Prevalence of dental caries in primary schools

1
‫والتكنولوجيا‬ ‫العلوم‬ ‫جامعة‬
‫االسنان‬ ‫طب‬ ‫كلية‬
‫المجتمع‬ ‫أسنان‬ ‫طب‬ ‫قسم‬
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
FEB2014
‫بسم‬‫الرحيم‬ ‫الرحمن‬ ‫اهلل‬

2
PERFACE
FOR OUR DOCTOR:
ALI AL-MASHHADANI
AND GRAET THANKS FOR OUR PARENT
FOR THEIR PATIENT AND SUPPORT TO
SEE OUR SUCCESS.

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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.

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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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CHAPTER 1
DENTAL CARIES
IN PRIMARY
SCHOOL

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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 carieson 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.

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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

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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

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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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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


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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: 1d 2d 3d other
Don’t know: Don’t like No time harmful not
useful
expensive other
Do you use Mouthwash ? Yes… No…
useful
expensive other
Do you use dental floss? Yes… No…
useful
expensive other
Do you eat snack? Yes… No…
If yes how many times? 1d 2d 3d Other
Type of snack: Sug: fru: Ch: Ju: other

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Malocclusal
Crowding Open bit
Cross bit Un competent lip
Normal Other..

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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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AGE
DMF OF 6-11 YEARS OLD IN RIYADH, SAUDI ARABIA IN 1991
10-118-96-7AGE
708793NO.
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
10-118-96-7AGE
106157188NO.
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
11109876AGE
303030304040NO.
575462414843DMF
3.5%3.70%3.22%4.87%4.16%4.65%DMF%
By :Hisham Ibrahem . Mohammed Algabri . Tariq Musawa Table(5)

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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
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%

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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%
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
If no why ? NO. DMF DMF%
Expensive 15 70 10.89%
Not useful 14 90 13.99%
Other 59 281 43.70%

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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%
If no , why ? NO. DMF DMF%
Expensive 3 9 1.33%
Not useful 25 195 28.72%
Other 40 211 31.07%

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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%
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%
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%

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» 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.

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

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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
dental care in modern day China community. Dent Oral Epidemiol, 29(5):
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],
Accessed on October 14, 2010.
http://www.localhealth.com/article/dental-caries/treatments
http://www.codental.uobaghdad.edu.iq/uploads/lectures/5
th%20class%20prevention/Professor%20Dr.%20Sulafa%
20El%20Samarrai-
Etiology%20of%20dental%20caries.pdf

Prevalence of dental caries in primary schools

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