Post graduate student department of public health dentistry rajarajeswari dental college and hospital, no



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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE

KARNATAKA

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION



1.

NAME OF THE CANDIDATE AND ADDRESS

(IN BLOCK LETTERS)

Dr. PRAVEEN. G

POST GRADUATE STUDENT

DEPARTMENT OF PUBLIC HEALTH DENTISTRY

RAJARAJESWARI DENTAL COLLEGE AND HOSPITAL, NO.14, RAMOHALLI CROSS, KUMBALGODU, MYSORE ROAD, BANGALORE – 560074.



2.
NAME OF THE INSTITUTION

RAJARAJESWARI DENTAL COLLEGE & HOSPITAL.

3.
COURSE OF STUDY AND SUBJECT

MASTER OF DENTAL SURGERY IN PUBLIC HEALTH DENTISTRY

4.
DATE OF ADMISSION TO COURSE


28th MAY 2011.





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TITLE OF THE TOPIC:

“DENTAL CARIES PREVALENCE AND

ORAL HEALTH BEHAVIOUR IN 6

AND 12 YEAR OLD RURAL AND

URBAN SCHOOL CHILDREN IN

BANGALORE” -A COMPARATIVE

STUDY.





6.




BRIEF RESUME OF THE INTENDED WORK :

6.1 NEED FOR THE STUDY :
Dental caries is a destructive process causing decalcification of the tooth enamel and leading to continued destruction of enamel and dentin, and cavitation of the tooth1. Dental caries is known as the principal problem in public oral health2. Dental caries continues to be the most common infectious disease of childhood. It is therefore important to identify target patients at high risk of developing caries in order to develop specific preventive measures3.

A large number of studies have confirmed that there is a relationship between socio-economic status and the incidence and prevalence of caries. Traditionally, there have been lower economic and educational levels in rural populations as well as lower accessibility to dental services4. Studies have shown that caries experience in primary teeth is correlated with caries in permanent teeth in diverse countries and ethnic groups, with a relatively strong association compared to other variables. Such relations are modified by associations between socioeconomic variables and dental caries. Various authors reported a difference between sexes, observing that boys have higher dental caries experience in primary dentition than girls. This situation was reversed in permanent teeth2. An expanding number of epidemiological studies around the world have demonstrated a direct relationship between various behavioural, social, economic, and clinical factors and dental caries. Among these factors, studies have shown that tooth brushing and oral hygiene behaviour in children is associated with dental caries experience2. Dental caries has increased in prevalence and severity in urban and cosmopolitan population over the last couples of decades5.

However there is no definite picture as yet regarding the disease status in rural and backward areas of country in the comparison where 80% of the population inhabits. With this perspective, this study was undertaken to assess dental caries prevalence and oral health behaviour among 6 and 12 year old school children in urban and rural Bangalore.




6.2 REVIEW OF LITERATURE :

1) A study was conducted in 1995 in Wuhan to describe the occurrence of dental caries in Chinese school children and to highlight the oral health behaviour situation. Clinical examination of grade 1 children (age 6 years) 381 sample and grade 6 (age 12 years) 413 samples were performed and personal interview with mothers was done. They showed caries prevalence of 86 per cent among 6 year children and the mean DMFT of 12 year olds was 1.0 and 31% urban children and only 9% rural children had visited the dentist in past 12 months. It was reported that only 22% of children brushed twice daily 20% had seen the dentist in past 1 year and only 4 % had practical support from their parents in tooth cleaning They concluded that dental care habits of children was poor and systematic school based programme should be implemented to promote oral health6.


2) A pathfinder pilot survey was done in 1995 in Windhoek area, Namibia to assess the oral health status knowledge and dietary habits among urban and rural 6-7 year old children. Where 99 children were randomly selected and examined in that 50 children are from urban township school and 49 are from rural primary school. A structured questionnaire was given for child to complete under supervision of teacher or oral health promoter. The results showed that dental caries was present in 73% of the children and the urban children had a significantly higher mean dmft than the rural children. Oral hygiene habits such as tooth brushing frequency were more established in the urban children, whereas frequent consumption of sweet/candy and soft drinks was significantly higher in this group of children. There was no significant difference between the two groups regarding caries free children, and oral health knowledge. The study concluded that increased caries prevalence among urban children and to continue and extend the existing preventive programme “Smiling Schools of Namibia” throughout the country7.
3) A cross sectional study was done in 1997 in southern Thailand to assess dental caries in urban and rural school children and to analyse self care practices and dental visiting habit of children. A total of 1156, 6 year olds and 1116, 12 year old children of urban and rural school were chosen randomly. Clinical examination to record dental caries and a questionnaire was used to record oral health behaviour. They showed that at age 6 yrs, 96.3 % children had caries and their mean dmft was 8.1 and among 12 yr olds, 70% had dental caries in permanent tooth and their mean DMFT was 2.4. 53% students reported with experience of pain during last 12 months, 66% visited dentist in last one year, 88% claimed that they brush twice daily, 24% reported having hidden sugar in soft drinks, 34% in milk with sugar and 26% tea with sugar. They concluded that systematic health education may further improve the oral health of Thai children8.

