1

جامعة العلوم والتكنولوجيا

كلية طب االسنان

قسم طب أسنان المجتمع

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

FEB\2014

اهلل الرحمن الرحيم بسم

2

PERFACE FOR OUR DOCTOR:

ALI AL-MASHHADANI

AND GRAET THANKS FOR OUR PARENT

FOR THEIR PATIENT AND SUPPORT TO

SEE OUR SUCCESS.

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

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

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6

CHAPTER 1

DENTAL CARIES

IN PRIMARY

SCHOOL

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 caries on 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

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

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). -

-

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

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

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

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

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CHAPTER2

WORK

ENVIROMENT

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

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: 1\d 2\d 3\d 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: 1\d 2\d 3\d 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: 1\d 2\d 3\d 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? 1\d 2\d 3\d Other

Type of snack: Sug: fru: Ch: Ju: other

17

Malocclusal

Crowding Open bit

Cross bit Un competent lip

Normal Other..

18

CHAPTER 3

Research

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

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CHAPTER 4

RESAULTS

21

AGE

DMF OF 6-11 YEARS OLD IN RIYADH, SAUDI ARABIA IN 1991

10-11 8-9 6-7 AGE

70 87 93 NO.

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

10-11 8-9 6-7 AGE

106 157 188 NO.

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

11 10 9 8 7 6 AGE

30 30 30 30 40 40 NO.

57 54 62 41 48 43 DMF

3.5% 3.70% 3.22% 4.87% 4.16% 4.65% DMF%

By :Hisham Ibrahem . Mohammed Algabri . Tariq Musawa Table(5)

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

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

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

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

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

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

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

CHAPTER 5

Search Result

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

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

Chapter 6

Recommendation

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

Chapter 7

summary

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

References:

BOOKS

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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

» 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],

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