Caries, diet, dental knowledge and socioeconomic variables in a population of 15-year-old Israeli schoolchildren

Quantifying Dietary Diversity by Using Food Group Scores among Schoolchildren of Jaipur: A Seasonal Longitudinal Study

Need of the study

Most dentists are concerned that their patients are consuming a record number of sugar-filled sodas, sweetened fruit drinks, and other stuff that affect their oral environment. Children are invariably the victims of these foodstuffs. These items generally have very little nutritional value, albeit their commercial value. Thus, dietary habits and the choice of food among children and teens are important factors that determine how quickly they may develop oral diseases. Thus, to design good intervention programs and preventive strategies, information on food habits and dietary intake of the target population is very important.

Aim and objective

To determine dietary diversity using food group score (FGS) among 12–15 years schoolchildren of urban and rural areas of Jaipur.

Materials and methods

Jaipur district is divided into 13 Tehsils. Based on a simple random number table, Bhanpur (Rural) and Central Jaipur (Urban) were selected for the present study. Food group scores were calculated from the 5-day diet diary of the study subjects.

Results

Scores were found to be higher in winters as compared to the summer season and this difference is observed to be highly statistically significant. Scores were found to be higher in urban schoolchildren as compared to rural and the difference was highly statistically significant among urban schoolchildren in winters. Scores were found to be higher among private schoolchildren as compared to government and this difference was highly statistically significant among schoolchildren belonging to urban areas.

Conclusion

There is a need for nutritional counseling and basic oral health care in the study area irrespective of the season. The dietary diversity of children is determined by social, psychological, and economic factors. Thus, counseling should be given accordingly in conjunction with a team of health professionals including physicians, dieticians, and dentists under the supervision of parents, guardians, and schoolteachers and management.

How to cite this article

Gaur A, Sharma M, Sharma R. Quantifying Dietary Diversity by Using Food Group Scores among Schoolchildren of Jaipur: A Seasonal Longitudinal Study. Int J Clin Pediatr Dent 2021;14(3):376–382.

Dental fluorosis and caries experience in relation to three different drinking water fluoride levels in South Africa

OBJECTIVES

The purpose of this study was to determine the relationship between caries experience, degree of fluorosis and different concentrations of fluoride in the drinking water of children.

SAMPLE AND METHODS

The study included 282 children aged 10-15 years, who lived continuously since birth in three different naturally fluoridated areas (Leeu Gamka, 3.0; Kuboe 0.48 and Sanddrif 0.19 p.p.m. F), with virtually no dental care or any fluoride therapy The teeth of the children were examined for caries using the DMFT index according to th WHO criteria and for fluorosis, using Dean's criteria according to the WHO guidelines.

RESULTS

The prevalence of fluorosis (scores 2, 3, 4 and 5) among the school children was 47% in Sanddrif, 50% in Kuboes and 95% in Leeu Gamka. Almost half the children in the two low fluoride areas had no fluorosis (scores 0 and 1), whereas only 5% in Leeu Gamka had no fluorosis. Of the children in Sanddrif, 42.5% had very mild/mild (scores 2 and 3) fluorosis, 44.3% in Kuboes and 34.1% in Leeu Gamka. Except for one individual in Kuboes, severe fluorosis (score 5) was only observed in the high fluoride area in 30% of the children. According to the Bonferroni adaptation for multiple comparisons, the degree of fluorosis in Leeu Gamka differed significantly from both those of Sanddrif and Kuboes. The mean DMFT for the children in Sanddrif and Kuboe was similar (164 +/- 0.30 and 1.54 +/- 0.24, respectively) but the caries experience of Leeu Gamka (198 +/- 0.22) was significantly higher (P < 0.05) than that of both the other two areas. A strong positive correlation (P < 0.05) was found between the caries experience and the fluorosis scores of children in the high fluoride area (Leeu Gamka) but no correlation could be found in the other two areas. Significantly (P < 0.01) more children had decayed teeth in the high F area (Leeu Gamka) than in the other two areas.

CONCLUSION

The results suggest a positive association between high F levels in the drinking water and dental caries. Furthermore, a low caries experience and no difference in DMFT and fluorosis between the two low fluoride areas were found.