4) A study was done in 1999 in Portugal to assess the actual oral health status of Portuguese school children aged 6 and 12 years according to gender and urbanization, to highlight the trend over time in dental caries prevalence of children, to assess the dental care habits and the provision of preventive services to children, and to analyze the effect of dental care habits on caries experience. The study comprised of 799, 6 year olds and 800, 12 year olds and clinical examination was carried out according to WHO criteria and result showed 46.9% of dental caries in 6 year olds and 52.9 % in 12 year olds . At age 12, 90% children had poor oral hygiene. 31% of 6 year olds and 55.6 % 12 year olds reported that they brushed twice daily, 17.8% 6 year and 58.3% 0f 12 year olds had seen a Dentist during past one year. They concluded that further implementation of school based oral health promotion and application of population-directed preventive strategies are needed in Portugal9.

5) A study was conducted in 2001 Southern China to describe the oral health status and treatment needs of 5-6-year-old (n=1587) and 12-year-old (n=1576) urban and rural schoolchildren living in Guangdong Province. Three calibrated dentists clinically examined the children, and trained interviewers interviewed the 12- year-olds. The result was high prevalence of caries in 5 to 6-year-old children (urban 78% vs. rural 86%); the mean dmft of the urban and rural children was 4.8and 7.0, respectively and the caries prevalence and mean DMFT score of the 12-year-olds were 41% and 0.9 (urban) and 42% and 0.9 (rural). Oral hygiene practice and utilization of dental services was found to be low in rural children. It was concluded that prevalence of dental caries among the 5 to 6 year olds in Guangdong Province, Southern China, was high and the

prevalence was higher among rural than urban children thus need for caries treatment was substantial and there is an urgent need for establishing caries-preventive activities for pre-school children10.

6) A cross sectional study was done in 2006 Municipality of Banja Luka, Bosnia and Herzegovina to assess caries prevalence and to determine risk factors for dental caries in the Primary and Permanent Dentition of Rural And Urban six year olds (n=372) and twelve year olds (n= 495) using random sampling technique. Clinical examinations and structured questionnaire were used in the study. The mean DMFT was higher in rural six-year-old boys and girls 1.26(±0.16) and 1.34(±0.19), respectively than in urban ones 0.68(±0.07) and 0.66(±0.06), respectively and at age 12 years, the mean DMFT for boys was 5.49(±0.61) from rural areas and 4.29(±0.35) from urban areas and for girls 5.72(±0.55) and 4.98 (±0.39), respectively. It was found that there was insufficient dental services and very high frequency of sugar intake and significant differences regarding dental visits. They concluded that high caries was prevalent in all the groups that were examined, with a higher level among children from rural areas. It is essential to implement a long term oral health education programme in Banja Luka4.

6.3 AIM OF THE STUDY :-
To assess caries prevalence and oral health behaviour in 6 and 12 year old rural and urban school children in Bangalore.



    1. OBJECTIVES OF THE STUDY:-

  1. Evaluate caries prevalence in 6 and 12-years old School children in urban and rural populations in Bangalore.




  1. Determine the oral health behaviour of the study population in relation to possible risk factors for the development of caries.



7.



7. MATERIAL AND METHODS :

MATERIALS AND INSTRUMENTS:-

1. Gloves

2. Mouth masks

3. Mouth mirrors

4. Dental explorer

5. Tweezers

6. Cotton holder

7. Chip blower

8. Kidney trays

9. Disinfectants

10. Sterilized Cotton rolls

The examination will be carried out under adequate illumination. Sufficient numbers of autoclaved instruments will be taken for day to day examination.



7.1 SOURCE OF DATA :-

Data is collected from 6 and 12 years old children from urban and rural schools in Bangalore which are selected by stratified random sampling technique.



7.2. METHOD OF COLLECTION OF DATA:-

List of schools was obtained from the office of Deputy Director Of Public instruction, Bangalore. Stratified random sampling technique was used and schools were stratified into north and south Bangalore schools. From each stratum equal numbers of urban and rural schools were selected randomly i.e. 10 urban and 10 rural schools. From each school sample size was limited to 20 to incorporate more number of schools and sample was selected randomly with equal number of boys and girls. Hence total sample size of 400 will be included in the study.

Before clinical examination written informed consent will be taken from the parents of both 6 and 12 year olds. A structured questionnaire will be given to parents of 6 years; and children of 12 year olds under the supervision of teacher to fill the questionnaire. Clinical examination will be carried out and dmft and DMFT indices will be recorded.

Inclusion criteria :-

1. 6 years and 12 year old children.

2. Participants of the study who have signed the consent form.
Exclusion criteria:-

1. Subjects who do not consent to participate.

2. Medically compromised and mentally challenged students.
7.3 STUDY DESIGN:-

A cross sectional comparative study will be carried out on 400 six and twelve years old children from selected 20 schools of Bangalore.


