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 Table of Contents  
ORIGINAL ARTICLE
Year : 2012  |  Volume : 3  |  Issue : 4  |  Page : 227-230

The determinants of dental caries among school-going children of Jaipur, Rajasthan: A cross-sectional study


1 Department of Community Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, India
2 Department of Pharmacology, Mahatma Gandhi Medical College and Hospital, Jaipur, India
3 Department of Conservative Dentistry and Endodontics, Jaipur Dental College, Jaipur, Rajasthan, India

Date of Web Publication12-Jul-2013

Correspondence Address:
Rajaat Vohra
D-4 Ganesh Marg, Bapu Nagar, Jaipur - 302 015, Rajasthan
India
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DOI: 10.4103/0976-433X.114965

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  Abstract 

Introduction: The rise in prevalence of dental caries in developing countries is mainly because oral health care system mostly focuses on curative care. The community-based prevention and oral health promotion have not been systematically implemented. Aims: The present study is designed to assess the magnitude and determinants of dental caries in school children in Jaipur district. Materials and Methods: A list of government and private schools was procured from Office of Basic Shiksha Adhikari. Four schools each, in urban and rural areas, were selected by simple random sampling. All children belonging to class 1 st to 5 th standard, available at the time of study, were included as study unit. Predesigned and pretested questionnaire was used to elicit the information on family characteristics, individual characteristics, and their food consumption patterns. The subjects were examined on an upright chair in adequate natural light to detect dental caries. Statistical Analysis Used: Data was analyzed using statistical package for social services (SPSS) version 11.5. Chi-square test was used to find out the significant association between prevalence of dental caries and demographic and individual characteristics. Results: A total of 564 children of 1 st to 5 th standard participated in the study. Overall, the prevalence of dental caries was found to be 67.11%. Mother's education, residence, consumption of more sweets per week or more chocolates/toffees per day were the statistically significant factors associated with dental caries. Conclusions: Children belonging to rural area, consuming more sweets and chocolates, and whose mothers were less educated had higher prevalence of dental caries. As a preventive strategy, there is a need to implement health education program for maintaining good oral hygiene.

Keywords: Dental caries, determinants, school-going children


How to cite this article:
Vohra R, Vohra A, Jain A. The determinants of dental caries among school-going children of Jaipur, Rajasthan: A cross-sectional study. SRM J Res Dent Sci 2012;3:227-30

How to cite this URL:
Vohra R, Vohra A, Jain A. The determinants of dental caries among school-going children of Jaipur, Rajasthan: A cross-sectional study. SRM J Res Dent Sci [serial online] 2012 [cited 2020 May 28];3:227-30. Available from: http://www.srmjrds.in/text.asp?2012/3/4/227/114965


  Introduction Top


Dental caries is defined as an infectious microbiologic disease of the teeth, in which Streptococcus mutans is considered to be the main etiological agent, which leads to localized dissolution and destruction of the calcified tissues. It is the most commonly seen oral disease, which shows a striking geographic variation, socioeconomic patterns, and severity of distribution all over the World. [1],[2],[3],[4],[5]

Polarization of caries is occurring on a worldwide basis, with the prevalence of caries declining in developed countries, increasing in less developed countries, and becoming an epidemic in countries with emerging economies. [6] Improper feeding practices by mothers/caregivers increase the risk for the development of early childhood caries in infants and toddlers, by promoting the early establishment of S. mutans in the oral cavity. [7]

Voluminous literature exists on the status of dental caries in the Indian population. Despite several attempts to cure and prevent the disease, its prevalence has increased over the last couple of decades. The present study is designed to assess the prevalence of dental caries and its determinants in school children in Jaipur district.


  Materials and Methods Top


It was a cross-sectional study, conducted for a period of 3 months from January 2012 to March 2012. Considering prevalence to be 70% and taking absolute error to be 4%, sample size was calculated to be 525.

First, the list of all schools coming under Jaipur district was procured from the office of Basic Shiksha Adhikari. Four schools each, in urban and rural areas, were selected by simple random sampling. All children belonging to class 1 st to 5 th standard, available at the time of study, were examined to detect presence of dental caries.

Due permission was taken from school authorities before examining the school children. A predesigned and pretested questionnaire was used to elicit the information about participant's demographic characteristics like age, sex, parent's educational status, and occupation. The class teacher's support was taken while eliciting the demographic characteristics. Information on individual characteristics like daily-brushing of teeth, method of cleaning, frequency of brushing teeth per day, rate of consumption of sweets per week, consumption of number of chocolates/toffees per day, type of food consumed, mouth rinsing after each meal was also collected.

Informed consent was taken from the child before examination. The subjects were examined on an upright chair in adequate natural light. Examination of the child was done by only one examiner to avoid interexaminer variability.

Statistical analysis

Data was analyzed using statistical package for social services (SPSS) version 11.5. Chi-square test was used to find out the significant association between prevalence of dental caries and demographic and individual characteristics.


  Results Top


A total of 564 children of 1 st to 5 th standard participated in the study. A total of 203 children were from 1 st and 2 nd standard (5-7 years age group); 247 children from 3 rd and 4 th standard (8-10 years age group) and 114 children were from 5 th standard (11-13 years age group).

[Figure 1] shows the prevalence of dental caries among school going children. The prevalence of dental caries was 80.29% among 5-7 years old children compared with 63.15% among 8-10 years old and 57.89% among 11-13 years old. Overall, the prevalence of dental caries was found to be 67.11%.

