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Table of Contents   
ORIGINAL RESEARCH  
Year : 2015  |  Volume : 26  |  Issue : 1  |  Page : 48-52
Prevalence of dental caries, periodontitis, and oral hygiene status among 12-year-old schoolchildren having normal occlusion and malocclusion in Mathura city: A comparative epidemiological study


1 Department of Public Health Dentistry, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
2 Department of Oral Medicine and Radiology, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India

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Date of Submission22-Dec-2014
Date of Decision24-Jan-2015
Date of Acceptance18-Feb-2015
Date of Web Publication11-May-2015
 

   Abstract 

Objective: The aim was to find the prevalence of dental caries, periodontitis, and oral hygiene index-simplified (OHI-S) among 12-year schoolchildren having normal occlusion and malocclusion in Mathura city.
Materials and Methods: The present study was a cross-sectional study done among the 100 subjects who have been selected from 5 schools in four different geographical locations. The data regarding their socio-demographic characteristics, dental caries status, periodontitis status and oral hygiene status was collected using structured proforma. Means, standard deviations and test of significant were used as statistics to describe the data.
Results: The results showed that there was no significant difference between dental caries status, periodontitis status among subjects having normal occlusion and malocclusion (P = 0.06, 0.093) but significant relationship was found OHI-S and children who were having malocclusion (and P = 0.022). Significant difference was also found between periodontitis and oral hygiene status (P = 0.00).
Conclusion: It was observed from the present study that normal occlusion and malocclusion had no or weak significant effect on overall caries and periodontitis prevalence whereas oral hygiene status had a strong effect on overall periodontitis prevalence but not in relation to prevalence of dental caries in 12-year-old school children in Mathura city.

Keywords: Dental caries, malocclusion, normal occlusion, oral hygiene status, periodontitis status

How to cite this article:
Arora G, Bhateja S. Prevalence of dental caries, periodontitis, and oral hygiene status among 12-year-old schoolchildren having normal occlusion and malocclusion in Mathura city: A comparative epidemiological study. Indian J Dent Res 2015;26:48-52

How to cite this URL:
Arora G, Bhateja S. Prevalence of dental caries, periodontitis, and oral hygiene status among 12-year-old schoolchildren having normal occlusion and malocclusion in Mathura city: A comparative epidemiological study. Indian J Dent Res [serial online] 2015 [cited 2019 Nov 20];26:48-52. Available from: http://www.ijdr.in/text.asp?2015/26/1/48/156801
Malocclusion is one of the most wide spread oral health problems facing the society. The acceptable physical appearance, including the dentition is an important aspect of human self-esteem. The prevalence of malocclusion in population has been the debate for many years. Due to change in food habits, increase in caries and other associated factors, malocclusion in Indian society and in the world, has been on the rise. [1]

It is difficult to prove a single major cause of malocclusion as it develops slowly as a child grows and the development of occlusion is very vulnerable to many influences. Etiology of malocclusion (Proffit, 1986; McDonald and Ireland, 1998) include genetic and environmental factors. [2]

Prevalence of malocclusion is estimated to be higher in developed countries as compared to developing and under-developed countries. Jalili et al. in 1989 in Mandu district of Madhya Pradesh studied 6-14 years age group and reported 14.4% had malocclusion. Kharbanda, Sidhu, Sundaram in 1991 in New Delhi reported 36.6% malocclusion in age group 5-13 years. Few sporadic studies have been carried out on the prevalence of malocclusion in India. [3]

To detect malocclusion among children, 12 years of age is important, as it is likely at this age that all the permanent teeth exist in the oral cavity except third molars (WHO Oral Health Survey, 1997). [4]

The relationship between the malocclusion (mainly crowding) and the prevalence of dental caries is an important finding found in very few epidemiological studies. This association is due to increased susceptibility of plaque retention among the mal-occluded teeth, and thus it results in caries development.

