Büyük Azı-Keser Hipomineralizasyonunun Çocukların Yaşam Kalitesi Üzerine Etkisi
Özet
Büyük azı-keser hipomineralizasyonu (BAKH), sürekli birinci büyük azı ve keser dişleri etkileyen sistemik kökenli kalitatif bir mine defektidir. Bu makale, BAKH'nin çocukların ağız sağlığı ile ilişkili yaşam kalitesi, dental korku/kaygı, diş çürükleri ve tedavi sonrası iyileşme süreçleri üzerindeki etkilerini inceleyen çalışmaları sentezlemektedir. Klinik olarak opak lezyonlar, mine parçalanmaları ve dentin açığa çıkmasıyla karakterize olan bu durum, çocuklarda aşırı diş hassasiyeti ve ağrıya yol açarak yemek yeme ve diş fırçalama gibi günlük fonksiyonel aktiviteleri kısıtlamaktadır. Özellikle keser dişlerin etkilenmesiyle ortaya çıkan estetik bozukluklar, çocuklarda gülmekten kaçınma ve utanç gibi olumsuz duygusal ve sosyal etkilere neden olmaktadır. Literatürde, BAKH şiddeti arttıkça yaşam kalitesinin daha fazla bozulduğu ve kız çocuklarının bu durumdan psikososyal açıdan daha belirgin etkilendiği rapor edilmiştir. BAKH'li çocuklarda tekrarlayan tedavi ihtiyaçları ve anestezi güçlükleri nedeniyle dental tedavi sırasında davranış yönetimi sorunları sık yaşansa da dental korku düzeyinde genel bir farklılık saptanmamıştır. Ayrıca, gözenekli yapı nedeniyle bu çocuklarda DMF-T skorları ve çürük prevalansı daha yüksektir. Buna karşın; mikroabrazyon, rezin infiltrasyonu ve fissür örtücü gibi minimal invaziv, önleyici ve estetik tedavilerin uygulanmasının ardından çocukların diş hassasiyetinin azaldığı, benlik algılarının ve yaşam kalitelerinin anlamlı derecede yükseldiği görülmüştür. Sonuç olarak, BAKH'nin olumsuz etkilerini en aza indirmek için erken teşhis, multidisipliner tedavi yaklaşımları ve ebeveyn farkındalığının artırılması büyük önem taşımaktadır.
Molar incisor hypomineralization (MIH) is a qualitative enamel defect of systemic origin affecting the permanent first molars and incisors. This article synthesizes studies investigating the effects of MIH on children's oral health-related quality of life, dental fear/anxiety, dental caries, and post-treatment recovery processes. Characterized clinically by opaque lesions, enamel breakdown, and dentin exposure, this condition causes severe tooth sensitivity and pain, thereby limiting daily functional activities such as eating and brushing teeth. Aesthetic impairments arising especially from the involvement of incisors lead to negative emotional and social consequences in children, such as avoiding smiling and feeling embarrassed. The literature reports that as the severity of MIH increases, the quality of life deteriorates further, and female children are more significantly affected psychosocially. Although behavior management problems during dental treatment are frequently encountered in children with MIH due to recurrent treatment needs and difficulties in achieving anesthesia, no general difference has been detected in dental fear levels. Furthermore, due to the porous structure, DMF-T scores and caries prevalence are higher in these children. Conversely, following the implementation of minimally invasive, preventive, and aesthetic treatments—such as microabrasion, resin infiltration, and fissure sealants—it has been observed that children's tooth sensitivity decreased, while their self-perception and quality of life significantly improved. In conclusion, early diagnosis, multidisciplinary treatment approaches, and increasing parental awareness are of paramount importance to minimize the adverse impacts of MIH.
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