A brief look at the recent epidemiological trends of dental caries, periodontal disease, oral cancer and malocclusion in India as of available research in March 2021

1. EPIDEMIOLOGICAL
TRENDS OF ORAL
DISEASES IN INDIA
Dr. R.K.HARITHA
www.rkharitha.wordpress.com

2. CONTENTS
 Introduction
 Oral health burden in India
 Epidemiological trends -
 Dental caries
 Periodontal disease
 Oral cancer
 Malocclusion

3. INTRODUCTION
Two National level epidemiological
oral health surveys in India – 2004 and
2007
2016 State-wise Global disease burden
(GDB) – Oral health not recorded

4. ORAL HEALTH
BURDEN IN INDIA

5. Batra, P., Saini, P., &Yadav, V. (2020). Oral health concerns in India. Journal of oral biology
and craniofacial research, 10(2), 171–174. https://doi.org/10.1016/j.jobcr.2020.04.011
 Decayed component prevalent in 5,
12, 15 years and younger adults (35–44
years). 84.7% in 65–74 year age group.
 Missing teeth component was most
dominant in older adults (65–74 years).
 There was no marked gender-based
differentials but the prevalence was
slightly higher in rural residents.
 Root caries was prevalent in the 3.9
and 5.4% subjects in the country in the
age-groups of 35–44 and 65–74 years,
respectively.
 The predominant treatment need, by
type of need, was that of fillings (one
or more surfaces), followed by
extractions and pulp care

6.  Periodontal pockets, both shallow (4–5 mm) and deep
(6 mm) were markedly more prevalent in older adults (65–74
years).
 Loss of attachment (4–5 mm depth) - 42.2% in age group of
35–44 years and 60.6% in age group of 65–74 years.
 The percentage of subjects with malocclusion was
1.6, 23.6 and 23.9 in children aged 5, 12 and 15 years
respectively
 In adults aged 35–44 years, 42% subjects in the
country had malocclusion. The majority (18.4%) had
‘definite’ malocclusion followed by 14.1%, who had
‘very severe’ malocclusion.
 Prevalence of fluorosis was found to be 12.1%,
11.8%, 9.3% 5.2% in the age groups of 12,15, 35–
44 and 65–74 respectively.
 Three states, viz. Haryana, UP and Andhra
Pradesh, in that order, had a prevalence of ‘severe’
fluorosis in children aged 12 years.
 The prevalence for the oral mucosal lesions was found
to be highest in older adults (65–74 years), with oral
cancer in 0.4% and leukoplakia 3.1%. Lichen planus
was observed in 0.4% (35–44 years) and 0.5%
subjects (65–74 years).
 80,000 new cases of oral cancers are detected every
year out of which 95% are squamous cell carcinoma.
PERIODONTAL DISEASES FLUOROSIS
MALOCCLUSION
ORAL CANCERS AND OTHER MUCOSAL LESIONS
Batra, P., Saini, P., &Yadav,V. (2020). Oral health concerns in India. Journal of oral biology and craniofacial research, 10(2), 171–174.
https://doi.org/10.1016/j.jobcr.2020.04.011

7. EPIDEMIOLOGICAL
TRENDS OF DENTAL
CARIES

8. PREVALENCEOF DENTALCARIES IN INDIA
Chandrasekar Janakiraman, Bobby Antony, Joe Joseph Prevalence of Dental caries in
India among the WHO Index age groups : A meta-analysis 2018Vol. 12 Issue 8, p8-13

9.  The mean deft/DMFT was 2.36, 1.95, 3.31 and 7.01 among 5, 12, 15
and 65-74 years respectively.
 The SiC index shows steady increase from 3.36 to 8.11 across the
groups.The mean prevalence of dental caries is almost similar at 5
years and 12 years at 49% while it shows steady increase from 15
years (60%) to 35-44 years (78%) and peaks at 65-74 year group
(84%).
 In the Eastern andWestern regions of India, the 15 year old had
higher caries prevalence and mean DMFT compared to the 12-
year-old.
 Across India, the 60-74-year-old had the highest DMFT of 7.01. In
North and South India, 65-74- year-old had the highest caries
prevalence of 84% and 85% respectively.

10. PREVALENCEOF DENTALCARIES STATE-WISE
Chandrasekar Janakiraman, Bobby Antony, Joe Joseph Prevalence of Dental caries in
India among the WHO Index age groups : A meta-analysis 2018Vol. 12 Issue 8, p8-13

11. REGIONWISE DISTRIBUTIONOF CARIES IN
INDIA
WEIGHED MEAN DECAYED, MISSING,AND
FILLEDTEETH IN 5YEAR INTERVALGROUP
WEIGHED MEAN DMFT IN DIFFERENTAGE GROUPS
 Pooled prevalence of dental caries in Indian children is
more than 50%
 Average dmf/DMF values are between 2 and 3 in all the
age groups.
 Caries experience was found less in the northern and
eastern part of India as compared to southern and
western parts
 One out of two children in India is affected by dental
caries and there is an increase in caries burden in
deciduous dentition.
Mehta A. Trends in dental caries in Indian children for the past 25 years. Indian J Dent Res. 2018 May-Jun;29(3):323-328. doi: 10.4103/ijdr.IJDR_615_17.
PMID: 29900916.

