Prevalence of dental caries and treatment needs among children of Cuttack (Orissa).

Transcription

1 J Indian Soc Pedo Prev Dent December (2002) 20 (4) : ISSN Prevalence of dental caries and treatment needs among children of Cuttack (Orissa). Dash J.K. a Sahoo P. K. b Bhuyan S.K. C Sahoo S.K. d. a. Asst. Prof. Paediatric Dentistry, b, Asst. Prof. Paediatric Dentistry, c. Lecturer in Oral Diagnosis, d. House Surgeon Paediatric Dentistry, Dental Wing S.C.B. Medical College, Cuttack. An epidemiological investigation was carried out to know the prevalence of Dental Caries amongst 1257 children in the age group of 5, 8, 11 & 15 years respectively attending schools in the city of cuttack, Orissa. The examination was carried out under natural light and dental caries was diagnosed according to W.H.O. Criteria The point prevalence of dental caries was recorded to be 64.3% with an average DMFT of The prevalence of caries showed a pattern of occurrrence i.e. prevalence consistantly increased from 5 years to 8 years age group and subsequently decreased at 11 years and 15 years age. Regarding treatment needs, 63.6% children required dental treatment for various reason and it is in accordance with dental caries prevalence of different age group. KEY WORDS : Epidemiology, dental caries, treatment needs. INTRODUCTION Dental Caries is the outcome of a multiple complex process involving factors like diet, microorganisms, trace elements, saliva, genetic predisposition and tooth morphology. Apart from these, many related factors like individual, social, environmental and cultural factors are also responsible. In recent years, the global distribution of dental caries present a varied picture, most of the countries with low caries prevalence are experiencing an unprecedent increase in caries prevalence and severity of dental caries including India. On the other hand, in several. Industrialized countries a reduction of dental caries incidence and improvement of gingival health care are evident 1,2. This decline in dental caries was mainly due to appropriate use of fluorides and preventive oral health measures 3,4. The scenario in India is no different from other developing countries. Available literature of 1940 to 1960, the prevalence of dental caries in India showed a varied picture i.e., caries being very high in some areas and low in some areas 5,6,7,8. In spite of conflicting reports it has been observed that during 1940 the prevalence of dental caries in India was 55.5%, during 1960 it was reported to be 68% 4. Further it has been observed that dental caries was always higher in highly urban and cosmopolitan places 7. The dental caries experience in an individual in both permanent dentition is directly related to oral microflora established with completion of primary dentition. Studies revealed the fact that if caries was not allowed to progress and involved tooth surfaces in late primary dentition, it was not likely to do so in mixed dentition period 9. Proper application of preventive methods can reduce incidence of dental caries. This can be possible from the experience derived from the countries where the disease is in decline and it is the right time to get basic information about the disease pattern all over the country, its exact nature, degree of severity and to understand its association with specific factors. The aim of the present study was to assses caries experience on child population of 5, 8,11 & 15 years old children of Cuttack, Orissa. A city with its own peculiarity of having both urban and rural population. a. To determine the status of dental caries of Children using WHO criteria 10. b. To evaluate curative and preventive need to fight dental caries.

2 Prevalence of Dental Caries and Treatment needs 140 MATERIAL AND METHODS The study sample comprised of 1257 Children, 628 Boys and 629 Girls (Table No. 1) in the age group of 5,8, 11 and 15 years belonging to both urban and rural population representing Cross section of Socio - economic status having continuous residence in their respective areas. The reason for selection of the present study was available information of Dental Caries in the state was mainly in the form of pevalence studies which were confidence to tribal area 11,12 in the city of Berhampur 13 and epidemiological study using different recording system 14. The children were selected randomly through cluster sampling techniques, i.e., section of each age group was randomly selected from schools and were equally distributed to each of the group according their age 15. The children were examined in their respective schools seated on an ordinary chair, in broad day light facing away from direct sunlight. The children were asked to rinse mouth thoroughly before examination, then the teeth were dried with cotton swab and the dental caries was recorded as per WHO1983. Criteria and identification of data of each children was recorded on a semistructural schedule, unilever recording chart. The early status of dental caries that could not be diagnosed positively were excluded. They were, white or chalky spots, discolored or rough spots, hard stained pits or fissures in enamel which catches an explorer but do not have a detectable softened cavity floor. The data was compiled edited and analysed at Dental Wing of S.C.B. Medical College, Cuttack, Orissa. RESULTS In all the four age groups 5, 8, 11 & 15 years, the point prevalence of dental caries showed a common pattern of occurrence i.e., the prevalence of dental caries consistantly increase from 5 years to 8 years and subsequently decreased at 11 and 15 years. The point prevalence was observed to be 57.9%, 73.1%, 66.2% and 62.2% at 5, 8, 11 and 15 years age respectively, with an overall caries prevalence of 64.3% (Table No. 2). Similarly the def + DMF teeth showed 2.59, 2.98, 2.06, 2.06 with overall recording of The def+dmf surfaces shows a recording of 4.45, and 3.02 with a overall recording of 3.81 at the age of 5, 8, 11 and 15 years respectively. Intra analysis of deft + DMFT and deft + DMFS components analysed as decayed, missing due to caries and filled teeth surfaces revealed that d+mteeth/surfaces revealed that d+d teeth/surfaces contributed maximum followed by e+m teeth/surfaced and f+ F teeth/surface in all four age groups (Table No. 3&4) regarding treatment needs (Table No. 5&6) for the child population assessed was that 63.6 % of children required some kind of treatment. Requirements of of dental treatment % of children require restorative procedures invloving single surfaces (Code 1), two surfaces (Code 2), three surfaces code(3), more than three surfaces or crown (Code 4) Children requiring extraction due to caries (Code 5), periodontal disease (Code 6), Dentures (Code 7) and other restroration (Code 8) account for only 14.7% of treatment needs. Lastly other treatment like Orthdontics, habits etc. (Code 9) accounts for only 4.5% of treatment need. Table No. 1: Distribution Of Samples

