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ORIGINAL RESEARCH Table of Contents   
Year : 2005  |  Volume : 16  |  Issue : 4  |  Page : 140-6
Prevalence pattern of dental caries in the primary dentition among school children


1 Community Dentistry, Rajah Muthiah Dental College and Hospital, Annamalai University, India
2 Oral and Maxillo Facial Surgery, Saveetha Dental College and Hospital, Chennai, India
3 Rajah Muthiah Dental College and Hospital, Annamalai University, India
4 Community Medicine, Rajah Muthiah Medical College and Hospital, Annamalai University, India

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   Abstract 

The purpose of the study was to assess the pattern of prevalence of dental caries in the primary dentition among 5 year old children. The area of study was urban Pondicherry and the study population consisted of 1009 school children of both sexes (527 boys and 482 girls). A simple random sampling method was used to select the schools. Dental caries was assessed by the Dentition status and Treatment Need (WHO 1997). Statistical analysis was done using the Proportion test. The prevalence of caries was 44.4% among the study population, being higher in the boys (P < 0.05); In Mandibular arch in both the sexes (boys P < 0.05, girls P < 0.01); in posterior teeth (both sex wise & arch wise). Comparison of caries among anterior teeth (Boys vs Girls) [corrected] and posterior teeth (upper vs. lower) revealed higher caries prevalence in Maxillary anterior teeth (P < 0.001) and Mandibular posterior teeth (P < 0.001). In both the sexes and arches, primary second molars showed higher caries prevalence.

Keywords: Dental caries, Primary dentition, Prevalence pattern, School Children, Prevalence.

How to cite this article:
Saravanan S, Madivanan I, Subashini B, Felix J W. Prevalence pattern of dental caries in the primary dentition among school children. Indian J Dent Res 2005;16:140

How to cite this URL:
Saravanan S, Madivanan I, Subashini B, Felix J W. Prevalence pattern of dental caries in the primary dentition among school children. Indian J Dent Res [serial online] 2005 [cited 2019 Aug 23];16:140. Available from: http://www.ijdr.in/text.asp?2005/16/4/140/29907

   Introduction Top


Dental caries is an important Dental Public Health Problem and it is the most prevalent oral disease among children in the world. The prevalence of dental caries is of great interest for long and is a principal subject of many epidemiological researches carried out in our country and abroad. This disease not only causes damage to the tooth, but is also responsible for several morbid conditions of the oral cavity and other systems of the body (WHO 1981)[1]. The prevalence pattern of dental caries not only varies with age, sex, socio economic status, race, geographical location, food habits and oral hygiene practices but also within the oral cavity. All the teeth and all the surfaces are not equally susceptible to caries. It is of interest therefore, to know the relative caries susceptibility of the teeth in the maxilla and mandible. The main objective of this investigation was to assess the prevalence pattern of dental caries among 5 year old school children in primary dentition.


   Materials and methods Top


This epidemiological study was carried out on 5 year old school children of urban Pondicherry for the assessment of dental caries prevalence pattern in primary dentition. The study population consisted of 9383 (boys = 4834, girls = 4549) 5 year old school children. Ten percentage of this population was considered to be suitable sample size, which came to be 938 and rounded off to 1000 (all the children from the last examined school were included, hence the sample became 1009). Twenty three schools were estimated to be sufficient to cover the sample size and these schools were selected using random number table. School going children aged 5 years who were present on the day of examination were included in the study. Approval from the concerned authorities was obtained prior to beginning the study.

Out of the total sample of 1009,527(52.2%) were boys and482(47.8%) were girls. The survey was conducted between January 2000 and March 2000. The dental examination was carried out by a single investigator. Prior to the survey, intra examiner reproducibility was evaluated by two examinations performed on the same school children in a gap of 2 days. Agreements between the first and second examiner were found to be good. During the survey, 10 children in each school were re- examined to assess intra examiner consistency. There was a good agreement between the examiners.

Dental caries was assessed by Dentition status and Treatment Need (WHO 1997)[2] using mouth mirror and CPI probe. The data was statistically analyzed using Proportion test for comparison of caries prevalence among the different groups: sex, arch, teeth (anterior and posterior teeth) and right and left side of the oral cavity. Oral health education was given to the school children in the local language and for those who required treatment, were provided in Mahatma Gandhi Dental College and Hospital.


   Results Top


The study population consisted of 1009, school children of the age of 5 years. It included 527 (52.2%) boys and 482(47.8%) girls.

Table 1 and Graph 1 shows prevalence of dental caries among study population. Caries prevalence was 44.4%. Sex wise comparison revealed that caries prevalence was higher in boys (47.4%) than in girls(41.1%) and the difference was significant statistically(P<0.05)

Table 2 and Graph 2 shows prevalence of dental caries in the arches. Caries prevalence was 26.7% in the maxillary arch and 36.9% in the Mandibular arch. Among boys, the mandibular arch showed a higher caries level (38.7%) than the maxillary arch (30.9%) and the difference was significant statistically (P<0.05). Similarly among girls, the mandibular arch showed higher caries prevalence (34.9%) than the maxillary arch (22%) and the difference was statistically significant (P<0.01).

