Beruflich Dokumente
Kultur Dokumente
Original Article
Abstract Dental caries is an important community dental health problem with limited studies in the
mixed dentition stage. The aim of this study was to determine the caries prevalence and treatment
needs among 7- 9 year old school children in Kelantan which is situated in North East Malaysia. A
retrospective dental record review of fully documented dental records belonging to primary school
children attending a paediatric dental clinic was conducted. Dental caries was recorded using dmft
index and DMFT index for deciduous teeth and permanent teeth respectively. Three hundred and
nineteen dental records of 175 (54.9%) boys and 144 (45.1%) girls were selected and subjected to a
dental record study. The prevalence of dental caries was 93% (95% CI : 89,97) in primary dentition
and 50.5% (95% CI : 42.2, 58.8) in permanent teeth. Mean dmft and DMFT was 6.2(SD 3.39) and
1.04(SD 1.34) respectively. Regarding treatment needs in the primary dentition, 35.4% of teeth needed
one surface filling, 34.7% needed extraction, 24.5% needed two or more surfaces filling and 5.6%
needed pulp care. In the permanent dentition, 54.7% required sealants and 21.9% required one surface
restoration. The caries prevalence and treatment needs were high among this study population in the
mixed dentition stage, particularly showing the early involvement of newly erupted permanent teeth. It
appears that high caries prevalence in the primary dentition is a risk factor for caries in newly erupted
permanent teeth. Oral health promotions programmes are required in the mixed dentition stage and
may reduce the risk of caries in permanent dentition.
Keywords: dental caries, mixed dentition, prevalence, school children, severity, treatment needs.
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Tin Oo et al. / Dental caries experience and treatment needs in the mixed dentition
same period (Dye et al., 2010). In school children are invited for oral
contrast, the trend among 7-year-old health examination and provided
Belgian children showed an increase in treatment accordingly by dental
the percentage of caries free children students during their paediatric dentistry
from 26% to 44% and a decrease in clinical training. Since caries prevalence
dmft from 4.1 to 2.24 from 1983 to 1996 in the mixed dentition has not been
(Vanobbergen et al., 2001). Nearby in reported in Malaysia previously, the aim
Spain, caries prevalence among 9-year- of the present study is to determine the
olds in primary and permanent teeth caries prevalence and treatment needs
was found to be 62.8% and 49.1% in 7 to 9 year old school children
respectively (Alvarez-Arenal et al., attending the dental clinic of Universiti
1998). In India, mixed dentition caries Sains Malaysia.
was prevalent in 92.11% in Chandigarh
among 9 year olds (Goyal et al., 2007), Material and methods
67.26% in Nainital among 7 to 9 year
olds (Grewal et al., 2009) and 49.23% in This is a retrospective record review
Udaipur among 8 to 10 year old (Dhar study on school children attending the
and Bhatnagar, 2009). Caries dental clinic, School of Dental Sciences,
experience ranged from 1.97 to 4.61 in Universiti Sains Malaysia between July
the above studies in India (Dhar and and December 2008. Dental records of
Bhatnagar, 2009; Goyal et al., 2007; children aged 7-9 years in the above
Grewal et al., 2009). Elsewhere, in period were selected for the study.
