|Year : 2017 | Volume
| Issue : 4 | Page : 340-343
Dental caries prevalence and treatment needs among 12- and 15-year-old school-going children of rural and Urban Areas of Bhopal District, India
Vijayta Sharva1, Pooja Khare2, Venugopal Reddy3, Manish Jain1, Anshika Khare1, Prakash Singh1
1 Department of Public Health Dentistry, People's Dental Academy, Peoples University, Bhopal, Madhya Pradesh, India
2 Department of Oral Medicine and Radiology, Peoples Dental Academy, Bhopal, Madhya Pradesh, India
3 Department of Public Health Dentistry, Peoples College of Dental Sciences and Research Centre, Bhanpur Road, Bhopal, Madhya Pradesh, India
|Date of Web Publication||13-Dec-2017|
Dr. Vijayta Sharva
Department of Public Health Dentistry, People's Dental Academy, Peoples University, Bhopal, Madhya Pradesh
Source of Support: None, Conflict of Interest: None
Introduction: Dental caries is highly prevalent among children and persists to be a significant public health problem worldwide. Aim: The aim of this study is to assess the prevalence of dental caries and treatment needs of 12- and 15-year-old schoolchildren of Bhopal district and to compare the dental caries levels and treatment needs of government schoolchildren of urban and rural areas of Bhopal district. Materials and Methods: A cross-sectional study was conducted among 12- and 15-year-old urban and rural school-going children of Bhopal district. A total of 1100 schoolchildren were screened using a multistage sampling procedure. The children were examined according to the dentition status and treatment needs, WHO (modified) oral health assessment. Student's t-test was used for continuous variables and Chi-square test used for categorical data and P < 0.05 was considered statistically significant. Results: The prevalence of dental caries at the age of 12 years was 33.5% and 26.5% at the age of 15 years. Dental caries was higher in urban schools as compared to rural schools. The maximum need was for one-surface restoration. Conclusion: The prevalence of dental caries at both the age groups was low. This suggested a need of dental health education program including proper oral hygiene instruction which helps children to improve positive dental attitude and behavior.
Keywords: Dental caries, prevalence, rural, schoolchildren, treatment needs
|How to cite this article:|
Sharva V, Khare P, Reddy V, Jain M, Khare A, Singh P. Dental caries prevalence and treatment needs among 12- and 15-year-old school-going children of rural and Urban Areas of Bhopal District, India. J Indian Assoc Public Health Dent 2017;15:340-3
|How to cite this URL:|
Sharva V, Khare P, Reddy V, Jain M, Khare A, Singh P. Dental caries prevalence and treatment needs among 12- and 15-year-old school-going children of rural and Urban Areas of Bhopal District, India. J Indian Assoc Public Health Dent [serial online] 2017 [cited 2020 Feb 20];15:340-3. Available from: http://www.jiaphd.org/text.asp?2017/15/4/340/220724
| Introduction|| |
Worldwide, dental caries is the most prevalent of the oral diseases with considerable variations in its occurrence between countries, regions within countries, and areas within regions and within social and ethnic groups. Dental caries is highly prevalent among children and persists to be a significant public health problem. It has detrimental consequences on children's quality of life by inflicting pain, premature tooth loss, and malnutrition, eventually influencing overall growth and development. The children suffering from poor oral health are twelve times more likely to have restricted activity days as compared to their healthy counterparts.
It has been observed that during 1940, the prevalence of dental caries in India was 55.5%, and during 1960, it was reported to be 68%. The National Oral Health Survey and Fluoride Mapping-2003 reported that the prevalence of dental caries among 12-year-old children was 72.5% and among 15-year-old children was 75.4% in India. Overall the general impression is that dental caries has increased in prevalence and severity in urban and cosmopolitan population over the last couples of decades. However, there is no explicit picture as yet regarding the disease status in rural and backward areas of country, where 80% of the population resides. Oral health care in rural areas is limited due to shortage of dental workforce, financial constraints, and lack of perceived need for dental care.
While dental caries has decreased in many industrialized countries, the contrary is the case in many low-income countries. The increase of caries is caused by a variety of factors one being the adoption of food habits high in refined carbohydrates. Health behavior such as the use of fluoridated toothpaste and regular toothbrushing is rare among children in low-income countries. In addition, national public health programs often do not consider oral health as important as general health.
