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the Reasons of a mortality of the population from illnesses of an oral cavity, sialadens and jaws

the Reasons which have caused mors of men, are more diverse, than the reasons of a female mortality. In total for men it is noted 62 illnesses specified as a cause of death. In table 3.3 the share of the reasons in structure of a mortality of men of the Russian Federation from illnesses of an oral cavity, sialadens and jaws of which from 2000 for 2008 has died more than 5 men is resulted.

More than in half of cases as the reason of lethal outcomes the phlegmon and an oral cavity abscess (Ê12.2) have served: in 60,1 % of cases among men. The abscess and an oral cavity phlegmon arise from an infection getting from the centres of an inflammation. They not always develop acutely and suddenly, sometimes they are preceded by periodontitises, parodontity, osteomyelites of jaws, stomatites and other inflammatory diseases of an oral cavity. At abscesses and phlegmons a contagium is the resident admixed microflora of the dontogenous centres. According to various authors, in 85 - 95 % of cases the infection has the dontogenous

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the nature. Preventive maintenance of phlegmons and oral cavity abscesses consists in oral cavity sanation during which time the doctor-stomatologist checks all teeth, deletes a debris and an odontolith, treats caries.

Table 3.3 the Share of the most frequent reasons in structure of a mortality of men of the Russian Federation from illnesses of an oral cavity, sialadens and jaws during the period with 2000 for 2008

the Code

MKB

Causes of death the Share (%)
Ê12.2 the Phlegmon and an oral cavity abscess 60,1
Ê10.2 Inflammatory diseases of jaws 9,1
Kl 1.3 a sialaden Abscess 4,2
Kl 1.2 the Sialadenitis 3,6
Ê14.0 the Glossitis 1,8

Ê12.0 Relapsing aphthas of an oral cavity and
Ê05.2 Acute parodontit 1,0
Ê04.9 Other and not specified illnesses of a pulp and periapical tissues 1,0
Ê00.9 Disturbance of development of a teeth not specified 0,9
Ê04.7 the Periapical abscess without a cavity 0,9
Ê10.0 Disturbances of development of jaws 0,9
TO 1.0 Retenirovannye a teeth 0,8
Ê05.5 Other illnesses parodonta 0,7
Other reasons 13,9
All 100

On the second place on frequency of lethal outcomes among men (9,1 %) there are inflammatory diseases of jaws (Ê10.2).

To diseases of this group carry an ostitis, a periostitis, an osteomyelitis (a dontogenous infection). Morfogeneticheski these diseases are bound to an acute purulent apical periodontitis or with an exacerbation of a chronic apical periodontitis, a pyesis of gnathic cysts, purulent parodontitom. Preventive maintenance inflammatory diseases of jaws consists in sanation of an oral cavity and observance of individual hygiene.

On the third place on frequency of lethal outcomes among men (4,2 %) there is a sialaden abscess (Ê11.3), on the fourth place - a sialadenitis (Ê11.2, 3,6 %), on the fifth - a glossitis (Ê14.0, 1,8 %). Originators of an actinomycosis can be the reason of an inflammation of sialadens, a tuberculosis, a syphilis, viruses of an epidemic parotitis, cytomegalies, etc. glossitis Risk factors are also an unsatisfactory hygienic condition of an oral cavity, a bad food, tooth prostheses, smoking, an alcoholism, advanced age, immunodefitsitnye conditions. In absence of treatment the purulent inflammation regionarnyh lymph nodes can become its complication. Preventive maintenance of these diseases

consists in observance of rules of hygiene of an oral cavity, especially at infectious diseases and after operative measures.

the Leading reasons of a mortality of men from stomatologic diseases are bound to infectious process at which the mors is caused by insufficient immune protection of an organism. That men most often die of these reasons in the middle age, unlike women, allows to assume in this case weakening of the immune status caused by abusing by alcohol and smoking.

Among other reasons, being causes of death of men more than in 1 % of cases, are relapsing aphthas of an oral cavity, acute parodontit both other and not specified illnesses of a pulp and periapical tissues. Apparently, at these diseases as well as at a periapical abscess without a cavity and other illnesses parodonta, as a mors immediate cause developing infectious process has served. The same reason can be assumed at disturbances of development of a teeth and jaws which quite often became perceptible as causes of death of men. For example, retenirovannye the third molar tooths can lead to such complications, as acute perikoronarit, a periostitis, an osteomyelitis an abscess and a phlegmon. Possibility of occurrence of such complications is caused by absence of hygienic care of an oral cavity and neokazaniem timely medical aid. Such situation is most authentic among marginal elements that confirms a hypothesis about communication of a stomatologic mortality of men of able-bodied age with abusing alcohol. Besides, it is impossible to exclude, that the medical error which has been not reflected in any medical documents can be a mors immediate cause in such cases. At an establishment as a cause of death of the patient of not lethal disease it is necessary to spend careful investigation.

Other diseases served as a cause of death of 5 and less men for 9 years.

