الفهرس 
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Abstract
The current study was conducted to establish base line data on oral health conditions including dental caries prevalence, gingival health as well as salivary risk factors namely flow rate, pH and bacterial load in a group of Egyptian children with moderate to severe bronchial asthma. In addition a series of preventive treatment regimens were proposed and tested in the present work to determine their efficacy in enhancing oral health of those asthmatic patients.
A total of sixty children with age range from 5 to 16 years were selected to participate in the present study. Forty asthmatic children were enrolled from among outpatients of the Clinic of Pulmonology, Pediatrics Department, Faculty of Medicine, Ain Shams University. All of the asthmatic patients were categorized into moderate and severe categories. A control group comprised of twenty subjects was selected from siblings of asthmatics such that they matched with respect to age, sex, social living conditions. Before enrolling in the study, all subjects were given oral and written information on the study & written informed consent was obtained from the parents/guardians of the eligible subjects.
Thorough clinical examination was performed by the same operator for all patients throughout the study. Dental caries experience was assessed using the deft index in the primary dentition and DMFT index in the permanent dentition as well as laser fluorescence device (LF) DIAGNOdent pen 2190 which was used as an adjunct tool for early detection of non cavitated occlusal carious lesions.
Gingival index (GI) and Plaque index (PI) were measured to determine the degree of gingival inflammation and amount of plaque deposits respectively. Saliva sampling was performed to determine salivary pH and levels of S. mutans and Lactobacilli.
Both unstimulated and stimulated salivary flow rates were calculated as well.
The results of the present study revealed that asthmatic children are at higher risk to develop dental caries. This could be explained by the reduced salivary secretion and salivary pH as well as increased levels of Lactobacilli and S. Mutans which were also demonstrated in studied asthmatic subjects. Moreover statistical analysis showed a significant difference between asthmatics and matched non-asthmatic children regarding gingival health and degree of plaque accumulation. Asthmatics tend to have more severe gingivitis and higher amounts of plaque deposits.
On studying the effects of the proposed preventive regimens, MI paste plus containing CPP-ACFP and professional topical fluoride application had favourable effect on the mineralization of teeth as reflected by reduced LF readings which indicate their capability of remineralizing initial carious lesions.
Significant decrease in both salivary SM and LB counts was demonstrated after three months of intervention in asthmatic children subjected to bacteriotherapy through ingesting probiotic-containing cheese. Similar reduction was brought about in the bacterial load of subjects receiving comprehensive dental treatment in association with professional fluoride application as well as those belonging to the group where patients were instructed about home usage of CPP-ACFP containing cream.
On evaluating changes in oral hygiene condition following the intervention period it was found that the mean GI scores of asthmatic children participating in the four groups were significantly improved. Moreover significantly lower amounts of plaque deposits were detected in the examined patients.