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ORIGINAL ARTICLE
Year : 2015  |  Volume : 33  |  Issue : 2  |  Page : 111-115
 

Dental anomalies of the deciduous dentition among Indian children: A survey from Jodhpur, Rajasthan, India


1 Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India
2 Department of Pedodontics and Preventive Dentistry, Jodhpur Dental College, General Hospital, Jodhpur, Rajasthan, India
3 Department of Public Health Dentistry, Jodhpur Dental College, General Hospital, Jodhpur, Rajasthan, India
4 Department of Public Health Dentistry, Sri Dharmasthala Manjunatheshwara College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India
5 Department of Orthodontics and Dento-Facial Orthopedics, Jodhpur Dental College, General Hospital, Jodhpur, Rajasthan, India

Date of Web Publication15-Apr-2015

Correspondence Address:
Dr. Shravani Govind Deolia
Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Sawangi (M), Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-4388.155120

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   Abstract 

Background: Anomalies and enamel hypoplasia of deciduous dentition are routinely encountered by dental professionals and early detection and careful management of such conditions facilitates may help in customary occlusal development. Objective: The aim of this study was to determine the prevalence of hypodontia, microdontia, double teeth, and hyperdontia of deciduous teeth among Indian children. Materials and Methods: The study group comprised 1,398 children (735 boys, 633 girls). The children were examined in department of Pedodontics and Preventive Dentistry in Jodhpur Dental College General Hospital, Jodhpur, Rajasthan, India. Clinical data were collected by single dentist according to Kreiborg criteria, which includes double teeth, hypodontia, microdontia, and supernumerary teeth. Statistical analysis of the data was performed using the descriptive analysis and chi-square test. Results: Dental anomalies were found in 4% of children. The distribution of dental anomalies were significantly more frequent (P = 0.001) in girls (5.8%, n = 38) than in boys (2.7%, n = 18). In relation to anomaly frequencies at different ages, significant difference was found between 2 and 3 years (P = 0.001). Conclusion: Double teeth were the most frequently (2.3%) observed anomaly. The other anomalies followed as 0.3% supernumerary teeth, 0.6% microdontia, 0.6% hypodontia. Identification of dental anomalies at an early age is of great importance as it prevents malocclusions, functional and certain psychological problems.


Keywords: Fused teeth, hypodontia, primary dentition, supernumerary teeth


How to cite this article:
Deolia SG, Chhabra C, Chhabra KG, Kalghatgi S, Khandelwal N. Dental anomalies of the deciduous dentition among Indian children: A survey from Jodhpur, Rajasthan, India. J Indian Soc Pedod Prev Dent 2015;33:111-5

How to cite this URL:
Deolia SG, Chhabra C, Chhabra KG, Kalghatgi S, Khandelwal N. Dental anomalies of the deciduous dentition among Indian children: A survey from Jodhpur, Rajasthan, India. J Indian Soc Pedod Prev Dent [serial online] 2015 [cited 2019 Oct 22];33:111-5. Available from: http://www.jisppd.com/text.asp?2015/33/2/111/155120



   Introduction Top


Developmental dental anomalies of the deciduous dentition qualify successfully an important and scarcely explored category. Their incidence, prevalence, and extent of expression in diverse population groups can provide valuable information in terms of phylogenic, genetic make-up, and environmental factors and at times by interplay of these factors which might help understanding of variations within and between the different populations. Even though their incidence and prevalence is relatively less when compared to other oral diseases like dental caries and periodontal diseases, but if left neglected can pose serious problems in the development of the child and also complicates treatment planning. These developmental anomalies represent itself in the form of malocclusion, esthetic, and functional problems, and possible disposition to other oral diseases making their clinical management complicated.