Table 3 and Graph 3 shows dental caries prevalence on right and left side of oral cavity. On comparing the right and left side of oral cavity it was found that caries occurs in a bilateral phenomenon (right side = 37.6%, left side= 38.6%). Among boys caries prevalence was 40.4% and 41.2% for right and left sides respectively. Among girls caries prevalence was 34,4% and 35.7% for right and left sides respectively. The differences were not significant.

Table 4 and Graph 4 (a) 4(b) presents tooth wise and sex prevalence of dental caries. In both the sexes, when caries was compared between the anterior and the posterior teeth, caries prevalence was higher in the posterior segment than the anterior segment.

When the caries prevalence of the anterior teeth was compared between the sexes, boys showed higher caries prevalence than girls and this difference was statistically significant (P<0.01).

Table 5 and Graph 5(a) 5(b) shows tooth wise and arch wise prevalence of dental caries. In both the arches, caries occurred more frequently in the posterior teeth. Comparison of caries between the aches in the anterior segment revealed that caries attack was higher in the maxillary arch and the difference was significant statistically (P<0.001>. On the other hand, comparison of caries prevalence was higher in the mandibular arch. The difference was significant statistically (P<0.001).


   Discussion Top


Among the study population, caries was significantly more prevalent in boys than in girls, which suggest that dental caries show some predilection for sex. Similar findings were noted by Peter. F Infante, George M. Gillespie(1976)[3]; Zerfowski M et al (1997)[4]. This higher caries prevalence in boys in primary dentition was due to early eruption and longer retention of these teeth in boys[5].

Dental caries shows some relation to the arches regarding prevalence pattern and the mandibular arch is affected more often than the maxillary arch, says P. V Sathe[6]. In the present study, inter arch comparison revealed that caries prevalence was higher in mandibular arch and it was significant statistically in both the sexes. Similar findings were reported by Tewari, A. et al (1997[7]; Jawadekar S.J et al (1989)[8]. However, higher caries prevalence in upper arch was reported by Healey and Cheyne(1943)[9].

On comparing caries prevalence in relation to right and left side of the oral cavity it is evident that dental caries occurs predominantly as a bilateral phenomenon. Similar observation were reported by Finn S.B. [10]; Dunning JM [11]; and Fawadekar ST et al (1989)[8].

In the present study, caries prevalence was higher in posterior teeth as compared to anterior teeth in both the sexes. Similar findings were observed by Peter F Infante and George M. Gillespie (1976)[3]; Chawla HS et al (2000)[12]. Caries attack was 4 times and 6 times more in the posterior teeth than in the anterior teeth among boys and girls respectively. This is due to the complex morphological nature of the posterior teeth [6], [13].

In the present study, among the posterior teeth, primary first molars in both the arches are less susceptible to caries than the primary second molars, even though the former erupts at an earlier date.

This suggests that in primary dentition, among 5 year olds, the second molar is the tooth with highest caries experience[10], [14], [15]. This difference in individual tooth susceptibility is due to the fissure topography of molars. The pits and fissures in second primary molars are deeper and less completely coalesced[10],[16].

It is also evident that the sequence of caries attack follows a specific pattern: mandibular molars, maxillary molars and maxillary anterior teeth were predominantly affected by caries, whereas the mandibular anterior teeth was least affected. This is similar to the caries pattern described by Chawla HS et al (2000)[12] and Ralph E. McDonald for primary dentition [16].

In the present study, the mandibular incisors are unaffected. This resembles the Early childhood caries pattern (Nursing caries) where the maxillary primary incisors, maxillary and mandibular primary molar are affected sparing mandibular primary incisors[12], [17], [18]. The protection by the tongue and the opening of major salivary ducts near the lower incisors has been advanced as a reason for this resistance to caries, but the opening of the parotid glands near the upper molar teeth has failed to give these teeth similar protection, which requires further investigation[11],[18].

It was also evident that caries attack was higher in the lower arch than in the upper arch in the posterior teeth. Similar findings were reported by Chawla HS et al (2000)[12]; Subrata Sarkar and K.S. Roy Chowdhury(1992)[19].


   Conclusion Top


The prevalence of dental caries in primary dentition:
  • Was higher in the boys than in the girls (P<0.05).
  • Was higher in the mandibular arch in both the sexes (boys P<0.05;girls P<0.01).
  • Shows a bilateral phenomenon in both the sexes.
  • Was higher in posterior teeth in both the sexes and both the arches.
  • Was higher in the boys than in the girls among the posterior teeth (P < 0.01).
  • Was higher in the boys than in the girls among the posterior teeth (P < 0.01).
  • Was higher in the primary second molars than the primary first molars in both the sexes and both the arches.
  • Follows a specific pattern: mandibular molars(21.7%), maxillary molars (10.1%) maxillary anterior teeth (6.5%) were predominantly affected; whereas the mandibular anterior teeth was least affected (0.4%).
  • Was higher in the maxillary arch than the mandibular arch among the anterior teeth(P < 0.001).
  • Was higher in the mandibular arch than the maxillary arch among the posterior teeth (P<0.001).

