MASTER OF DENTAL SURGERY IN PUBLIC HEALTH DENTISTRY
DATE OF ADMISSION TO THE COURSE
MAY 21, 2009
TITLE OF THE TOPIC
“ORAL HEALTH STATUS AND TREATMENT NEEDS AMONG SUGAR FACTORY WORKERS IN MANDYA DISTRICT, KARNATAKA, INDIA”
BRIEF RESUME OF INTENDED WORK: 6.1 Need for the study:
Today the trend in all countries is towards industrialization. Industrial workers are placed in a highly complicated environment which is getting more complicated as man is becoming ingenious in nature. As industries are developing, occupational diseases are also becoming more prominent.
In many occupations, environmental hazards like sugar dust, bone dust, flour dust, saw dust etc. contribute to poor oral health. The injurious effect of environmental hazards manifest themselves in the teeth, jaw bones, periodontal tissues, tongue, lips and oral mucosa. The effects of the various etiologic agents responsible for oral occupational disease depend on their specific chemical, physical and bacterial nature, their physical state and their mode of entry.
In the sugar industry, the main raw materials consist of carbohydrates. Workers in this industry are exposed to the effects of air polluted by carbohydrates (especially sugar dust) and consume relatively large amounts of sugar for a number of hours, over long periods of time.
Hence this study is aimed to assess the oral health status and treatment needs among sugar factory workers in Mandya district, Karnataka, India.
6.2 Review of Literature: In this study1 the author’s purpose was to assemble data on the prevalence of dental caries among workers in sweet industry in Israel. A total of three confectionaries were selected for the study. A total of 423 participants were taken for the study. The participants were divided into two main groups: production line workers (228 participants) and non- production line workers (195 participants). The control group (812 participants) consisted of a group of production line workers from five textile industrial establishments. The results indicated that the mean DMFT values recorded for the sweets industry workers were significantly higher than those recorded for the control group. Significantly higher mean DMFT values recorded in the production line workers, as compared with the non- production line workers, in the confectionary industry were assumed to be attributed to a higher consumption of sweets and closer exposure to sugar dust. Mean DMFT values were found to increase significantly in relation to the duration of exposure to the effect of carbohydrates in both groups of workers in the sweets industry.
In this study2 the author’s purpose was to develop and evaluate a preventive dental program at two Danish chocolate factories. The total number of workers at two Danish factories (n=112); were offered preventive program for two years. Out of which eighty-nine persons (80%) of 19-61 years of age participated in a 2-year follow up study. Preventive care was offered by a dental hygienist. Clinical prophylaxis was given at four visits in the first year and two visits in the second year. Health education was based on active involvement of the participants and safety group members in order to stimulate self-care activities at the factories. The outcome of the program was evaluated by the clinical recordings of visible plaque index (VPI), gingival bleeding (GB), calculus index (CI) and DMFS. Data on dental conditions were recorded at baseline, after 12 and after 24 months. Questionnaires were completed by the workers each time in order to obtain data on dental knowledge, attitudes, dental health behaviour, social network activities and perception of process. The results showed improvement in dental health in terms of stepwise reduction in VPI, GB, CI and DS. For example, mean GB decreased from 36 % of the teeth scored at baseline to 9% at 24 months and mean DS decreased from 2.3 to 0.7. Positive developments of dental health behaviour were observed. The proportion of workers reporting daily tooth brushing at work increased from 6% to 24% during the program and the proportion of workers using dental floss regularly increased from 24% to 47%. However, the changes in dental knowledge and attitudes were rather diffuse. The majority of the workers (73%-81%) were satisfied with scaling of their teeth, fluoride treatment, instructions and advice in preventive care, and regular control of dental health status. After 12 and 24 months, qualitative interviews were made with the management, the workers of the safety committees and the occupational health personal. Passive as well as active activities should be considered casual with respect to positive outcome of the program.
In this study3 the author’s purpose was to investigate the association between type of work and dental findings and the relevance of sugar dust as an occupational hazard to dental health in workers of modern Finnish confectionary industry, producing sweets, biscuits and bakery products, and in controls in a work environment not concerned with sugar. 298 employees, 42±11 years of age, were investigated clinically and by means of chemical and microbiological tests of their saliva. Mean total time of work on the production line in question was 10±8.5 years. The results indicated that periodontal treatment needs increased similarly with increasing age in all subgroups. Subjects concerned with biscuit production had significantly higher DMFS values than subjects in other groups. They also had significantly higher numbers of untreated cavities: 79% compared to 54.7% in those making sweets, 48.3% in bakery workers and 62.6% in the controls not exposed to sugars. High levels of lactobacilli and Streptococcus mutans were found equally in all subgroups. It was previously shown that sugar and flour dust concentrations were below accepted limits in the confectionary industry by work hygiene measurements, the hypothesis that airborne sugar is an occupational hazard has not been supported. Some other factors need to be accounted for to explain the findings.