Saudi Arabia, 6 to 9 year old children Criteria for inclusion were presence of
had a mean dmft and DFT of 4.23 and clearly recorded data, written consent
1.85 respectively with only 26.1% being given by the parent for examination and
caries free (Alamoudi et al., 1996). From treatment and records checked and
these studies, it can be noted that caries countersigned by a paediatric dental
prevalence in the mixed dentition is high specialist. Those records not fulfilling
and varies widely regardless of the the above criteria were excluded from
public dental health services available. the study. The selected dental records
A number of factors make the were then subjected to a Dental Record
mixed dentition period particularly at risk Study that investigated the clinical
for caries. Social factors include the parameters which included caries
start of schooling for the child that experience, dental trauma experience,
entails a new and busy schedule for the malocclusion and dental treatment
child and parent, likely to result in needs. All teeth were referred to using
neglect of oral hygiene. Concurrently, the FDI notation. Dental caries was
the child is not dexterous in brushing recorded using the DMFT (D = decayed,
teeth. The child is also free to exert M = missing, F = filled, T = teeth) and
independent choices regarding food and dmft (d = decayed, m= missing due to
drink from the school canteen, without caries, f = filled, t = teeth) indices for
the parents influence. Moreover, caries permanent teeth and primary teeth
in the mixed dentition is predictive of respectively according to WHO criteria
caries in the permanent dentition (1997). Students who examined the
(Kassawara et al., 2010), which makes children were calibrated according to
it imperative to study this particular age the above criteria during the course of
group and to do the necessary their training through a lecture and
intervention. Consequences of early multiple clinical sessions which was
loss of deciduous teeth due to caries in followed by an assessment. From the
this age group can result in space dental charting, each tooth was
discrepancies, malocclusion and categorized into sound tooth, decayed
periodontal problems in adulthood. tooth, filled tooth with decay, filled tooth
In the School of Dental Sciences, without decay, missing tooth and tooth
Universiti Sains Malaysia, primary to be extracted, tooth with fissure
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Tin Oo et al. / Dental caries experience and treatment needs in the mixed dentition
sealants, tooth with partial loss of filled teeth. There were no significant
fissure sealants with or without caries differences in caries experience between
and traumatized tooth. For the treatment the different types of molars.
needs, each tooth was categorized as
no treatment needed, tooth requiring Permanent teeth
preventive resin restoration, tooth
One hundred and fifty eight children
requiring fissure sealant, tooth needing
(49.5%) had no caries in the permanent
one surface filling, tooth needing two or
teeth. Caries prevalence was 50.5%
more surfaces filling and tooth requiring
(95% CI: 42.2, 58.8). Children with
pulp care and restoration, tooth to be
caries had DMFT ranging from 0 to 8 of
extracted and children requiring space
which 142 (44.6%) had between 1 and
maintainer following extraction of teeth.
3 DMFT. The distribution of DMFT
The data from the completed forms
scores is shown in Table 1 and the
were entered into the SPSS v12.0
mean DMFT among boys and girls is
(SPSS, 2003). The descriptive statistics
shown in Table 2.
is presented as mean (SD) and
frequency (%). The difference between Table 1 Distribution of DMFT Index for deciduous and
male and female was tested using permanent teeth of study sample
independent t-test.
dmft/ Deciduous teeth Permanent teeth
DMFT
Results n (%) n (%)
0 19 ( 6.0) 158 (49.5)
Study sample 1 16 ( 5.0) 68 (21.3)
2 14 ( 4.4) 43 (13.5)
A total of 319 well documented dental
records which were approved by the 3 23 ( 7.2) 31 ( 9.7)
Deciduous Teeth
Three hundred children (93.0% [95% CI: Male 6.5 (3.30) 0.91 (317) 0.366
89, 97]) were found to suffer from one or Female 6.2 (3.35)
more carious teeth in the deciduous
dentition. The distribution of children Permanent Teeth
Male 1.1 (1.36) 0.66 (317) 0.510
suffering between 1 and 12 carious teeth Female 1.0 (1.33)
is shown in Table 1. Table 2 shows the a
Independent t-test.
mean dmft scores among boys and girls.
The dental status of deciduous molars in
Percentage of each permanent tooth
ages 7, 8 and 9 year old children are
affected
shown in Table 3, 4 and 5 respectively.
Among teeth with caries, untreated The total number of each permanent
caries was found in most teeth, followed tooth present and the percentage of
by missing teeth. There were very few caries affecting each of these teeth are
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Tin Oo et al. / Dental caries experience and treatment needs in the mixed dentition
shown in Figure 1. Caries rates on 45, of treatment. The various treatment needs
14 and 44 were found to be 22.6%, in the deciduous dentition is shown in
14.5% and 10.8% respectively. More Table 6. It was found that 35.4% required
numbers of lower first permanent molars one surface restoration, 24.7% required
(19.1%) were carious when compared to extraction and 24.5% required two
upper first permanent molars (12.3%). surface restorations.
