|Year : 2015 | Volume
| Issue : 1 | Page : 44-47
Assessment of oral health status of Santal (Tribal) children of West Bengal
Shyamapada Mandal1, Chiranjit Ghosh2, Subrata Sarkar3, Jayita Pal4, Sudipta Kar3, Badruddin Ahmed Bazmi3
1 Dental Surgeon, West Bengal Health Service, Institute of Dental Science, Bhubaneswar, Orissa, India
2 Department of Pedodontics and Preventive Dentistry, Institute of Dental Science, Bhubaneswar, Orissa, India
3 Department of Pedodontics and Preventive Dentistry, Gurunanak Institute of Dental Science and Research, Kolkata, West Bengal, India
4 Department of Epidemiology, Gurunanak Institute of Dental Science and Research, Kolkata, West Bengal, India
|Date of Web Publication||9-Jan-2015|
Dr. Badruddin Ahmed Bazmi
138 Keshab Chandra Sen Street, Kolkata - 700 009, West Bengal
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Context: Santal is the third largest tribal community of India leading a very poor standard of education and life style. There are, however, few population-based studies evaluating the oral health status among Santal children in West Bengal. Aims: The aim of the study was to evaluate the oral health status of Santal children of West Bengal by assessing prevalence of dental caries and inflammatory condition of gingival. Settings and Design: Santal children aged between 2-14 years (N = 1205) were randomly selected from different Santal communities of West Bengal for this study. The children were divided into three different groups according to dentition. Materials and Methods: Caries for permanent dentition Decayed Missing Filled Tooth (DMFT), for deciduous dentition decayed extracted filled (def index was used. For mixed dentition DMF and def was measured respectively and then added together. Inflammatory condition of gingival was assessed by papillary marginal attachment (PMA) index. Statistical Analysis Used: the data was analyzed statistically by SPSS software version 11. Results: The study showed there was no significant difference (P > 0.05) between the average decayed extracted filled teeth (deft)/DMFT for boys and girls in deciduous and permanent dentition. But in mixed dentition this value for the boys was significantly higher (P < 0.001) than girls. 'Z' values were found to be non significant when compared mild, moderate and severe gingivitis between boys and girls in each dentition group, but mild gingivitis significantly increases from deciduous dentition to mixed to permanent dentition (P <0.001).
Keywords: DMFT, PMA index, Santal
|How to cite this article:|
Mandal S, Ghosh C, Sarkar S, Pal J, Kar S, Bazmi BA. Assessment of oral health status of Santal (Tribal) children of West Bengal. J Indian Soc Pedod Prev Dent 2015;33:44-7
|How to cite this URL:|
Mandal S, Ghosh C, Sarkar S, Pal J, Kar S, Bazmi BA. Assessment of oral health status of Santal (Tribal) children of West Bengal. J Indian Soc Pedod Prev Dent [serial online] 2015 [cited 2019 Dec 8];33:44-7. Available from: http://www.jisppd.com/text.asp?2015/33/1/44/148976
| Introduction|| |
Santal is the third largest tribal community of India with a population of 6,050,000. They are found in different district of West Bengal, Jharkhand, Bihar, Orissa and Assam. They are mainly non vegetarian and their standard of education and living is very poor. Children have been the target of oral health promotion policies for a long time in India. Several prevalence studies carried out earlier depicts that the children are the part of population who are most susceptible to dental caries and inflammatory condition of gingiva and also the most benefited from prevention programs. According to Baldani, et al.,  the polarization of dental caries is a phenomenon associated with economic deprivation. Socioeconomic factors have also been identified as risk indicators to the development of dental caries.  There are few population-based studies evaluating the oral health status among Santal children in India, so this study was carried out to find the oral health status of Santal in west Bengal.
Aim of the present study was to evaluate the oral health status of Santal children of West Bengal by considering the following criteria - prevalence of dental caries and evaluation of inflammatory condition of gingiva.
| Materials and Methods|| |
The study was carried out after the informed consent was obtained from the Head of the Santal communities and ethical clearance from the institution. Total 2-14 year aged 1205 Santal children (637 boys and 568 girls) were randomly selected from different Santal communities of West Bengal for this study. The children were divided into three different groups according to dentition (deciduous: N = 377, mixed: N = 387, permanent: N = 441) [Figure 1]. The clinical examination was performed in natural light or artificial light, maintaining asepsis condition with the help of mouth mirror and explorer. The quantitative evaluation of each parameter was carried out according to the following criteria.
|Figure 1: Gender distribution of children affected by dental caries according to DMFT|
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Caries for permanent dentition DMFT
Caries for deciduous dentition def index was used.