   Acknowledgements Top


Our Sincere thanks to Mr. A. Ramalingam, Budget officer, Chief Secretariat; Mr. G. Rages B Chandra, the Director of Education; and Dr. Sathyanarayanan, M.D.S, Professor, Div of Conservative Dentistry, RMDC and H, For their timely help and advice.

 
   References Top

1.World Health Organisation. Dental Health published in World Health, Cited in Chakraborty M, Saha JB, Bhattacharya RN, Roy A, Ram R. Epidemiological correlates of dental caries in an urban shun of West Bengal. Indian J of Pub Hlth,1997; 41[2]: 56,198 1.   Back to cited text no. 1    
2.World Health Organisation. Oral health surveys - Basic methods. 4thedrr.Geneva, WHO, 1997.  Back to cited text no. 2    
3.Peter F. Infante, George M. Gillespie. Dental caries experience in the deciduous dentition of rural Guatemalan Children ages 6 months to 7 years. JDent Res, 55[6]:951-957,1976.  Back to cited text no. 3    
4.Zerfowski M, Koch ML Niekusb U, Staehle HL Caries prevalence and treatment needs of 7 to 10 - year-old school children in South western Germany. Community dent. Oral Epidemiol, 25:348-351,1997.  Back to cited text no. 4    
5.Graves RC, Bohannan LEVI, Disney JA, Staman JW, Bader JD, Abernathy JR, Recent dental caries and treatment patterns in U.S. Children. J Public Health Dent, 46:23-29,1986. Citedby R. GaryRozier. Dental public health. In:Maxcy - Rosenau - Last. Public health and Preventive medicine. 13th edn. Appleton and Lange, PrenticeHall International Inc,1992;1007.  Back to cited text no. 5    
6.Sathe P.V. A textbook of Community Dentistry. 1st edn. Hyderabad, Paras medical publisher, 84-94,1998.  Back to cited text no. 6    
7.Tewari A, Chawla, Harpinder Singh. A study of prevalence of dental caries in an urban area of India - Chandigarh. J Ind Dent Assoc, 49: 231-237,1977.  Back to cited text no. 7    
8.Jawadekar SL Dandare MP, Maya Nato, Jawadekar SS. Dental caries susceptibility pattern. J Ind Dent Assoc, 60 (10): 200 - 203,1989.  Back to cited text no. 8    
9.Healey, Cheyne. Cited by Soben Peter. Essentials of Preventive and Community Dentistry. 1st edu. New Delhi, Arya (Medi) publishinghouse, 137,1999.  Back to cited text no. 9    
10.Finn SB. Clinical Pedodontics. 4th edn. Philadephia, WB Saunders Company, 454 - 474, 1991.  Back to cited text no. 10    
11.Dunning JM, Epidemiology: Dental caries. Principles of Dental Public Health. 4th edn. Cambridge, 1986.  Back to cited text no. 11    
12.Chawla HS, Gauba K, Goyal A. Trend of dental caries in children of Chandigarh over the last sixteen years. J Indian Soc Pedo Prev Dent, 18[1]:41-45, 2000.  Back to cited text no. 12    
13.Pandit IK, Mouaumi Singh, Nikhil Srivastava. Prevalence of dental caries in mixed dentition period amongst children of Yamuna Nagar District (Haryana), J Ind Dent Assoc, 71[1]: 23 - 24, 2000.  Back to cited text no. 13    
14.GoranKoch,SvenPoulsen. Pediatric Dentistry A clinical approach. Istedn.Munksgaard, 192,2001.   Back to cited text no. 14    
15.Pinkham. Pediatric Dentistry Infancy through adolescence. 3rd edn. W.B. Saunders Company, 263,1999.  Back to cited text no. 15    
16.Me Donald R.E, Avery D.R. Dentistry for the child and the adolescent. 7th edn. Mosby Co, 212, 2000.  Back to cited text no. 16    
17.Damle SG. Pediatric Dentistry. 1st edn. Arya (Medi)publishing house, January, 34, 2000.  Back to cited text no. 17    
18.Shobha Tandon. Textbook of pedodontics. 1st edn.ParasMedical Publisher, 178-209,2001.   Back to cited text no. 18    
19.Subrata Sarkar, Roy Chowdhury KS. Incidence of caries on various surfaces of deciduous teeth. JIndDentAssoc, 63(10):421-425,1992.  Back to cited text no. 19    

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Correspondence Address:
S Saravanan
Community Dentistry, Rajah Muthiah Dental College and Hospital, Annamalai University
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.29907

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    Figures

[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]

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