No. (%)
n
0 1 2 3 4 5
D55 85 21 (24.7) 59 (69.4) 0 (0.0) 2 (2.4) 3 ( 3.5) 0(0.0)
D54 84 30 (35.3) 48 (56.5) 1 (1.2) 1 (1.2) 4 ( 4.7) 0(0.0)
D65 86 19 (22.4) 53 (62.4) 2 (2.4) 4 (4.7) 8 ( 9.4) 0(0.0)
D64 84 22 (25.9) 52 (61.2) 1 (1.2) 3 (3.5) 6 ( 7.1) 0(0.0)
D75 86 11 (12.9) 57 (67.1) 1 (1.2) 5 (5.9) 11 (12.9) 1(1.2)
D74 85 16 (18.8) 62 (72.9) 1 (1.2) 4 (4.7) 2 ( 2.4) 0(0.0)
D85 86 14 (16.5) 51 (60.0) 2 (2.4) 3 (3.5) 16 (18.8) 0(0.0)
D84 85 15 (17.6) 54 (63.5) 1 (1.2) 4 (4.7) 11 (12.9) 0(0.0)
Dental Status: 0=Sound; 1=Decayed; 2=Filled with decay; 3=Filled without decay; 4=Missing due to caries
5= Pulp care and restoration.
No. (%)
n
0 1 2 3 4
D55 134 40 (29.9) 73 (54.5) 2 (1.5) 7 (5.2) 12 ( 9.0)
D54 128 40 (31.3) 71 (55.5) 1 (0.8) 4 (3.1) 12 ( 9.4)
D65 130 29 (22.3) 81 (62.3) 2 (1.5) 5 (3.8) 13 (10.0)
D64 128 26 (20.3) 75 (58.6) 0 (0.0) 5 (3.9) 22 (17.2)
D75 133 22 (16.5) 80 (60.2) 2 (1.5) 6 (4.5) 23 (17.3)
D74 132 24 (18.2) 79 (59.8) 2 (1.5) 7 (5.3) 20 (15.2)
D85 126 30 (23.8) 69 (54.8) 1 (0.8) 3 (2.4) 23 (18.3)
D84 127 19 (15.0) 85 (66.9) 1 (0.8) 8 (6.3) 14 (11.0)
Dental Status: 0=Sound; 1=Decayed; 2=Filled with decay; 3=Filled without decay; 4=Missing due to caries.
No. (%)
n 0 1 2 3 4
D55 63 20 (31.7) 34 (53.9) 1 (1.6) 6 (9.5) 2 ( 3.1)
D54 46 14 (30.4) 30 (65.2) 0 (0.0) 1 (2.2) 2 ( 4.3)
D65 67 21 (31.3) 41 (61.2) 1 (1.5) 1 (1.5) 3 ( 4.5)
D64 51 12 (23.5) 23 (45.0) 0 (0.0) 1 (2.0) 4 ( 7.8)
D75 62 16 (25.8) 36 (58.0) 1 (1.6) 2 (3.2) 7 (11.2)
D74 63 9 (14.3) 34 (54.0) 1 (1.6) 4 (6.3) 5 ( 7.9)
D85 60 12 (20.0) 36 (60.0) 0 (0.0) 3 (5.0) 9 (15.0)
D84 54 15 (27.8) 28 (51.9) 0 (0.0) 4 (7.4) 7 (13.0)
Dental Status: 0=Sound; 1=Decayed; 2=Filled with decay; 3=Filled without decay; 4=Missing due to caries.
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Tin Oo et al. / Dental caries experience and treatment needs in the mixed dentition
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Tin Oo et al. / Dental caries experience and treatment needs in the mixed dentition
350 25
22.6
310
20.3
Number of Cases having particular tooth
300
267 20
250
14.6
Percent of Caries
15
200
10.8
150
10
100
5
48
50 37 31
0 0
P36ST
P46ST
P26ST
P16ST
P31ST
P41ST
P42ST
P32ST
P11ST
P21ST
P12ST
P22ST
P14ST
P24ST
P15ST
P25ST
P44ST
P34ST
P45ST
P35ST
P13ST
P23ST
P33ST
P43ST
Permanent Teeth in Sequence of Eruption
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Tin Oo et al. / Dental caries experience and treatment needs in the mixed dentition
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Tin Oo et al. / Dental caries experience and treatment needs in the mixed dentition