Abstract

Objectives: The present study was conducted to assess area wise distribution oI caries and caries-Iree school children among 5-
year-old oI Meerut, Uttar Pradesh.
Methods: Cross-sectional analytical study was conducted. Atotal oI 2008 school children upto the age oI 5 years were selected.
DMFTindex was recorded Ior all the subjects.
Results: Prevalence oI caries-Iree children came out to be 63.07 in urban and 36.93 in rural population.
Key words: Cross sectional study, caries prevalence, urban children, rural children.
Area wise distribution of dental caries among 5 year old government school children in Meerut city:
Adescriptive cross-sectional epidemiological survey
1 2 3 4 5
Shipra Jaidka , Rishi Jaidka , Deepti Jawa Singh , Sanjeet Singh , Ripin Singh Garewal
Introduction The present study was carried out on a total oI 2008 childr
Oral health is an integral part oI overall health. Oral cavity en, out oI which a sample size oI 1500 was taken among 5-

plays a vital role in the liIe oI human beings through Iunct- year old group oI children in Meerut City (U.P, India) and

ions like mastication, aesthetics, phonetics, communica- dmIt was recorded.

tion and emotional expressions etc. It is highly essential to The study was conducted by the examiner in the Govern-
saIe guard oral health oI all the children Irom childhood ment schools oI Meerut city was a cross sectional point

otherwise poor oral health will lead to various dental disea prevalent study. The design oI the survey was in accord
ses like dental caries and periodontal diseases which- ance with the guidelines and criteria oI WHO's oral health
1 10
adversely aIIect the overall health. basic methods. The survey was conducted in Meerut city
Ahealthy liIe is the dream oI every individual, irrespective oI Uttar Pradesh state in India. Written consent was
oI any physical or social diIIerence and oral health is very obtained Irom administrative authorities and educational
important Ior the achievement and maintenance oI general authorities. The representative sample oI the study popula-
health. tion comprised oI 15 government schools in Meerut dist-
In India, dental caries has been consistently increasing rict.
both in prevalence and severity over the last three decades.
In year 1940-1950, the prevalence oI dental caries reported Sampling
has been 40-50 with average DMFT being 5 in urban Two stage sampling method was used. The Iirst stage was
2-4
the selection oI the schools. The primary schools selected areas and 4 in rural areas at the age oI 16 years. The preva-
were placed within the three strata oI increasing school size lence also depends upon literacy rate. Literacy rate in India
and within the strata, small schools (343), medium schools according to census 2001 is 57.36 with corresponding
(551) and large schools (1114) were chosen, each school males 70.23 and Iemales 42.98 . Change in literacy rate
5
had an equal opportunity oI being selected. Irom the year 1991 to 2001 is 16.65 . Healthy individuals

Next step was to calculate the proportion oI total school are the most precious assets any country can have. For the
population oI 5 years old attending each group oI school, same purpose an oral health survey is must Ior every

Ior example 343 oI 2008 children aged 5 years attend the country to determine the oral health status and the treatm
6
small schools. So the proportion was 343/2008, 17 percent,
ent needs oI that population. There is no doubt about the
likewise proportion oI medium schools was 27 and large
useIulness oI mapping out the actual oral health situation in
7
schools was 56. Thus, the result oI the calculation oI the
selected population groups. Thus, the World Health Orga

number oI children needed in each school group using
nisation (WHO) has consistently advocated epidemiol
these proportions reIlected as17 oI 1500, which equaled
ogical studies as the major component oI the nation's

