also, among population of working age the frequency of acute apical periodontitis is increased in 1,3 - 2,7 times in case of infectious diseases or respiratory diseases or digestive diseases, the frequency of chronic apical periodontitis - in 1.5-1.8 times in case of presence of endocrine diseases or diseases of respiratory, digestive or urinary systems.

The cost of treating dental disease is generally not dependent on concomitant somatic pathology in patients. This pattern is seen most clearly in areas with high levels of dental care (Khanty-Mansijsk Autonomous District). Exceptions sometime occur in regions with medium and inadequate funding (Samara and Kaliningrad regions). The presence of respiratory diseases tends to interfaced with the lower cost of treatment of dental diseases. The presence of the pathology of endocrine and genitourinary systems leads to higher costs of treatment of dental diseases range from 5 to 25%, but selectively (certain diseases in men or women).

Keywords: Dental morbidity; influence of comorbid conditions on pathological processes in the oral cavity; level of dental health care; prevalence of chronic apical periodontitis; the cost of dental treatment, cost of dental treatment.

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