Caries-risk assessment

Dental caries has a multifactorial aetiology in which there is an interplay of three principal factors: the host (saliva and teeth), the microflora (plaque), and the substrate (diet), and a fourth factor: time. There is no single test that takes into consideration all these factors and can accurately predict an individual's susceptibility to caries. The risk of dental caries can be evaluated by analysing and integrating several causative factors. These include caries experience (initial caries lesions and established caries defects, secondary caries and present caries activity), fluoride use, extent of plaque present, diet, bacterial and salivary activity and social and behavioural factors.

Dental caries and social factors in 12-year-old South African children

Dental caries prevalence (percentage caries-free) and experience (DMFS) were recorded, in 414 12-yr-old Indian and 401 white children living in adjacent urban communities with the same fluoride concentration in the drinking water (0.21-0.33 ppm) using WHO (11) criteria. Details of social factors: education level, family income, home space and occupants and parental occupation were obtained by questionnaire. Dental caries was significantly worse in the Indian children with regard to numbers caries-free (30%--white and 40%--Indian) and DMFS mean (sd) (3.65 (3.98) and 2.66 (3.49) working group, respectively). Social class, white or blue collar, family income and room to person ratio were significantly associated with dental caries in the white children but there were no significant associations in the Indian children. Multiple regression analysis showed race and sex to be significant factors.

Prevalence and distribution of caries in a Jerusalem adolescent population by age, sex, and family income

Four hundred and fourteen high school students aged 12-17 were examined clinically using the DMFS index and bitewing radiographs. Analyses by age, sex, economic status, and types of teeth and tooth surfaces were performed and results were compared with other international studies. Only 7.5 percent of the study population had a zero DMFS score. Females had a significantly higher DMFS score than males (13.21 vs 9.59). Caries experience increased with age and a general trend of increasing DMFS was observed with increasing levels of income. Socioeconomic status (SES) was related directly to DMFS in Israel, in contrast to an inverse relationship observed in most other western countries. First molars were most susceptible to caries attack and accounted for 41.2 percent of the total DMFS. Almost 50 percent of all affected surfaces were occlusal and 29.4 percent were proximal. Caries prevalence in general and proximal caries in particular were found to be much higher in the study population than corresponding figures in other industrialized countries. A significant decrease in caries prevalence could be expected in Israel in the next decade if primary preventive measures are implemented immediately.

Oral health knowledge and sources of information among elementary schoolchildren

The dental health knowledge and sources of health information of 848 elementary schoolchildren (aged 9-12) in southwestern Michigan were assessed. Demographic parameters (education level, percent below poverty level, median income level) of the area were similar to state and national averages. The children were found to have some knowledge of caries and periodontal disease prevention, yet basic misconceptions were evident. More than one-third of the children thought that plaque should only be removed by a dentist. While 75 percent of the subjects knew that fluoride protected teeth from decay, only 4 percent of the children identified fluoridated water as the best source of this preventive agent. Knowledge of pit and fissure sealants was limited. Extent of correct dental knowledge was not related to age, sex, or mean DMFS scores. Children who answered the most questions correctly named parents and family as their source of information; dentist's office was the second most frequently mentioned source. Findings suggest a need to correct basic misinformation about dental health and to inform children about current efficacious preventive agents.

Changing patterns of dental caries in Ethiopian adolescents who immigrated to Israel

The aim of this investigation was to explore changes in caries prevalence and gingival health in adolescents who immigrated from Ethiopia to Israel, experiencing an abrupt cultural transition. Fifty adolescents, aged 15-17, born in Ethiopia, and 196 adolescents born in Israel were examined. All were pupils of a boarding school, sharing the same living conditions and eating schedules. The results showed a nearly sixfold difference in caries prevalence between the Ethiopian and the Israeli group (1.5/9.6). No differences could be seen clinically between the Ethiopians who immigrated more than 1 yr ago and those who arrived within the last year. Radiographically, a significant difference was found between the two Ethiopian subgroups. Those who arrived more than 1 yr ago had nearly three times more initial caries. Total interproximal caries scores for the Israeli group, Ethiopians who arrived more than 1 yr ago, and newly arrived Ethiopians were 6.9, 5.7 and 2.1 respectively. Oral hygiene was poorer in the Ethiopian group than in the Israeli group; little difference was found in gingival health. Change in dietary habits, more meals per day and more frequent consumption of fermentable carbohydrates, could have been the cause of the change in caries rate.