Oral hygiene is one of the important etiological factors, which results in dental diseases such as dental caries and periodontitis. Difficulty in maintaining oral hygiene can result in greater accumulation of dental plaque, which is considered a primary etiological agent in inflammatory periodontal disease. In children having malocclusion, there is failure to maintain oral hygiene in the concerned areas may result in subsequent plaque accumulation, gingivitis, and periodontal disease. Hence, oral hygiene is the most effective means of preventing and controlling periodontal disease.

Keeping these points in mind an attempt is done to evaluate the prevalence of dental caries and periodontitis in children having normal occlusion and children having malocclusion in Mathura city.

  • To find and compare the prevalence of dental caries in children with normal occlusion and children with malocclusion
  • To find and compare the prevalence of periodontitis in children with normal occlusion and children with malocclusion
  • To find the prevalence of oral hygiene status in children with normal occlusion and children with malocclusion
  • To correlate prevalence of dental caries and periodontitis in relation to children having normal occlusion and children having malocclusion.

   Materials and methods Top


Study design

The present study was a cross-sectional comparative study conducted in four different regions of Mathura city by conducting dental screening camps. The ethical clearance for the study was obtained from the ethical committee of the institution and permission was obtained prior to the start of the study from the respective School Principal/Headmaster/Head Mistress of concerned schools where study was conducted.

Study population and study sample

The study sample was determined from the available data regarding the prevalence of dental caries in Uttar Pradesh (62%) among the 12 year age group. The study sample of 100 was estimated by taking 10% of the actual sample size. The study subjects should follow certain inclusion and exclusion criteria.

Inclusion criterion

  • Subjects who were willing to participate and completed 12 years of age were included in the study
  • Children who have fully erupted permanent dentition.


Exclusion criterion

  • Subjects for whom consent was not obtained from the parents
  • Subjects who are undergoing or undergone orthodontic treatment or having mixed or retained or supernumerary dentition.
Training and calibration of examiners

All the clinical examinations were carried out by a single examiner who was accompanied by the recording clerk, trained and calibrated by "experienced staff" in the Department of Preventive and Community Dentistry prior to the study. The method of examination and scoring was standardized until inter- and intra-examiner reliability of 88% was achieved. The adequate numbers of instrument sets were carried to the survey site to ensure that all the instruments were used once only. Proper sterilization and infection control measures were taken.

Study area

The study was carried in five schools in four different areas of Mathura city namely Chhatikara, Charora, Krishna Nagar and Goverdhan. The school children were examined in the room of the school where sufficient natural daylight was available. The data were gathered using proforma and the examiner carried out clinical examination of the subjects and details were clearly recorded by the recorder. The proforma included the following sections:

  • General and personal information
  • Clinical examination was done using Community Periodontal Index (CPI) of WHO criteria mentioned in Basic Oral Health Survey Methodology (1997)
[4]

  • Dental caries - by using dentition status
  • Gingival status - by using CPI
  • Oral hygiene status - by using oral hygiene index-simplified (OHI-S)
  • Occlusion - by using dentofacial anomalies.
Statistical analysis

The data collected were retrieved and entered in the Microsoft Word Excel Sheet 2007 version and the data obtained were analyzed using the SPSS 11.5 version (Statistical Package for the Social Sciences, Chicago, USA) for the descriptive analysis and statistical tests of significance. This was done to test whether the statistical analysis will be amenable for the data or not.

The mean, standard deviations and the proportions (% of subjects affected) were calculated for each clinical parameter and the various statistical test of significance (independent t-test, Chi-square test and one-way analysis of variance [ANOVA]) were used.

Significance for all statistical tests was predetermined at a P value of 0.05 or less.


   Results Top


An epidemiological survey was conducted to assess the prevalence of dental caries, periodontitis and oral hygiene status in relation to normal occlusion and malocclusion of 12-year-old school children in Mathura city. 100 school children of age group 12 years participated in the study and out of 100 study subjects 49 and 51 were males and females, respectively.

