N 2 (199) 2026. P. 62–68

PECULIARITIES OF THE STRUCTURALAND FUNCTIONAL STATE OF TOOTH ENAMEL IN INTERNALLY DISPLACED CHILDREN UNDER VARIOUS PSYCHOEMOTIONAL CONDITIONS

Yu. L. Bandrivsky, Ye. V. Osarchuk

Ivan Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, Ternopil, Ukraine

DOI 10.32782/2226-2008-2026-2-9

Introduction. It is well-established that psychoemotional stress can alter physiological processes, including the remineralization dynamics of dental enamel, thereby influencing its resistance to carious lesions. However, the specific relationship between wartime psychological stressors and the structural and functional characteristics of enamel in children remains insufficiently explored.

The aim of the study: to assess the state of structural and functional enamel resistance, the level of reactive anxiety, and the severity of depressive symptoms in children, with consideration of age, sex, and migration status.

Materials and methods. A total of 375 school-aged children (6–13 years old) were examined, comprising a main group (149 internally displaced children) and a comparison group (226 permanent residents). Psycho-emotional status was assessed using the Spielberger-Hanin Inventory (reactive anxiety) and the M. Kovacs Children’s Depression Inventory (CDI) (depressive symptoms). The structural and functional resistance of dental enamel was determined using the TER-test.

Results. Internally displaced children demonstrated a high level of psychoemotional maladjustment, evidenced by a significantly elevated prevalence of depressive disorders – 96.64% and reactive anxiety – 95.30%. These indicators exceeded those in the comparison group by 1.2-fold and 1.12-fold, respectively, р < 0,05. Furthermore, the mean structural-functional enamel resistance score, determined by the TER-test, was 4,74 ± 0,10, in the main group, which was significantly higher than the comparison group’s value of 3,69 ± 0,09, р < 0,01.

Conclusions. Thus, as a result of the conducted research, it was found that internally displaced children aged 6 to 13 years (the main study group) exhibited significantly higher frequencies of moderate to high levels of reactive anxiety and depressive symptoms, with a marked predominance among girls. Notably, the TER-test scores in this cohort exceeded those observed in the comparison group by a factor of 1.3, p < 0.01.

Keywords: children, internally displaced persons, psycho-emotional state, dental caries, enamel resistance.

