Oral health status of children in the Western region of the Eastern Cape Province: a regional survey
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Date
2002
Authors
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Publisher
University of the Western Cape
Abstract
Purpose: To assess the oral health status of 4-15-year-old schoolchildren in the Western Region of the Eastern Cape Province, by determining the prevalence of dental caries, periodontal disease, dental fluorosis, malocclusion and oral mucosal lesions and to create baseline data for planning oral health services in this region. Materials and Methods: The prevalent analytic survey was undertaken on 822 schoolchildren between the ages of 4-15 years in 27 different schools. The sample size selected for this region by the Department of Statistics, University of
Pretoria, for the National Oral Health Survey of 1999/2000 was used. The data on 209, 210, 209 and 194 scholars in the 4-5, 6, 12 and 15-year-old age groups respectively were collected. The World Health Organization's (1997) criteria were used to determine the prevalence of caries, periodontal treatment needs, the dental fluorosis, malocclusion and prevalence of oral mucosal lesions. Six calibrated and trained examiners recorded the data on a survey form. The WHO survey forms were used for data collection. The data were analysed and processed by the author on Microsoft Excel 2000. Results: The sample size consisted of 1.35 % Asian, 51.89 % Black, 26.07 % Coloured and 20.06 % White scholars. Nearly equal amounts of males (48.3 %) and females (51.7%) were examined. The dental caries prevalence in the primary dentition of 4-5-year-olds with an average age of 4.43 years was 40.67%, with a mean dmft of 3,56. The dental caries prevalence in the permanent dentition of6-, 12- and 15-year-oldage groups was 67.62%, 46.05% and 67.92% respectively. The mean DMFT for 6-, 12- and 15 year olds were 0.05, 1.19 and 2.02 respectively. Gender differences and differences in prevalence of dental caries between the populations groups were
recorded. The Coloured children experienced the highest dental caries prevalence. In the 4-5- and 15-year-old groups the males were affected more than the females by dental caries. Prevalent differences were recorded between rural and urban areas in the same population group. The prevalence of periodontal disease in 373, 12-15-year-olds was 79.09%. Only 4.02 % were in need of dental hygiene instructions and polishing. Dental education, dental hygiene instructions, dental scaling and polishing were needed by 75.07% of the children. Dental fluorosis prevalence in 450, 6-15-year-olds was 13.03%. Dental fluorosis did not affect 86.97% of the scholars; 10.63% had mild fluorosis and 2.05% was severely affected. The mean fluoride concentration in the drinking water in this region were 1.07 mgIL, ranging between 0.3-3 mgIL. Definite malocclusion was recorded in only 0.48% of the 12-year-old group, whom needed elective treatment. In the 12-year-olds, 99.52% needed no or slight treatment for no or minor malocclusions. The majority of children had no oral mucosal lesions (91.55%). The prevalence of oral mucosal lesions was 8.5% in this survey. The most frequent conditions were traumatic lesions (1.96%), dento-alveolar abscess (1.22%) and herpes labialis (1.22%). The intra-examiner reliability for caries, dental fluorosis, periodontal treatment needs and prevalence of malocclusions was 97.66%, 100%, 88.89% and 86.67% respectively. The inter-examiner reliability was 98.75%, 98.34%, 100%, 100% and 100% respectively for the five examiners. Conclusion: This survey indicated a higher prevalence of dental caries in the primary dentition (63.48%), than the permanent dentition (41.3%). The mean dmft was 3.65 and the DMFT 1.2, which indicated a low mean caries experience for these children. The WHO goal for the year 2000 for the 6-year-olds of 50% being caries free has not reached for only 32.56% were caries free. The mean DMFT of 1.2 for 12-year-olds in this survey is below the WHO goal of a mean DMFT of 1.5 or less. The lack of available preventative service provision, were ) indicated by the low percentage of fissure sealants (2.8%). The need for dental treatment was highlighted by the need mostly for one-surface restorations. Preventative treatment, two-surface fillings and extractions were also needed.
Periodontal disease was a major public oral health concern for this region for a prevalence of 79.09% was recorded for the 12-15-year-olds. The majority of the children affected by periodontal disease (75.07%) were in need of professional cleaning and calculus removal. The prevalence of dental fluorosis was 8.2%, 19.87% and 13.05% for 6-, 12- and IS-year age groups respectively. The prevalence of malocclusion was 0.48% for the 12-year-old group. The prevalence of oral mucosa lesions was 8.5% for 4-15-year-old schoolchildren. Therefore, the
conclusion can be made that dental fluorosis; malocclusions and oral mucosal lesions were no public concern in this region. The major public oral health concerns were dental caries in the primary dentition and periodontal disease in all age groups. Recommendations: Dental services in this region should be directed towards prevention of dental caries in the primary dentition and periodontal disease in all age groups. The focus of dental services should be primarily on preventative programs and treatments. The public dental treatments needs indicated in this survey, namely scaling and polishing, restorations and extractions, consists of the primary health care package delivery. Currently, no evaluation tool exists to monitor the efficiency of oral health programs, no baseline data for the Province exists. Therefore, the urgent need for dental research and oral health service planning and delivery are recommended.
Description
Magister Chirurgiae Dentium - MChD
Keywords
Community Periodontal Index of Treatment Needs (CPITN), Deans Fluorosis Index (DFI), Dental Aesthetic Index (DAl), Teeth Surface Index of Fluorosis (TSIF), National Oral Health Survey (NOHS), Oral Mucosal Lesions, Acute Necrotising Ulcerative Gingivitis (ANUG), Salivary Gland Disease (SGD), Oral Hairy Leukoplakia (OHL), South African Statistics (SAS)