12. PREVALENCEOF ECC IN INDIA
Ganesh A, Muthu MS, Mohan A, Kirubakaran R. Prevalence of Early Childhood Caries in India - A Systematic Review.
Indian J Pediatr. 2019 Mar;86(3):276-286. doi: 10.1007/s12098-018-2793-y. Epub 2018 Oct 3. PMID: 30284117.
 The overall prevalence of
ECC in India to be 49.6%
 Andhra Pradesh was
found to have the highest
prevalence of ECC at
63%, followed by Tamil
Nadu (55.73%)
 The lowest prevalence of
ECC was found in Sikkim
(41.92%) followed by
Assam (43.4%)

13. EPIDEMIOLOGICAL
TRENDS OF
PERIODONTAL
DISEASE

14. NATIONAL
ORAL HEALTH
SURVEYS

15. Shewale, A. H., Gattani, D. R., Bhatia, N., Mahajan, R., & Saravanan, S. P. (2016). Prevalence of Periodontal Disease in the General Population of India-
A Systematic Review. Journal of clinical and diagnostic research : JCDR, 10(6), ZE04–ZE9. https://doi.org/10.7860/JCDR/2016/17958.7962

16. Chandra, A., Yadav, O. P., Narula, S., & Dutta, A. (2016). Epidemiology of periodontal diseases in Indian population since last
decade. Journal of International Society of Preventive & Community Dentistry, 6(2), 91–96. https://doi.org/10.4103/2231-
0762.178741
Majority of
surveys
conducted in the
last decade have
used Community
Periodontal Index
of Treatment
Needs (CPITN)
as an
epidemiological
tool but a
plethora of
studies point out
the demerits of
the same. The
hierarchical
principles
underlying its use
are not
universally valid

17. POOLED
ESTIMATESOF
PERIODONTAL
DISEASE
ACCORDINGTO
GEOGRAPHIC
DIVISIONSOF
INDIA
Janakiram, C., Mehta, A., & Venkitachalam, R. (2020). Prevalence of periodontal disease among adults in India: A systematic review
and meta-analysis. Journal of oral biology and craniofacial research, 10(4), 800–806. https://doi.org/10.1016/j.jobcr.2020.10.016

18. EPIDEMIOLOGICAL
TRENDS OF ORAL
CANCER

19.  11 out of 28 registries encountered lung cancer as
the leading Site.The second place was captured by
mouth cancer, which was the leading one in 10
registries out of 28.
 This suggests that tobacco control must be the
priority for cancer control in India as smoke or
smokeless tobacco is the prime etiological factor for
the lung and mouth cancer.
 The previous time trend prevalence study shows a
significant rise of lung cancer in Delhi, Chennai, and
Bengaluru and of mouth cancer in Bhopal and
Mumbai.
Mohan S, Asthana S, Labani S, Popli G. Cancer trends in India: A review of population-based cancer registries (2005-2014). Indian J Public Health.
2018 Jul-Sep;62(3):221-223. doi: 10.4103/ijph.IJPH_115_17. PMID: 30232973.

20.  The average age adjusted incidence rates for all sites together, in males and females varied from 46.1
and 54.2 in Barshi registry to 116.2 and for 125.8 Delhi registry
 In males for the sites tongue and mouth, highest incidence rate was noted by Bhopal registry and
lowest in Barshi.
 For mouth cancer in females the highest incidence was noted in Bangalore and the lowest in Barshi
(1.2).
Yeole BB. Trends in incidence of head and neck cancers in India. Asian Pac J Cancer Prev. 2007 Oct-Dec;8(4):607-12. PMID: 18260738.

21. ARR MOUTH CANCER IN NORTHEAST POPULATION
BASED CANCER REGISTRIES IN MALESAND FEMALES
ARR MOUTH CANCER IN
CENTRAL REGION
ARR LIP CANCER IN
SOUTH REGION
ARR LIP CANCER IN NORTHEAST POPULATION BASED
CANCER REGISTRIES IN MALESAND FEMALES
 Maximum incidence for mouth cancer was in
central region followed by females in the
northeast region
 AAR (mouth and tongue) cancers among males
show cases at a very early age group of 0–20
years specially in the western region PBCRs
followed by the north region PBCRs
Sharma, S., Satyanarayana, L., Asthana, S., Shivalingesh, K. K., Goutham, B. S., &
Ramachandra, S. (2018). Oral cancer statistics in India on the basis of first report of
29 population-based cancer registries. Journal of oral and maxillofacial pathology :
JOMFP, 22(1), 18–26. https://doi.org/10.4103/jomfp.JOMFP_113_17

