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ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 5  |  Page : 184-186  

Prevalence of oral health status and needs in institutionlized physically challenged children


1 Department of Dentistry, Uttar Pradesh University of Medical Science, Saifai, Etawah, Uttar Pradesh, India
2 Department of Conservative Dentistry and Endodontics, Bhabha Dental College, Bhopal, Madhya Pradesh, India
3 Dental Surgeon, PHC, Parwalpur, Nalanda, Bihar, India
4 Department of Pedodontics and Preventive Dentistry, Kalka Dental College and Hospital, Meerut, Uttar Pradesh, India
5 Dental Practitioner, Muzaffarpur, Bihar, India

Date of Submission02-Oct-2020
Date of Decision03-Oct-2020
Date of Acceptance05-Oct-2020
Date of Web Publication05-Jun-2021

Correspondence Address:
Atul Kumar Singh
Department of Dentistry, Uttar Pradesh University of Medical Science, Saifai, Etawah, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.JPBS_637_20

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   Abstract 


Background: Oral hygiene has significant effect on the overall health of an individual as it has vital role in human life, so it is necessary to protect oral hygiene of all children since childhood. Objectives: The objectives were to evaluate and compare the prevalence of dental caries and oral hygiene status in institutionalized physically challenged children of Bihar. Materials and Methodology: A total of 700 (400 male and 300 female) children were included in the study that were physically handicapped and were institutionalized in various special schools. In this study, complete oral examination was done and was recorded by using Oral Hygiene Status-Simplified given by Greene and Vermillion, 1964, and all statistical analyses were done by using SPSS software. For statistical analysis, Chi-square test and ANOVA were used. Results: Out of 700 children, 48.8% (342) had dental caries with mean Decayed, Missing, and Filled Teeth (DMFT) index of 0.86 (standard deviation [SD] ±1.37) and mean dmft index of 0.36 (SD ± 0.98). In this study, orthopedic, blind, deaf and dumb, and compound students were examined. It was observed that the dental caries prevalence was high in the blind group (71%) compared to that of the deaf and dumb group (40.2%), while oral hygiene status was observed as good in 42.2%, fair in 46.9%, and poor in 10.9% of children. Conclusion: Every dental professional should be aware of his/her responsibilities and provide both comprehensive and incremental dental care to improve the overall oral hygiene condition of physically handicapped children.

Keywords: Dental caries, oral hygiene status, physically handicapped children


How to cite this article:
Mishra R, Singh AK, Tyagi S, Choudhary HV, Gupta SK, Kumar K. Prevalence of oral health status and needs in institutionlized physically challenged children. J Pharm Bioall Sci 2021;13, Suppl S1:184-6

How to cite this URL:
Mishra R, Singh AK, Tyagi S, Choudhary HV, Gupta SK, Kumar K. Prevalence of oral health status and needs in institutionlized physically challenged children. J Pharm Bioall Sci [serial online] 2021 [cited 2021 Oct 17];13, Suppl S1:184-6. Available from: https://www.jpbsonline.org/text.asp?2021/13/5/184/317599




   Introduction Top


Oral hygiene has significant effect on the overall health of an individual as it has a vital role in human life.[1] In India, there are various communities in which special children have fundamental rights than any other normal individual.[2] However, the quality of their life is adjusted according to their capabilities.[2] Many handicapped children have normal teeth and gums during the initial stage of their life. However, their diet, eating habits, medications, parental and health providers' attitude, and lack of cleaning habits lead to poor oral hygiene in them. Good oral hygiene is very essential for proper mastication digestion, speech, and health of handicapped children as many use their mouth and teeth to compensate the challenged organ.[3],[4],[5]

It is necessary to protect the oral hygiene of all children since childhood. Several studies emphasize the dental health of normal children, but there are less studies regarding the dental health of handicapped children who actually require more special care and attention.[6]

The aim and objective of this study was to evaluate the prevalence of dental caries and oral hygiene status in physically handicapped children attending various special schools.


   Materials and Methodology Top


An epidemiological survey was conducted among 700 children (400 males and 300 females) to evaluate the prevalence of dental caries and oral hygiene status among 6–15-year-old physically handicapped children attending special schools in the city. Ethical clearance was obtained from institutionalized review board. For this study, a survey pro forma was prepared according to WHO oral health assessment form,[7] and OHI was recorded by using OHI-S index.[8]

Prior to the study, the purpose and significance of the study was informed and explained to the children. For deaf and dumb students, help of the class teacher was taken and information to these students was conveyed through sign languages with the help of the teacher.

In this study, different physically handicapped children were divided into the following categories: orthopedic, blind, deaf and dumb, and compound handicap groups.

Dental caries examination was recorded by a Community Periodontal Index probe and a plane mouth mirror; oral hygiene index was recorded by using an explorer and a plane mouth mirror and for light, natural sunlight was used; and the children were made to sit in such a way to obtain maximum illumination.

By the end of the day, clinical findings were reported to the class teacher and a reference slip was forwarded to the parents or guardian through their class teacher so that they can get the maximum benefit of the treatment.

Statistical analysis

After data collection, descriptive statistics was used to determine significant difference in mean Decayed, Missing, and Filled Teeth (DMFT)/dmft between different handicapped groups. Data were analyzed using SPSS software 21.0 Armonk (2012), and significance of all the statistical tests was predetermined at P ≤ 0.05.


