The State of the Oral Cavity of Adolescents Who Spend More than 3 Hours at the Computer

A significant increase in dental diseases in adolescents who spend a long time at the computer, according to modern concepts, is mediated by the electromagnetic field of the computer, the impact of which has not been fully studied. The paper presents data from a comparative study of the dental status of the oral cavity and the state of periodontal tissues in adolescents aged 18 to 15 who spend more than 5 (target group of 55 adolescents) and less than 5 hours (control group of 20 adolescents) at the computer. The se-lection of the contingent was carried out randomly. According to the dental characteristics of the oral cavity, the number of dental plaque was assessed according to the simplified Turkish OHI-S hygiene index, in the modification Hi Fedorov-Volotkina, the severity of inflammatory and destructive changes in periodontal tissues according to the Pi index (Russell), and their prevalence according to the Papillary-Marginal-Alveolar index PMA in Parma modification. The conducted comparative study showed that in adolescents who worked 8 - 12 hours at the computer, periodontal changes occur much more often and are more pronounced than in adolescents who worked less than 5 hours. In addition, the neurohormonal parameters of the saliva of adolescents who are at the computer for less than 5 hours practically do not change, but in adults who work longer than 8 hours the saliva data in the mouth changes while.


Introduction
Some studies suggest that EMF is another Fenton reaction mechanism, suggesting that it promotes free radical activity in cells [1]. Although some researchers report that ROS (reactive oxygen species) perform a beneficial function, high levels of ROS production can cause cell damage, leading to a variety of diseases. These radicals react with various biomolecules, including DNA ( Figure 1). Namely, the energy of free radicals is not enough, and for this reason, they behave like robbers who take energy from other cells and rob a person for their own satisfaction [2] [3]. Many studies have shown that EMF can induce the formation of reactive oxygen species in exposed cells in vitro [4] and in vivo [5]. The initial stage of ROS production in the presence of RF is controlled by the NADPH oxidase enzyme located in the plasma membrane. Consequently, ROS activate matrix metalloproteases, thereby initiating intracellular signaling cascades to alert the nucleus to the presence of external stimulation.
These changes in transcription and protein expression are observed after RF exposure [6] [7]. The effect of 900 MHz EMF on oxidative stress induction and intracellular ROS levels was studied in human mononuclear cells. An excessive increase in ROS levels is an important cause of oxidative damage to lipids, proteins, and nucleic acids. Therefore, it causes changes in enzyme activity and gene expression, which ultimately leads to various diseases, including sleep disorders, arthrosis, loss of appetite, diabetes mellitus, dizziness, rheumatoid arthritis, cardiovascular disease, nausea, and stroke [8] [9]. In addition, the degradation of the pro-oxidant-antioxidant balance due to an uncontrolled increase in ROS can also lead to lipid peroxidation. Lipid peroxidation is a process in which cell membranes are rapidly destroyed due to the oxidation of phospholipid components containing unsaturated fatty acids. Continuing this reaction, lipid peroxides (-CO, H) accumulate in the membrane and transform polyunsaturated fatty acids into biologically active substances [10] [11]. Consequently, lipid peroxidation leads to significant damage in cells, such as impaired membrane transport, structural changes, cell membrane fluidity, damage to protein receptors in membrane structures, and altered activity of cell membrane enzymes [12]. Significant changes in lipid peroxidation parameters were obtained after exposure to EMF on SH-groups of mouse cells. Non-ionizing radiation also causes changes in HSP in various tissues, including the brain [13] [14], myocardium [15] [16], testis [17] [18] and skin [19] [20], which causes oxidative stress (OS), therefore, based on the above, we decided to study d-ROMs, PAT, OBRI, OSI REDOX in the blood [21].
With rapid technological progress and the rapid development of computerization, the flow of information is constantly increasing. A person working at a computer inevitably encounters the action of such a factor as electromagnetic radiation, which, according to various authors [22], depending on the dose, time of exposure and condition of the person, can have an adverse impact. The impact of these factors occurs on the personal-psychological, psychophysiological, The aim of the study was to study the dental morbidity of adolescents (18 -25 years old) who spend a lot of time at the computer and mobile phone (more than 5 hours). At the same time, it should be noted that the users themselves rated their own condition as "healthy". Such a level of psychological stress, as noted earlier, inevitably leads to disruption of the body's self-regulation mechanisms and the development of somatic pathology [11].
Because adolescents sometimes use a cell phone and sometimes a leptop computer for both gaming and learning, we used both devices in the study with the power of a cell phone and a computer being almost the same (SAR = 1.6 Wat).
The longer the syndrome of neuroemotional stress persists, the slower the recovery processes in the body proceed. The following stages of dysfunction during prolonged psycho-emotional stress are distinguished: physiological, adaptive and pathological state of stress. Due to a long-term chronic stress reaction, in response to the impact of a complex of factors of the industrial environment, multisystem disorders of the type of polypathies are formed in the body [23] [24]. Dysmetabolic computer syndrome-a disruption of lipid, carbohydrate, mineral, hormonal metabolism (OS), which is characterized by more than 5 hours of use, is determined by computer syndrome and is manifested by a change in humoral immunity and the phagocytosis system against the background of previously occurring disorders. It indicates the formation of a com-  [24]. It should be noted that the main feature of the factors affecting PC users is their possible cumulative effect-which does not have immediate or instant consequences. All described pathological syndromes and conditions develop as a result of a long-term and systematic impact of these factors on the user's body [25].
It is logical to assume that such a variety of factors could not but affect the tle-studied area of dentistry. Therefore, we decided to study (OS) and the physicochemical properties of oral fluid.

