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Table of Contents   
ORIGINAL RESEARCH  
Year : 2011  |  Volume : 22  |  Issue : 2  |  Page : 364
Prevalence of permanent tooth loss among children and adults in a suburban area of Chennai


1 Department of Public Health Dentistry, Pushpagiri College of Dental Sciences, Medicity, Perumthuruthy, Tiruvalla, Kerala, India
2 Department of Public Health Dentistry, Saveetha Dental College, Saveetha University, Velappanchavadi, Chennai, Tamil Nadu, India

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Date of Submission18-May-2009
Date of Decision07-May-2010
Date of Acceptance02-Jun-2011
Date of Web Publication27-Aug-2011
 

   Abstract 

Aim: To determine the prevalence of permanent tooth loss among children and adults in a suburban area of Chennai.
Design: Cross sectional descriptive study.
Study setting: The study was conducted in Tiruverkadu, a suburban area of Chennai.
Materials and Methods: A house-to-house survey was done in Tiruverkadu. The study population consisted of 6, 12, 15 years children, 35-44 years, and 65-74 years adults. Type III dental examination was carried out. Cross tabulations and Chi-square statistics were computed. The level of significance was chosen as P<0.05.
Results: Out of the total 679 subjects, 309 subjects had tooth loss. Females (47.9%) had greater tooth loss compared to males (42.9%). Tooth loss increased as age progressed. Subjects in the lower socio-economic status had greatest tooth loss. The mean tooth loss among the subjects was 2.7.
Conclusion: This study indicates that tooth loss increases with age and differs for gender and socio-economic status. The prevalence of tooth loss among the subjects was found to be high in children as well as in adults. Therefore, dental professionals should utilize various measures available in preventive dentistry to minimize tooth loss.

Keywords: Chennai, prevalence, tooth loss

How to cite this article:
George B, John J, Saravanan S, Arumugham I M. Prevalence of permanent tooth loss among children and adults in a suburban area of Chennai. Indian J Dent Res 2011;22:364

How to cite this URL:
George B, John J, Saravanan S, Arumugham I M. Prevalence of permanent tooth loss among children and adults in a suburban area of Chennai. Indian J Dent Res [serial online] 2011 [cited 2019 Jul 22];22:364. Available from: http://www.ijdr.in/text.asp?2011/22/2/364/84284
Despite significant improvements in oral health among children, tooth loss remains a dental public health problem among adults. [1] The most important function of dental profession is to prevent tooth loss. [2] Tooth loss is the ultimate barometer of failure or success in dentistry and dental health programs. [3] Success is measured by the declining rates of edentulism and an increase in the number of retained teeth. [4] Fadekemi reported a prevalence of 12.3% in a suburban Nigerian population. [5] Cristiano Susin revealed a prevalence of 44.8% in a young population in Brazil. [6]

Tooth loss is a terminal event in the life of a tooth and is a frequent episode in individuals with uncared and neglected oral cavity. [7] Tooth extraction appears to be mainly in response to the need for acute treatment and when there is a great accumulated need for treatment, patients increasingly selected extraction of teeth as the primary treatment rather than restorative procedures. [1] Known indications for extraction of teeth include dental caries and its sequelae (pulpitis and periapical infections), periodontal diseases, fractured teeth, malpositioned teeth, impacted teeth, orthodontic treatment, retained deciduous teeth, prosthetic considerations, supernumerary teeth, and preparation for radiotherapy. [5]

Several recent studies have reported more teeth loss due to periodontal reasons compared with dental caries. Ong et al. found that both dental caries and periodontal reasons equally accounted for tooth loss in Asian population. [8] Phipps et al. and Murray et al. have reported markedly higher numbers of teeth have been lost due to periodontal reasons compared to dental caries in United States and Canada. [9],[4] Dental caries was reported to be the most frequent reason for tooth extraction in Japanese, [10] Chinese, [11] and Sri Lankan population. [12]

Tooth loss diminishes the quality of life, often substantially, and tooth loss is also related to poor general health. [13] Studies on tooth loss have shown that although edentulism is on the decline, a substantial proportion of adults are still losing teeth. [1] Tooth loss has its impact not only on masticatory function, but also on aesthetic part of an individual.

