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Prevalence of dental caries in primary schools

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البحث عبارة عن مدى إنتشار تسوس الاسنان بين طلاب المدارس الابتدائيه في مدينة صنعاء-اليمن …

البحث عبارة عن مدى إنتشار تسوس الاسنان بين طلاب المدارس الابتدائيه في مدينة صنعاء-اليمن
إشراف الدكتور/علي المشهداني
رئيس قسم طب المجتمع في جامعة العلوم والتكنولوجيا

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  • 1. 1 ‫والتكنولوجيا‬ ‫العلوم‬ ‫جامعة‬ ‫االسنان‬ ‫طب‬ ‫كلية‬ ‫المجتمع‬ ‫أسنان‬ ‫طب‬ ‫قسم‬ Prevalence of dental caries in Primary schools (It is a part of community Dentistry requirement) Supervised by: Ass. Prof.Ali Almashhadani Done by: HISHAM IBRAHEM MOHAMMED ALI MOHSEN Tareq Ali Musawa FEB2014 ‫بسم‬‫الرحيم‬ ‫الرحمن‬ ‫اهلل‬
  • 2. 2 PERFACE FOR OUR DOCTOR: ALI AL-MASHHADANI AND GRAET THANKS FOR OUR PARENT FOR THEIR PATIENT AND SUPPORT TO SEE OUR SUCCESS.
  • 3. 3 ACKNOWLEDGMENT First of all we thank our doctor /Ali Al-Mashhadani for his effort and patient with us. We thank the school managers whom cooperated with us to optimize our research. We thank the student whom has been so kindly and cooperate with us.
  • 4. 4 CONTENT CHAPTER 1 ……………………………………………….. ……….6  DENTAL CARIES IN HIGH SCHOOL Definition……………………………………………7 Etiology……………………………………………...9 Prevention…………………..……………………….11 CHAPTER 2………………………..……………………………..14  WORK ENVIRONMENT Time of work ……………………………....15 Place of research……………………………15 Number of samples………………………….15 Equipment of examination…………………...15 Price………………………………………….15 Sample of case sheet……………………………………….16 CHAPTER 3…..………………………………………………….18  Research ………………………………………19 CHAPTER 4……………………………………………………...20  Results…………………………………………21 CHAPTER 5………………………………………………….…..29  Search result…………………………………...30  Discussion………..……………………………30 CHAPTER 6……………………………………………………..32 Recommendation …………………………………….33 CHAPTER 7……………………………………………………..34 summary …………………………………….35 References……………………… ………..36
  • 5. 5
  • 6. 6 CHAPTER 1 DENTAL CARIES IN PRIMARY SCHOOL
  • 7. 7 What is dental caries? (1) Dental caries is an infectious (chronic) disease caused by acidogenic bacteria and fermentable carbohydrates in the diet due to acid by product that may lead to dissolution of enamel and dentin, (coronal caries) and cementum and dentin (root caries). Patients vary in their susceptibility to caries process and in managing dental caries. There is either a mild or a moderate challenge to caries attack, usually affecting deep pits and fissures and proximal surfaces. Rampant carieson the other hand is a sudden rapid destruction of many teeth, affecting surfaces that considered relatively immune to caries attack. Other terms are also present as:  Nursing caries: Caused by prolonged Brest or bottle feeding, especially during night.Recurrent or secondary caries: Seen in the margins of an old restored area.  Arrested caries: Re mineralized carious lesion.