For women it is noted 48 illnesses specified as a cause of death. In table 3.4 the share of the reasons in structure of a mortality of women of the Russian Federation from illnesses of an oral cavity, sialadens and jaws of which from 2000 for 2008 has died more than 5 women is resulted.

As well as at men, the phlegmon and an abscess of an oral cavity caused lethal outcomes of women more than in half of cases - in 53,1 % of cases. The second place among the reasons of a female mortality occupies a sialadenitis (Kl 1.2), being on the fourth place from men. This illness of sialadens was a cause of death of women in 11,4 % of cases. On the third place on frequency of lethal outcomes among women are a sialaden abscess (6,8 %), on the fourth place - inflammatory diseases of jaws (6,6 %). As well as the men, the leading reasons of a mortality of women from stomatologic diseases are bound to infectious process. Sharp growth of a mortality of women from illnesses of an oral cavity, sialadens and jaws is elderly after 60 years allows to bind insufficiency immune protection of an organism of women to hormonal reorganisation of an organism.

Table 3.4 the Share of the most frequent reasons in structure of a mortality of women of the Russian Federation from illnesses of an oral cavity, sialadens and jaws during the period with 2000 for 2008

the Code

MKB

Causes of death the Share (%)
Ê12.2 the Phlegmon and an oral cavity abscess 53,1
Kl 1.2 the Sialadenitis 11,4
Kl 1.3 a sialaden Abscess 6,8
Ê10.2 Inflammatory diseases of jaws 6,6
Ê12.0 Relapsing aphthas of an oral cavity 1,8
Ê05.2 Acute parodontit 1,1

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Ê05.3 Chronic parodontit 1,1
Ê05.4 the Parodontosis 1,1
Ê02.9 Caries of a teeth not specified 1,0
GOATS.9 Illness of firm tissues of a teeth not specified 1,0
Kl 1.0 a sialaden Atrophy 1,0
Other reasons 14,0
All 100

7 More diseases were causes of death of women more than in 1 %

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cases: relapsing aphthas of an oral cavity (1,8 %), acute and chronic parodontit (on 1,1 %), a parodontosis (1,1 %), caries of a teeth not specified, illnesses of firm tissues of a teeth and a sialaden atrophy (on 1,0 %). Other diseases served as a cause of death of 5 and less women for 9 years.

Presence in this list of caries of a teeth as a cause of death causes bewilderment and testifies or to poor quality of filling of certificates on mors, or about attempt of concealment of a true cause of death that can be undertaken in the presence of medical errors. Among causes of death meet such improbable as Ê00.3 - a speckled teeth (0,07 %), ÊÎÎ.8 - other disturbances of development of a teeth (a discoloration of a teeth, 0,3 %), Ê01.1 - impaktnye a teeth (changed the position at

prorezyvanii because of obstacles from the next tooth, 0,3 %), Ê02.0 - enamel caries (0,7 %), KOZ.O - the raised dental abrasion (0,4 %), Ê03.1 - soshlifovyvanie teeth (0,3 %), KOZ.Z - pathological rezorbtsija teeth (0,07 %), ÊÎÇ.9 - illness of firm tissues of a teeth not specified (0,4 %), Ê06.0 - gum recession (0,07 %), Ê06.8 and Ê06.9 - changes of a gum and toothless alveolar edge (0,3, and 0,1 %) and others. Carrying out of investigation of cases of mors with similar diagnoses will lead to revealing of medical errors and, as consequence, to depression of their frequency, and also to better filling of certificates on mors.

For the analyzed period quality of filling of certificates on mors has improved, to what depression of number of the stomatologic diseases which have served by a cause of death, with 37 in 2000 to 5 in 2008 (fig. 3.5) testifies. The number of such reasons as enamel caries has decreased with 4 in 2000 to 1 in 2005, the raised dental abrasion - with 2 to 1, illness of firm tissues of a teeth not specified - with 3 to 0. In 2008 of these diseases was not in the list of causes of death of the population from illnesses of an oral cavity, sialadens and jaws. In 2007 it is registered three cases of mors because of KOO.O - an adentia.

the Drawing 3.5. Number of illnesses of an oral cavity, sialadens and the jaws which have served by a cause of death of the population of Russia in 2000-2008

For men and women occurrence of separate stomatologic illnesses as the reason of lethal outcomes is various. In table 3.5 ranks of causes of death at men and women are resulted. It is possible to conclude, that a glossitis, disturbances of development of jaws, retenirovannye a teeth, a periapical abscess without a cavity, a pulpitis, other and not specified illnesses of a pulp, periapical tissues and parodonta - more man's causes of death, and chronic parodontit, a parodontosis and not specified illnesses of firm tissues of a teeth - more female causes of death.