However in India, very few data are available about tooth loss. A south Indian study done on adults aged over 60 years showed a mean missing component of 10.98 teeth in the total Decayed, Missing and Filled Teeth (DMFT). [14] As there is no information available on prevalence of tooth loss in children and adults in suburban area of Chennai, the present study has been conducted.


   Materials and Methods Top


Study design

A cross-sectional descriptive study was conducted in Tiruverkadu, a suburban area of Chennai, which consisted of a population of 30,734 according to 2001 census. Males constituted 50% and females constituted 50% of the total population. [15] Tiruverkadu is being provided with dental services only by a satellite center of Saveetha Dental College, Saveetha University, Chennai. The satellite center is located in the center of Tiruverkadu, which renders free basic dental treatments to the public of Tiruverkadu.

The study population consisted of 6, 12 and 15 year old children, 35-44, and 65-74 year old adults. A convenient sampling technique was employed in the study. Participants were enrolled by house-to-house visits. The study was conducted during the period, January to February 2009.

A pretested questionnaire consisting of questions pertaining to general information and socio-demographic information was used in the survey. A modified Kuppuswamy's socio-economic status scale was used in assessment of the socio-economic status. The socio-economic scale utilized information like education of the head of the household, occupation of the head of the household, and family income/month. [16] The questionnaire was duly filled by the investigator. A single investigator conducted the survey. Clinical examination for tooth loss was done on the basis of visual and tactile examination. The study participants were examined using mouth mirror and explorer. Only permanent dentition was included and third molars were excluded from the study. No radiographs were employed for the survey. The investigator was trained through a series of clinical training sessions at the department of public health dentistry, Saveetha dental college, Chennai. The intra-examiner variability was 0.96. Sterilized instruments were used for oral examination.

Ethical issues

Ethical clearance was obtained from the Institutional Ethical Committee of Saveetha University, Chennai. The study subjects were clearly informed about the study and a written informed consent was obtained.

Statistical analysis

Data collected were entered in Windows Excel spreadsheet and analyzed using SPSS (Statistical Package for the Social Sciences) version 15.0 software. Cross tabulations and Chi-square statistics were computed. The level of significance was chosen as P <0.05.


   Results Top


[Table 1] represents the distribution of study subjects with tooth loss by socio-demographic variables. The total subjects examined were 679 of which males constituted 322 and females 357. Among these subjects, 138 (42.9%) males and 171 (47.9%) females had tooth loss. Adults of age group 65-74 years formed the group with maximum proportion with tooth loss (81.8%). Tooth loss increased as the age progressed. It was observed that the subjects in lower socio-economic status had the maximum tooth loss (71.4%). The mean tooth loss among the study subjects was 2.7. The mean tooth loss for males was 2.6 and 2.9 for females. It was observed that the mean tooth loss for 6, 12, 15, 35-44, and 65-74 years group was 0.4, 0.5, 0.6, 1.5, and 10.5, respectively. The mean tooth loss was found to be highest (6.8) in the lower socio-economic status subjects.
Table 1: Distribution of study subjects with tooth loss by socio-demographic variables

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[Table 2] presents the distribution of subjects with tooth loss by age and gender. It was observed that 309 (45.5%) subjects had tooth loss among the 679 subjects. It reveals that as progresses, the prevalence of tooth loss increases in both the genders. Among males and females, the prevalence of tooth loss increased with age. Nearly 47% males and 57% females of the age group 35-44 years had tooth loss. But the difference was found to be statistically not significant (P=0.28). A total of 76% males and 87% females of the age group 65-74 years had tooth loss. The difference was statistically not significant (P=0.11).
Table 2: Distribution of subjects with tooth loss by age and gender

