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UnitNineteenChernobyl“fall–out”onoralhealthP.A.LeousPoororalhygiene,highprevalenceofperiodontaldisease,andlackofdentalservicearecurrentfeatureoforalhealthamongpeoplelivinginareasofBelaruscontaminatedbytheChernobylnuclearaccident.HerstateoforalhealthwastheleastoftheworriesofthepopulationwhofoundthemselvesinaradioactivezoneaftertheChernobylnuclearpowerstationdisasterin1986.Infact,thefirstteamsofdentistsfromtheMinskMedicalInstitutewhoarrivedatstrictlycontrolledareasofBelarusseveraldaysaftertheaccidenthadnoevidenceofanyspecificoralhealthproblemsamongthepopulation.Furthermore,throughlackofinformation,thedentalscientistshadlittleinterestintheafter-effectsonoralhealth,althoughsomestudiesontheeffectoflowradiationonoralanddentalstructureswereconductedunderlaboratoryconditionsatthePaedodonticsandOralSurgeryDepartments.Publishedinlocaljournals,thesestudiesshoweddifferentkindsofpathologicaleffecttothejawbonesandsoftoraltissues.SincethentherehasbeengrowingconcernaboutthesharpincreaseintheincidenceofthyroudcancerobservedamongchildrenincontaminatedareasofBelarus.Between1986and1991,131caseswerediagnosedcomparedwithonlysevencasesoverthesameperiodoftimebeforetheaccident.Morethan50%ofthesecancerswerefoundinGomelOblast.In1992,67caseswerereported.Aconsiderablegrowthinthyrouddisorderssuchasautoimmunethyroiditishasalsobeenreportedamongchildrenincontaminatedareas.Systematiccontinuousstudiesoftheoralhealthstatusinaffectedareaswererevivedin1990-91.Theirmainpurposewastoassessoralhealthindifferentagegroupsofthepopulationlivinginstrictlycontrolledzones.Anoralhealthproject,whichstartedlatein1992aspartoftheInternationalProgrammeontheHealtheffectsoftheChemobylAccident,aimstoimprovediagnosticandcurativeservicesinoralhealthincontaminatedareasofBelarus.Samplesoftoothenamelcollectedwillbeusedforindividualdosimetrybyelectronspinresonancespectrometry.WHO'sstandardoralhealthsurveymethodswereusedfororalexaminationswhichhighlightedseveralriskfactorsorcofactorsoforaldisease.Fordentalcaries.salivaryfunction,oralhygiene,fluorideintakeandotherdietarycomponentscameunderstudyand,forperiodontaldisease,theimmunestatusandoralhygiene.About5000peopleofallagegroupsunderwentexamination.PoororalhygieneTherewasanobviousdeteriorationintheoralhealthstatusofthesurveyedpopulation.Thelatestdatashowedmoderatetohighlevelsofdentalcaries,ahighlevelofperiodontaldisease,andanincreasingproportionoforalmucosaldiseases.Theaveragenumberofdecayed,missing,orfilled(DMF)teethvariedfrom4.6in15year-oldchildrento19.6intheover65-year-oldagegroup.Oralhygienewaspoor.Thefoodpatternshavechangedtowardsmorerefinedproductsandsweets,whicharedeliveredfromsafeneighbouringregionsandfromabroad.Severalinternationalstudieshaveshownthattheintakeofradionuclidesinfoodstaffsisagrowingriskfactor.From3923samplesofdifferenttypesoffoodmeasuredintheGomelOblastareabetweenAprilandDecember1992,anexcessofradioactivecaesiumwasdetectedin56cases.Theprevalenceofgingivitisand/orperiodontitis,whichwasalmost100%inteenagersandtheadultpopulation,coincidedwiththelackofregularoralhygienepractices.Themostfrequentcomplaintwasgumbleedinganddrynessofthemouth.Thelatterconditionwasobservedin12%of18-year-olds,29%inthe35-44agegroup,and86%in65-year-olds,comparedwith3%,20%,and33%respectivelyinsimilaragegroupssurveyedinnon-contaminatedregionsofthecountry.About17%ofthesurveyedpopulationhadsomeabnormalityororalmucosalesionscomparedwith10%innon-contaminatedareas.Oralhealthservicesforthepopulationincontaminatedareawereinadequateorpoor,duetotheshortageofdentists,dentalequipmentandmaterials,and500Aormoreofdecayedteethwereunfilled.Onaverage,fiveteethwereextractedfromeverytenteenagersaged15years.Inadults,fewteethwerefilledandmostwereextracted,althoughaverageDMFteethwerethesameasinnon-contaminatedzones.Insum,wefoundahighprevalenceofthecommonoralhealthdiseases,poororalhygieneandpoorcareamongthetwomillionpeoplelivingincontaminatedareasofBelarus.Todate,onlyasmallproportionofthepopulationhasmovedtonon-contaminatedareas.ThyroudcancergivesconcernObservationsontheincreaseofsomeoraldiseasesincontaminatedzonesduetoradiationarequestionable,sincenopreciserecordswereavailableintheareabeforetheChernobyldisaster.Nopossibleside-effectsofprolongedlowdosesofradiationonoralstructureshavebeenreported.Nevertheless,theincidenceofthyroudcanceramongchildrenremainsamajorconcerntodayforthehealthauthoritiesinBelarus.Harddentaltissue,particularlytoothenamel,isaccumulatingradioactivityand-withtime-itcouldhaveapotentialpathogeniceffectonoralbiology.Therearealsosignsofthedevelopmentofgastroduodenalpathologyandanincreaseofthyroiddis5ases,certainhaematologicaldiseasesanddisturbancesoftheimmunesystem.AIItheseconditionscouldseriouslyaffecttheoralhealthsituationduetolocalpathogenicfactors,theshortageofservicesandlackofprimaryprevention.Carefultooth-brushingiseffectiveinreducingtheprevalenceofperiodontaldisease,butoralhygieneispoorandhascertainlycontributedtotheperiodontalconditionsobserved.Lackoforalhygieneaidsandtheextremelylowmotivationofthepopulationarethemainobstaclestotheintroductionofaproper,regular,effectiveoralhygieneprogramme.Inconjunctionwithoralhygieneeducationandinstruction,itwouldbenecessarytouselocalanti-inflammatorysubstancesboththroughself-careandwithprofessionalhelp.Asyetwehaveinsufficientevidencetopredictspecificlevelsofdental/oraldiseaseintheareasstudied.However,thefollowingoralhealthproblemscanbeexpected:severeperiodontaldiseasesduetopoororalhygiene,lossofteethduetolackoforalhealthservices,enamelhypoplasiaduetodietaryimbalance,andoralmucosallesionsassymptomsofpoorgeneralhealth.VOCABULARYl.fall-out放射性塵埃,意外的副產(chǎn)品,剩余物2.contaminate(d)污染3.nuclearaccident核事故4.radioactivezone放射性區(qū)域(地帶)5.nuclearpowerstation核電站6.disaster災(zāi)難7.team(s)小分隊(duì)(小組)8.strictlycontrolledareas禁區(qū),嚴(yán)格控制區(qū)9.theafter-effects后效應(yīng)(影響)10.radiation輻射,放射11.thyroudcancer甲狀腺癌12.thyrouddisorder(s)甲狀腺(功能)紊亂13.autoimmunethyraiditis自動(dòng)免疫性甲狀腺炎14.systemic(adj.)系統(tǒng)的15.revive(d)(v.)恢復(fù)(健康)(使)靈活,蘇醒16.oralhealthproject口腔衛(wèi)生項(xiàng)目(工程)17.healtheffects健康效應(yīng)(影響)18.sample(s)樣本19.dosimetry(放射)劑量測(cè)定法20.electronspinresonancespectrometry電子旋轉(zhuǎn)諧振光譜測(cè)定法21.highlight(ed)使顯著,突出重點(diǎn)22.riskfactor危險(xiǎn)因素23.cofactor(s)協(xié)同(共同)因素24.fluorideintake氟化物攝取25.dietarycomponants膳食成份26.immunestatus免疫狀態(tài)27.deterioration退化變質(zhì)、惡化28.oralmucosaldiseases口腔粘膜疾病29.foodpattern(s)食品花樣(種類)30.refinedproducts精制產(chǎn)品(食品)31.deliver(ed)供應(yīng)(給)32.radionuclides(n.)放射性核素33.foodstuff(s)食品(物)34.radioactivecaesium放射性鉑35.teenager(s)青少年36.coincide(d)與……相同,同時(shí)發(fā)生37.complaint申訴38.drynessofthemouth口干39.respectively分別地,各自地40.abnormality異常,反常41.oralmucosalesio

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