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Table of Contents
Year : 2020  |  Volume : 8  |  Issue : 3  |  Page : 35-38

Assessment of dental caries prevalence among institutionalized visually impaired children in delhi state

1 Consultant Pedodontist, Department of Paedodontics and Preventive Dentistry, New Delhi, India
2 Department of Public Health Dentistry, Hazaribag College of Dental Sciences and Hospital, Demotand, Hazaribag, Jharkhand, India
3 College of Dentistry, Imam Abdulrahaman Bin Faisal University, Dammam, Saudi Arabia
4 Department of Pedodontics and Preventive Dentistry, Oxford Dental College and Hospital, Bengaluru, Karnataka, India

Date of Submission21-May-2020
Date of Acceptance03-Jun-2020
Date of Web Publication24-Jul-2020

Correspondence Address:
Dr. Aarti Kumari
Department of Public Health Dentistry, Hazaribag College of Dental Sciences and Hospital, Jharkhand State Highway-7, Demotand, Hazaribag, Jharkhand.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/INJO.INJO_16_20

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Aim: To assess the prevalence of dental caries in visually impaired children and adults aged 6–25 years attending special schools in Delhi. Materials and Methods: A total of 1131 visually impaired individuals studying in various special care institutions in Delhi were examined. Extraoral as well as intraoral examinations were carried out and decayed-missing-filled teeth (DMFT) index and decayedextracted-filled teeth (deft) index were used. The relevant findings were entered in the proforma. Result: It was seen that of 285 students in the mixed dentition group, 77 individuals had dental caries constituting 27.02%; whereas in the other group, of 1131, 575 individuals presented with DMFT scores constituting 50.84%. On the whole, it was noted that 44.3% of the individuals were caries free in both the groups. Conclusion: The DMFT index showed a cumulative increase with age. As age advanced, the incidence increased. Dental caries prevalence was more in males as compared to females.

Keywords: Children and adults, dental caries, institutionalized, special children, visually impaired

How to cite this article:
Mohan N, Sharma B, Kumari A, Chatterjee S, Khan AM, Haqh MF. Assessment of dental caries prevalence among institutionalized visually impaired children in delhi state. Int J Oral Care Res 2020;8:35-8

How to cite this URL:
Mohan N, Sharma B, Kumari A, Chatterjee S, Khan AM, Haqh MF. Assessment of dental caries prevalence among institutionalized visually impaired children in delhi state. Int J Oral Care Res [serial online] 2020 [cited 2021 Dec 9];8:35-8. Available from: https://www.ijocr.org/text.asp?2020/8/3/35/290669

  Introduction Top

Dental caries is the most prevalent oral disease all over the world and is rapidly emerging among the children of India. Its incidence in different states varies between 60% and 90%.[1] According to National Oral Health Survey, caries prevalence in India was 51.9%, 53.8%, and 63.1% at ages 5, 12, and 15 years, respectively. In the absence of baseline data, the exact magnitude of the oral health problems is seldom recognized in India; as a result, oral health always remains a low-priority area in the government programs. Therefore, in developing countries such as India, this is quite a serious yet one of the most neglected problems.[2] Dental plaque deposited over the tooth surface is the main causative factor. Conventional methods for teaching oral hygiene involve the use of visual perception, using disclosing agents to visualize the plaque and tooth brushing to remove it, and redisclosing periodically to monitor their improvement of oral hygiene status. Unfortunately, none of these measures are beneficial to visually impaired children who depend much more on feeling and hearing to learn.

The main factor of differentiation between normal patients and blind ones is the difficulty in removing plaque. The visually impaired people are at a greater risk to develop caries, as they are unable to see the early signs of the disease process. In order to prevent the disease, our main concern is to reduce plaque deposition on the tooth surface by different means.

The objective of this study was to assess the prevalence of dental caries among the institutionalized visually impaired children and adults in Delhi.

  Materials and Methods Top

A total of 1131 visually impaired individuals in the age group of 6–25 years with 100% bilateral blindness were included in the study. A self-administered close-ended questionnaire written in English was prepared to record the information.