Community Periodontal Index

From a total of 100 study subjects, 68 subjects were having healthy periodontium, 2 subjects were having bleeding on probing and 30 subjects were having calculus, respectively.

Oral hygiene status

From a total of 100 study subjects, 84 subjects having good oral hygiene status and 16 subjects having fair oral hygiene status, respectively.

Dental caries status

Among 100 study subjects, 57 subjects had dental caries, and 43 were not having dental caries, respectively.

Occlusion status

Among 100 study subjects, 57 subjects had normal occlusion and 43 study subjects were having malocclusion [Table 1] and Graph 1].
Table 1: Distribution of study subjects according to variables OHI-S, CPI, DMFT and occlusion


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When independent t-test was used to compare the difference between dental caries status, periodontitis status and oral hygiene status among subjects having normal occlusion (1.35 ± 0.48), (0.54 ± 0.88) and (1.12 ± 0.33) and dental caries status, periodontitis status and oral hygiene status among subjects having malocclusion (1.53 ± 0.05), (0.72 ± 0.95) and (1.21 ± 0.41), it was found that there was no significant difference between dental caries status, periodontitis status and oral hygiene status among subjects having normal occlusion and malocclusion (t = 1.85, 0.95 and 1.16, P = 0.06, 0.093 and 0.022, NS, NS, S).

As shown in [Table 2], ANOVA (one-way) was applied to determine the relationship between mean decayed, missing, and filled teeth (DMFT) and CPI categories of study subjects (healthy, bleeding on probing and calculus) but no significant relationship was found among children having normal occlusion (F = 2.056, P = 0.138, NS) and malocclusion (F = 0.45, P = 0.641, NS).
Table 2: Correlation between dental caries (DMFT) and CPI among study subjects having normal occlusion and malocclusion (one-way ANOVA)


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Analysis of variance (one-way) was applied to determine the relationship between mean DMFT and OHI-S categories of study subjects (good, fair and poor) but no significant relationship was found between mean DMFT and OHI-S categories among children having normal occlusion (F = 2.063, P = 0.157, NS) and malocclusion (F = 0.027, P = 0.870, NS) [Table 3].
Table 3: Correlation between dental caries (DMFT) and oral hygiene status among study subjects having normal occlusion and malocclusion (one-way ANOVA)


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[Table 4] shows that no significant relationship was found between mean CPI and OHI-S categories (χ2 = 0.79, P = 0.373, NS) among children having normal occlusion but significant relationship was found between mean CPI and OHI-S categories (χ2 = 21.24, P = 0.000, S) among children having malocclusion.
Table 4: Correlation between CPI and oral hygiene status (OHI-S) among study subjects having normal occlusion and malocclusion (Chi-square test)


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   Discussion Top


The present study was undertaken on one hundred 12-year-old school children, with an aim to determine the prevalence of dental caries, periodontitis and oral hygiene status in relation to children having normal occlusion and malocclusion of Mathura city. The data were normally distributed, and power of the study is 80%.

Dental caries and normal occlusion and malocclusion

It was found from the present study that, the prevalence of dental caries was little higher (1.53 ± 0.05) among study subjects having malocclusion as compared to study subjects having normal occlusion (1.35 ± 0.48) in 12-year-old school children of Mathura city but there was no statistically significant relationship found between prevalence of dental caries among 12-year-old school children having normal occlusion and malocclusion (t = 1.85, P = 0.064). Similar results were obtained in an epidemiological study carried out by Katz (1977), [5] Helm, and Petersen. [6]

Dental caries and oral hygiene status

No statistically significant results were found between the dental caries and oral hygiene status of the 12-year-old school children having normal occlusion (P = 0.192) and malocclusion (P = 0.373). Similar findings were found by other authors (Lewis and Ismail; 1995). [7] This is in contrast to other research, which concluded that caries prevalence could be virtually eliminated by the regular meticulous professional removal of plaque. [8],[9] These results were contradicted by few researches carried out by Kolmakow et al., [10] Alexander et al., [11] Gαbris et al., [12] according to them malocclusion, may be associated with susceptibility to plaque retention and further results in dental caries. The reason for such finding in the present study might be due to that most of the children brushed their teeth at least once daily (74%) along with toothbrush and toothpaste (83%).