Caries for mixed dentition DMF and def was measured respectively and then added together.
Inflammatory condition of gingiva was assessed by PMA index. Facial surface of gingiva was divided into three component parts - papillary gingival, marginal gingiva and attached gingiva. In PMA index, the severity of inflammation papillary gingiva and marginal gingiva are expressed in scores from 0-5 and in attached gingival from 0-3. In general mild gingivitis is confined to the papillary gingiva; moderate gingivitis means spread to marginal gingiva and severe gingivitis is identified by its spread to attached gingiva. Cross examination was made by three different investigators and data was sent for statistical analysis.
| Results|| |
In the present study the average decayed extracted filled teeth (deft)/DMFT in deciduous, mixed and permanent dentition are 1.32, 1.21 and 0.99 respectively [Table 1] It was observed that there was no significant difference (P > 0.05) between the average deft/DMFT for boys and girls in deciduous and permanent dentition. But in mixed dentition the average deft and DMFT value for the boys was significantly higher (P < 0.001) than girls [Table 2]. In each dentition group the percentage of boys affected by caries was significantly higher than that of girls but Z test analysis indicates that there was no significant difference (P > 0.5) between boys and girls [Table 3]. In the present study 'Z' values were found to be non significant when compared mild, moderate and severe gingivitis between boys and girls in each dentition group. But when compared within different dentition groups, it was found that mild gingivitis significantly increases from deciduous dentition to mixed dentition to permanent dentition. (x 2 = 33.91, d.f =2, P < 0.001), but for moderate gingivitis there was no significant difference between these groups. (x 2 = 0.61, d.f = 2, P > 0.05) [Table 4].
|Table 2: Comparison of the averages of deft /DMFT between boys and girls in different dentition|
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|Table 3: Distributions of children affected by dental caries in different dentition|
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|Table 4: Distribution of severity of gingivitis for different dentition and sexes|
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| Discussion|| |
In the present study it was observed that the prevelance of dental caries in Santal children in deciduous dentition group was higher than mixed and permanent group. The value of deft/DMFT of mixed dentition group was also higher than permanent dentition group [Table 1]. Similar observation was found by Dutta,  Sing and Sing,  Ramprasad , and Pandit et al.  One of the reasons may be the ignorance of parents on maintenance of oral hygiene of their children due to lack of parental education.
It was observed that incidence of caries among boys was higher than girls in all the groups, but this difference is statistically significant only in mixed dentition group (P < 0.001) and not significant (P > 0.05) in deciduous and permanent dentition group [Table 2]. Similar findings were observed by Nagaraja et al.,  Gaikwad et al.,  and Rao et al.  It is possible due to over retained deciduous teeth causing irregular arrangement of teeth, which increases the oral clearance time.
In the present study the prevalance of caries among Santal children was comparatively lower than that of urban as well as rural children, which was also observed by Ramachandran et al.,  Chandra et al.,  and Guaba et al.  Reason may be, Santal children chew neem leaf up to the age of 2-3 years for maintaining their oral health, when they become 4-5 years they start to brush their teeth by neem, vendra, arjun daton and this herbal substances may have some anticaries properties. Moreover Santal children are only breast fed and do not consume animal or commercial milk, they take more raw fresh vegetable and high fluoride containing water.
Mobley and Smith observed that children of low socioeconomic status have more gingivitis than others.  It was also noted that girls had more gingivitis than boys during pubertal and prepubertal period. In the present study it was observed that sex difference has no role in gingivitis in each group. It was also observed that prevalence of gingivitis in deciduous dentition is least and it is highest in permanent dentition.
| Conclusion|| |
It can be concluded from the present study that the incidence and ginigival inflammation in Santal children is less compared with other children, though their education, socioeconomic status is poor. If the government or other nongovernmental organization can give proper health education program and training to the Santal community, then they will posses more sound oral and dental health and may lead a better healthy life.
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[Table 1], [Table 2], [Table 3], [Table 4]