|Year : 2014 | Volume
| Issue : 3 | Page : 163-166
Dentition status and treatment need in urban slum dwellers in Indore city, Central India
Bhuvnesh Airen, Pralhad Dasar, Sandesh Nagarajappa, Sandeep Kumar, Deepika Jain, Shilpa Warhekar
Department of Public Health Dentistry, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
|Date of Web Publication||15-Nov-2014|
20, Gaurav Nagar, Aerodrome Road, Indore 452 005, Madhya Pradesh
Source of Support: None, Conflict of Interest: None
Objective: To estimate the dental caries experience and treatment needs of residents of slum area, in Indore.Materials and Methods: A survey was conducted in one of the largest slum areas, Panchsheel nagar of Indore, (M.P.). The sample size was estimated assuming the prevalence of dental caries to be 90% as found in the pilot study. The minimum sample required was 138. The dentition status was recorded according to the WHO guidelines. Examination was performed by the trained and calibrated examiner. The statistical analysis was performed using SPSS 16.5 software. Results: A considerably higher prevalence (76.2%) of dental caries in the residents of slum as compared to the general population of India (50-60%) was found. The mean decayed, missing and filled teeth recorded was 2.54. Statistically significant difference was found in the caries prevalence between different age groups and occupations. Males exhibited significantly higher caries experience as compared to females. Conclusion: The residents of slum have a high prevalence of dental caries. The prevalence of dental caries differed for different occupational groups and gender.
Keywords: Dentition status, slum, treatment need
|How to cite this article:|
Airen B, Dasar P, Nagarajappa S, Kumar S, Jain D, Warhekar S. Dentition status and treatment need in urban slum dwellers in Indore city, Central India. J Indian Assoc Public Health Dent 2014;12:163-6
|How to cite this URL:|
Airen B, Dasar P, Nagarajappa S, Kumar S, Jain D, Warhekar S. Dentition status and treatment need in urban slum dwellers in Indore city, Central India. J Indian Assoc Public Health Dent [serial online] 2014 [cited 2021 May 7];12:163-6. Available from: https://www.jiaphd.org/text.asp?2014/12/3/163/144786
| Introduction|| |
Dental caries is an irreversible microbiologic disease of calcified tissues of teeth characterized by demineralization of inorganic portion and destruction of the organic substance of the tooth which often leads to cavitation.  It is the major oral health problem in developing countries, affecting 60-90% of the schoolchildren and the vast majority of adults.  In India, the prevalence of dental caries is reported to be 50-60%.  The data of comprehensive National Health Survey conducted in 2004 in India showed 51.9% of 5-year-old children, 53.8% of 12-year-old children and 63.1% of 15-year-old teenagers are affected by dental caries.  The lack of availability of dental care, postponement of treatment due to cost consideration, and under-utilization of available facility are the factors associated with the high prevalence of dental caries. 
Health of people is strongly influenced by the social and economical environment in which they live.  Burden of all diseases was more in disadvantaged and socially marginalized individuals.  The social determinants of health identified by the Dahlgren and Whitehead are: Healthy living conditions (including access to food, water, and sanitation), education, literacy and health literacy, stress, early life, social exclusion, employment and unemployment, age, sex and heredity factors, culture, racism, discrimination, access to information and appropriate health care, social supports, and access to transport.  Oral diseases are the most common of chronic diseases and important public health problem.  Limited literature is available to assess dental diseases in urban slum dwellers. Hence, this study was undertaken to assess the dental caries experience and treatment needs of residents of slum area, Panchsheel nagar, Indore. The study findings will help to draft policies to treat and prevent oral disease among slum residents.
| Materials and methods|| |
A cross-sectional community-based survey was conducted in the month of April 2014 at Panchsheel Nagar (Slum area), Indore.
Sample size was calculated on the basis of the prevalence of dental caries obtained from the pilot study, that is, 90% prevalence. The minimum sample size calculated was 138, however, the final sample comprised of 143 residents. The study employed random sampling technique for the selection of study participants. Participants were enrolled by house-to-house visits.
An initial training and calibration exercise was conducted prior to main survey to provide practical experience of the study methodology and the coding system for the dental examiner. Examination of the study subjects was done according to the criteria for dentition status and treatment needs WHO oral health assessment 1997. Oral examination was performed under natural light, using a mouth mirror and WHO probe.
A prior permission was obtained from Collector's office, Indore. Ethical clearance was obtained from the Institutional review board committee, Sri Aurobindo College of Dentistry, Indore. Verbal informed consent was sought from each participant.
Data were analyzed using SPSS 16.5 software (IBM, Chicago). Mean and standard deviation were calculated to express the decayed, missing and filled teeth (DMFT) values. The Chi-square test was employed to study the association of the prevalence of caries experience of individuals with gender, age, and occupation.
| Results|| |
Epidemiological survey was conducted on 143 residents of Panchsheel Nagar (Slum area) Indore. The individuals belonged to the age group of 5-74 years which were further categorized as age groups of 5-14 years, 15-34 years, 35-44 years, 45-64 years, and 65-74 years of age. Mean age of participants was 30.90 ± 10.29 years. Of the total study subjects, 97 (67.8%) were males and 46 (32.2%) were females. Participants belonged to different occupations, there were 14.1% shopkeepers, 13.3% driver or rickshaw puller, and 30.1% population were unemployed [Table 1].
|Table 1: Descriptive table showing the distribution of study population within different categories |
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The overall prevalence of dental caries was 76.2%, and the mean DMFT score of the study population was 2.54. The major contribution in DMFT score was made by missing teeth with a mean score of 1.29 and standard deviation (SD) of 0.21. The mean score of decayed and filled teeth was 1.18 and 0.13, respectively, with SD of 0.14 and 0.04, respectively [Table 2].
|Table 2: Mean decayed, missing, filled and DMFT scores of the study population |
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Decayed, missing and filled teeth scores were classified into four categories based on caries experience. A DMFT score of 0 was categorized as no caries, mild caries experience represented a DMFT score of 1-4, moderate caries experience was DMFT score of 5-9, and a score of 10 was categorized as severe caries experience.