[Table 1] shows that mother's education and residence were the two statistically significant factors associated with dental caries. Other factors like mother's occupation, religion, type of school, and type of family were not found to be statistically significant.
Figure 1: Prevalence of dental caries according to age

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Table 1: Risk factors of dental caries: Family characteristics

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When individual characteristics were seen, daily brushing of teeth, brushing at night before sleep, and mouth rinsing after each meal were found to be statistically significant factors of dental caries, while method of cleaning or material used for cleaning was not found to be statistically significant [Table 2].

[Table 3] showed that consuming more sweets per week and eating more chocolates/toffees per day were statistically significant with prevalence of dental caries.
Table 2: Risk factors of dental caries: Individual characteristics

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Table 3: Association of dental caries with food consumption patterns

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  Discussion Top


The overall prevalence of dental caries in the present study was found to be 67.11%. Grewal et al., [8] found the prevalence of dental caries to be 52.3% in urban Delhi. A study by Dash et al., [9] found the prevalence of dental caries among children of Cuttack, Orissa to be 64.3%. A similar study by Grewal et al., [10] in Nainital district, Uttaranchal found prevalence of dental caries among rural children to be 77.7%. In the present study, dental caries was seen in 80.29% school children belonging to 5-7 years compared with 63.15% among 8-10 years old and 57.89% among 11-13 years old. As the age advances, the prevalence of dental caries decreases because older children can maintain a better oral hygiene status than younger children.

Mother's education and residence were the two statistically significant factors associated with dental caries. School children with less educated mothers were found to have higher prevalence of dental caries in comparison to children of educated mothers. Similar study by Hashizume et al., [11] in Japan also showed that mother's educational level was strongly associated with dental caries. Children belonging to rural area had higher prevalence of dental caries in comparison to children of urban area. In the present study, dental caries was found in 72.5% children belonging to rural areas in comparison 62.9% urban children.

In the present study, important determinants which prevented dental caries were daily brushing of teeth, brushing at night before sleep, and mouth rinsing after each meal. Dental caries was found in 82% children who do not brush their teeth daily, in 93.1% children who do not brush in night before sleep and in 73.1% children who do not rinse their mouth after each meal. Consuming more sweets per week and eating more chocolates/toffees per day were found to be statistically significant factors associated with dental caries. In the present study, older children were found to consume more sweets per week and more chocolates/toffees per day. But since they maintain good oral hygiene; the incidence of dental caries was found to be less. Thus, hygiene is a more important factor determining dental caries irrespective of the diet patterns.

Thus as a preventive strategy, it is recommended to start a school-based program where:

  1. There should be regular class hours on how to maintain a good oral hygiene.
  2. Health education should be given on daily brushing of teeth, brushing at night before sleep and mouth rinsing after each meal.
  3. Periodic examination should be done by class teacher with the help of a dental surgeon if possible.
  4. Parents should be advised on how to maintain a good oral hygiene not only for their children but also for themselves.
  5. There is a need of a dental health program which targets the specific segment of the population through systematic public and school health education program.


Due to scarcity of public resources for oral health care and keeping in mind the current incidence of dental caries, a national oral health policy that emphasizes on preventive care rather than curative care is more advantageous.

The findings of the study are based on interview of students of class 1 st to 5 th . Although the full information about the study was explained to the students, there are chances that the interpretation made by them may be different because of their age and perception. The limitation of this interview-based study is that the findings are based on recall of the interviewee.


  Conclusion Top


Children belonging to rural area, having less educated mothers, consuming more sweets and chocolates/toffees had higher prevalence of dental caries. As a preventive strategy, there is a need to implement health education program for maintaining good oral hygiene. Regular oral health check-ups should be conducted in school for early diagnosis and treatment of cases.

 
  References Top

1.Beal JF, James PM. Social differences in the dental conditions and dental needs of 5-year-old children in four areas of the West Midlands. Br Dent J 1970;129:313-8.  Back to cited text no. 1
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2.Brain AB, Stephen AE. Dentistry, Dental Practice and the Community. 4 th ed, vol 15. Philadelphia: WB. Saunders Company; 1992. p. 96-7.  Back to cited text no. 2
    
3.Enwonwu CO. Review of oral disease in Africa and the influence of socio-economic factors. Int Dent J 1981;31:29-38.  Back to cited text no. 3
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4.Enwonwu CO. Socia-economic factors in dental caries prevalence and frequency in Nigerians. An epidemiological study. Caries Res 1974;8:155-71.  Back to cited text no. 4
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5.Petersen PE. Social inequalities in dental health. Toward a theoretical explanation. Community Dent Oral Epidemiol 1990;18:153-8.  Back to cited text no. 5
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6.Studervant CM, Roberson TM, Heymann HO, Studervant JR. The Art and Science of Operative Dentistry. 3 rd ed. Elsevier: Mosby Co; 1995. p. 62-3.  Back to cited text no. 6
    
7.Berkowitz RJ. Mutans streptococci: Acquisition and transmission. Peadiatr Dent 2006;28:106-9.  Back to cited text no. 7
    
8.Grewal H, Verma M, Kumar A. Prevalence of dental caries and treatment needs amongst the school children of three educational zones of urban Delhi, India. Indian J Dent Res 2011;22:517-9.  Back to cited text no. 8
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9.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.  Back to cited text no. 9
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10.Grewal H, Verma M, Kumar A. Prevalence of dental caries and treatment needs in the rural child population of Nainital district, Uttaranchal. J Indian Soc Pedod Prevent Dent 2009;27:224-6.  Back to cited text no. 10
    
11.Hashizume LN, Shinada K, Kawaguchi Y. Factors associated with prevalence of dental caries in Brazilian schoolchildren residing in Japan. J Oral Sci 2011;53:307-12.  Back to cited text no. 11
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    Figures

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    Tables

  [Table 1], [Table 2], [Table 3]



 

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Abstract
Introduction
Materials and Me...
Results
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