PP Mr. Samnang

7/30/2019 PP Mr. Samnang

1/34

UNIVERSITY OF HEALTH SCIENCE

FACULTY OF ODONTO-STOMATOLOGY

Thesis defended

by

Mr. Sim Samnang and Bun Chanrakmsey

Topic:An Investigation on the Impact of Dental

Caries on Quality of Life among 6 and 12

year-old Children in Phnom Penh, 2012

1


2/34

Content

I. Introduction

II. Literature review

III. MethodologyIV. Result

V. Discussion

VI. Conclusion and recommendationVII. References

2


3/34

I. Introduction

BackgroundOral health makes an individual be able to talk, eat andsocialize without any problems that associate withdisease, discomfort or embarrassment. Oral health is

fundamental to general health and well-being,significantly impacting on quality of life. It can affectgeneral health conditions.

Oral health means more than healthy teeth. The health ofthe gums, oral soft tissues, chewing muscles, the palate,tongue, lips and salivary glands are also significant. Poororal health can have a bad impact on childrensperformance both in school and their daily living as wellas their success in later life.

3


4/34

I. Introduction

Dental caries in other countries

Worldwide, dental caries is the most prevalent ofthe oral diseases with considerable variations in its

occurrence between countries, regions withincountries, areas within regions and within socialand ethnic groups. During the past four decades, forexample, the prevalence of dental caries in the

general populations of Western industrializedcountries has decreased markedly. In children also,a reduction of dental caries experience has beenreported by many authors.

4


5/34

I. Introduction

Dental caries in Cambodia

Based on the facts issued by the Ministry of Health in the

National Oral Health Master Plan report, in 1999, only

0.5% of the Gross Domestic Product (GDP) was spent onhealth, compared to around 2% in other developing

countries.

The caries experience (DMFT) of 6 years old children was

7.9+/- 5.6. The caries experience (DMFT) of 12 years old

children was 1.1+/-1.6 and all were untreated caries (DT).

5


6/34

I. Introduction

Aim

The aim of this study is to investigateon the impact of dental caries on the

quality of life among 6 and 12-year-olds children in 7 Makara in Phnom Penh, 2012.

Objectives

General objective

To record the oral health status and quality of life of 6 and 12-year olds in 7

Makara in Phnom Penh, 2012.

Specific objective

To record the prevalence of dental caries in 6-and 12-year-olds

To assess the impacts of dental caries on the quality of life of 6-and 12- year-olds

6


7/34

7


8/34


Dental caries

Dental caries or tooth decay is a multifactorial disease

experienced by 90% of the worlds population. It is

therefore, a common chronic disease that causes painand disability across all age groups. If left untreated,

dental caries can lead to pain and infection, tooth

loss, and edentulism (total tooth loss). In astatistically very few cases, if left untreated, it can

lead to septicemia and death.

8


9/34


Etiology and pathology of dental caries

In general, tooth decay requires the simultaneous

presence of many factors such as bacteria (in the

plaque), sugar, and a vulnerable tooth surface.Although several micro-organisms found in the

mouth can cause tooth decay, the primary disease

agent appears to be Streptococcus mutans.Streptococcus mutans is the primary etiologic agent

of dental caries in humans, a common infectious

disease in the world.

9


10/34



The simple sugars used by the bacteria are glucose,sucrose, lactose. They are converted primarily into

lactic acid. When this acid builds up on the toothsurface, it dissolves the minerals in the enamel,creating micropores or spaces, which if notreversed may ultimately result in cavities. Dental

caries may develop on any tooth surface in the oralcavity where a microbial biofilm (dental plaque) isallowed to develop and remain for a period.

10


11/34



The presence of microbial biofilm (dental plaque) is aimportant factor for caries. Metabolic activity takes

place constantly within the biofilm resulting innumerous minute fluctuations in pH. These maycause loss of mineral from the tooth surface wherethe pH is dropping or a gain of mineral where the pH

is increasing. The cumulative result may be a net lossof mineral leading to dissolution of the dental hardtissues and a carious lesion.