REFERENCES

  1. Kadir A, Battersby A, Spencer N, Hjern A. Children on the move in Europe: a narrative review of the evidence on the health risks, health needs and health policy for asylum seeking, refugee and undocumented children. BMJ Paediatr Open. 2019;3(1):bmjpo-2018-000364. https://doi.org/10.1136/bmjpo-2018-000364.
  2. Tabakcilar D, Yilmaz DO, Seymen F. Hormonal factors affecting teeth development. Int J Med Invest. 2020;10(1):328–336. Available from: http://intjmi.com/files/site1/user_files_1e3831/admin-A-10-1-328-656d6d8.pdf.
  3. Bandrivsky Y, Bilan V, Bandrivska O, Malko N, Krupei V. Local oral immunity and psycho-emotional state in military personnel with chronic gingivitis. Rom J Stomatol. 2024;70(4):388–394. Available from: https://rjs.com.ro/articles/2024.4/ RJS_2024_4_Art-15.pdf.
  4. Hamid SH. Oral Health-Related Quality of Life and PTSD in war-affected children. Res Sq [Preprint]. 2020;9(1):1–12. https://doi.org/10.21203/rs.2.20107/v1.
  5. Amargianitakis M, Antoniadou M, Rahiotis C, Varzakas T. Probiotics, prebiotics, synbiotics and dental caries. new perspectives, suggestions, and patient coaching approach for a cavity-free mouth. Appl Sci. 2021;11(12):5472. https://doi.org/ 10.3390/app11125472.
  6. Espinoza JL, Harkins DM, Torralba M, Gomez A, Highlander SK, Jones MB, et al. Supragingival Plaque Microbiome Ecology and Functional Potential in the Context of Health and Disease. mBio. 2018;9(6):e01631–18. https://doi.org/10.1128/ mBio.01631-18.
  7. García-Godoy F, Hicks MJ. Maintaining the integrity of the enamel surface: the role of dental biofilm, saliva and preventive agents in enamel demineralization and remineralization. J Am Dent Assoc. 2008;139(Suppl):25S–34S. https://doi.org/ 10.14219/jada.archive.2008.0352.
  8. Arheiam A, Alhashani A, Kwidir T, Bosif Y, Ballo L, Tantawi ME. Untreated dental caries among Libyan children during and after the war and in internally displaced person camps. Community Dent Oral Epidemiol. 2023;51(4):636–643. doi:10.1111/cdoe.12886.
  9. Bilan VO, Bandrivsky YL, Bambuliak AV, Bandrivska OO. The role of neurogenic mechanisms in the pathogenesis of generalised periodontitis: psychoemotional influences and adaptive responses. Stomatol Bull. 2024;129(4):52–60.
  10. Griffiths J, Jones V, Leeman L. Oral Health and Mental Illness: Guidelines. British Society for Disability and Oral Health; 2000. Available from: https://www.academia.edu/download/34224202/mental.pdf.
  11. Barranca-Enríquez A, Romo-González T. et al. Your health is in your mouth: a comprehensive view. Front Oral Health. 2022;3:971223. https://doi.org/10.3389/froh.2022.971223.
  12. Protsiuk TL, Yablon OS, Protsiuk LO, Bykovska OA, Herasymova ОV, Kapitan TV. Features of clinical manifestations of disease and psychological status of adolescents with bronchial asthma of various levels of control and the influence of risk factors. Wiad Lek. 2019;72(5):795-801. PMID: 31175775.
  13. Rivera CL, Bernal G, Rosselló J. The Children’s Depression Inventory (CDI) and the Beck Depression Inventory (BDI): Their validity as screening measures for major depression in a group of Puerto Rican adolescents. Int J Clin Health Psychol. 2005;5(3):485–498. Available from: https://www.redalyc.org/pdf/337/33705305.pdf.
  14. Danyltsiv LO, Rozhko MM. Doslidzhennia strukturno-funktsionalnoi kyslotostiikosti emali postiinykh zubiv u ditei zalezhno vid osoblyvostei vyiavu riznykh rivniv tryvozhnosti [Study of structural and functional acid resistance of permanent tooth enamel in children depending on the characteristics of different levels of anxiety]. Art Med. 2022;2(1):62–67 (In Ukrainian). https://doi.org/10.21802/artm.2022.2.22.32.
  15. Bilan V, Bandrivsky Y. The state of periodontal tissues in military personnel of the Armed Forces of Ukraine depending on the psycho-emotional state. East Ukr Med J. 2024;12(3):615–624. Available from: https://eumj.med.sumdu.edu.ua/index. php/journal/article/view/635.
  16. Bandrivsky Y, Bilan V. Investigation of immunological indicators in the oral fluid of military personnel with chronic generalised periodontitis with consideration of their psycho-emotional state. Odesa Med J. 2024;5(190):35–39. https://doi.org/ 10.32782/2226-2008-2024-5-5.
  17. Ponomarenko M, Kaifie A. Oral health, stress and barriers accessing dental health care among war-affected Ukrainian refugees in Germany. BMC Oral Health. 2023;23(1):804. https://doi.org/10.1186/s12903-023-03513-x.
  18. Urbański PK, Schroeder K, Nadolska A, Wilski M. Symptoms of depression and anxiety among Ukrainian children displaced to Poland following the outbreak of the Russo-Ukrainian war: Associations with coping strategies and resilience. Appl Psychol Health Well Being. 2024;16(3):851–867. https://doi.org/10.1111/aphw.12510.
  19. Golanska P, Saczuk K, Domarecka M, Kuć J, Lukomska-Szymanska M. Temporomandibular Myofascial Pain Syndrome-Aetiology and Biopsychosocial Modulation. A Narrative Review. Int J Environ Res Public Health. 2021;18(15):7807. https:// doi.org/10.3390/ijerph18157807.
  20. Jankovic-Rankovic J, Panter-Brick C. Physiological and genomic signatures of war and displacement: A comprehensive literature review and future directions. Psychoneuroendocrinology. 2024;166:107084. https://doi.org/10.1016/j.psyneuen.2024.107084.
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