  • 8. 8 What are the symptoms of dental caries? Generally, you will not experience any serious symptoms from dental caries. When symptoms are present, they may include toothache or sensitivity to hot or cold foods and beverages. Common symptoms of dental caries: You may experience symptoms of dental caries all the time or just occasionally. At times, any of these dental caries symptoms can be severe. Symptoms of dental caries are usually localized to the mouth. They include:  Holes in the surface of a tooth  Pain when chewing  Sensitivity to hot or cold foods and beverages  Toothache
  • 9. 9 What causes dental caries? Dental caries is a multi factorial disease; it is the result of complex interaction between HOST, PLAQUE, DIET and TIME. Host Factors: This involves susceptible tooth and saliva, in addition to the subject him/her self. Teeth vary in their susceptibility to dental caries from one surface to other and from one subject to other. There are several factors affecting tooth susceptibility as:  Morphology of teeth: (susceptible sites) Sites on the tooth, which favour plaque retention and stagnation, are prone to decay. - These are: 1- Enamel pits and fissures. 2- Approximal enamel smooth surfaces. 3- Cervical margin of teeth. 4- Exposed root surfaces because of gingival recession. 5- Deficient or over hang restoration (recurrent caries). 6- Tooth surfaces adjacent to denture and bridges.  Positions of teeth: posterior teeth are labial to be affected by caries compared to anterior.  Composition of teeth, teeth composed of inorganic elements (96% in enamel, 70% in dentin), organic elements and water. - Composition of teeth is effected by environmental factors (water, diet and nutrition).  Saliva affects caries etiology through the rate of secretion and composition. - Saliva affects the integrity of teeth by the composition of (buffer system, calcium and phosphate). - -
  • 10. 11 - - By the cleansing action of saliva (oral clearance), it can affect the number of oral micro organisms and food debris from the mouth.  The oral immune system (specific and non specific) affect to a large degree the cariogenic bacteria. Subject: The behavior, attitude and dental knowledge affect the caries etiology. These can influence the oral hygiene of the person as well as his dietary habits. Dental plaque: Plaque quantity and quality greatly influence caries etiology. Bacteria adhere to tooth surface and ferment carbohydrate causing release of acid thus demineralization of tooth surfaces. Cariogenic bacteria involve mutans streptococci, lactobacilli and others.
  • 11. 11 Diet: Sweet consumption especially between meals may lead to continuous drop of pH and not allowing the enough time for the pH to return to normal, thus de mineralization of teeth.
  • 12. 12 What are the risk factors for dental caries? A number of factors increase the risk of developing dental caries. Not all people with risk factors will get dental caries. Risk factors for dental caries include:  Autoimmune diseases (such as Sjögren’s syndrome, characterized by dry eyes, dry mouth, and connective tissue disorder).  Excessive consumption of sugary, starchy or acidic foods or drinks.  Poor dental hygiene.  Smoking. Reducing your risk of dental caries You may be able to lower your risk of dental caries by:  Avoiding excessive sugar, starch or acid in your diet.  Avoiding sticky foods or foods that may become stuck in your teeth (such as peanut butter or popcorn)  Brushing your teeth at least twice a day  Flossing your teeth at least twice a day  Going to your dentist regularly for routine cleaning and examinations  Having dental sealants, or protective coatings, applied to your teeth if recommended by your dentist  Receiving fluoride treatments as recommended by your dentist  Using antiseptic mouthwash
  • 13. 13 How are dental caries treated? - Prompt treatment of dental caries by your dentist is important in preventing further damage to your tooth or an infection. A simple dental examination can identify dental caries, and an X-ray may help your dentist to determine the extent of the caries. - Dental caries are typically painless, but a larger or deeper area of destruction in the tooth may be painful. If you have a toothache, over-the-counter pain relievers, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol), may make you more comfortable until the caries are treated by your dentist. - In addition to medications, dental work is necessary to fill the cavity. - Your dentist will begin by numbing your mouth with a local anesthetic. After your tooth is numb, your dentist will use a drill to clean out the area of decay and shape the surrounding tooth to allow it to be filled in smoothly with replacement materials. More severe caries may require more extensive dental work, including a root canal or tooth extraction. What are the potential complications of dental caries? Dental caries are not normally life threatening. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of dental caries include:  Dental abscess  Difficulty chewing  Pain  Tooth abscess  Tooth damage or loss  Tooth sensitivity
  • 14. 14 CHAPTER2 WORK ENVIROMENT
  • 15. 15 The Study was conducted on 20 FEB 2014 in Primary schools students in Sana’a city. A sample of 200 students aged between 6- 11 years was randomly selected. Period of time: 10 hours Place: First day: AL-fateh school Second day: Al-bonian school Amount o f samples: 200 Equipment of examination: Gloves mask tongue depressor torch light 
  • 16. 16 Sample of case sheet: THE PREVALENCE OF D.C AMONG PRAIMARY SCHOOL STUDENTS IN SANAA CITY Age: Sex: Level: Place of birth Father occupation: Mother education: Do you brush your teeth? Yes… No… If yes how many time: 1d 2d 3d other Don’t know: Don’t like No time harmful not useful expensive other Do you use Mouthwash ? Yes… No… If yes how many time: 1d 2d 3d other Don’t know: Don’t like No time harmful not useful expensive other Do you use dental floss? Yes… No… If yes how many time: 1d 2d 3d other Don’t know: Don’t like No time harmful not useful expensive other Do you eat snack? Yes… No… If yes how many times? 1d 2d 3d Other Type of snack: Sug: fru: Ch: Ju: other
  • 17. 17 Malocclusal Crowding Open bit Cross bit Un competent lip Normal Other..
