|Year : 2013 | Volume
| Issue : 1 | Page : 27-30
Dental caries prevalence and treatment needs in 12 and 15-year-old school children of Ludhiana city
Vaibhav Munjal1, Abhishek Gupta2, Parneet Kaur3, Ripin Garewal1
1 Department of Paedodontics and Preventive Dentistry, National Dental College and Hospital, Patiala, Punjab, India
2 Department of Conservative Dentistry and Endodontics, Maharaja Ganga Singh Dental College and Research Centre, Sri GangaNagar, Rajasthan, India
3 Department of Prosthodontics, Maharaja Ganga Singh Dental College and Research Centre, Sri GangaNagar, Rajasthan, India
|Date of Submission||13-Feb-2013|
|Date of Acceptance||16-Aug-2013|
|Date of Web Publication||20-Sep-2013|
House No. 131, Sector - 6, Panchkula - 134 109, Haryana
Source of Support: None, Conflict of Interest: None
Aims: This study was done to determine caries prevalence and corresponding treatment needs in 12- and 15-year-old school children of Ludhiana city.
Materials and Methods: A total of 2,500 school children were selected randomly and caries along with its treatment needs was recorded according to World Health Organization (WHO) index (1997).
Results: Caries was found to be 81.36% with mean decayed, extracted, filled tooth/decayed, missing, filled tooth (deft/DMFT) and decayed, extracted, filled tooth surfaces/decayed, missing, filled tooth surfaces (defs/DMFS) scores being 0.89 deft, 2.74 DMFT, 1.21 defs, and 3.61 DMFS in 12 years age group. In the 15 years age group, caries was 86.16% with a mean DMFT of 4.21 and a mean DMFS of 5.38. Females were found to have higher caries prevalence than males in both age groups. Treatment needs evaluation revealed that need for one surface restoration was the maximum followed by two or more surface restorations.
Conclusion: Dental caries prevalence figures along with high deft/DMFT and defs/DMFS indicate that in spite of increased number of dental facilities available nowadays, caries is yet not under control in this area; and there is need for implementation of preventive programs and creating awareness of public health measures.
Keywords: Dental caries, India, Ludhiana, prevalence, school children, treatment needs
|How to cite this article:|
Munjal V, Gupta A, Kaur P, Garewal R. Dental caries prevalence and treatment needs in 12 and 15-year-old school children of Ludhiana city. Indian J Oral Sci 2013;4:27-30
|How to cite this URL:|
Munjal V, Gupta A, Kaur P, Garewal R. Dental caries prevalence and treatment needs in 12 and 15-year-old school children of Ludhiana city. Indian J Oral Sci [serial online] 2013 [cited 2019 Jun 18];4:27-30. Available from: http://www.indjos.com/text.asp?2013/4/1/27/118523
| Introduction|| |
Dental caries is one of the most prevalent diseases afflicting human beings and persists till date as a challenge to the medical and dental profession in particular and the society in general. Information on epidemiological figures of dental caries is a fundamental requirement which updates our knowledge on changing trends of the disease, its treatment needs and helps in understanding ways and means to prevent its onset, limit its progression, and consequences.
The present study was done to determine caries prevalence and treatment needs in 12- and 15-year-old school children of Ludhiana city, a true representative city of north India.
| Materials and Methods|| |
The present study was carried out on 2,500 children; randomly selected from schools from all parts of Ludhiana. The sample was selected from both private as well as government schools to include children of all socioeconomic status.  Age was recorded as; age at last birthday, rounded off to 6 months, and this information was taken from the school admission records. Age of 12 years has been universally accepted as global monitoring age for caries since all permanent teeth except third molars would most likely have erupted by this age. By the age of 15, the dietary habits of the individuals are more or less established and the permanent teeth have been exposed to the oral environment for 3-9 years, thus making the assessment of caries prevalence even more meaningful at this age. 