Dental caries is a preventable disease, and if the burden of factors leading to such condition is known only, then better health education activities can be designed.
One of the most important factors to be considered when planning for the improvement in dental care facilities in rural areas is the baseline data for dental diseases and treatment needs of the population. In Madhya Pradesh, no systematic assessment on the prevalence of dental caries is available, especially in the rural areas where awareness and oral health facilities are almost negligible. In an attempt to fill this gap, this cross-sectional study conducted with the following objectives to assess the prevalence of dental caries and corresponding treatment needs of 12- and 15-year-old schoolchildren of Bhopal district and compare the dental caries levels and treatment needs of government schoolchildren of urban and rural areas of Bhopal district.
| Materials and Methods|| |
The present cross-sectional study was conducted among 12- and 15-year-old urban and rural school-going children of Bhopal district. Official permission was obtained from the district education department Bhopal, and ethical clearance was obtained from institutional ethical committee. Written consent for the participation of the children in the study was obtained from the principals of the concerned schools.
A pilot survey was done to assess the feasibility of the study and to calculate the sample size. One school was selected randomly and the students who were present on that day were examined.
The sample size was determined to be 1100 (538 males and 562 females).
A multistage random sampling procedure used to select the schoolchildren. During the first stage, stratification of urban and rural areas of Bhopal district was done. Then, in the second stage, a total number of school in Bhopal district were listed out. During the third stage, students were selected from each class by simple random technique using the student's attendance register till the desired sample from each class was met. Information on demographic details and oral hygiene practices was collected from the participants using a questionnaire. Children were examined by a single examiner who was trained to record the WHO (modified) oral health assessment form. After completion of the survey, an oral health education on basic oral hygiene was given to all the schoolchildren with the help of charts and models in their respective classes. The children in need of emergency dental treatment are referred to the institution along with parents to render emergency dental care.
SPSS version 20 (SPSS Pty Ltd, Chicago, IL, USA) was used for the statistical analysis. t-test used for continuous variables and Chi-square test used for categorical data. P ≤ 0.05 was considered statistically significant.
| Results|| |
A total of 1100 schoolchildren were examined, 217 (40.2%) males and 323 (59.8%) females were from urban schools, and 321 (57.3%) males and 239 (42.7%) females were from rural schools [Table 1].
In urban areas, 75.4% of children brushed once daily and 24.4% brushed twice daily. In rural areas, 80.4% brushed once daily and 18.4% brushed twice daily. Frequency of “brushing twice” was higher in urban areas which is statistically significant (P< 0.007).
In urban schools, 98.1% used toothbrush, 1.85% used finger while in rural schools, 93.9% used brush, 5.7% used finger, and 0.4% used neem-stick [Graph 1]. In urban schools 90.7% used toothpaste, 9.3% used tooth powder. In rural areas 80.7% used toothpaste, 18.7% used tooth powder and 0.53% used the other materials such as ash, charcoal etc [Graph 2].
The prevalence of dental caries was 30.0% in the entire population. The prevalence of dental caries for male was 27.0%, and for female, it was 33.2%. Whereas the prevalence for 12-year and 15-year children, it was 33.5% and 26.5%, respectively [Table 2]. The prevalence of dental caries was 30.4% and 30.0% in the urban and rural schoolchildren, respectively [Table 3].
The mean decayed, missing, and filled teeth (DMFT) score for the entire schoolchildren was 0.59 ± 1.176 (0.53 ± 1.151 for males and 0.65 ± 1.198 for females), the corresponding value for 12 years was 0.59 ± 1.057 (0.54 ± 1.061 for males and 0.63 ± 1.054 for females) and for 15 years 0.59 ± 1.285 (0.52 ± 1.24 for males and 0.67 ± 1.327 for females), respectively. The mean DMFT score for the urban schoolchildren was 0.62 ± 1.246. For rural children, it was 0.57 ± 1.1052 [Table 4].
|Table 4: Mean caries experience (decayed, missing, and filled teeth) in relation to age and gender and location|
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Participant brushing their teeth once a day had higher mean DMFT as compared to those who brush twice a day which is statistically significant and the participant brushing their teeth occasionally had higher mean DMFT as compared to who brush once or twice a day and the difference is statistically significant (P< 0.04) [Table 5].