22. EPIDEMIOLOGICAL
TRENDS OF
MALOCCLUSION

23. Cumulative prevalence estimate of malocclusion among Indian
children according to different indices and classification
Mehta, A., Negi, A., Verma, A. & Jain, K. (2020). Pooled prevalence estimates of malocclusion among Indian children and adolescents: a systematic
review and meta-analysis. International Journal of Adolescent Medicine and Health, (). https://doi.org/10.1515/ijamh-2020-0142
 Pooled prevalence of
malocclusion among Indian
children and adolescents has
increased since the last
national oral health survey.
 Prevalence of malocclusion
ranged from 28.4% (CI 25.02,
31.9) to 66.7% (CI 50.7, 81.06)
depending on the type of
index or classification used for
recording.
 Boys recorded higher
cumulative prevalence than
girls.

24. OVERALL PREVALENCEOF MALOCCLUSION
 The pooled estimate of prevalence of
malocclusion as assessed by mean
DAI score was 21.23
 Among males and females were
21.46 and 21.52
 Based on mean DAI score, 15 years
old children showed higher
prevalence of malocclusion i.e. 23.22
 Urban population had a
comparatively higher mean DAI
score than rural
Balachandran, P., & Janakiram, C. (2021). Prevalence of malocclusion among 8-15 years old children, India - A systematic review and meta-analysis. Journal of oral
biology and craniofacial research, 11(2), 192–199. https://doi.org/10.1016/j.jobcr.2021.01.011

25. REFERNCES
1. Batra, P., Saini, P., & Yadav, V. (2020). Oral health concerns in India. Journal of oral biology and craniofacial
research, 10(2), 171–174. https://doi.org/10.1016/j.jobcr.2020.04.011
2. Chandrasekar Janakiraman, Bobby Antony, Joe Joseph Prevalence of Dental caries in India among the WHO
Index age groups : A meta-analysis
3. Mehta A. Trends in dental caries in Indian children for the past 25 years. Indian J Dent Res. 2018 May-
Jun;29(3):323-328. doi: 10.4103/ijdr.IJDR_615_17. PMID: 29900916.
4. Ganesh A, Muthu MS, Mohan A, Kirubakaran R. Prevalence of Early Childhood Caries in India - A Systematic
Review. Indian J Pediatr. 2019 Mar;86(3):276-286. doi: 10.1007/s12098-018-2793-y. Epub 2018 Oct 3. PMID:
30284117.
5. Shewale, A. H., Gattani, D. R., Bhatia, N., Mahajan, R., & Saravanan, S. P. (2016). Prevalence of Periodontal
Disease in the General Population of India-A Systematic Review. Journal of clinical and diagnostic research :
JCDR, 10(6), ZE04–ZE9. https://doi.org/10.7860/JCDR/2016/17958.7962
6. Chandra, A., Yadav, O. P., Narula, S., & Dutta, A. (2016). Epidemiology of periodontal diseases in Indian
population since last decade. Journal of International Society of Preventive & Community Dentistry, 6(2), 91–
96. https://doi.org/10.4103/2231-0762.178741
7. Janakiram, C., Mehta, A., & Venkitachalam, R. (2020). Prevalence of periodontal disease among adults in India:
A systematic review and meta-analysis. Journal of oral biology and craniofacial research, 10(4), 800–806.
https://doi.org/10.1016/j.jobcr.2020.10.016
8. Mohan S, Asthana S, Labani S, Popli G. Cancer trends in India: A review of population-based cancer registries
(2005-2014). Indian J Public Health. 2018 Jul-Sep;62(3):221-223. doi: 10.4103/ijph.IJPH_115_17. PMID:
30232973.
9. Yeole BB. Trends in incidence of head and neck cancers in India. Asian Pac J Cancer Prev. 2007 Oct-
Dec;8(4):607-12. PMID: 18260738.
10. Mehta, A., Negi, A., Verma, A. & Jain, K. (2020). Pooled prevalence estimates of malocclusion among Indian
children and adolescents: a systematic review and meta-analysis. International Journal of Adolescent Medicine
and Health, (). https://doi.org/10.1515/ijamh-2020-0142
11. Balachandran, P., & Janakiram, C. (2021). Prevalence of malocclusion among 8-15 years old children, India - A
systematic review and meta-analysis. Journal of oral biology and craniofacial research, 11(2), 192–199.
https://doi.org/10.1016/j.jobcr.2021.01.011

26. THANK YOU
Dr. R.K.Haritha
www.rkharitha.wordpress.com
harithaknn@gmail.com
https://www.linkedin.com/in/dr-haritha-rk-
6978b8162