11


12/34



There are four principal elements in this

multi-factorial disease:

1- Micro-organisms in the oral bio-film or dental

plaque

2- Substrate/diet (foods, sugars)

3- Host teeth

4- Time

12


13/34


Impact of dental disease on quality of life

Despite a low mortality rate associated with dentaldiseases, they have a considerable impact on self-

esteem, eating ability, nutrition and health both inchildhood and older age [31]. Teeth are important inenabling consumption of a varied diet and inpreparing the food for digestion. In modern society,

the most important role of teeth is to enhanceappearance; facial appearance is very important indetermining an individuals integration into society.

13


14/34


Impact of dental disease on quality of life

Teeth also play an important role in speech andcommunication. The second International CollaborativeStudy of Oral Health Systems (ICSII) revealed that in allcountries covered by the survey substantial numbers ofchildren and adults reported impaired social functioningdue to oral disease, such as avoiding laughing or smilingdue to poor perceived appearance of teeth.

Throughout the world, children frequently reportedapprehension about meeting others because of theappearance of their teeth or that others made jokesabout their teeth.

14


15/34

III. Methodology

Data collection was performed in 2012. Four primaryschools were chosen in order to investigate dental cariesstatus.

A total sample of 600 students was selected for the

interview and the oral health examination. The protocoland detection criteria used in the clinical examinationwere those of the World Health Organization.

The clinical exanimations were carried out by twoexaminers throughout the survey in order to minimize

examiner error.The examinations and interviews were conducted out-door using daylight, but not direct sunlight as the lightsource.

15


16/34

IV. Result

Age

Sex

TotalBoy Girl

Number Percentage Number Percentage Number Percentage

6 186 62% 114 38% 300 50%

12 132 44% 168 56% 300 50%

Total 318 53% 282 47% 600 100%

Percentage of sample size, by age and sex

16


17/34

IV. Result

Sex

Tooth Brushing Total

Yes Percentage No Percentage Number Percentage

Male 292 92% 26 8% 318 53%

Female 259 92% 23 8% 282 47%

Total 551 92% 49 8% 600 100%

Frequency of teeth brushing

17


18/34

IV. Result

Oral health problem Yes Percentage No Percentage Total

Toothache during last month 437 73% 163 27% 600

Go to school when toothache 373 63% 227 37% 600

Pain at night 221 37% 379 63% 600

Difficult in chewing 198 33% 402 67% 600

Self-report of oral health problems in selected schools

18


19/34

IV. Result

Age

Time/day

Total

0 (%) 1 (%) 2 (%) 3 (%)

6 26 8.7% 108 36% 164 54.7% 2 0.6% 300

12 22 7.3% 92 30.7% 186 62% 0 0% 300

Total 48 8% 200 33.35% 350 58.35% 2 0.3% 600

Frequency of tooth brushing for selected school

19


20/34

IV. Result

Problems Age Number Percentage Total

Eating6 155 25.8%

310 (51.6%)12 155 25.8%

Cleaning 6 149 24.8% 295 (49.2%)12 146 24.3%

Smiling

6 80 13.3%

165 (27.4%)12 85 14.1%

Sleeping

6 83 13.8%

164 (27.3%)12 81 13.5%

Speaking

6 87 14.5%

164 (27.3%)12 77 12.8%

Performing

6 41 6.8%

107 (17.9%)12 66 11%

Feeling6 33 5.5%

94 (15.6%)12 61 10.1%

Interacting

6 40 6.6%

86 (14.2%)12 46 7.6%

Total 1385

Oral impairments affect childrens daily living, by sex

20


21/34

IV. Result

Age Sex

dt > 0 dmft > 0

Number Percentage Number Percentage

6

Boy 185 61.66% 185 61.66%

Girl 113 37.66% 113 37.66%

Total 298 99.32% 298 99.32%

12

Boy 67 22.33% 69 23%

Girl 75 25% 76 25.33%

Total 142 47.33% 145 48.33%

Prevalence of dental caries (Primary teeth)