  • 18. 18 CHAPTER 3 Research
  • 19. 19 Relationship of study with DMF According to : 1.Age 2.Toothbrush 3.Mouthwash 4.Dental floss 5.Snakes between food by: Hisham Ibrahem. Tariq Musawa and Mohammed Algabri Table (2) DMF= 304
  • 20. 21 CHAPTER 4 RESAULTS
  • 21. 21 AGE DMF OF 6-11 YEARS OLD IN RIYADH, SAUDI ARABIA IN 1991 10-118-96-7AGE 708793NO. 20.36%13.68%8.76%DMF% AL SHAMMARY A., GUILE A., EL BACKLY M., LAMBORNE A. Table (3) An oral health survey of Saudi Arabia : Phase I (Riyadh). 1991. King Abdulaziz City for Science and Technology. Riyadh. DMF OF 6-11 YEARS OLD IN DAKAH, BANGLADESH 10-118-96-7AGE 106157188NO. 16.07%29.33%15.54%DMF% Journal of Clinical and Diagnostic Research (2011 February) , Vol-5(1):146-151 Table(4) Our study of DMF according to the AGE (6-11) in 14/2 /2013 11109876AGE 303030304040NO. 575462414843DMF 3.5%3.70%3.22%4.87%4.16%4.65%DMF% By :Hisham Ibrahem . Mohammed Algabri . Tariq Musawa Table(5)
  • 22. 22 TOOTHBRUSH DMF of children in India (2009) TOOTH BRUSH YES DMF% NO DMF TOTAL CHENNIA 283 26.88% 62 73.12% 354 KOLKATA 319 17.9% 33 82.1% 352 Journal of Nepal Dental Association (2009), Vol. 10, No. 1, Jan.-Jun., 25-30 Table(6) DMF in Tehran , Iran (2005) University of Medical Sciences , Iran Table(7) Oral Health Center, Semnan University of Medical Sciences, Iran 7.4 14.9
  • 23. 23 Our study of DMF according to the Toothbrush (6-11) in 20/2 /2014 TOOTH BRUSH YES Dmf% NO Dmf% 6-7 9 26.85% 12 73.15% 8-9 3 6.54% 19 93..46% 10-11 9 28.11% 31 71.89% Total 44 27.96% 156 72.21 By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(8) if yes how many time 1/D 2/D 3/D 6-7 6 3 0 8-9 2 1 0 10-11 7 2 0 By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(9) If no why? NO. DMF DMF% Expensive 8 49 9.61% Not comfortable 44 238 46.67% Not useful 15 90 17.65% Not available 16 117 22.94% Other 8 57 11.18% By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(10)
  • 24. 24 MOUTHWASH DMF of pre-school children in India (2009) MOUTH WASH YES DMF% NO DMF% TOTAL CHENNIA 41 12.91% 304 87.09 345 KOLKATA 73 17.9% 279 82.1% 352 Journal of Nepal Dental Association (2009), Vol. 10, No. 1, Jan.-Jun., 25-30 Table (11) DMF in Jordan , Irbid (2004) MOUTH WASH Yes DMF% No DMF% Total 6-9 7 9.1% 70 90.9% 77 10-12 14 17.07% 68 82.93% 82 13-15 27 24.77% 82 75.23% 109 Al-Wahadni AM, Al-Omiri MK, Kawamura M. Differences in self reported oral health behavior between dental students and dental technology/dental hygiene students in Jordan. J Oral Sci. 2004;46:19 Table(12)
  • 25. 25 Our study of DMF according to the Mouth wash (6-11) in 20/2 /2014 YYeess DDMMFF%% NNoo DDMMFF%% 66 8.33% 91.67% 77 0.00% 100% 88 12.44% 87.56% 99 14.54% 85.46% 1100 7.83% 92.17% TToottaall 7 9.18% 15 90.82% By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(13) if yes how many time 1/D 2/D 3/D 6-7 2 0 0 8-9 2 0 0 10-11 3 0 0 By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(14) If no why ? NO. DMF DMF% Expensive 15 70 10.89% Not comfortable 19 140 21.77% Not useful 14 90 13.99% Not available 11 92 14.31% Other 59 281 43.70% By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(15)