There are many types of developmental anomalies found in the teeth that occur during the morpho-differentiation stage of development. The most common of these is malformations in the structure of enamel and dentine. Apart from these, there can also be anomalies in the size, number, and shape of teeth. The anomalies of size can be in the form of microdontia, characterized by marked reduction in the size of the tooth compared to others and macrodontia, larger size tooth in comparison with others. Both these conditions, i.e., anomalies in size may be either generalized to all the teeth or isolated to one or several teeth. The differences in the number of teeth can be either decrease (hypodontia, oligodontia, and anodontia) or increase in the number, supernumerary teeth. Shape alterations of teeth include double teeth (fusion and gemination), talon cusp, dens evaginatus, and dens invaginatus (dens in dente). [1],[2]

The developmental dental anomalies may be either an isolated abnormality or as part of various syndromes. These developmental disturbances can be a result of local as well as systemic factors that may begin before or after birth, hence deciduous or permanent teeth may be affected. Along with affecting the esthetic appearance of teeth, these anomalies also pose delayed or incomplete eruption of teeth, attrition, difficulty in breast feeding, occlusal interference, accidental cusp fracture, interference with tongue space causing difficulty in speech and mastication, temporo-mandibular joint pain, and dysfunction, malocclusion, periodontal problems, and increased susceptibility to caries and difficulties during dental treatment .[3] If these dental conditions are detected early in life, it gives better long-term treatment planning options as well as a more favorable prognosis. [4],[5],[6]

A number of studies have been done reporting prevalence of dental anomalies in primary dentition and permanent dentition. [7],[8],[9],[10] Studies have been also conducted to compare the prevalence of various dental anomalies in primary dentition with permanent dentition. [11],[12],[13] Despite having sufficient number of studies documenting the prevalence of dental anomalies in permanent dentition there is paucity of such studies in primary dentition in Indian scenario. [3],[14],[15] Moreover, India has diverse cultural and religious background that may also have an affect on the prevalence of dental anomalies. Hence, this study was undertaken to find the frequency and distribution of dental anomalies along with their differences between gender and various religion in primary dentition in children attending a private dental hospital in India.


   Materials and methods Top


The present study was conducted among patients aged 2-5 years visiting department of Pedodontics and Preventive Dentistry, Jodhpur Dental College General Hospital (JDCGH), Jodhpur National University, Jodhpur, Rajasthan, India. Prior to the study, ethical clearance was obtained from the Ethical committee of the Institutional Review board of JDCGH, Rajasthan. Purpose of the study was explained to the parents of the patients and was invited to be part of the study. Those who gave informed consent participated in the study. A total of 1,398 children (735 boys and 633 girls) participated in the study over a 12-month period starting from January to December 2013.

Clinical dental examination

A single examiner carried out the examination in a systematic manner using a plane mirror and a sickle probe with no additional aid and 10% of children were re-examined to minimize the intra-examiner variability. The examination included assessments of the dental anomalies representing variations in tooth size, morphology, and number were recorded according to the criteria described by Kreiborg et al.[16] :

  1. Local microdontia: Single tooth smaller than normal;
  2. Fusion: Union in dentin and/or enamel between two or more separately developed normal teeth;
  3. Gemination: Incomplete division of a tooth germ;
  4. Hypodontia: Absence of one or only a few teeth;
  5. Hyperdontia: Presence of a supernumerary tooth. Because the clinical distinction between fusion and gemination is difficult, these were grouped under the term "double teeth" as suggested by Carvalho et al. [17]


Statistical analysis

The data were entered into the MS Excel (MS Office version 2007 developed by Microsoft, Redmond, WA) and Intercooled STATA version 9.2 (Stata Corp, TX, USA) was employed to perform statistical analysis. Descriptive analysis was performed to evaluate the frequencies of dental anomalies. Chi-squared test was used to assess associations of age, gender, and religion with prevalence of dental anomalies in study subjects. To quantify the association between demographic variables and dental anomalies odds ratio was calculated.


   Results Top


Sample distribution and prevalence of dental anomalies according to gender, age, and religion are shown in [Table 1]. Anomalies were observed in 56 children, representing an overall prevalence of 4.0%. The distribution of dental anomalies were significantly more frequent (P = 0.001) in girls (5.8%, n = 38) than in boys (2.7%, n = 18). In relation to anomaly frequencies at different ages, significant difference was found between the frequencies observed between the age of 2 and 3 years (P = 0.001) 11.7% at 3 years old, 5.72% at 4 years old, and 0.95% at 5 years old. Anomaly frequencies in various religions were also statistically different among Hindus and Muslims.
Table 1: Odds ratio for associations between demographic variables and dental anomalies


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   Discussion Top


Slightly higher prevalence of dental anomalies were observed in present study in comparison to the previous studies [1],[5],[17],[18],[19],[20],[21],[22],[23] whose results varied between 0.4% and 1.74%, this can be due to the fact that present study was conducted in a hospital set up and the above studies were conducted on the general population. However, low proportion of children with dental anomalies was reported in present study when compared to other studies conducted in clinical services set up [6],[13],[24] , which might be due to the difference in racial characteristics, local environment and nutrition in Indian children.