Care was taken to include only those children with continuous stay in Ludhiana city so as to ensure that the selected children were exposed to the same environment from birth till date. Each child was examined for dental caries and its treatment needs according to World Health Organization (WHO) index (1997)  using mouth mirror and standardized dental probes, seated on an ordinary chair under adequate daylight and facing away from direct sunlight.
| Results|| |
The study group comprised of 1,250 children in each of the two age groups [Table 1].
The overall prevalence of dental caries in the 12-year-old age group was found to be 81.36%, with the mean decayed, extracted, filled tooth/decayed, missing, filled tooth (deft/DMFT) and decayed, extracted, filled tooth surfaces/decayed, missing, filled tooth surfaces (defs/DMFS) scores being 0.89 deft, 2.74 DMFT, 1.21 defs, and 3.61 DMFS. Females in the 12 year age group had higher caries prevalence than males, and the result was found to be statistically significant [Table 2].
In the 15 year age group, the overall dental caries prevalence was observed to be 86.16% with a mean DMFT of 4.21 and a mean DMFS of 5.38. Again the females were found to have higher caries prevalence than males [Table 3] and study showed a statistically significant correlation existed between both DMFT and DMFS and variation in sex.
The intra-analysis of the DMFT components in 12 years [Table 4] and 15 years [Table 5] age groups revealed that the 'D' component was predominant followed by 'M' component, whereas the 'F' component was negligible.
The treatment needs evaluation in 12-year-old children [Table 6] revealed that the need for one surface restorations was the maximum followed by two or more surface restorations, extractions, fissure sealants, preventive (caries arresting) care, pulp care, and other treatments like partial dentures and crown or bridge abutments.
|Table 6: Treatment needs for dental caries in 12 and 15 years age groups|
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In the 15 years age group [Table 6], the need for one surface restorations was the most; followed by two or more surface restorations, preventive (caries arresting) care, extractions, pulp care, fissure sealants, crown or bridge abutments, and other treatments like partial dentures.
| Discussion|| |
Oral health, although an integral part of general health, is the most neglected one. The lack of awareness, limitation of access to the dental specialist, and underestimation of the preventive measures; even among the educated class of the society; has placed India among the most disease prone nations.
The caries prevalence figures along with high deft/DMFT and defs/DMFS scores in both age groups indicate that the caries is yet not under control in this area and there is need for dental care. DMFT in 15 years children was reported higher probably due to prolonged exposure of teeth to caries associated risk factors in 15 years age group as compared to 12 years age group.
Similar results were reported by Khera et al.,  in 1984 from Ludhiana (rural), Gauba et al.,  in 1986 from Ludhiana (rural), and Damle and Ghonmode  in 1993 from Nagpur (urban). Khera et al., in 1984  found dental caries to be 86.3% in 6-16-years-old children with mean deft, defs, DMFT, and DMFS of 1.2, 1.8, 2.2, and 2.76; respectively. Gauba et al.,  in 1986 found caries prevalence to be 86.13% at 12 years of age with mean DMFT of 3.89 ± 2.39 and mean DMFS of 4.57 ± 2.90. In 15-year-old children, caries prevalence was 88.12% with DMFT 4.98 ± 3.16 and DMFS 6.44 ± 3.23. Damle and Ghonmode (1993)  reported a high caries prevalence of 83.33% in the 12 years age group, with a mean DMFT of 4.14 and mean DMFS of 5.03, and 82.62% in the 15 years age group with a mean DMFT of 3.96 and mean DMFS of 5.02. The authors attributed high caries prevalence to influence of civilization, high intake of sweets, poor oral hygiene, and general negligence of oral health.