21


22/34

IV. Result

Age Sex

DT > 0 DMFT > 0

Number Percentage Number Percentage

6

Boy 125 41.66% 122 40.66%

Girl 77 25.66% 75 25%

Total 202 67.32% 197 65.66%

12

Boy 117 39% 117 39%

Girl 145 48.33% 147 49%

Total 262 87.33% 264 88%

Prevalence of dental caries (Permanent teeth)

22


23/34

IV. Result

Age Sample size Mean (dmft) SD

6 300 12.20 4.17

12 300 1.58 2.26

Total 600 6.89 6.28

Mean of decayed, missing, and filling teeth (dmft)

23


24/34

IV. Result

Age Sample size Mean (DMFT) SD

6 300 1.39 1.22

12 300 4.37 3.45

Total 600 2.88 2.33

Mean of Decayed, Missing, and Filling teeth (DMFT)

24


25/34

V. Discussion

The results show the mean dmft of 12.20 4.17, DMFT of1.39 1.22 among six-year children, and the mean dmftof twelve-year children is 1.58 2.26, DMFT of 4.37 3.45 and overall mean dmft is 6.89 6.28, DMFT is 2.88

2.33 for 4 primary schools in 7 Makara District in PhnomPenh.

The value of six-year children (12.20 4.17) is the highestmean dmft among all the studies, including Vong Viengdistrict in Laos (9.60), Phnom Penh National Survey

(9.00), National Oral Health Survey Philippine (8.40 4.20), Suratthani province southern Thailand (8.10 0.10), Romania Constanta district (5.74 3.73), andKunming city in China (4.47 4.39).

25


26/34

V. Discussion

For twelve-year children, the mean DMFT of (4.37 3.45)

is also the highest mean among other studies, including

Romania Constanta district (3.31 3.04), Phnom Penh

National Survey (3.20), National Oral Health SurveyPhilippine (2.90 2.90), Suratthani province southern

Thailand (2.40 0.10), Vong Vieng district in Laos (1.90

0.30), and Kunming city in China (1.42 1.83).

It is clear that all the studies cannot be compared directly

and properly due to the socio-demographic reasons

associated with living in different environments26


27/34

V. DiscussionMean Decayed, missing and filled teeth dmft and (DMFT) among 6 year-old

children, reported in studies conducted in Cambodia and Thailand since 1991

27

Country / Province Year Ndmft DMFT

Mean SD Mean SD

7 Makara district, Cambodia 2012 300 12.20 4.17 1.39 1.22

Kunming city, China 2011 212 4.47 4.39

National Oral Health Survey, Philippine 2010 2030 8.40 4.20 0.70 1.10

Constanta district, Romania 2009 163 5.74 3.73 0.91 1.30

Vong Vieng district, Laos 2006 47 9.60 0.7 0.70 0.1

Suratthani province, Thailand 2001 1156 8.10 0.10

Phnom Penh (National survey) 1991 288 9.00


28/34

V. DiscussionMean Decayed, missing and filled teeth dmft and (DMFT) among 12-year-old

children, reported in studies conducted in Cambodia and Thailand since 1991

28

Country / Province Year Ndmft DMFT

Mean SD Mean SD

7 Makara district, Cambodia 2012 300 1.58 2.26 4.37 3.45

Kunming city, China 2011 1149 1.42 1.83

National Oral Health Survey, Philippine 2010 2022 0.20 0.60 2.90 2.90

Constanta district, Romania 2009 259 3.31 3.04

Vong Vieng district, Laos 2006 59 1.60 0.30 1.90 0.30

Suratthani province, Thailand 2001 1116 2.40 0.10

Phnom Penh (National survey) 1991 288 3.20


29/34

V. Discussion

Strengths and weaknesses of the study

This study is firstly conducted in 4 primary schools in

7 Makara district of Phnom Penh city which is never

done before.