3 Dash J.K., Sahoo P. K., Bhuyan S.K., Sahoo S. 141

4 Prevalence of Dental Caries and Treatment needs 142 Table No.4 : Analysis of defts + DMFS Components. Table No.5 : Assessment of Treatment Needs in Children Table No.6 : Treatment Needs in the Child Population of Cuttack Requiring Various Types of Dental Treatment

5 Dash J.K., Sahoo P. K., Bhuyan S.K., Sahoo S. 143 DISCUSSION Dental Caries apparently called by a product of affluence and civilization now form an alarmimg health risk in children. In Orissa available information on dental caries status was mainly in the form of prevalence studies confined to tribal areas and city of Berhampur 13. The only epidemiological study carried out by comparing and using two different recording system to assess the prevalence and severity of dental caries, the only scientific data available covering both Urban and Rural populations in Orissa 14. The reason for the prevalence of dental caries being more at 8 years of age compared to that of 5 years can be attributed to the fact that caries being a continuous and cumulative process had obviously increased with a span of 3 years. The first permanent molar (6 year molar) have also been at risk for 2 years, sufficient for caries to set in. The fall in point of prevalence at 11 years age is understandable, because most of the deciduous teeth have been exfoliated and suceedneous premolar have not been in oral cavity long enough for caries process to set in. There is no significant difference in prevalence of dental caries at 11 years and 15 years, the possible reason for this can be explained by the fact that the new carious lesion appearing at the age of 11 years be compensated by the exfoliation of deciduous molar. The result of the present study is in concurrence with Mishra and Sahoo 13,14. The e+mteeth / surface score and f+f teeth / surface scores contributed very little to the total deft + DMFT scores with f+f scores was very low. This indicates the fact for need of dental professional, professional service and general awareness in general. Data in treatment needs are of great value at local level because, they provide a reliable basis to estimate manpower requirement, cost of oral health care programme under prevailing condition and type of treatment necessary. The percentage of children requiring various type of dental treatment found to be in accordance with dental caries prevalence of different age group. Measures like brushing with fluoride dentifrices, topical fluoride application, community awareness programme and diet planning shall help in decreasing the incidence of dental caries in general population. REFERENCES 1. Kalsbeek H, Virrips C. W. H. : Dental caries prevalence and use of fluoride in different european countries J Dent Res ; 69 : Marthaler T. M.: Caries status in Europe and prediction of future trends. Caries Res. 1990; 24 : W.H.O., World Health No. 1, Jan -Feb 4. Oral Health, ICMR Bulletin, 1994 (Apr.) 24: Damle S.G., Patel A.r.: Caries prevalence and treatment needs amongst children at Dharavi, Mumbai. J Comm Dent Oral Epidem. 1994; 22: Antia F.E.: The dental caries experience of school going children in the City of Bombay. JIDA, 1962: Shourie K. L: Dental Caries in Indian Children. Ind J Medical Res. 1941, 29: 4: Tewari a., Chawla H. S.: Study of prevalence of Dental Caries in an urban area of India, (Chandigarh), JIDA 1977; 49: Greenwell A.L., Jhonson D., Disantis T.A., Gerstenmair J., Limbart N.: Longitudinal evaluation of caries pattern fo the primary and mixed dentition : Paed Dent. 1990, : 12 : World Health Organisation, Oral Health Survey, basis methods, 3 edition, geneva, WHO, Vaish R.P.: Prevalence of Caries among tribal school children in phulbani District Orissa JIDA 1983, 54: Vaish R.P. : Prevalence of Dental Caries amongst School going tribal children in Ganjam District, Orissa JIDA 1982; 53: Mishra F.M, Shee B.K.: Prevalence of Dental Caries in school go ing tribal children in ganjam District, Orissa JIDA 1982; 53 : Sahoo P.K., Tewari A., Chawla H.S., Sachdev V.: Inter compari son of pevalence and severity of Dental Caries using two recording system J Ind Soc Pedo Prev Dent 1990., 8: Sample size determination in Health Studies. A practice manual, 1991, WHO, Geneva. Reprint requests to: Dr. Jayanta Kumar Dash. Asst. Prof., Dental Wing, S.C.B. Medical College, Cuttack, Orissa