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Table of Contents   
ORIGINAL RESEARCH  
Year : 2011  |  Volume : 22  |  Issue : 3  |  Page : 396-399
Prevalence of dental diseases in 5- to 14-year-old school children in rural areas of the Barabanki district, Uttar Pradesh, India


1 Department of Pedodontics and Preventive Dentistry, Chandra Dental College and Hospital, Safedabad, Barabanki, India
2 Department of Periodontics, Chandra Dental College and Hospital, Safedabad, Barabanki, India
3 Department of Periodontics, Faculty of Dental Sciences, Chhatrapati Shahuji Maharaj Medical University, (Upgraded, King George's Medical University), Lucknow, Uttar Pradesh, India
4 Department of Anthropology, University of Lucknow, Lucknow, Uttar Pradesh, India

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Date of Submission07-Aug-2010
Date of Decision25-Oct-2010
Date of Acceptance05-Feb-2011
Date of Web Publication3-Nov-2011
 

   Abstract 

Background: Epidemiological studies are helpful in planning and implementing oral health programs in a given population. This initiative is a consequence of the absence of any information on any study being conducted in the past on the prevalence of dental diseases in the Barabanki district of Uttar Pradesh (UP).
Aims: The aims were to (1) assess the prevalence of gingivitis, fluorosis, and malocclusion in the school-going children of rural areas of district Barabanki and (2) evaluate the pattern of above-mentioned diseases in different age groups and genders.
Materials and Methods: A total of 836 school-going children comprising 430 boys and 406 girls were examined. A total of 238 children were in the age group of 5-7 years. A total of 277 and 321 children were in the age groups of 8-10 and 11-14 years, respectively.
Statistical Analysis: A chi-square test was used for deriving results.
Results: The prevalence of gingivitis, fluorosis, and malocclusion was 78.35%, 33.37%, and 34.09%, respectively. The difference between age groups for the prevalence of gingivitis was highly significant, and was more among girls as compared to boys. A significant increase in the prevalence of malocclusion was observed with age. No significant difference was found among genders for the prevalence of malocclusion. An increase in the prevalence of fluorosis was highly significant with age. The difference in fluorosis was insignificant between boys and girls.

Keywords: Barabanki, fluorosis, gingivitis, malocclusion, prevalence

How to cite this article:
Singh M, Saini A, Saimbi CS, Bajpai AK. Prevalence of dental diseases in 5- to 14-year-old school children in rural areas of the Barabanki district, Uttar Pradesh, India. Indian J Dent Res 2011;22:396-9

How to cite this URL:
Singh M, Saini A, Saimbi CS, Bajpai AK. Prevalence of dental diseases in 5- to 14-year-old school children in rural areas of the Barabanki district, Uttar Pradesh, India. Indian J Dent Res [serial online] 2011 [cited 2019 Jul 18];22:396-9. Available from: http://www.ijdr.in/text.asp?2011/22/3/396/87060
Most of the oral diseases are preventable, but still they are a cause of suffering to millions of individuals worldwide. Moreover, if a disease can be prevented or intercepted at an early stage, it will minimize the impact on the cost and methods of treatment. India is a developing country and is struggling to eradicate many dental and medical diseases. Epidemiological studies to evaluate the prevalence and severity of dental diseases are a prerequisite in planning and implementing oral health programs in a given population. This would help the nation in combating these diseases. The rural India has been the most neglected in terms of oral health maintenance due to financial constrain and lack of education. Fluoride content has been reported in Uttar Pradesh (UP) by various researchers, and State and Central Governments in the districts of Varanasi, [1] Unnao, [2] Kanpur, Agra, [3] and Mathura. [4] Many studies have been conducted to evaluate the extent of dental diseases in various parts of India, yet the Barabanki district has been an exception. Assessing the prevalence of gingivitis, fluorosis, and malocclusion in the school-going children of rural areas of district Barabanki and evaluating the pattern of these diseases in different age groups and genders has been the main objective of this study.


   Materials and Methods Top


This study was conducted by the Department of Pedodontics and Preventive Dentistry, Chandra Dental College and Hospital, Safedabad, Barabanki, UP. The study was carried out between the months of January 2010 and April 2010. A sample size of 836 school-going children from three schools located in the rural areas of district Barabanki was examined. These schools were randomly selected by a computer-generated list. Written permissions were obtained from the school authorities. Only children who were permanent residents of that area were included in the study.

