Необходимо активизировать лечебно-профилактическую направленность в работе медицинских учреждений региона от фельдшерско-акушерских пунктов до специализированных лечебных учреждений с целью повышения онкологической настороженности всех специалистов этих звеньев. Обследование больных при наличии у них неврологической симптоматики должно быть ускоренным с применением нейрохирургического диагностического комплекса.

From 01.01.2018 year came into force the new order of Ministry of health of the Russian Federation «About carrying out of preventive medical examinations of minors» No. 514н, according to which the dentist is part of the medical Commission and examines children in the following life periods: 1 month, 2 years, 3 years, and then annually until the age of 17. The aim of our study was to compare the prevalence and intensity of dental caries in children, the prevalence of dental anomalies in children aged 2 years, 4 years, 6 years and 7 years, which were carried out preventive examinations in 2016 and 2017. In children aged two years, the prevalence of caries of temporary teeth increased from 14.3% in 2016 to 20.7% in 2017, the intensity of caries also increased by 2 times from 0.3 to 0.6 (p

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Relevance. Dental caries is a leading dental disease in children. Aim – to study the quality of drinking water in Smolensk and its region to provide evidence for implementing dental caries preventive measures in children.Materials and methods. We took tap water samples from ten water intake points in seven districts of Smolensk and six Smolensk regions. An accredited testing laboratory of the Center for Hygiene and Epidemiology in the Smolensk Region carried out water chemical analysis. The study analyzed standard parameters of drinking water quality: pH 6.5-8.5, fluoride content 0.60-1.2 mg/l; water hardness 7.0-9.0 (Sanitary Regulations and Standards 2.1.4.1116-02). The parameter was considered normal if its 95% confidence interval was within the reference range.Results. In Smolensk, the hydrogen ion concentration in centralized drinking water supply systems is within normal limits and amounts to 7.39 (95% CI: 7.32-7.46; р < 0,05) pH units. The mean fluoride concentration in the Smolensk water is 0.19 (95% CI: 0.14-0.23; р < 0,05) mg/l, which is below the normal range. In most Smolensk districts, water hardness is within normal limits, 8.21 mmol/l (95% CI: 7.03-9.39; р < 0,05). However, the upper limit of the confidence interval of 9.39 mg/l and the maximum of 12.0 mg/l exceed the normal range. In the Smolensk region cities, the hydrogen ion concentration is 7.2 (95% CI: 7.02-7.38; р < 0,05) pH units in the centralized drinking water supply. The fluoride concentration in the Smolensk region water is 0.45 mg/l (95% CI: 0.23-0.68; р < 0,05), which demonstrates the fluoride deficiency in water. In the Smolensk region cities, mean water hardness is 6.66 mmol/l (95% CI: 6.00-7.03; р < 0,05), which is below the normal values. However, the CI upper limit of 7.03 mmol/l and the maximum of 7.05 mmol/l are within normal limits.Conclusions. The water of the centralized drinking water supply system in Smolensk and the Smolensk region is low in fluorides. Urgent community and individual preventive measures should be taken to expose children to fluoride.