Methods
We measured the concentration of free radicals in adolescents who were at the laptop computer or mobile phone for more than 3 hours (d-ROM)-active oxygen metabolites in blood plasma, using a photometric test, we measured the concentration of hydroperoxides (ROOH). Hydroperoxides, also called reactive oxygen metabolites (ROM), are formed during oxidative attack when reactive oxygen species (ROS) react with various organic substrates (e.g. carbohydrates, lipids, amino acids, proteins, nucleotides, etc.).
To assess the antioxidant capacity of plasma, we used PAT (antioxidant concentration test) by measuring the ability to restore iron, and to assess the effectiveness of antioxidants, we determined OSI (oxidative stress index) and OBRI (oxidative balance status). All these measurements were performed using the 2) Points-a thin continuous strip of plaques (up to 1 mm) in the cervical region of the tooth.
3) Points-a strip of plaques more than 1 mm wide, but covers less than 1/3 of the tooth crown.
4) Points-plaque covers more than 1/3, but less than 2/3 of the tooth crown. Journal of Biosciences and Medicines 5) Points-plaque covers 2/3 of the tooth crown and more.
The results were assessed as follows: Tureski Index − PI = total plaque score/2 × 2 = n, where n is the number of teeth (Picture 1).
To assess the dental status, the level of oral hygiene and the condition of periodontal tissues were determined. Oral hygiene was assessed according to the Fedorov-Volodkina hygiene index (HI), and the hygienic condition was assessed based on the Simplified Green-Vermillion index [8] [19], and the OHI-S index.
The prevalence of inflammatory changes in periodontal tissues was assessed by the Parma modification of the papillary-marginal-alveolar index (PMA) [22] and the periodontal community index CPI (MMCI 1987).
The CPI index is used to assess the degree of damage to periodontal tissues.
Examination of the oral cavity was carried out using a dental mirror, a dental probe and a periodontal probe (to measure periodontal pockets CPI. The index was calculated using the following Formula (1): where ci is the sum of the scores; n is the number of teeth.
All adolescents underwent a clinical examination. The condition of periodontal tissues was assessed according to the dental index: PMA.
In adolescents of the target and control groups, the levels of histamine 11-OCS, serotonin, norepinephrine, and dopamine in saliva were also determined, which was collected 1 hour after eating. The ELISA system test ("Immun Diagnostik") was applied.
Oxidative stress measurement with photometric analytical system FRAS-5, dedicated solely to the global assessment of oxidative stress in biological systems Picture 1. The Oral Index is determined by dividing the total score by the number of surfaces examined (maximum 2 × 2 × 14 = 56 surfaces). The participation of adolescents in the study was agreed with the parents and ethical norms were observed.