There were 300 six-year and 300 twelve-year children

selected to be examined in this study. Some children

could not give 100% correct answer.During examination, there were some teeth need to

be treated, but due to the lack of instruments and

materials, no treatment was provided to the children.29


30/34

VI. Conclusion and recommendation

This study showed an increase number in the DMFT of six-year and twelve-year school children in 7 Makara districtcompared to the 1991 National Survey. The prevalence ofdental caries (dt) among six-year was 99.33%. The boys(61.66%) tend to have higher caries than the girls (37.66%).

For twelve-year children, the prevalence of dental carries (DT)was 87.33%. The girls (48.33%) have higher caries than theboys (39%).

Most of the children had dental problem which caused manyproblems, such as difficult in eating, sleeping, speaking, and

so on. These problems reduce quality of their life and hindertheir growing and studying. Furthermore, if they do not growand study well, it can affect the development of the country,because there will be a reduction of high qualified humanresources.

30


31/34

VI. Conclusion and recommendation

Therefore, it is recommended that there is a need forstrengthening of activities and cooperation of the OralHealth Preventive School Program among primaryschools in 7 Makara district of Phnom Penh City in order

to reduce the prevalence of dental caries.One more thing is that the cooperation of schools to thepreventive program being a key factor to reduce dentaldecay, new approaches should be developed and put into

action to improve the motivation and willingness ofschool directors to implement the program regularly andeffectively.

31


32/34

VII. References

1. Kruger E, Whyman R, Tennant M. High-acuity GIS mapping of private

practice dental services in New Zealand: does service match need?

International dental journal. 2012;62(2):95-9

2. Oral health in America: a report of the Surgeon General. Journal of the

California Dental Association. 2000;28(9):685-95.

3. Nurelhuda NM, Trovik TA, Ali RW, Ahmed MF. Oral health status of 12-

year-old school children in Khartoum state, the Sudan; a school-based survey.

BMC oral health. 2009;9:15.

4. Horowitz HS. The 2001 CDC recommendations for using fluoride to

prevent and control dental caries in the United States. Journal of public health

dentistry. 2003;63(1):3-8; discussion 9-10.

32


33/34

VII. References

5. Beltran-Aguilar ED, Barker LK, Canto MT, Dye BA, Gooch BF, Griffin

SO, et al. Surveillance for dental caries, dental sealants, tooth retention,

edentulism, and enamel fluorosis--United States, 1988-1994 and 1999-2002.

Morbidity and mortality weekly report Surveillance summaries (Washington,

DC : 2002). 2005;54(3):1-43.

6. Vieira AR. New directions in cariology research. International journal of

dentistry. 2010;2010.

7. Harris R, Nicoll AD, Adair PM, Pine CM. Risk factors for dental caries inyoung children: a systematic review of the literature. Community dental

health. 2004;21(1 Suppl):71-85.

33


34/34

VII. References

8. Takahashi N, Nyvad B. Caries ecology revisited: microbial dynamics and

the caries process. Caries research. 2008;42(6):409-18.

9. Liljemark WF, Bloomquist C. Human oral microbial ecology and dental

caries and periodontal diseases. Critical reviews in oral biology and medicine :

an official publication of the American Association of Oral Biologists.

1996;7(2):180-98.

10. Agarwal S, Pandit IK, Srivastava N, Gugnani N. Genetic engineering and

dental caries. Indian journal of dental research : official publication of Indian

Society for Dental Research. 2003;14(4):284-8.

11. Moynihan P, Petersen PE. Diet, nutrition and the prevention of dental

diseases. Public health nutrition. 2004;7(1A):201-26.

34

Documents

PP Mr. Samnang