CLINICAL AND METHODOLOGICAL FRAMEWORK FOR EARLY CARIES DIAGNOSIS AND INDIVIDUALIZED PREVENTION IN CHILDREN WITH DIABETIC POLYNEUROPATHY

This methodological article presents an integrated protocol for detecting noncavitated carious lesions and tailoring preventive care in children with diabetic polyneuropathy. The prospective controlled comprised 130 children aged 7-15 years who were examined in Bukhara between 2022 and 2026: 85 children with dental caries in the setting of diabetic polyneuropathy and 45 age-comparable healthy controls. The diagnostic battery combined DMFT/DMFS, OHI-S and ICDAS II with 655-nm laser fluorescence, 2% methylene blue lesion indication, and a structured assessment of salivary flow, pH, viscosity, buffering, calcium-phosphate balance, enzyme activity, oxidative stress markers, cariogenic microorganisms and secretory IgA. The clinical cohort was divided into a conventional subgroup receiving fluoride varnish (n=40) and a multidisciplinary subgroup receiving professional hygiene, lesion-directed indication, dietary and hygiene counselling, and a targeted remineralizing gel protocol (n=45). Follow-up was scheduled at 3, 6 and 12 months. The framework moves clinical decision-making from late cavitation-based diagnosis toward lesion staging, biological risk assessment and individualized non-operative management.