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| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 20
| Issue : 2 | Page : 137-141 |
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Association between oral hygiene status and dental caries among 13–14 years old children of Kamrup District, Assam
Sulekha Doley1, Manvi Srivastava2, Roopali Gupta3, Ankita Piplani4
1 Department of Pedodontics and Preventive Dentistry, Regional Dental College and Hospital, Guwahati, Assam, India
2 Department of Pedodontics and Preventive Dentistry, K. D. Dental College and Hospital, Mathura, Uttar Pradesh, India
3 Department of Public Health Dentistry, K. D. Dental College and Hospital, Mathura, Uttar Pradesh, India
4 National Oral Health Program, New Delhi, India
| Date of Submission | 11-Dec-2020 |
| Date of Decision | 17-Apr-2021 |
| Date of Acceptance | 26-Nov-2021 |
| Date of Web Publication | 8-Jun-2022 |
Correspondence Address:
Manvi Srivastava
Department of Pedodontics and Preventive Dentistry, K. D. Dental College and Hospital, Mathura, Uttar Pradesh
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jiaphd.jiaphd_220_20
Background: Dental caries and periodontal problems are mainly caused due to poor oral hygiene practices. Aim: This study aims to determine the relationship between oral hygiene status and dental caries in 13–14 years old school-going children of rural and urban locality in Kamrup Metropolitan District, Assam. Materials and Methods: A total of 1501 school children in the age group of 13–14 years were included in the study and dental caries was recorded from decayed missing filled teeth (DMFT) index as described by World Health Organization (1997) and Oral hygiene status was assessed using Oral Hygiene Index-Simplified (OHI-S) given by Greene and Vermilion 1964. The unpaired t-test, Chi-square test, and Pearson correlation test were used to assess the relation between oral hygiene status and dental caries among different age groups, and location of the school-going children using SPSS version 21 and P < 0.05 was considered to be statistically significant. Results: The results showed a significant positive correlation (P < 0.05) between mean OHI-S score and decayed component of DMFT score among rural school children whereas in urban children a significant positive correlation (P < 0.05) was found between mean OHI-S score and mean score of Decayed, Missing and Filled teeth component of DMFT. Conclusion: The overall prevalence of dental caries among school children of Kamrup (Metropolitan) District was 33.6%. The present study showed a significant positive correlation of mean OHI-S score with a mean of decayed teeth and DMFT score.
Keywords: Caries prevalence, dental caries, decayed missing filled teeth index, oral hygiene status
How to cite this article:
Doley S, Srivastava M, Gupta R, Piplani A. Association between oral hygiene status and dental caries among 13–14 years old children of Kamrup District, Assam. J Indian Assoc Public Health Dent 2022;20:137-41 |
| Introduction | |  |
The oral cavity is the gateway to the body and plays an important role in maintaining general health.[1] The two major oral health concerns are dental caries and periodontal diseases which show striking geographic variations, socioeconomic patterns, and severity of distribution all over the world.[2],[3] Dental caries and periodontal problems are mainly caused due to poor oral hygiene practices.[4],[5] Adolescents who brush their teeth more than once a day by the time they are 12 years old are more likely to continue to do so throughout their teenage years.[6]
According to the literature, the increase in the dental caries prevalence in the Indian population is mainly because of a lack of awareness, infrastructure, and implementation of preventive measures among the population of school children. Schools can be considered as an important site to deliver the knowledge regarding the maintenance of oral hygiene in children. Conducting a survey or an educational program in the schools can let us reach the children and their parents from urban and rural areas. Children are more receptive during their school-going age as they are under the influence of peers, hence during this period, if some habits are established, then its impact could be long-lasting. Moreover, the messages can be reinforced regularly throughout the school years.[7]
Thus, the present study aimed to determine the association between oral hygiene status and dental caries in 13–14 years old school-going children of rural and urban locality in Kamrup Metropolitan District, Assam.
| Materials and Methods | | |
Before starting the survey, the ethical approval for the study was obtained from the Institutional Review Board (THE/150C) and Official permission was obtained from District Elementary Education Officer (Assam Letter No. EAC/Esstt./39/2014/3), Kamrup (M), Guwahati and School Principal/Headmaster/Headmistress of concerned schools.
The sample size was calculated from the pilot study done before the commencement of this survey on a sample of 50 children who were not included in the final sample.