   Results Top


The study population consisted of 700 schoolchildren, out of which 400 (60%) were male and 300 (40%) were female. Overall, when caries prevalence was compared between vegetarian and mixed diet, the difference was not statistically significant (χ2 = 1.50, P = 0.31, not significant). [Table 1] represents the distribution of DMFT components among the handicap groups. [Table 2] shows the distribution of dmft components among the handicap groups. The total number of dmft components was 233, out of which 231 were decayed, 2 were missing, and no teeth were filed. The mean dmft was 0.32 (standard deviation [SD] ±0.98). [Table 3] depicts the sex-wise distribution of oral hygiene status among the handicap groups. [Table 4] mentions the caries prevalence among the study population according to oral hygiene status in the handicap groups. When the overall caries prevalence was compared with oral hygiene status, the difference was not statistically significant (χ2 = 1.50, P = 0.47).
Table 1: Distribution of Decayed, Missing, and Filled tooth components among the handicap groups

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Table 2: Distribution of decayed, missing, and filled teeth components among the handicap groups

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Table 3: Sex-wise distribution of oral hygiene status

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Table 4: Oral hygiene status and caries prevalence among the handicap groups

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   Discussion Top


The handicapped are often one of the ignorant groups in our society and due to which they are deprived of many social benefits in the society. Therefore, the prevalence of dental caries and oral hygiene status in special children has drawn the attention of many researchers.[7],[8]

The study population consists of 700 handicapped children attending special schools, out of which, 48.8% (342) had dental caries with a mean DMFT of 0.86 (SD ± 1.37) and dmft of 0.32 (SD ± 0.98). Yee and Mc Donald in 2002 found similar results.[9]

In our study, we found that the caries prevalence was higher in male handicapped children (49.25% (197)) than their female counterparts (48.66% (146)). The difference was statistically significant (P < 0.05).

Present study shows treatment required in permanent dentition was one surface filling and two or more surface fillings was highest while in deciduous dentition one surface filling, two or more surface fillings and extraction was required more. Yee R, Mc Donald N. in 2002 and Constance B Greeley also found similar results.[9],[10]

This study shows fair to good oral hygiene status. The poor score of few children may be because of their extent of disability. Shaw et al. in 1986 showed similar findings.[11] The high caries activity leads to difficulty in maintaining oral hygiene, poor muscular co-ordination, and muscle weakness, interfering with routine oral hygiene practices.[12]

The present study showed some unexpected observation in contrast to the general belief. A dental caries prevalence of 52% was observed in children with good oral hygiene, 49.9% caries prevalence was observed in children with fair oral hygiene, and 43.5% prevalence was observed among children with poor oral hygiene. The differences between oral hygiene status and caries prevalence were not statistically significant, χ2 = 1.50, P = 0.47. Some other factors such as fluoride, environment, genetics, and diet in the study population were known to affect oral hygiene.


   Conclusion Top


Every dentist and health-care professional should be aware of their responsibility and play a vital role in improving the dental health of handicapped children. The idea has been proposed to several chief dental officers to arrange dentists or dental auxiliaries who can visit these special institutionalized schools on a regular basis for providing oral hygiene instructions to parents, staff, and children. Regular follow-up for these children is sufficient to help them maintain good oral hygiene. In addition to that, chemical plaque control measures should be emphasized.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization. Oral Health Surveys: Basic Methods. 4th ed. Geneva: World Health Organization; 1997.  Back to cited text no. 1
    
2.
Greene JC, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc1964;68:25-31.  Back to cited text no. 2
    
3.
Nunn JH, Murray JJ. The dental health of handicapped children in Newcastle and Northumberland. Br Dent J 1987;162:9-14.  Back to cited text no. 3
    
4.
Ohito FA. Opinya GN, Wang Ombe J. Dental caries gingivitis and dental plaque in handicapped children in Nairobi, Kenya. East Afr Med J 1993;70:71-4.  Back to cited text no. 4
    
5.
Gupta DP, Chowdhury R, Sarkar S. Prevalence of dental caries in handicapped children of Calcutta. J Indian Soc Pedod Prev Dent 1993;11:23-7.  Back to cited text no. 5
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6.
Misra FM, Shree BK. Prevalence of dental caries in Lucknow school going children. J Indian Dent Assoc 1979;51:109-10.  Back to cited text no. 6
    
7.
Megas Basil F. Athanassouli TN. Dental caries prevalence in the permanent teeth in Greek school children related to age, sex urbanization and social status. Community Dent Health 1989;6:131-7.  Back to cited text no. 7
    
8.
Chiranga L, Manji F. Dental caries in 12 years old urban and rural children in Zimbabwe. Community Dent Oral Epidemiol 1989;17:31-3.  Back to cited text no. 8
    
9.
Yee R, Mc Donald N. Caries experience of 5-6 year old and 12-13 year old school children in central and western Nepal. Int Dent J 2002;52:453-60.  Back to cited text no. 9
    
10.
Greeley CB, Goldstein PA, Forrester DJ. Oral manifestations in a group of blind students. ASDC J Dent Child 1976;43:39-41.  Back to cited text no. 10
    
11.
Shaw L, Maclaurin ET, Foster TD. Dental study of handicapped children attending special schools in Birmingham, UK. Community Dent Oral Epidemiol 1986;14:24-7.  Back to cited text no. 11
    
12.
Rao DB, Hegde AM, Munshi AK. Caries prevalence amongst handicapped children of South Canara district, Karnataka. J Indian Soc Pedod Prev Dent 2001;19:67-73.  Back to cited text no. 12
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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