The training and calibration of the principal investigator was done under the chief supervisor before proceeding further to avoid intra examiner variability. In the interview, the responses were recorded with the help of the guardians or the class teachers who were used as co-coordinators for the study, followed by the Type III clinical examination of children which was carried out inside the school premises using mouth mirror and explorer. Teeth were examined for dental caries using the decayed-missing-filled teeth (DMFT) index given by Klein et al.[3] and decayed-extracted-filled teeth (deft) Index given by Gruebbel.[4] After a thorough oral examination, for those children needing treatment, oral prophylaxis and antiretroviral therapy (ART) was performed. Clinical findings of the individuals were reported and reference slips were forwarded to the parents or guardians of the individuals through their class teachers for information and necessary action.

All the data obtained were punched using Microsoft Excel. The same sample was divided accordingly into two different groups: mixed dentition (6–12 years) (Category A) and permanent dentition (13–25 years) (Category B). Mann–Whitney U test was used to compare the categorical variables (age and gender). Statistical significance was fixed at P ≤ 0.05.

  Results Top

Among the different groups, majority of the individuals were males [Graph 1] and belonged to the permanent dentition category.
Graph 1: Age- and sex-wise distribution of the study population

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The mean DMFT score in Category A was 0.44 and that in Category B was 1.57. This difference is statistically significant (P < 0.001) stating that dental caries is higher among the individuals with permanent dentition, whereas the mean deft score observed was 0.65 [Table 1].
Table 1: Age-wise distribution of dental caries (DMFT and deft) in mixed and permanent dentition

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Of 285 subjects in this group, 201 were males and the remaining were females. The difference in the mean DMFT and deft scores were nonsignificant [Table 2].
Table 2: Gender-wise distribution of dental caries (DMFT and deft) in mixed dentition (6–12 years)

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Among 846 students, the gender-wise distribution of dental caries (DMFT) in Category B was observed. The mean DMFT (mean ± standard deviation [SD]) among 600 males was 1.86 ± 1.72 and 1.76 ± 1.73 among 246 females. A statistically significant difference was observed (P = 0.018) among the males and females. Males presented with higher DMFT scores as compared to females. The prevalence of dental caries among the two groups was found to be 27.02% among the mixed dentition and 50.84% among the permanent dentition group [Table 3].
Table 3: Dental caries prevalence

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  Discussion Top

This study reveals the mean DMFT score of 1.29 and deft score of 0.65. The caries in the permanent dentition was among 50.84% individuals and 27.02% had decay in the mixed dentition. This was considered contrasting to studies conducted by Prashanth et al.[5] and Reddy et al.,[6] where, 35.2% and 26.6% of children had dental caries in permanent dentition, respectively. The higher caries rate among these individuals could be due to the frequent consumption of sweets and in between snacking as reported by their care providers. The reason being different living environment that includes various factors such as socioeconomic status, peer influence, illiteracy, and lack of awareness toward oral health among the parents, which might have encouraged the frequent consumption of refined sugars resulting in a higher DMFT before their admission to the special care institutions.

However, the “D” and the “d” components accounted for a higher proportion of the total DMFT and dft, respectively. The trends in this study are similar to those found in other studies, which may indicate that the unmet treatment need was large with very few individuals having been treated by a dentist, a high demand for provision of dental services still remains.[7],[8] Conversely, many previous studies on children with disabilities or with special health-care needs found higher percentages of caries-free participants than in our study (44.3%), also in the studies by Ajami et al. (2007), the caries-free percentages were 81.7%.[9] On a global level, the proportion of caries-free children (53.2%) in a study done by Tagelsir et al.[10] was higher than those reported from comparable population in Turkey (26.4%), India (1.5%), and Kuwait (35.5%). Differences in the proportion of caries-free children could be attributed to differences in dietary patterns and accessibility to sweet snacks. Visually impaired children have more difficulties in performing oral health-care measures compared to children with other types of disabilities. This could explain the lower percentage of caries-free children in our study. Moreover, a recent study by Bekiroglu et al.[11]revealed no significant association between the degree of blindness and their caries experience.