Since most of the children were not able to disclose their fathers' income and occupation reliably, therefore the exact socioeconomic status of these children could not be determined. The type of school and its location was used as a proxy indicator of a child's socioeconomic background. Since all the three schools were government schools located in rural areas of the same district, so the socioeconomic status was considered to be homogenous. A similar method for determining the socioeconomic status was employed in a previous study. [5]

Children were examined in their respective schools on predecided dates. An examination was carried out in broad daylight. Children were seated on an ordinary chair in an upright position. Intraoral examinations were made using a mouth mirror and an explorer. Instruments were disinfected with an antiseptic solution after every use. The children were examined by a single examiner who was trained to record the WHO oral health assessment form [6] to avoid interexaminer variations. The age and sex of each child were recorded.

Among children, 238 were in the age group of 5-7 years. A total of 277 and 321 children were in the age groups of 8-10 and 11-14 years, respectively. The total number of boys and girls was 430 and 406, respectively.

The Loe and Silness index was used for recording gingivitis and WHO indices were used for recording fluorosis and malocclusion. Similar indices have been used by Dhar et al. [7] in 2007. Recording of data was done by a trained person who assisted the examiner throughout the study.

The observations recorded were subjected to statistical analysis using a chi-square test. Water samples were collected from the participants' primary sources of drinking water. These samples were used to analyse fluoride concentrations.


   Results Top


A total of 836 children were examined in this study out of whom 430 were boys and 406 girls. Of them, 238 children belonged to the age group of 5-7 years, and 277 and 321 to the age groups of 8-10 years and 11-14 years, respectively [Table 1].
Table 1: Demographic data

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The overall prevalence of gingivitis was 78.35% (mild gingivitis 54.38%, moderate 21.77%, and severe 2.27%). In 5-7 year olds, gingivitis prevalence was 71.43% (mild gingivitis 52.94%, moderate 17.62%, and severe 0.84%). In 8-10 year olds, gingivitis prevalence was 74.36% (mild gingivitis 53.06%, moderate 18.77%, and severe 2.52%). In 11-14 year olds, gingivitis prevalence was 86.92% (mild gingivitis 56.38%, moderate 27.41%, and severe 3.11%). The difference between age groups was highly significant. The prevalence of gingivitis among boys was 74.65% (mild gingivitis 51.86%, moderate 20.23%, and severe 2.56%) and among girls was 82.26% (mild gingivitis 56.90%, moderate 23.40%, and severe 1.97%). The difference between boys and girls was found to be significant [Table 2].
Table 2: Gingivitis

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The total prevalence of malocclusion was 34.09% (mild to moderate 30.98% and severe 3.11%). In the age group of 5-7 years, 25.63% had malocclusion (mild to moderate 23.95% and severe 1.68%). Among 8-10 year olds, 36.46% had malocclusion (mild to moderate 30.32% and severe 6.13%) and among 11-14 year olds, 38.32% had malocclusion (mild to moderate 30.84% and severe 7.48%). A total of 32.79% of boys had malocclusion (mild to moderate 30.46% and severe 2.32%) and 35.46% of girls had malocclusion (mild to moderate 31.52% and severe 3.94%). The age-wise difference was significant. No significant difference was found between boys and girls [Table 3].
Table 3: Malocclusion

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The children suffering from fluorosis were 33.37% (questionable 18.06%, very mild 9.69%, mild 4.54%. moderate 0.72%, and severe 0.36%). Among 5-7 year olds, the prevalence of fluorosis was 17.23% (questionable 10.08%, very mild 2.10%, mild 4.62%, moderate 0.42%, and severe 0%). Among 8-10 year olds, 37.55% had fluorosis (questionable 19.13%, very mild 12.99%, mild 4.33%, moderate 0.72%, and severe 0.36%). Among 11-14 year olds, 41.74% children had fluorosis (questionable 23.05%, very mild 12.46%, mild 4.67%, moderate 0.24%, and severe 0.62%). The prevalence of fluorosis among boys was 34.42% (questionable 18.37%, very mild 10.69%, mild 4.65%, moderate 0.47%, and severe 0.23%). A total of 32.27% girls had fluorosis (questionable 17.73%, very mild 8.62%, mild 4.43%, moderate 0.98%, and severe 0.49%). The differences between age groups were highly significant. The difference between boys and girls was not significant [Table 4]. The average water fluoride concentration of the participants' primary source of drinking water was 1.2 ppm for all locations.
Table 4: Fluorosis