A detailed study of investigations conducted in the state of Punjab, namely Vacher (1952)  from Amritsar; Thapar (1953)  from Moga district; Tewari and Chawla (1977)  from Chandigarh; Chopra et al., (1983)  from Amritsar; Khera et al., (1984)  from rural Ludhiana; Gauba et al., (1986)  from rural Ludhiana; Chawla et al., (2000)  from Chandigarh; and Simratvir et al., (2009)  reveals a high caries prevalence in the range of 51.5-86.3% along with DMFT in the range of 1.25-3.89. The only study reporting lower caries prevalence in Punjab was done by Singh et al., (1985)  at Faridkot. This could probably be due to Faridkot being situated in the high fluoride belt region.
The treatment needs of 12 and 15-year-old children were also found to be high. The treatment needs evaluation in both age groups revealed that the need for one surface restoration was the maximum followed by two or more surface restorations.
Mandal et al., (2001)  also showed that in all age groups, single surface restorations were maximum; indicating lack of restorative treatment, preventive oral care facility, and awareness among populations. Similar results were shown by Rodrigues (1998)  and Kulkarni et al., (2002). 
| Conclusion|| |
In spite of increased number of dental facilities available nowadays, still the caries prevalence was found to be high. The reasons for this would mainly be lack of dental awareness, motivation, illiteracy and ignorance, poor oral hygiene, improper tooth brushing techniques, and inadequate exposure to fluorides. Other contributing factors could be improper dietary habits, longer outdoors stay of children at this age leading to greater consumption of in-between meals snacks, cariogenic diet, and nutritional deficiencies.
Ludhiana being an industrial hub; factors such as continuous influx of migrant population, rise in per capita income, fast changing lifestyles, influence of mass media, nuclear families, and pampered children along with superstitious beliefs of people regarding primary dentition, also contribute to the high DMFT.
The higher 'decayed' component in the present study indicates that dental caries is yet not under control in this area and there is need for dental care. The negligible 'filled' component reveals that the treatment received for dental caries is still very low in Ludhiana.
The difference between the treatment needs of both age groups was found to be statistically insignificant, thus indicating that age has no correlation with increase in treatment needs.
| Recommendations|| |
Studies done till date, make it evident that Dental caries is still a major dental disease in our country. Awareness of various dental diseases and their consequences using audio-visual aids like newspaper and magazine publications, pamphlets, radio and television advertisements, public notices, etc., should be created in order to improve the oral health. Therefore, the need for the implementation of preventive programs and awareness of public and personal health measures is a must.
Dental health education programs should be incorporated as an essential part of the curriculum of schools and children and should be motivated by means of lectures, presentations, poster and painting competitions, dental quizzes, etc., Various social organizations, nongovernmental organizations (NGOs), and clubs should join hand in spreading awareness about this endemic dental disease and means to prevent it. Public health measures like use of fluorides in toothpastes and mouth rinses should be advocated.
Regular dental attendance should be promoted. Specialized pediatric dental clinics with recreational activities for children of all ages should be set up for motivation. A cavity check-up can be turned into a game played with the child at every visit. Importance of a good personal oral hygiene should be emphasized with the help of audio visual aids, plaque disclosing agents along with brushing demonstrations. Subsidized pit and fissure sealants and topical fluoride application should be done in every child.
Diet is a major factor contributing to caries prevalence, and therefore adequate dietary counseling is a must. Sufficient time should be devoted for counseling and a separate team member allocated for it. Children should be explained in detail about harmful effects of various foodstuffs especially fast food, sweet beverages and candies, and suggested appropriate substitutes. Frequency of sugar exposures should be reduced and children should be educated to consume sweet foods strictly at meal times.
Study in professional colleges should educate dentists to stress to the general population about prevention of dental caries and importance of maintaining healthy milk teeth in development of a child, rather than just cure.
Government and social organizations should donate time to the cause, and fund research projects for more elaborate and detailed determination of incidence/prevalence of oral diseases from time to time, keeping in mind the sociocultural make-up of the society. This will help in assessing the cost-effectiveness and utilization patterns of the existing infrastructure that can bring about a balance between the treatment needs of the population and the services which can be provided. Research team should be honored so as to encourage them.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]
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