|Table 5: Mean decayed, missing, and filled teeth according to frequency of brushing|
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The greatest treatment need was for one-surface restoration (20.6%), followed by two-surface restoration (6.9%), extraction (4.5%), pulp care (0.4%), and others (0.3%) [Table 6].
| Discussion|| |
Oral health is essential for general health and well-being throughout life and is a marker for overall health status. The present study was targeted at school-going children because of the ease of accessibility. The 12 and 15 age groups were chosen for this study as these are global monitoring ages for dental caries for international comparisons and monitoring of disease trends. The present study sample consisted of schoolchildren from both urban and rural schools to have representation of children from all the social, economic, and cultural communities.
At both the age groups, around 96% of population used toothbrush and toothpaste or tooth powder for cleaning their teeth. This clearly indicates their awareness about oral hygiene. About 3.8% of children clean their teeth with their finger and 0.35% of children use neem sticks, which is the traditional method of cleaning the teeth in India. The custom of cleaning teeth with finger and neem sticks is still followed in certain parts of rural India. Nevertheless, the percentile usage of these traditional methods is decreasing. From this finding, it is evident that a better usage of oral hygiene aids was found in schoolchildren of Bhopal district.
Most of schoolchildren (78%) used to brush once a day which is in line with the findings of Shailee et al. but high as compared with findings of Harikiran et al. and Peng et al., whereas only 21.3% of students brushed twice daily which is low. The fact that all the children examined belong to government school and most of them come from illiterate, low socioeconomic families are responsible for this finding. The frequency of brushing twice was more common in urban schools as compared with rural schools which were also reported by Mahesh Kumar et al.
In the present study, it was observed that the prevalence of dental caries among schoolchildren was found to be 33.5% in 12 years and 26.5% in 15 years' age groups. The prevalence of dental caries was 27% in males and 33.2% in females. This is in accordance with study done by S. S. Hiremath.
The prevalence of dental caries was found to be more in urban areas than rural areas. This is probably due to more cariogenic diet and easier access to refined sugars and sugar products among the urban schoolchildren. Similar results were found in some studies conducted in African countries.
In both the age groups, the caries prevalence was consistently found to be higher among females than males. The difference between genders may be largely attributed to the fact that among the girls, teeth erupt at an earlier age than boys (15–17). It may also be due to their habits of taking snacks between meals for their longer indoor stay in comparison to that of males, who mostly spend their time outdoors. This finding goes together with the previous studies.
In the present study, the mean DMFT at 12 years and at 15 years was 0.59 ± 1.057 and 0.59 ± 1.285, respectively, which was also reported by Shailee et al. and Petersen and Kaka  but is less than 2.4 as reported by the National Oral Health Survey in Himachal Pradesh. Females had a significantly higher mean DMFT value than males and difference is statistically significant at 12 years. This is in line with the findings of al-Shammery et al., Dummer et al., and Sogi and Bhaskar. This may be due to the fact that teeth erupt earlier in females than males which lead to prolonged exposure of the teeth to the oral environment in females.
At both the age groups, there was statistically significant difference in mean DMFT between the urban and the rural schools. The level of caries was higher in children attending an urban school which is in line with the findings of Almeida et al. This is probably due to more cariogenic diet and easier access to refined sugars and sugar products among the urban schoolchildren. Similar results were found in some studies conducted in African countries. Participants brushing their teeth once a day had significantly higher mean DMFT as compared to those who brush twice a day. Treatment need was seen for 32.6% of children. On examination, the treatment needs for dental diseases among children of 12 and 15 years, we found that the greatest need was for one-surface restoration followed by two-surface restoration, extraction, pulp care, and others. This is similar to the finding of Dash et al.
There is a need to implement school dental health programs, especially for rural areas, and students should participate in the oral health promotion and preventive activities. Some form of training should be given to schoolteachers so that they can give basic oral health education and oral hygiene instruction. Along with the teachers and students, parents should also participate and they should be made aware of the proper brushing methods and importance of preventive measures for children.
| Conclusion|| |
The prevalence of caries was found to be low in both urban and rural areas. Still, there is a need of dental health education program, including proper oral hygiene instruction which would help the children to improve positive dental attitude and behavior throughout the life.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Edelstein BL. Pediatric caries worldwide: Implications for oral hygiene products. Compend Contin Educ Dent 2005;26:4-9.