Table 3.5

Ranks of the most frequent causes of death of men and women Russian

Federations from illnesses of an oral cavity, sialadens and jaws

Code MKB Causes of death the Rank
Men Women
Ê12.2 the Phlegmon and an oral cavity abscess 1 1
Ê10.2 Inflammatory diseases of jaws 2 4
Kl 1.3 the Abscess salivary okelezy 3 3
Kl 1.2 the Sialadenitis 4 2
Ê14.0 the Glossitis 5 16
Ê12.0 Relapsing aphthas of an oral cavity 6 5
Ê04.9 Other and not specified illnesses of a pulp and periapical tissues 7 24
Ê05.2 Acute parodontit 8 6
Ê00.9 Disturbance of development of a teeth not specified 9 13
Ê04.7 the Periapical abscess without a cavity 10 -
Ê10.0 Disturbances of development of jaws 11 25
TO 1.0 Retenirovannye a teeth 12 21
Ê05.5 Other illnesses parodonta 13 37
Ê02.0 enamel Caries 14 14
Ê02.9 Caries of a teeth not specified 15 9
Ê04.0 the Pulpitis 16 -
Ê05.3 Chronic parodontit 28 7
Ê05.4 the Parodontosis 23 8
ÊÎÇ.9 Illness of firm tissues of a teeth not specified - 10

the Received results mean, that the analysis of diffusion of the most frequent causes of death among the population should be spent separately for man's and female population under various lists.

At modern development of public health services and at existing system of rendering all listed reasons should not serve the Russian population of medical aid as a cause of death even patients in old age.

Occurrence of phlegmons, abscesses and the inflammatory diseases of an oral cavity caused by a dontogenous infection, is possible after
following medical errors: drift of an infection as a result of stomatologic manipulations, the premature termination or wrong appointment of treatment of the centres of an infection. Untimely sanation of an oral cavity and non-observance by patients of hygiene of an oral cavity, and also later the reference of patients behind medical aid hardly can be carried to the category of medical errors though these reasons lead to serious complications of stomatologic diseases more often.

the Majority of lethal cases, apparently, is bound to presence

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serious accompanying illnesses at patients with presence of stomatologic problems that has led to loss of resistibility of an organism of the patient, development of irreversible complications and as to a consequence, to a lethal outcome. As a true cause of death somatopathies that is disguised by wrong coding of causes of death have served in such cases. The stable mortality of the population from the diseases which are not lethal, gives all bases to believe, that among cases of mors from illnesses of an oral cavity, sialadens and jaws there is a share of the morses bound to medical errors, caused by low qualification and a carelessness of doctors, the noneffective organisation of medical aid or absence of necessary medicamental agents. It is impossible to exclude also possibility of influence of the factor of the irresponsible relation to health of patients.

For check of such conclusions it is necessary to have the additional information. We have analysed certificates on mors of the died Muscovites in 2003. The analysis of these certificates on mors has not given the additional information not only on possible medical errors, but also on accompanying diseases as in most cases as accompanying disease it is specified only purulent mediastenit. From somatopathies in one case the purulent destructive cholangitis and in one case - wet brain has been specified.

to study a question on prevalence of medical errors in stomatology, it is necessary to change practice of conducting documents existing today as any information on errors in them does not contain.

the Analysis of errors and the reasons of their occurrence is necessary for normal development of stomatologic service. Possibility of a recognition doctors of the errors demands change of a policy of insurance of medical errors, creation of legal safety of professional work of the doctor, change of the relation of doctors and patients, and also change of system of conducting the registration-accounting documentation. In conditions existing nowadays any error message is the potential basis for punishment, that for a long time is realised as the main obstacle to revealing of errors and elimination of the reasons of their occurrence. Besides, opening of the information on perfect errors will protect medical workers from unreasonable charges from patients.

Rising of safety of medical aid is possible only through change of culture of professional work, including through patsientotsentrichesky the approach and open discussion of errors for the purpose of detection and elimination of their reasons (instead of the people made mistakes). Without fulfilment of steps on change of the developed situation will not appear

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possibilities really to be engaged in quality management of the medical stomatologic help and consequently, we cannot liquidate a mortality from illnesses of an oral cavity, sialadens and jaws.

the carried out analysis of a mortality of the population of the Russian Federation from stomatologic diseases has allowed to make the list of the stomatologic diseases which are the reasons of lethal outcomes which is used in the further analysis.

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Scientific source Ajrapetjan Simon Mihajlovich. Maintenance of safety of patients in stomatologic practice. The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow - 2011. 2011

Other medical related information the Reasons of a mortality of the population from illnesses of an oral cavity, sialadens and jaws:

  1. the Characteristic of surveyed children
  2. Chapter 4 Discussion of the received results
  3. the Ethnic characteristic of Aginsky Buryat district of Transbaikalian edge
  4. the general clinical characteristic of observable children.
  5. THE CONCLUSION
  6. Chapter 1 the literature Review
  7. Chapter 2 Base, the program, a research technique
  8. 6.2. The Sanitary-and-hygienic characteristic of settlements Komis of republic
  9. Kulakova Elena Vladimirovna. Value of antimicrobial peptides in formation of a pathology of an oral cavity at children with atopicheskim a dermatitis. The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014, 2014
  10. Chapter 4 the Conclusion