  • 26. 26 DENTAL FLOSS DMF in Morocco , Rabat (2001) AGE Yes DMF% No DMF% Total 6-8 12 14.11% 73 85.89% 85 9-11 27 23.03% 90 76.96% 117 11-14 13 12.26% 93 87.74% 106 Frencken JE, Rugarabamu P, Mulder J(2001). The effect of sugar cane chewing Table(16) on the development of dental caries. Dent Res, 68(6):1102- 4. DMF according to dental floss in USA , Canada , Sweden , Norway and Portugal (2009) To be presented with the permission of the Faculty of Medicine of the University of Table(17) Helsinki, for public discussion in the main auditorium of the Institute of DentistryMannerheimintie 172, Helsinki, on 15 May, 2009 at 12 noon 6.2 9.5 15.1 16 16.3 0 5 10 15 20 USA Canada Sweden Norway Portugal
  • 27. 27 Our study of DMF according to the Dental floss (6-9) in 14/2 /2014 YES DMF% NO DMF% 6-7 4 8.34% 17 91.76% 8-9 0 100% 22 0.00% 10-11 1 4.60% 39 95.39% tOTAL 12 4.1% 120 95.90% By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(18) If no , why ? NO. DMF DMF% Expensive 3 9 1.33% Not comfortable 30 186 27.39% Not useful 25 195 28.72% Not available 29 148 21.79% Other 40 211 31.07% By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(19)
  • 28. 28 snake DMF in Bankura Sammilani Medical College, India (2013) Snake YYeess NNoo 6-7 90.9% %9.1 8-9 82.93% 17.07% 10-11 75.23% 24.77% By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(20) Our study of DMF according to the Snake (6-9) in 14/2 /2014 YES DMF NO DMF 6-7 19 93.51% 2 6.49% 8-9 20 89.71% 2 10.29% 10-11 33 83.41% 7 16.59% TOTAL 117 91.67% 11 8.34% By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(21) Type snake NNoo.. DDMMFF DDMMFF%% SSoofftt ddrriinnkkss 78 489 75.35% SSwweeeettnneessss 70 448 69.03% FFrruuiitt 41 252 38.83% SSaannddwwiicchh 60 350 53.93% ootthheerr 11 57 8.78% By : Hisham Ibrahem , Tariq Musawa and Mohammed Algabri Table(22)
  • 29. 29 CHAPTER 5 Search Result
  • 30. 31 » There is no relationship between Age and DMF . » Low result of DMF in person who brush there teeth regulary . » Low result of DMF in person who use mouth wash . DISCUSSION Dental caries is prevalent in the age (6-11) because: - Time is an important factor to increase caries prevalence. - Hormonal changes. Dental caries is more prevalence in the rich student due to: - Having more sugar and sticky food unlike poor student who has less carbohydrate. Incidence of dental caries in student with highly educated parents is less due to: - Environment condition and child is will oriented to practice good oral health. Student that takes snacks daily have a higher rate due to: - Intake of carbohydrate and sticky food is increase. - Doesn’t allow the PH of the mouth to return to the normal rate. - Doesn’t brush after eating the snacks which allow more contact of carbohydrate with tooth surface.