Statistically significant higher anomalies were observed in girls than in boys [Table 1], which was in contrast to the previous studies of deciduous dentition in other countries. [1],[6] Since this is the first study done in the northern part of India, the dissimilarities may be ascribed to the area of patient selection, and probably the ethnic and hereditary differences among the population of Jodhpur and other places where studies of this sort are done. However, previous study of permanent dentition in Indian population however showed dental anomalies statistically independent of sex. [14]

In the present study, the differences were statistically significant in distribution of dental anomalies according to age 2 and 3 years [Table 1]. This could be attributed to the fact that by the age of 3, all the deciduous teeth appear in the oral cavity and accounted for the significant difference. Contrasting findings for anomalies at different ages of primary dentition have been observed in previous studies. [1],[5],[8],[10],[20],[25] In the present study, there were more of dental anomalies among Hindus which could be accredited to the fact that in the different religions in India, the culture and concept of child rearing, food patterns and variety, nutritional status, consanguineous marriages among certain sections of Hindus and among most of the Muslims, importance of oral hygiene, the environmental factors, and the interaction of genetic and environmental factors might be responsible for the observed difference.

In the present study, double teeth was the anomaly with the greatest prevalence, with a prevalence of 2.36% [Table 2], which was in accord to previous studies. [1],[4],[6],[10] The unilateral occurrence of this anomaly coincide with the majority of previous studies. [5],[6],[8],[18],[21]
Table 2: Dental anomalies distribution according to gender (unit of analysis: Children) and dental arch (unit of analysis: Teeth)


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The prevalence of microdontia of this study, 0.64% [Table 2] confirms the low prevalence suggested by other studies, between 0.1% and 0.6%. [3],[5],[9],[17],[24] In the present study, prevalence of hypodontia was 0.64%, supernumerary teeth was 0.36%, [Table 2]. Frequencies reported by previously published works were also in the same range. [4],[17],[22] Studies have also indicated that presence of hypodontia in deciduous dentition consequently lead to missing permanent teeth [4],[8],[21] and thus emphasizing the timely identification of these condition for better long-term treatment planning.

Such kind of prevalence studies will help in early recognition of such anomalies in deciduous dentition which will help us plan better preventive and interceptive orthodontics treatment modalities so as reduce or avoid adult orthodontics, the time required for treatment, less number of relapse cases, and thus decrease the economic burden which parents face for such treatments. Previous studies have reported that patients with anomalies in deciduous dentition usually have permanent dentition also affected. From previous studies, it is evident that minimal attention is provided toward dental problems and in addition primary dentition is further neglected. Current survey helps in the early diagnosis of the dental problems and will make parents aware of their child's dentition. Also, helps in preparing parents psychologically toward future dental problems, treatment needed, and cost incurring toward the same.

The distribution of these anomalies in accordance with various demographic factors will not only provide the information for phylogenic and genetic studies and help in understanding of differences within and between populations but also will help in planning the public health policies.

A limitation of the study includes non-inclusion of radiographic appraisal and nutritional assessment of the study participants which might have influenced the results and further studies are necessary to explore the above described variables in depth. Nonetheless, the study sets a stage for the inception and initiation of preventive dental health policies and services in the Indian scenario.


   Conclusions Top


Present study evaluated the frequency of occurrence of various developmental dental anomalies in non-syndromic preschool children who visited dental hospital in India. It was noted that anomalies were more frequent in female patients than in males and double teeth was found to be most common anomaly. The current study highlights the importance of early detection of dental anomalies to interject the further propagation to irreversible level. Combined efforts of dental professionals, school authorities, and parents will help in achieving the same and help seed the oral health importance at tender ages.

 
   References Top

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