Results and Discussion
According to Table 1, Figure 1, when assessing the condition of the periodontium, the dependence of changes associated with the time spent by adolescents at the computer was revealed. When questioning the dental status, the most common complaints were: the presence of an unpleasant taste and smell, the presence of tartar, partial absence of teeth, and bleeding. Hygienic condition deteriorated with age, before treatment, on visual examination, most patients showed gingival swelling, hyperemia, hypertrophy, retraction, cyanosis, bleeding.
Oxidative stress: As is known from the literature [ Adolescents who were at the computer for 12 hours with a simultaneous combination of several complaints were higher in the main group (p < 0.001) ( Table   2, Figure 2). Bleed gums when brushing their teeth bothered 31% of the surveyed adolescents who were at the computer for more than 8 hours on the day of the examination. In the control group, they did not exceed 10% of those ex-    hours) increases significantly (Table 3, Figure 3, Picture 3).
According to Table 4, the severity of gingivitis according to the PMA index, (average values) in adolescents who were at the computer for more than 8 hours, is much higher than those of the control group. According to Table 4 (Table 4).
We also studied saliva mineralization.
The study of salivary mineralization showed that there was a change in mineralization during both mild and moderate periodontitis, which indicates the development of an inflammatory process and tissue damage.
Clinical studies have shown that in patients with periodontitis there are some changes in oral fluid, which were manifested in the mineral metabolism Ca and P, as shown in (Table 5 and Table 6) as well as patients with moderate A similar expression is observed for the P shift. In control, it is 0.23 ± 0.03, while in the mild form it is 0.16 ± 0.06, in the medium form 0.14 ± 0.01, which indicates the development of an inflammatory process.
So, the pH index (Table 6) at the initial level of 7.08 (7.09 -7.1) increased to 7.2 (7.3 -7.35). Such dynamics is explained by the natural process of alkalization of the oral fluid due to the release of CO 2 [20].
Emphasizing the hygienic significance of the state of the oral cavity, we determined (Table 7) in the saliva of adolescents of the target and control groups 11-OCS histamine, serotonin, dopamine and norepinephrine, which play an important role not only in the functional state of the periodontium, but also in the processes of general adaptation of the whole organism [21] and neuroendocrine system to the electromagnetic effects of the computer. The content of these physiologically active substances in saliva and blood is interrelated [9] [11] [16].
About 0.05 to 3.0 mL of saliva is usually secreted per minute, which amounts to approximately 150.0 mL of saliva per day, it was collected (0.5 mL) in special polypropion vessels and stored at −200˚C. ELISA analysis was carried out according to the ELISA test system (Immun Diagnostik).
It appears in (Table 7) [25]. It leads to the development of oxidative stress in the body of a teenager; oxidative stress then affects the oral cavity and causes a number of problems that were discussed in the article.

Conclusions
1) Adolescents who spend more than 5 hours in an electromagnetic field cause a change in the OHI hygiene index with a Turecki modification.
2) Causes the severity of inflammatory and destructive changes in periodontal tissues according to Pi and their distribution Papillary-Marginal-Alveolar index PMA in Parma modification.
3) The conducted comparative study showed that in adolescents who worked 8-12 hours at the computer, periodontal changes occur much more often and are more pronounced than in adolescents who worked less than 5 hours.
4) In addition, the neurohormonal parameters of the saliva of adolescents who are at the computer for less than 5 hours practically do not change, but in adults who work longer than 8 hours the saliva data in the mouth changes while.

5)
We cannot avoid the need to use the electromagnetic field, but the need for its judicious use in adults should be determined and this time should not exceed 5 -6 hours a day.