The sample size for this cross-sectional study was calculated as follows using the following formula for cross-sectional studies based on the prevalence of disease:
Sample size = Z2 × (p) × (1-p)
c2
Where:
Z = Z value (1.96 for 95% confidence level) p = percentage of picking a choice, expressed as decimal
There was 20% prevalence of decayed missing filled teeth (DMFT) ≥ 1. So, this was expressed as 0.20.
c = precision, expressed as decimal
Absolute precision = 16.4% of c Hence, the sample size was calculated as per formula = (1.96)2 × 0.8 × 0.2
(0.05)2 × 0.164
So, the sample size was calculated to be 1501.
The data collection was scheduled during the school working hours with an average of 30–35 children examined per day. The study period in which data were collected was from August 2014 to March 2015.
Children of age 13–14 years were included in this study. The children who were suffering from any serious systemic health problems that can affect their oral health or any intellectual developmental disorder, children with behavioral disorders and also with impaired audio, speech, or visual acuity were excluded from the study.
The basic information of the children was taken before starting the dental examination. Dental caries was recorded using DMFT index as described by the World Health Organization (WHO), 1997 and Oral hygiene status was assessed using Oral Hygiene Index-Simplified (OHI-S) given by Greene and Vermilion 1964. The OHI-S has two components: Debris Index-Simplified (DI-S) and Calculus Index-Simplified (CI-S). The children were seated on an ordinary chair positioned to ensure adequate daylight to facilitate the examination. The examiner was assisted by an alert and cooperative recorder who followed the instructions exactly. The armamentarium used was mouth mirrors, dental probes, explorers, and tweezers. After each day's survey, all the instruments were first disinfected and then autoclaved. Children suffering from pain or infection and those who needed immediate care or routine treatment got referred to nearby dental hospitals. After the examination, a dental health education class was held daily for the students, teachers, or caregivers to maintain their oral health and hygiene.
All the collected data were entered into the Microsoft Word Excel sheet 2007 version and subjected to statistical analysis using statistical package of social sciences (SPSS) version 21. The statistical tests used in this study were unpaired t-test, Chi-square test, and Pearson correlation test whereas P < 0.05 was considered to be statistically significant.
| Results | | |
Out of 1501 children, 655 (43.6%) were 13 years old and 846 (56.4%) were 14 years of age. Among them, 709 (47.2%) were female and 792 (52.8%) were male. The rural population and urban population constituted 50% of the total study sample each. Mean values of the OHI-S index were more among rural children as compared to children residing in urban areas. The mean values were compared using an unpaired t-test which showed that the P value was highly significant [Table 1]. [Table 2] shows the mean values of DI-S, CI-S, and OHI-S index among 13-and 14-year-old children. When the data were compared using an unpaired t-test, the P value came out to be highly significant (0.0001). The OHI-S values were found to be more among the males (2.72 ± 1.50) as compared to the females (2.31 ± 1.48) and the difference was highly significant (0.0001). | Table 1: Mean values of debris index simplified, calculus index-simplified and oral hygiene index - simplified indices based on the location
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 | Table 2: Mean values of debris index simplified, calculus index-simplified and oral hygiene index- simplified indices based on the age of the children
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The DMFT found in 13 years old children were 187, 12, and 55 respectively whereas in 14 years old children it was 287, 35, and 133, respectively. Hence, the overall DMFT index was higher in 14 years old children as compared to children with age 13 years. On comparing these data, a statistically significant result was found as shown in [Table 3]. The DMFT in rural subjects were 226, 6, and 21 whereas among urban subjects it was 248, 41, and 167, respectively. Hence, when the values were compared, a statistically significant difference was found among the children residing in two different localities. The overall DMFT index was higher among the urban population as compared to the rural [Table 4]. | Table 3: Mean and standard deviation of decayed, missing, filled, and mean decayed missing filled teeth among the different age groups
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 | Table 4: Mean and standard deviation of decayed, missing, filled and decayed missing filled teeth based on the location
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There was a significant positive correlation of mean OHI-S score with the mean number of Decayed teeth and DMFT score in 13-year-old children whereas in 14 years old a significant positive correlation was found between mean OHI-S score with the mean of a decayed teeth and filled teeth [Table 5]. There was a significant positive correlation found between mean OHI-S score with the mean of decayed teeth and DMFT score among rural school children whereas in urban children a significant positive correlation was found between mean OHI-S score with the mean of Decayed teeth, Missing teeth, Filled teeth, and DMFT score [Table 6]. | Table 5: Association between decayed teeth, missing teeth and decayed missing filled teeth and oral hygiene index - simplified among 13- and 14-years old school children using Pearson correlation test
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 | Table 6: Association between decayed teeth, missing teeth and decayed missing filled teeth and oral hygiene index - simplified among the rural and urban school children using Pearson correlation test
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| Discussion | | |
The present study was conducted to determine the relationship between oral hygiene status and dental caries in 13–14 years old school-going children of rural and urban locality in Kamrup Metropolitan District, Assam. As the highest priority risk group is between 11 and 14 years of age,[8] 13–14 years old children were chosen for the study. Research by Lewis and Ismail in 1995 claimed that one of the peak ages for dental caries experience is 14 years.[9] According to WHO, the global monitoring ages are 12 and 15 years because the dietary habits of the individuals are more or less established and the permanent teeth have been exposed to the oral environment for 3–9 years, thus assessing caries prevalence is even more meaningful at this age.[10]
The oral hygiene status was found to be poorer in rural children than the urban for the above age groups which were correlating with the results of the study done by Babu et al. and Saha.[11],[12] The high oral hygiene status among the urban children could be due to parent's dental awareness which is reflected in the child's oral hygiene maintenance. Poor oral hygiene status among rural school children could be attributed to poor oral hygiene practices like the use of finger instead of toothbrush and toothpaste being substituted with tooth powder and other substitutes. Oral hygiene was poor among 14 years old children as compared to 13 years old, the similar finding was found in the study conducted by Amid,[13] Yonemitsu,[14] and Tewari[15] reported that the oral hygiene index and its components increases as the age advances.