  • 31. 31 Students using dental brush and dental floss have significant decrease of caries due to: - Minimize the time of debris of substrate to be in contact with the tooth thus distributing the ring of caries process. Student using mouthwash increases the risk of decay due to: - The most of patient using mouthwash they don’t practice other tips of oral hygiene and eat snack more frequently and may also practice more bad habits such as smoking and qat chewing. Previous fluoride application increases the risk of decay due to: - In yemen the water fluoridation is sufficient so applying fluoride in fluoridated area increase mottled enamel that weakened the tooth structure. - Who had application of fluoride may not practice other tips of oral hygiene and have no diet control. When we compare between our researches and the researches that had mention we found that no big difference results according to age and sex.
  • 32. 32 Chapter 6 Recommendation
  • 33. 33 Dental health promotion is a group responsibility involving (community, dentist and individual) Community through:  Public health programs and dental health education by (ministry of health)  Public and school water fluoridation and good management if the water is over fluoride by (ministry of education and health).  Health diet promotion by (ministry of health )  Food modification and reorientation to alter dietary habits by (social programs) Dentist through:  Instruction of well performed oral hygiene measures and motivation by posters advertisement supervised by dental association.  Topical and supplemental fluoride  Encouragement of healthy diet by dental association.  Preventive measures (fissure sealant, ART, laser ….)  Immunization Individual through:  Maintaining good oral hygiene by regular brushing and use of dental floss by individual health.  Use of fluoride containing paste ,dentifrices or supplements by parent supervision.  Diet control by parent supervision.  Regular dental check up
  • 34. 34 Chapter 7 summary
  • 35. 35 We have summarized that dental caries among primary school has a pattern of spread according to specific division based on the age, sex, habits, and hygiene practicing. All of these has a direct effect in dental caries spread due to specific factor that have been discussed. And our duty is to minimize these numbers through applying scientific dental research and health education.
  • 36. 36 References: BOOKS dental care in modern day China community. Dent Oral Epidemiol, 29(5): 28-319. 1. Mandal kp, Tewari AB, Chawla HS, Gaubak D (2001). Prevalence and severity of dental caries and treatment needs among population in Eeasts of India. J Indian Socprer Dental, 19(3): 85-91. 2. Budner L, Anaise JZ (1977). Caries prevalence in workers in the sweets industryan epidemiological survey. Re Fuat Hapeh Vehashinagim, 26(3): 39- 45. 3. Anaise JZ (1980). Prevalence of dental caries among workers in the sweets industry in Israel.Community Dent Oral Epidemiol, 8()3 ( )142 -45. 4. Petersen PE (1989). Evaluation of a dental preventive program for Danisb chocolate workers. Community Dent Oral Epidemiol, 17(2): 53- 9. 5. Rekha R, Hiremathss (2002). Oral health status and treatment requirements of confectionary workers in Banglore city. A comparative study. Indian J Dent Res, 13(3-4) :161-65. 6. Masalin K, Murtomaa H, Meurman JH (1990). Oral health of workers in the modern finnish confectionery industry. Community Dent Oral Epidemiol, 18(3): 126 -30. 7. Werckmeister J, Ruppe k (1990). Prevalence of damages of dental, oral and the jaw areas among workers exposed to substances in a chemical company. Stomatol DDR, 40(4): 172- 74.
  • 37. 37 » Internet [http://www.cdc.gov/oralhealth/publications/ factsheets/sgr2000_fs3.htm], Accessed on October 14, 2010. World Health Organization: Significant Caries Index 2008 [http://www. W hocollab.od.mah.se/sicdata.html], Accessed on October 14, 2010. http://www.biomedcentral.com/1472-6831/10/24/prepub [http://www.cdc.gov/fluoridation/fact_sheets/sg04.htm], Accessed on October 14, 2010. http://www.localhealth.com/article/dental-caries/treatments http://www.codental.uobaghdad.edu.iq/uploads/lectures/5 th%20class%20prevention/Professor%20Dr.%20Sulafa% 20El%20Samarrai- Etiology%20of%20dental%20caries.pdf