Dawani N, Nisar N, Khan N, Syed S, Tanweer N. Prevalence and factors related to dental caries among pre-school children of Saddar Town, Karachi, Pakistan: A cross-sectional study. BMC Oral Health 2012;12:59.
Damle SC, Patel AR. Caries prevalence and treatment need amongst children of Dharavi, Bombay, India. Community Dent Oral Epidemiol 1994;22:62-3.
National Oral Health Survey and Fluoride Mapping. India: Dental Council of India Publication; 2002-2003.
Rao NC, Mehta A. Dentition Status and treatment needs of 12 year old rural school children of Panchkula District, Haryana, India. JIDA 2010;4:303-5.
Peterson PE. Global Oral Health in International Encyclopedia of Public Health. 1st
ed., Vol. 4. San Diego, CA: Oxford Elsevier Publications; 2008. p. 677-85.
Jürgensen N, Petersen PE. Oral health and the impact of socio-behavioural factors in a cross sectional survey of 12-year old school children in Laos. BMC Oral Health 2009;9:29.
Ganesan S. Traditional oral care medicinal plants survey of Tamil Nadu. National Prod Radiance 2008;7:166-72.
Shailee F, Girish MS, Kapil RS, Nidhi P. Oral health status and treatment needs among 12- and 15-year-old government and private school children in Shimla city, Himachal Pradesh, India. J Int Soc Prev Community Dent 2013;3:44-50.
Harikiran AG, Pallavi SK, Hariprakash S, Ashutosh, Nagesh KS. Oral health-related KAP among 11- to 12-year-old school children in a government-aided missionary school of Bangalore city. Indian J Dent Res 2008;19:236-42.
] [Full text]
Peng B, Petersen PE, Fan MW, Tai BJ. Oral health status and oral health behaviour of 12-year-old urban schoolchildren in the people's republic of china. Community Dent Health 1997;14:238-44.
Mahesh Kumar P, Joseph T, Varma RB, Jayanthi M. Oral health status of 5 years and 12 years school going children in Chennai city – An epidemiological study. J Indian Soc Pedod Prev Dent 2005;23:17-22.
Hiremath SS. Caries experience and enamel defects in relation to level of fluoride in drinking water among urban and rural school children of age 6-14 years in Tumkur district in Karnataka. J Indian Assoc Public Health Dent 2002;27:9.
Ramukumba AN, Rudolph MJ, Chikte U. Oral health in Venda: Dental caries of 6 and 12 year-old School children. J Dent Res 1991;70:845.
Frencken JE, Truin GJ, van't Hof MA, König KG, Mabelya L, Mulder J, et al.
Prevalence of dental caries in 7-13-yr-old children in Morogoro district, Tanzania, in 1984, 1986, and 1988. Community Dent Oral Epidemiol 1990;18:2-8.
Petersen PE, Kaka M. Oral health status of children and adults in the republic of Niger, Africa. Int Dent J 1999;49:159-64.
al-Shammery AR, Guile EE, el-Backly M. Prevalence of caries in primary school children in Saudi Arabia. Community Dent Oral Epidemiol 1990;18:320-1.
Dummer PM, Addy M, Hicks R, Kingdon A, Shaw WC. The effect of social class on the prevalence of caries, plaque, gingivitis and pocketing in 11-12-year-old children in south wales. J Dent 1987;15:185-90.
Sogi G, Bhaskar DJ. Dental caries and oral hygiene status of 13-14 year old school children of Davangere. J Indian Soc Pedod Prev Dent 2001;19:113-7.
de Almeida CM, Petersen PE, André SJ, Toscano A. Changing oral health status of 6- and 12-year-old schoolchildren in Portugal. Community Dent Health 2003;20:211-6.
Dash JK, Sahoo PK, Bhuyan SK, Sahoo SK. Prevalence of dental caries and treatment needs among children of Cuttack (Orissa). J Indian Soc Pedod Prev Dent 2002;20:139-43.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]