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[Table 3] provides data regarding the distribution of subjects with tooth loss by age and type of edentulousness. Only the subjects of the age group 65-74 years revealed complete edentulousness. Seventeen subjects were totally edentulous of which 7 (41.2%) were males and 10 (58.8%) were females. Two subjects (one male and one female) had maxillary edentulous arch. Only one male subject was found to have mandibular edentulous arch.
Table 3: Distribution of subjects with tooth loss by age and type of edentulousness

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   Discussion Top


Loss of teeth reflects a major public health problem in many developing countries. [1],[3],[6],[7] Tooth loss has resulted in a state of physical and mental handicapness among the individuals worldwide. The present study indicates that there are predisposing variables which are associated with tooth loss. Age is a predisposing variable associated with tooth loss. The results of this study are in agreement with previous studies where tooth loss increases as the age progresses. [1],[10],[17] Maximum tooth loss was observed in subjects of the age group of 65-74. The prevalence of tooth loss in the present study is 45.5% which is similar to a study conducted in Japan [18] and high compared to a study in Saudi Arabia. [19]

Gender was also another predisposing variable which is associated with tooth loss. The present study reveals that females had 47.9% of tooth loss compared to 42.9% of males. The findings were similar to a study conducted in an urban population of South Brazil. [17] Females had greater tooth loss compared to males except in the age group of 12 years. The reasons for females to have fewer teeth remain to be unidentified.

The results revealed that study subjects with upper lower socio-economic status have greater tooth loss compared to their counterparts. Upper lower class people are resigned to whatever happens and feel there is little they can do to stave off the inevitable, including their loss of their teeth. They acquire artificial dentures at a relatively early age and are reasonably happy with them. [20] The present study reveals that as the socio-economic status increases, the prevalence of tooth loss decreases. Higher social class individuals utilize the dentist more frequently than the lower social class. [21]

The mean tooth loss among adults aged 35-44 years was found to be 1.5 which was higher compared to a study conducted in Norway. [20] The mean tooth loss among elderly subjects (65-74 years) was 10.5 which is lower in comparison to studies conducted in Brazil [1] and Norway. [22] The overall mean tooth loss was 2.7 which is similar to studies conducted in China [11],[23] and lower compared to a study conducted in Sri Lanka [12] and Saudi Arabia. [24] The mean tooth loss for males and females were 2.6 and 2.9, respectively, which was lower compared to a study conducted in Saudi Arabia [24] and Sri Lanka. [12]

In the present study, no subject was edentulous among 35-44 years group which is similar to study conducted in Sri Lanka [12] and China. [11] The current study reveals 14% of the elderly (65-74 years) were fully edentulous. This is less when compared to studies conducted in China [23] and Saudi Arabia. [24]

The limitation of the present study is a convenient sample technique was employed for the survey. Radiographs were not used in the study. A study which would include the assessment of dental visits, knowledge about dental treatments, culture and beliefs about dental treatments would be meaningful in determining the reasons for tooth loss.


   Summary and Conclusion Top


The present study reveals that the prevalence of tooth loss among the study subjects is 45.5%. Females had greater tooth loss compared to their counterparts. The study shows an increasing trend of tooth loss as the age progresses. The maximum tooth loss was observed in elderly (65-74 years) subjects. A trend of decreasing tooth loss was observed as socio-economic status increases. Nearly 14% of the elderly (65-74 years) subjects were found to be totally edentulous. Of these, totally edentulous subjects 7 were males and 10 were females. Two subjects had maxillary edentulous arch and one had mandibular edentulous arch.

Preventive measures such as topical fluoride application and use of dental fissure sealants should be encouraged through continuous dental health educational programs for children. Thus, the results of the study suggest that preservation of the natural dentition should be the ultimate goal of the dental professionals.


   Acknowledgment Top


With deep sense of gratitude, we acknowledge the whole hearted effort of Mr. P.Jayabal, Assistant Professor (Statistics) in guiding the statistical part of this study.

 
   References Top

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Correspondence Address:
Benley George
Department of Public Health Dentistry, Pushpagiri College of Dental Sciences, Medicity, Perumthuruthy, Tiruvalla, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.84284

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