5 schools 20 students from each school {total=100}

10 schools (urban) (10 boys & 10 girls of equal 6 &12 year old)

(North zone) 5 schools 20 students from each school {total=100}

20 Schools (rural) (10 boys & 10 girls of equal 6 &12 year old)

(Bangalore) Total sample

Size (n=400)

10 schools 5 schools 20 students from each school {total=100}

(South zone) (urban) (10 boys & 10 girls of equal 6 &12 year old)

5 schools 20 students from each school {total=100}

(rural) (10 boys & 10 girls of equal 6 &12 year old)



7.4 STATISTICAL ANALYSIS :-

Data will be analyzed using SPSS and Manshar version 2.0 software. Results will be evaluated statistically using Chi-square test with Yeats correction if necessary. Further analysis will be done using appropriate statistical test.



7.5. Has ethical clearance been obtained from your institution?

Yes .Institutional ethical clearance certificate has been attached.


8



REFERENCES :-

  1. Dorland's Medical Dictionary for Health Consumers. © 2007 by Saunders, an imprint of Elsevier, Inc

2) Perla R. Beltrán-Valladares, Hector Cocom-Tun, Juan F. Casanova- Rosado, Ana

A. Vallejos-Sánchez, Carlo E. Medina-Solís, Gerardo Maupomé. Caries

prevalence and some associated factors in 6-9 years old school children in

Campeche, Mexico. Rev Biomed 2006; 17:25- 33.




  1. Sean L. Cook, E. Angeles Martinez-Mier, Jeffrey A. Dean, James A. Weddell, Brian J. Sanders, Hafsteinn Eggertsson. et.al. Dental caries experience and association to risk indicators of remote rural populations International Journal of Paediatric Dentistry 2008; 18: 275–283



  1. Olivera Dolic, Jovan Vojinovic, Dragoslav Djukanovic, Slobodan Cupic, Slava

Sukara, Marija Obradovic et.al. Caries Prevalence in the Primary and Permanent Dentition of Rural And Urban Children in the Municipality of Banja Luka, Bosnia and Herzegovina. OHDMBSC March2010; 10(1):39-47.

5) Joyson Moses, B N Rangeeth, Deepa Gurunathan. Prevalence Of Dental Caries,

Socio-Economic Status And Treatment Needs Among 5 To 15 Year Old School

Going Children Of Chidambaram. Journal of Clinical and Diagnostic Research



  1. ; 5(1):146-151.


  1. Poul Erik Petersen, Zhou Esheng. Dental caries and oral health behavior

Situation of children, mother and schoolteacher in Wuhan, People’s Republic of

China. International Dental Journal 1998; 48: 210-216.





  1. Helena Hofstedt, Elisabeth Stillerman .Oral health status, knowledge and dietary habits among urban and rural 6-7 year old children in the Windhoek area, Namibia. Available from :URL:http://wwwisis.unam.na/hivdocs/UNICEF/Health%20Namibia/Hofstedt%20Stillermann Child%20oral%20health Windhoek.pdf



  1. Poul Erik Petersen, Niels hoerup, Nattaporn poomviset, Janpim Prommanjan and Achara Watanapa. Oral health status and oral health behaviour of urban and rural school children in southern Thailand. International Dental Journal 2001; 51: 95-102.



  1. César Mexia de Almeida, Poul Erik Petersen, Sónia Jesus André and António

Toscan. Changing oral health status of 6- and 12-year-old schoolchildren in Portugal. Community Dental Health 2003; 20: 211–216.



  1. M.C.M. Wong, E.C.M. Lo, E. Schwarz and H.G. Zhang. Oral Health Status and

Oral Health Behaviors in Chinese Children. JDentRes 2001; 80(5):1459-1465.





9

SIGNATURE OF THE CANDIDATE



10

REMARKS OF THE GUIDE





11



11.1.

NAME & DESIGNATION OF

(in block letters)

GUIDE

Dr PADMA . K .BHAT , M.D.S. PROFESSOR AND HEAD

DEPARTMENT OF PUBLIC HEALTH DENTISTRY,

RAJARAJESWARI DENTAL COLLEGE AND HOSPITAL, BANGALORE





11.2 SIGNATURE OF GUIDE







11.3. CO-GUIDE

Dr ARUNA C. N. , M.D.S

READER ,

DEPARTMENT OF PUBLIC HEALTH DENTISTRY,

RAJARAJESWARI DENTAL COLLEGE AND HOSPITAL, BANGALORE.






11.4. SIGNATURE OF CO-GUIDE




11.5. HEAD OF THE DEPARTMENT


Dr PADMA . K .BHAT , M.D.S. DEPARTMENT OF PUBLIC HEALTH DENTISTRY,

RAJARAJESWARI DENTAL COLLEGE AND HOSPITAL, BANGALORE






11.6. SIGNATURE




12



12.1. REMARKS OF THE CHAIRMAN & PRINCIPAL







12.2. SIGNATURE









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