Chi-square test demonstrated a statistically significant difference in the caries severity between different age groups. Maximum participants belonged to the mild caries group having a DMFT score of 1-4 with the majority of participants in the age group of 15-34 years [Table 3].
|Table 3: Comparison of caries experience and severity between various age groups |
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Significant difference was also found between genders (P = 0.008). Males exhibited significantly greater number of caries than females [Table 4].
|Table 4: Comparison of caries experience and severity between the two genders |
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Significant difference was seen (P = 0.048) when caries experience was compared between different occupations. Severe caries experience was more in those individuals who are not associated with any occupation (P = 0.048) [Table 5].
|Table 5: Comparison of caries experience and severity between different occupations |
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Of 143 individuals, 73 required restorative treatment including one surface and two surface restorations. One or multiple teeth of 41 (32.2%) individuals required extraction, 8 persons (6.25%) required pulp care and six individuals (4.68%) require other care like removable partial denture or complete denture [Table 6].
| Discussion|| |
In the present study, the dental caries experience of residents of slum area of Indore city had been studied. The overall prevalence of dental caries in the residents of slum was found to be 76.2%. However, the prevalence of dental caries in the general population was reported to be 50-60%.  Findings of the study showed a higher prevalence of dental caries as compared to the general population. This can be explained on the basis of socioeconomic status of the residents of slum. This population belongs to the low socioeconomic status. According to Hobdell et al., a strong association exists between dental caries prevalence and socioeconomic status.  Similarly, Petersen also reported the existence of a social gradient in dental caries prevalence on studying the association in dental caries indicators and socioeconomic status.  High caries prevalence is associated with a low socioeconomic status. 
Studies done by Khan et al., in 2008 and Ferraro and Vieira, in 2010, reported that females are more prone to dental caries than males.  Maru and Narendran, in 2012 found that there is no difference in prevalence of dental caries between male and female.  However in the present study, males exhibited greater prevalence of dental caries than female, this can be attributed to the unequal male-female distribution in the study population. Mishra et al., in 2010  also found a higher prevalence of caries among males. Caries experiences are more in those who are not having any occupation.
The number of filled teeth was found to be very less (mean "F" component = 0.13) as compared to "D" and "M" component. This reason could be the inability of the slum dwellers to afford the dental treatment.
| Conclusion|| |
The present study revealed high prevalence of dental caries (76.2%) among residents of urban slum area (Panchsheel nagar, Indore) and presented the need for provision of oral health services in this community.
| References|| |
Shivapathsundaram B, Raghu AR. Dental caries. In: Shafer WG, Hine MK, editors. Textbook of Oral Pathology. 6 th
ed. Corporation: Elsevier Publishing; 2009. p. 409.
WHO. Oral Health. Available from: http://www.who.int/oral_health/disease_burden/global/en/. [Last accessed on 2014 May 12].
National Commission of Macroeconomics and Health. Burden of Disease in India. 2005. Available from: http://www.who.int/macrohealth/.../NCMH_Burden. [Last accessed on 2014 May 12].
Moses J, Rangeeth BN, Gurunathan D. Prevalence of dental caries, socioeconomic status and treatment needs among 5-15 year old school going children of Chidambaram. J Clin Diagn Res 2011;5:146-51.
Shailee F, Sogi GM, Sharma KR, Nidhi P. Dental caries prevalence and treatment needs among 12 and 15-year old schoolchildren in Shimla city, Himachal Pradesh, India. Indian J Dent Res 2012;23:579-84.
WHO. Social Determinants of Health: The Solid Facts. 2 nd
ed. World Health Organisation; 2003. Available from: http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf. [Last accessed on 2014 May 10].
WHO. World Oral Health Report 2003. Available from: http://www.who.int/oral_health/publications/report03/en/. [Last accessed on 2014 Apr 20].
Driscoll DL, Dotterrer B, Brown RA 2 nd
. Assessing the social and physical determinants of circumpolar population health. Int J Circumpolar Health 2013;72.
Sheiham A. Oral health, general health and quality of life. Bull World Health Organ 2005;83:644.
Shah N. Oral and Dental Diseases: Causes, Prevention and Treatment Strategies: Burden of Disease, National Commission on Macroeconomics and Health .Government of India; 2005. p. 275-98.
Hobdell MH, Oliveira ER, Bautista R, Myburgh NG, Lalloo R, Narendran S, et al.
Oral diseases and socio-economic status (SES). Br Dent J 2003;194:91-6.
Petersen PE. Sociobehavioural risk factors in dental caries-international perspectives. Community Dent Oral Epidemiol 2005;33:274-9.
Jerkovic K, Binnekade JM, van der Kruk JJ, van der Most JA, Talsma AC, van der Schans CP. Differences in oral health behaviour between children from high and children from low SES schools in the Netherlands. Community Dent Health 2009;26:110-5.
Ferraro M, Vieira AR. Explaining gender differences in caries: A multifactorial approach to a multifactorial disease. Int J Dent 2010;2010:649643.
Maru AM, Narendran S. Epidemiology of dental caries among adults in a rural area in India. J Contemp Dent Pract 2012;13:382-8.
Mishra RK, Tiwari P, Dikshit A. Socio-economic and susceptibility study of dental caries in different age group people at Allahabad, India. J Exp Sci 2010;1:9-13.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]