The overall prevalence of dental caries in 13–14 years old children was found to be 33.6%. The results of the present study were in concordance with the study done by Nasser GA in Chennai (2019) where the prevalence of dental caries was found to be 34.72%. The prevalence study conducted by Dash et al. in Cuttack, Jose in Kerala, Saravanan et al. in Puducherry have reported higher percentages of dental caries i. e., 64.3%, 54.3%, and 44.4%, respectively.[16],[17],[18],[19] Furthermore, the study conducted by Dhar et al. in Udaipur, Moses et al. have reported higher percentages of dental caries 46.75% and 63.83%, respectively.[20],[21] The study done by Shingare et al. in 2012 showed the contrasting results in which they found that the caries prevalence among Indian school children in the age group of 11–14 years was 73%.[22] This variation may be due to the diverse dietary factors in different areas, structural defects of teeth, anatomical relationship of teeth, form, and shape of teeth, and hereditary factors. The prevalence of dental caries in this study increases with the advancing age; it was 29.2% among 13 years old children as compared to 37.0% among 14 years old. This finding was similar to the results of the study conducted by Praveena in 2013.[23] Caries experience with age advancement might be due to more exposure of teeth to the cariogenic challenge of the oral environment.
In this study, the prevalence of dental caries is also higher in the urban population (36.8%) than the rural population (30.4%). Similar results were found in the study conducted by Mandal, Irigoyen et al., Kalita and Varenna et al. where the prevalence of dental caries was significantly higher among the urban children compared to rural children.[24],[25],[26],[27] This difference can be attributed to the dietary and snacking habits among urban school children.
The present study showed a significant positive correlation of mean OHI-S score with a mean number of decayed teeth and DMFT score. The results of our study were similar to the results of Ogunsile, who demonstrated that there is a close association between oral hygiene status and tooth decay whereas in contrast to the present study, Rehman did not find any relationship between DMFT and OHIS and[28],[29] Furthermore, it was seen in the study that although the rural population had poor oral hygiene status; the DMFT score was low as compared to urban population. On the other hand, Sudha demonstrated that caries prevalence did not have any statistically significant relation with oral hygiene habits.[30] The limitation of this study was that the cross-sectional studies cannot be generalized to the other population in the country. Hence, to know the exact status of oral hygiene and dental caries in Indian population, a national survey has to be conducted.
| Conclusion | | |
Dental caries is a major dental health problem; hence, an active and effective preventive program for dental care is needed for the child population in the area. The overall prevalence of dental caries among 13–14 years old school children of Kamrup (Metropolitan) District was 33.6%. The oral hygiene status was found to be poorer among rural school children compared to urban school children. The present study showed a significant positive correlation of mean OHI-S score with mean of decayed teeth and DMFT score.
Clinical significance
The present study provides objective data which will be required for dental health programs to be formulated and implemented in future to control and prevent dental diseases by the authorities. This study can help the oral health professionals not only to plan and implement treatment procedures but also to design and carry out appropriate preventive measures for dental caries. There is a need to provide oral health education in the schools with proper instructions on oral hygiene practices and school-based preventive programs to maintain and improve oral health in urban and rural school children. To increase the awareness regarding oral hygiene school dental camps should be organized in all schools to treat, train, and educate all the school children, teachers, and parents. Regular screening camps should be mandatory to check up the oral health as well as general health. There should be the training of teachers so that they can implement the preventive programs in schools.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]
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