In this study4 the author’s purpose was to assess the oral health status and treatment needs of confectionary workers of Bangalore city. A total of 502 confectionery workers [410 males and 92 females] ranging in age from 16 to 60 years were examined and studied under four groups: Biscuit Group (107), Chocolate Group (160), Sweets Group (144) and Bakery Group (91). 294 wheat flour workers [252 males and 42 females] with age and sex matched served as controls. 60.36% confectionary workers exhibited caries experience with significantly higher DMFT as compared to controls (39.11%). Chocolate and sweets group had higher caries experience while biscuit and sweets group had high prevalence of periodontal disease. Increase in caries experience with increase in duration of employment among confectionary workers was observed. Also confectionary workers who consumed confectionary products more than six times per day had higher caries experience than those who consumed 0 to 3 and 4 to 6 times/ day. Periodontal diseases were significantly higher among confectioners (biscuits and sweets groups) than controls (wheat flour workers). Further extensive unmet treatment needs like oral prophylaxis, periodontal therapy, extractions, prosthetic rehabilitations were observed among confectioners.
In this study5 the author’s purpose was to compare DMFT index in the workers of sweets and cable factories of Shahrood city which is located three hundred kilometers of east of Iran. A total of 124 workers [Mean age=40.9 years] of sweets industry with predetermined inclusion criteria and 127 production line workers [Mean age=34.7 years] of cable factory were selected for the study. A questionnaire was filled out and dental status was recorded for each one. Mean SD and DMFT were 12.59±6.5 in sweets industry and 9.7±5.4 in cable factory, which indicated higher mean DMFT values in sweets industry workers than cable factory workers. Caries free individuals in both industries were less than 1% which was neglectable. With ANOVA two- way analysis in two groups and with p< 0.000, there was a significant correlation between type of work and DMFT which proved the hypothesis that the consumption of sweets and neglecting oral hygiene can be considered of great importance in increasing DMFT in the workers of sweets factory as compared to cable factory.
6.3 OBJECTIVE OF THE STUDY:
To study the oral health status and treatment needs among sugar factory workers in Mandya district, Karnataka, India.
MATERIALS AND METHODS
Source of Data
Sugar factories of Mandya district, Karnataka, India
7.2 Method of collection of data(including sampling procedure, if any):
There are sixty-one sugar factories in Karnataka out of which five sugar factories are present in Mandya district of Karnataka. The official list of sugar factories (attached) is obtained from Commissioner of Cane Development and Director of Sugar, Krishna Bhawan, Bangalore.
Materials and methods-
The study population will consist of the employees working in the five sugar factories in Mandya. The sample size will consist of 25% of the total population working in the five sugar factories using systematic random sampling. The oral health status of these subjects will be determined based on the WHO proforma 1997 (attached). Data regarding the number of years of employment and position in the office of each subject will also be recorded.
The examination will be done using available light, mouth mirror and CPI probe.
The data will be statistically analyzed and results will be drawn using the appropriate statistical tests.
7.3 Does the study require any investigation or intervention to be conducted on patients or other Humans or Animals? If so, please describe briefly.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
List of references:
Joseph Z. Anaise. Prevalence of dental caries among workers in the sweets industry in Israel. Community Dent Oral Epidemiol 1980;8:142-145.
Peterson PE. Evaluation of a dental preventive program for Danish chocolate workers. Community Dent Oral Epidemiol 1989;17:53-59.
Masalin K, Murtomaa H, Meurman JH. Oral health of workers in the modern Finnish confectionary industry. Community Dent Oral Epidemiol 1990;18:126-130.
R. Rekha, S.S. Hiremath. Oral health status and treatment requirements of confectionary workers in Bangalore city. IJDR 2002July-Dec;13(3,4):161-165.
Z Tohidast Akrad, JM Beitollahi, AA Khajetorab. DMFT (Decayed, Missing, Filled, Teeth) oral health index in sweets and cable industry workers. Iranian J Publ Health 2006;35(2):64-68.
World Health Organization. Oral health surveys- basic methods. 4th edition.