Optimizing the treatment and preventive measures in poor patients with secondary edentulism

Aim. To develop an algorithm for diagnosis and integrated treatment of the poor people of the Republic of Bashkortostan, taking into account the possibility of using state support programs. Methods. The study sample included 296 low-income patients (women over 58 years, men over 63 years) receiving social pension supplements. As a comparison group, 300 patients of retirement age, who had paid for orthodontic treatment by themselves, were recruted. Results. Out of 296 patients, 211 (71.28%) had previous orthopedic treatment, the remaining 85 (28.72%) had never received orthopedic treatment. All poor patients received treatment according to the full comprehensive program of preferential dentures. Orthopedic treatment using the non-removable prosthesis was performed in 39 (13.17%) patients, removable dentures - in 27 (9.12%), combined prosthetics - in 230 (77.70%). In 300 patients who paid for orthopedic treatment from their own funds, 133 (44.33%) patients got removable prosthesis, 70 (23.33%) patients - non-removable dentures, combined prosthetics was used in the remaining 97 (32.33%). An algorithm of therapeutic and preventive measures for low-income citizens in order to improve oral health and quality of life, as well as to optimize the use of financial resources, was developed. It consists of five stages: I - examination of the anamnesis vitae and the history of the disease; II - Diagnosis and treatment of comorbidities; III - full mouth debridement; IV - selection and rational prosthetics, medical treatment; V - follow-up examination in 1 and 6 months. An integral indicator of quality of life after the conducted complex treatment has improved by 15.11 points (27.0%). Some criteria for the quality of life has improved by more than 2 points (3.51%): «Physical discomfort» - by 2.133, «physical disorders» - by 2.916, «psychological disorders» - by 2.855 points. Conclusion. The program of preferential dentures allows to expand the range of the treatment options with the use of new technologies; implementation of this program is not a direct source of health improvement, but serves as an auxiliary arm of social support and helps to minimize the severe health consequences for the examined population.