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   Discussion Top


School-going children were targeted in this study for ease of accessibility. [8] The Loe and Silness index was used to access the severity of gingivitis. The overall gingivitis was 78.35% which increased with age, as was observed by Jose et al. [9] in 2003, Kumar et al. [10] in 2005, and Dhar et al. [6] in 2007. More females were affected which may be attributed to hormonal changes. This is in accordance with the findings of Saha and Sarkar. [11] However, Rao [12] and Kumar et al. [10] reported contrasting observations.

The total prevalence of malocclusion was 34.09%. Malocclusion was high in the age group of 11-14 years similar to findings of Bhalaji. [13] The prevalence of malocclusion was significantly higher in the permanent dentition as compared to the primary dentition as observed by Graber and Lucker. [14] Girls had a slightly higher prevalence than boys; however, the difference was not statistically significant which is in accordance with Graber and Lucker, [14] Reddy, [15] and Das et al. [16]

The overall prevalence of fluorosis was seen to be 33.37% close to the findings (29.35%) in rural school children of the Lucknow district, UP. [17] Studies in different parts of India have shown a fluorosis prevalence of 36.30% in Udaipur, [7] 33% in Junagarh, 17.75% in Ahmedabad, 22% in Surendranagar, 77% in Sotai in Haryana, [18] 92.73% in the Bhiwani district in Haryana, [19] and 16.8% in Kerala. [20] A 100% prevalence was reported in the Nalgonda district in Andhra Pradesh. [21] Studies across the globe have revealed the prevalence of dental fluorosis in Saudi Arabia and in Nairobi (Kenya) to be 90% [22] and 76%, [23] respectively. A 100% prevalence was reported by Manji et al. [24] in Kenya (2 ppm) and by Wondwossen et al. [25] in high-fluoride areas of Ethiopia. In this study, the age group of 5-7 years showed the minimum prevalence of fluorosis. Maximum cases were seen in permanent dentition as compared to primary teeth. This may be attributed to the fact that fluoride is not able to cross the placental barrier. [26] Results of this study can be correlated with the studies conducted by Baelum et al. [27] in Kenya, Dental Council of India [28] in Tamil Nadu, and Dahiya et al. [19] in Haryana. But our observations for the age-wise difference in the prevalence of fluorosis are in contrast with the study of Sudhir et al. [21] Maximum cases of fluorosis were of questionable and very mild type. The prevalence and severity of fluorosis with respect to gender showed no statistically significant differences, as was reported by Sudhir et al. [21] in Nalgonda, Singh et al. [29] in Haryana, Chandrashekar et al. [30] in Karnataka (India), Gladys et al. [31] in Kenya, Na'ang'a and Valderhaug [23] in Nairobi (Kenya), Rwenyonyi et al. [32] and Hamdan [33] in Jordan. However, in Kerala a higher prevalence among girls had been documented. [20]

Information provided by the present study can be used as preliminary data and further large-scale epidemiological studies can be undertaken at a district level to access and confirm various dental diseases and associated risk factors in this region. School dental health programs should be conducted at regular intervals, because children in this rural area do not have access to qualified dental care.

Since, the school children do not know much about dental diseases and methods of their prevention, therefore education and motivation of children to maintain proper oral hygiene is of paramount importance. Teachers and parents should be taught and encouraged to inculcate healthy lifestyle habits in children. One more aspect which should be covered in school dental health programs is the management of dental fear which is a world-wide problem and universal barrier to oral health care services. Fears acquired in childhood through direct experience with painful treatment or vicariously through parents, friends, or siblings may persist into adulthood. Symptomatic treatment and lack of trust and control exacerbate fears. The prevention of fear development through the use of effective behavioral child management techniques combined with preventive dentistry should be a fundamental part of school dental health programs.


   Acknowledgment Top


The authors are greatly indebted to Geological Survey of India, Northern Region Headquarters, Lucknow, for analysis of the water fluoride concentration.

 
   References Top

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Correspondence Address:
Meghna Singh
Department of Pedodontics and Preventive Dentistry, Chandra Dental College and Hospital, Safedabad, Barabanki
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.87060

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    Tables

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