Burganova K.I.

Bashkir State Medical University, Ufa, Russian Federation

The influence of harmful production factors on the dental status of workers

The preventive focus of modern medicine is relevant for the preclinical diagnosis of the toxic effects of chemicals on industrial workers who contact workers in the course of their professional activities. According to most studies, it is revealed that a complex of occupational factors contributes to the development of chronic diseases of the oral cavity, such as inflammatory diseases of the oral mucosa [1, 3.5, 7, 8, 9], periodontal tissues [2, 3, 6 , 8], carious and non-carious lesions of hard tissues of teeth [1, 3, 4, 8]. The Republic of Bashkortostan is characterized by the presence of numerous chemical and petrochemical enterprises, where workers are exposed to toxic substances, which leads to the development occupational diseases. One of these enterprises is JSC "Khimprom" - one of the largest in Europe for the production of organochlorine herbicides, in particular chlorophenoxy-herbicides (HG) based on 2,4-dichlorophenoxyacetic acid [5, 9]. Products of organochlorine synthesis inhibit local and community nonspecific immunity, which is manifested by a decrease in IgA, serum lysozyme, SIgA nasal mucosa. CG have a mutagenic and carcinogenic effect, causing a disruption in the differentiation of epithelial cells in mucous membranes [5, 7, 9]. The study of dental morbidity in workers of organochlorine production revealed a high intensity of caries [8] and a high prevalence of periodontal pathology - 100% [6], diseases of the mucous membrane of the mouth and lips [7]. The red lip rim was most often affected, the most common disease of the lips was meteorological cheilitis, exfoliative cheilitis, hyperkeratotic glossitis. Leukoplakia of the oral mucosa and red rim lips was observed in 9.9% of cases. It is established that most often leukoplakia changes were localized on the surface keratinizing mucous membrane of the cheek along the clamping line teeth with a zone of lesion of the horny epithelium of the mucosa shells of the mouth cavity on the red border of the lips [5, 7, 9]. All Consequently, damage to the oral mucosa workers may be burdened by the hygienic state of the oral cavity, the intensity of the carious process, periodontal diseases. In the study of non-specific resistance of the oral cavity and the parameters of the humoral and cellular components of local immunity of the oral cavity, significant deviations from the norm were found in workers of production of chlorophenoxy-herbicides [8]. The concentration of lysozyme in mixed saliva among workers in the production of chlorophenoxy-herbicides on the average practically did not go beyond the limits of formal standards. There were sharply expressed values of this parameter in workers with different contact times with chlorogerbicides. Thus, the concentration of lysozyme in the oral fluid in workers who have contact with trichlorethylene, monochloroacetic acid, with 2,4-D and 2-methoxy-3,6-dichlorobenzoic acid is 1.3 times higher than the norm and much higher than that of the other workers [8]. The electrolyte composition of saliva in the oral cavity revealed an increase in the level of dominant cations (Na and K), leading to a weakening of the protective properties of biopolymers (glycoprotein mucin) due to the destruction of hydrate shells of macromolecules of high molecular compounds and their denaturation due to the hydration of sodium and potassium cations [8]. When studying the dental morbidity in workers of organochlorine production, a high intensity of caries was detected. There was a high prevalence of periodontal pathology in 100% of cases. In the course of our study, workers in the production of HG showed a high prevalence of diseases of the oral mucosa.

Based on the results of the literature analysis, there are significant deviations from the norms of the physico-chemical indices of homeostasis of the oral cavity, which determine the mineral metabolism in the oral fluid; changes in humoral and cellular components of local immunity; increase saliva viscosity and decrease the rate of salivation; an increase in the level of potassium and sodium in the oral fluid and the mineralizing potential of saliva, which can serve as serious prerequisites for the emergence of a cariogenic situation and, consequently, the development of pathology of hard tissues of teeth, periodontium, oral mucosa in contact with chlorophenoxy herbicides and intermediate products of their synthesis, in turn, calls for the development and implementation of preventive measures.

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