255 (small schools), 27 oI 1500 which equaled 405
planning Ior the evaluation oI its oral health care services
(medium schools) and 56 oI 1500 which equaled 840
and many countries in terms oI international collaborative
(large schools). This showed that all 5 years old children
studies; major stand-alone surveys and repeated studies
8
were included with regard to small schools. One in two
with regular intervals have heeded this advice.
children were included with regards to medium schools
Earlier studies have shown a higher prevalence oI caries in
and one in Iour children were included in the large schools
rural compared to urban areas, explained by a lower socio

using random number tables.
economic level in the rural areas. Although the socio-
We selected the random numbers ingroups oI two Irom the
economic diIIerences between urban and rural areas
random number table. For example, starting at line 10 and
persist, the diIIerence in caries prevalence seems to have
9
going horizontally we obtained diIIerent numbers. The
been eradicated.
numbers which matched the numbers given to an appro-
Material and methods
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1 3 5 2 4
Assoc. ProIessor, Sr. Lecturer, PG Student, Department oI Paedodontics and Preventive Dentistry, Reader, Sr. Lecturer, Department oI
Community Dentistry, DJ College oI Dental Sciences and Research, Modinagar- 201204, Uttar Pradesh, India.
Correspondence: Dr. Rishi Jaidka, email: shiprajaidka2gmail.com
Indian J Stomatol 2011;2(2):98-101
98
private school were taken and the children were selected and an explorer. Based on examination , a lesion in a pit and
accordingly. The school on the list was highlighted and the Iissure or a smooth surIace having a detectable soItened
number oI 5-years old in that chosen school was marked at Iloor or soItened wall or a tooth having a temporary Iilling
the bottom oI the page. The next school was selected Irom or a tooth which was Iilled with a recurrent decay were
the random number table and the process was repeated till recorded. Debris was removed Irom the Iield oI observat
total number oI 5-years old children in that particular group ion by gauze pads. Compressed air was not used. Tooth
was the same or slightly exceeded it. missing due to caries only were recorded as missing. The
We undertook the same process Ior the medium sized decayed, missing and Iilled components were added to get
schools, but remembering that only 1 in 2 children would dmIt oI the child.
be included in the study. Hence, the numbers oI 5-years old Atooth was considered as erupted when any part oI it was
in the chosen school were divided by 2 and then values visible or could be touched with the tip oI the explorer
were noted down at the bottom oI the table 2. without unduly displacing soIt tissues. Calibration exerci-
Similarly, we chose the large school children sample, ses were perIormed prior to and during the study to ensure
which were the total pupil selected, divided by 4. that the consistent standard oI diagnosis was maintained.
Repeated examinations were carried out on approximately
Methodology one in ten children selected at random by the concerned
The WHOoral health assessment Iorm (1997) was used Ior class teacher to have a constant check on intra-examiner
the survey. The Iormat reproduced Irom the 'oral health variability.
surveys-basic methods (4th edition) was printed. This Iorm
was designed Ior collection oI all the inIormation needed Results
Ior planning oral care services and through monitoring and Chi Square test was done (P0.05) Ior statistical evaluation
re-planning oI existing care services. oI the data.
The parents were inIormed by the letter Irom the school Area wise distribution of the study population
and oral consent was obtained Irom them. Examination Total number oI 5-years old children in 15 government
was done in an uniIorm Iashion beginning Irom the maxill schools oI Meerut City was 2008, out oI which a sample
ary right quadrant in a clockwise direction in both the size oI 1500 was taken. The percentage oI dental caries Iree
maxillary and the mandibular region using the FDI system. children in urban children was 63.07, while among rural
The subjects were examined using a plane mouth mirror children was 36.93. (Table 1, Figure 1).
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Indian J Stomatol 2011;2(2):98-101
70
60
50
40
30
20
10
0
Rural Urban
Percentage
Table 1: Percentile oI caries Iree children in rural and urban region
Subjects included in study
Urban Total Percentage Rural Total Percentage
Males
Females
Total
536
410
946
56.66
43.34
63.07
Males
Females
Total
367
187
554
66.25
33.75
36.93
Figure 1: Area wise distribution oI study subjects
99
Area wise Prevalence of Dental Caries in the Study dental caries pattern. Overall, mean DMFT was 2.463.
population Area wise prevalence in caries indicated that the rural
The prevalence oI dental caries belonging to rural commu children had high dmIt than the urban children, the reason
nity was 89.71 with mean DMFT oI 2.686, while those being lack oI dental education and scarcity oI dental

belonging to urban community was 87.84 percent with support in rural regions. Similar Iindings were also repor-