Periodontitis and normal occlusion and malocclusion

It was found from the present study that there was slight increase in the prevalence of presence of calculus among the 12-year-old school children having malocclusion (0.72 ± 0.95) than the children having normal occlusion (0.54 ± 0.88) but it was not statistically significant (t = 0.95, P = 0.093). Similar findings were reported by Behlfelt et al., [13] Helm and Petersen, [14] Elham et al. (2006), Hellgren (1956), Poulton and Aaron Son (1961), Bilimoria (1963), Mcgombie and Stothard (1964), Sutgliffe (1968) and Alexander and Tipnis (1970). [15] On the other hand, no correlation was found between periodontal status and malocclusion by Beagrie and James (1962), Gould and Pigton (1966) [16] and Grewe et al. [17]

Periodontitis and oral hygiene status

It was found from the study that the periodontal status and oral hygiene have a strong relationship irrespective of the school children having normal occlusion or malocclusion. Statistically significant results (P = 0.000) were found between the periodontal status (CPI scores) and the oral hygiene status (OHI-S scores). The reason for such finding is that due to mal-alignment of teeth it results in decreased effect of mechanical tooth cleansing whereas in normal occlusion it might be due to that poor oral hygiene is an important etiological factor contributing greatly in periodontal conditions such as gingivitis and periodontitis.

Oral hygiene status and normal occlusion and malocclusion

It was also found from the study that there was decrease in oral hygiene status of the school children having malocclusion (1.21 ± 0.41) than those children who were having normal occlusion (1.12 ± 0.33). Similar findings were also achieved by Buckley (1980), [15] Ingervall et al. (1977), [17] Behfelt et al. (1981), [13] Matilda (2009). [6] Statistically significant results were found from the present study regarding the relationship between malocclusion and oral hygiene status (t=1.16, P=0.022).

Relation between dental caries status (decayed, missing, and filled teeth) and periodontal status (Community Periodontal Index)

There was no statistically significant association found between dental caries status (DMFT) and periodontal status (CPI) among the school children of 12 year age having normal occlusion (F = 2.05, P = 0.138) and malocclusion (F = 0.45, P = 0.641). On the other hand, there was no research conducted till date regarding the relationship between dental caries and periodontal status among school children.


   Conclusion Top


It was concluded from the present study that:

  • The occlusion (normal occlusion or malocclusion) does not play any role in the prevalence of dental caries and periodontitis among 12-year-old school children in Mathura city
  • The malocclusion greatly affects the prevalence of oral hygiene status as it acts as an etiological factor in 12-year-old school children
  • The oral hygiene status of study population in 12-year-old school children played a major significant role in the prevalence of periodontitis (CPI).
It was concluded from the present study that normal occlusion and malocclusion had no or weak significant effect on overall caries and periodontitis prevalence whereas oral hygiene status had a strong effect on overall periodontitis prevalence but not in relation to prevalence of dental caries in 12-year-old school children in Mathura city.


