The dissertation identifies the relationship between dental status and medical-psychological characteristics in children with different levels of mental health (DLMH) and describes congruent measures for the prevention and correction of odontophobic reactions (OFR) by increasing compliance in the child-parent-dentist chain. The presence of mental illness in a child creates a psychopathological basis for an anxious response to a new, unusual situation, and thus increases the risk of developing OFR in such a child, as well as significantly complicates the dental examination due to difficulties in achieving compliance with a child. The study is based on the results of a comprehensive examination (anamnestic, dental, clinical and psychopathological, psychoexperimental, catamnestic, ethological, clinical and statistical methods), 100 patients were examined, including 30 patients with autism, from group 1 (G1), 30 patients with oligophrenia from group 2 (G2), 20 patients with ADHD from group 3 (G3) and 20 mentally healthy children from group 4 (G4) with various dental pathologies. The study of oral fluid in children with DLMH became necessary to assess the pathognomonic nature of pathological changes in saliva for certain mental disorders in childhood, as well as to establish a correlation between saliva parameters and dental status. Analysis of the structure of OFR and registration of the frequency of their identification in the examined groups allowed to develop their typology and classification. 12 types of OFR were identified and described. It was found that children with autism are characterized by the following OFR: insulating, transaffective, stenic-negativistic. For children with mental retardation, the most typical are the following OFR: confrontational, agitational, vocalizational. In children with ADHD, the following OFR are more common: motor, mosaic-conformal, explosive. The following OFR are most typical for mentally healthy children: algophobic, transcompliant, escapational. Based on a comparative analysis of the semiotic content of OFR in children with DLMH and taking into account the clinical and psychopathological characteristics of the studied contingents, the mechanisms of their pathogenesis were established. In patients with autism, an insulating type of OFR develops by statobehavioral pathogenetic mechanism, transaffective OFR develops by disposition-reactive mechanism, and stenic-negativistic OFR develops by hyperdefensive mechanism.In children with oligophrenia, confronational OFR develops by hypoanalytical pathogenetic mechanism, vocalizational OFR develops by situationally-determined mechanism, and agitational OFR develops by pathocerebrotonic mechanism.In children with ADHD, motor OFR develops by kinetodeprivational pathogenetic mechanism, partly-adherent OFR develops by isomotivational mechanism, and explosive OFR develops by transalgetic mechanism. In mentally healthy children, algophobic OFR develops by algopreventative pathogenetic mechanism, transcompialant OFR develops by hypomotivational mechanism, and escapational OFR develops by distancing mechanism. There is a clear relationship between the level of anxiety and the type of odontophobic response in patients of all groups. High anxiety levels in G1 corresponded to the development of a transaffective type of odontophobic response, medium-stenic-negativistic type, and low-insulating. A similar correlation was observed in G2. High anxiety figures corresponded to the development of agitationalodontophobic response, medium – confrontational type, and low-vocalization. In G3, moderate anxiety corresponded to the development of motor and explosive OFR, while the presence of low levels of anxiety had a direct correlation with the mosaic-conformal type of OFR. In G4 patients, high anxiety figures in G1 corresponded to the development of the algophobic type of odontophobic response, medium-escapational type, and low-transcompliant. The scientific novelty is that a comprehensive clinical-psychopathological and psychometric study of children with DLMH was conducted, which made it possible to establish the psychopathological basis for the formation of their odonophobic response. A typology of OFR in children with DLMH has been developed, which allows to create differentiated approaches to their diagnosis. The correlation between oral fluid and dental pathology in children with DLMH has been established, which allows to identify the risk group in advance. Peculiarities of dental status in children with DLMH were identified, which made it possible to develop highly specific approaches to the combination of dental and psychocorrectional effects on OFR in this category of patients. Based on the analysis of dental status, recommendations are developed for the prevention of typical dental pathology for children with DLMH.