Maciel et al.[12] quoted the increased rates of DMFT in children and adolescents, and especially in young adults, which are consistent with the data from SB Brazil 2003, indicating that 70% of Brazilian children at 12 years of age and about 90% of adolescents aged 15–19 have at least one tooth with caries. An increase in caries prevalence and severity with increasing age is attributed to the irreversibility and accumulative nature of the disease with age. This is well observed in this study. The mean DMFT score among the mixed dentition group was 0.44 which increased to 1.57 in the permanent dentition group. Also, males showed high DMFT and deft scores as compared to the females. The reason could be attributed to the lack of maintenance of oral hygiene among the male population. This is agreed in the study done by Solanki et al.;[13] when DMFT indices were examined with regard to sex, the mean DMFT was found to be higher for males. Although various studies on the prevalence of dental caries of the normal population have been carried out in the past, only limited studies have been done comparing dental health of different kinds of Special Care children more so for the visually impaired children and adults in the city of Delhi. This will be helpful in obtaining baseline data to understand their oral health needs and accordingly recommending appropriate preventive measures.

  Conclusion Top

The conclusions drawn from this study were that the overall dental caries prevalence was 55.7%, of which 27.02% individuals had dental caries in the mixed dentition with a mean deft score of 0.65 and 50.84% individuals presented with dental caries in the permanent dentition with a mean DMFT score of 1.29. The DMFT index showed a cumulative increase with age. Dental caries prevalence was more in males as compared to females. This was significant in the permanent dentition but not in the mixed dentition group.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Hiremath A, Murugaboopathy V, Ankola AV, Hebbal M, Mohandoss S, Pastay P Prevalence of dental caries among primary school children of India: A cross-sectional study. J ClinDiagn Res 2016;10:ZC47-50.  Back to cited text no. 1
Reddy VK, Chaurasia K, Bhambal A, Moon N, Reddy EK A comparison of oral hygiene status and dental caries experience among institutionalized visually impaired and hearing impaired children of age between 7 and 17 years in central India. J Indian Soc Pedod Prev Dent 2013;31:141-5.  Back to cited text no. 2
Klein H, Palmer CE, Knutson JW Studies on dental caries: Dental status and dental needs of elementary school children. Pub Health Rep 1938;53:751-65.  Back to cited text no. 3
Gruebbel AO A measurement of dental caries prevalence and treatment service for deciduous teeth. J Dent Res 1944;23:163-8.  Back to cited text no. 4
Prashanth ST, Bhatnagar S, Das UM, Gopu H Oral health knowledge, practice, oral hygiene status, and dental caries prevalence among visually impaired children in Bangalore. J Indian Soc Pedod Prev Dent 2011;29:102-5.  Back to cited text no. 5
Reddy KS, Reddy S, Ravindhar P, Balaji K, Reddy H, Reddy A Prevalence of dental caries among 6–12 years school children of Mahbubnagar District, Telangana State, India: A cross-sectional study. Indan J Dent Sci 2017;9:1-7.  Back to cited text no. 6
Rashad Al-Alousi JM Oral health status and treatment needs among blind children in Iraq. MDJ 2009;6:313-24.  Back to cited text no. 7
Shetty V, Hegde AM, Bhandary S, Rai K Oral health status of the visually impaired children: A South Indian study. J Clinical Pediatr Dent 2010;34:213-6.  Back to cited text no. 8
Ajami BA, Shabzendedar M, Rezay YA, Asgary M Dental treatment needs of children with disabilities. J Dent Res Dent Clin Dent Prospects 2007;1:93-8.  Back to cited text no. 9
Tagelsir A, Khogli AE, Nurelhuda NM Oral health of visually impaired schoolchildren in Khartoum state, Sudan. BMC Oral Health 2013;13:33.  Back to cited text no. 10
Bekiroglu N, Acar N, Kargul B Caries experience and oral hygiene status of a group of visually impaired children in Istanbul, Turkey. Oral Health Prev Dent 2012;10:75-80.  Back to cited text no. 11
Maciel MAA, Cordeiro PM, d’Ávila S, Godoy GP, Alves RD, Lins RDAU Assessing the oral condition of visually impaired individuals attending the Paraiba Institute of the Blind. Rev Odontocienc 2009;24:354-60.  Back to cited text no. 12
Solanki J, Gupta S, Arora G, Bhateja S Prevalence of dental caries and oral hygiene status among Blind School Children and Normal children, Jodhpur city: A comparative study. J Adv Oral Res 2013;4:1-5.  Back to cited text no. 13


  [Figure 1]

  [Table 1], [Table 2], [Table 3]


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