   Recommendation Top


From the study, it has been shown that dental caries and periodontal condition has been caused mainly due to plaque and not due to malocclusion but malocclusion results in increased plaque retention. Hence, it is recommended that the educational programs about oral health and mouth clearance for the community is very important started from the early stage of life. The importance of oral health status for improving oral health conditions and preserve tooth for long time in an oral cavity needs more attention by giving school children a proper oral health program, for them and their parents, teachers about oral hygiene maintenance as an oral preventive measures for keeping oral cavity healthy.[19]

 
   References Top

1.
Graber TM. Orthodontic: Principles and Practice. 3 rd ed. Philadephia: W.B Saunders Co.; 1972. p. 189-202.  Back to cited text no. 1
    
2.
Hassan R, Rahimah AK. Occlusion, malocclusion and method of measurements-An overview. Arch Orofac Sci 2007;2:3-9.  Back to cited text no. 2
    
3.
Peter S. Essentials of Preventive and Community Dentistry. 2 nd ed. New Delhi: Arya Publishing House; 2004.  Back to cited text no. 3
    
4.
World Health Organization. Oral Health Survey: Basic method. 3 rd ed. Geneva: Oral Health Unit; 1997  Back to cited text no. 4
    
5.
Katz RV. An epidemiological study of the relationship between various states of occlusion and the pathological conditions. Dental Res 1977;3:433-9.   Back to cited text no. 5
    
6.
Helm S, Petersen PE. Causal relation between malocclusion and caries. Acta Odontol Scand 1989;47:217-21.  Back to cited text no. 6
    
7.
Lewis DW, Ismail AI. Prevention of dental caries. Can Med Assoc J 1995;152:836-46.  Back to cited text no. 7
    
8.
Murray JJ. Prevention of Oral Disease. 3 rd ed. UK: Oxford Medical Publishers; 1996. p. 230-1.  Back to cited text no. 8
    
9.
Axelsson P. An Introduction to Risk Prediction and Preventive Dentistry. The Axelsson Series on Preventive Dentistry. 1 st ed. USA: Quintessence Publishing Co.; 1999. p. 1, 65, 109.  Back to cited text no. 9
    
10.
Kolmakow S, Honkala E, Puranen M, Sainio P. Dento-facial morphology and caries experience: An epidemiological study. J Clin Pediatr Dent 1991;16:31-7.  Back to cited text no. 10
    
11.
Alexander S, Hegde S, Sudha P. Prevalence of malocclusion and periodontal status in Tibetan school children of Kushalnagar, Mysore district. J Indian Soc Pedod Prev Dent 1997;15:114-7.  Back to cited text no. 11
[PUBMED]  Medknow Journal  
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Gábris K, Márton S, Madléna M. Prevalence of malocclusions in Hungarian adolescents. Eur J Orthod 2006;28:467-70.  Back to cited text no. 12
    
13.
Behlfelt K, Ericsson L, Jacobson L, Linder-Aronson S. The occurrence of plaque and gingivitis and its relationship to tooth alignment within the dental arches. J Clin Periodontol 1981;8:329-37.  Back to cited text no. 13
    
14.
Helm S, Petersen PE. Causal relation between malocclusion and periodontal health. Acta Odontol Scand 1989;47:223-8.  Back to cited text no. 14
    
15.
Alexander AG, Tipnis AK. The effect of irregularity of teeth and the degree of overbite and overjet and gingival health. Br Dental J 1970; 128:539-44.  Back to cited text no. 15
    
16.
Gould MSE, Picton OCA. The relationship between irregularities of the teeth and periodontal disease: A pilot study. British Dental J 1966;121:20-3.  Back to cited text no. 16
    
17.
Grewe JM, Chadha JM, Hagan D, Zermeno JA. Oral hygiene and occlusal disharmony in Mexican-American children. J Periodontal Res 1969;4:189-92.  Back to cited text no. 17
    
18.
Buckley LA. The relationships between irregular teeth, plaque, calculus and gingival disease. A study of 300 subjects. Br Dent J 1980;148:67-9.  Back to cited text no. 18
    
19.
Ingervall B, Jacobsson U, Nyman S. A clinical study of the relationship between crowding of teeth, plaque and gingival condition. J Clin Periodontol 1977;4:214-22.  Back to cited text no. 19
    

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Correspondence Address:
Geetika Arora
Department of Public Health Dentistry, Vyas Dental College and Hospital, Jodhpur, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.156801

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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]

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