mean DMFToI 2.333 (Table 2, Table 3). ted by Ohsaka et al., who indicated that certain environm-
ental Iactors are responsible Ior predisposition oI dental
11
Discussion caries in inIants living in rural areas. Vargas et al., also
AstratiIied cluster sampling methodology was adapted in Iound that prevalence oI edentulism and caries experience
12
the present study and the total sample was distributed among rural adults was almost twice that oI urban adults.
among the 5-year-old age group. The percentage oI dental Ringelberg et al., Iound that adults living in rural areas and
caries Iree children in urban children was 63.07, while those living in poverty were signiIicantly more likely to
13
among rural children was 36.93.When inter comparisons
have root caries.
were done, no signiIicant diIIerence was Iound in the
There is an urgent requirement to implement organized
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100
Indian J Stomatol 2011;2(2):98-101
Area Male Female Total Caries free
children
Children
with
caries
Male
with
caries
Female
with caries
mean
dmft
SD
Rural
Urban
367
536
187
410
554
946
61
111
497
831
89.71
87.84
338
472
92.09
88.59
155
363
82.88
88.53
2.686
2.333
2.149
2.146
Table 2: Area wise distribution oI caries
Rural
554
Decayed
1457
Missing
236
Filled
64
Total dmft
1757
Urban
946
2191 283 210 2684
Table 3: Total dmIt area wise
Rural Chi square P value Significant/ non
significant
Male/
Female
10.72 0.001 SigniIicant
Urban Chi square P value Significant/ non
significant
Male/
Female
0.05 0.90 Non signiIicant
Table 4: Statistical analysis oI signiIicance score in
rural and urban children in males and Iemales
Table 5: Statistical analysis oI males and Iemales oI both rural and urban area
Rural/ urban Chi square P value Significant/non
significant
Male 3.85 0.049 SigniIicant
Female 3.57 0.059 Non signiIicant
preventive school and community oral health programs, Epidemiological Study oI Oral Health Problems and Estim-
ation oI Fluoride Levels in Drinking Water. Dental Council utilizing the services oI volunteers and involving the health
14,15
oI India, NewDelhi, 2004; 32; 67-78.
schemes both in urban and rural regions. Dhar V et al.,

8. WHO Index oI dental caries-criteria and method oI
and Sarvanan et al., also suggested that dental caries is a

recording oI dental caries. Oral health surveys basic meth-
signiIicant health issue in the rural population requiring
nd
ods. 2 ed. WHO: Geneva; 1971
immediate attention and an extensive system to provide
9. Kallestal C. Dental caries in 16- and 18-year-old adolescents
primary oral health care has to be developed in the rural
in Northern Sweden. Eur J oI Oral Sci 1991;99:100-05.
16,17
areas oI India.
10. World Health Organisation. Oral health surveys - Basic
th
methods. 4 edn.Geneva, WHO, 1997.
Conclusion
11. Ohsuka K, Chino N, Nakagaki H, Kataoka I, Oshida Y,
Ohsawa I, Sato Y. Analysis oI risk Iactors Ior dental caries in As water Iluoridation is an eIIective, cheap and proven
inIants: a comparison between urban and rural areas. method in prevention oI dental caries so the Uttar Pradesh
Environ Health Prev Med 2009;14(2):103-10.
government should identiIy the non-Iluoridated areas and
12. Vargas CM, Dye BA, Hayes KL. Oral health status oI rural
try to implement the program oI water Iluoridation. An oral
adults in the United States. J Am Dent Assoc 2002;133
health surveillance system should be implemented in the
(12):1672-81.
primary schools. The dental health oI the 5-year old childr-
13. Ringelberg ML, Gilbert GH, Antonson DE, Dolan TA,
en should be monitored by Iurther epidemiological studies
Legler DW, Foerster U, HeIt MW. Root caries and root
in the Iuture.
deIects in urban and rural adults: the Florida Dental Care
Study. JAm Dent Assoc 1996;127(7):885-91.
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Disclosure: The authors report no conIlicts oI interest.