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ORIGINAL ARTICLE
Year : 2019  |  Volume : 37  |  Issue : 1  |  Page : 25-30
 

Assessment of Intelligence Quotient using Raven's Coloured Progressive Matrices among school children of Hyderabad Karnataka region and its correlation with prevalence of dental caries


Department of Pedodontics and Preventive Dentistry, AME's Dental College and Hospital and Research Centre, Raichur, Karnataka, India

Date of Web Publication25-Feb-2019

Correspondence Address:
Dr. G Dhanu
Department of Pedodontics and Preventive Dentistry, AME's Dental College and Hospital and Research Centre, Raichur - 584 103, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JISPPD.JISPPD_236_18

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   Abstract 


Background: Intelligence is the ability of a mind to acquire knowledge and skills; gain for a fact; to take care of issues; to adjust to new circumstances; and one's ability for rationale, understanding, mindfulness, arranging, and imagination. In a general description, it is a capacity to recognize information and to employ it as knowledge toward a modified behavior within an environment. This thought helps children to maintain oral hygiene in a better way. Materials and Methods: The present research was undertaken on 240 schoolgoing children aged 7–11 years of government schools of Hyderabad–Karnataka region, in order to estimate the relation between intelligence quotient (IQ) of a child with dental caries. IQ level has been assessed by using Raven's Colored Progressive Matrices as an IQ testing scale. Caries status was assessed by using Decayed, Missing, and Filled Teeth index. Results: There was no statistical difference between children with different levels of IQ and dental caries. However, the majority of children who belong to Grade V (intellectually impaired) had higher dental caries. Conclusion: An increase in IQ causes a decrease in dental caries and vice versa; however, no significant association was observed between the level of intelligence and caries (P = 0.202). There is a promising correlation between IQ and presence or absence of dental caries among children.


Keywords: Dental caries, intelligence quotient, Raven's Coloured Progressive Matrices


How to cite this article:
Dhanu G, Havale R, Shrutha S P, Quazi N, Shafna T P, Ahemd A. Assessment of Intelligence Quotient using Raven's Coloured Progressive Matrices among school children of Hyderabad Karnataka region and its correlation with prevalence of dental caries. J Indian Soc Pedod Prev Dent 2019;37:25-30

How to cite this URL:
Dhanu G, Havale R, Shrutha S P, Quazi N, Shafna T P, Ahemd A. Assessment of Intelligence Quotient using Raven's Coloured Progressive Matrices among school children of Hyderabad Karnataka region and its correlation with prevalence of dental caries. J Indian Soc Pedod Prev Dent [serial online] 2019 [cited 2019 Oct 19];37:25-30. Available from: http://www.jisppd.com/text.asp?2019/37/1/25/252855





   Introduction Top


Dental caries is one of the major public health problems. The latest concept of dental caries includes the relation between hereditary and environmental elements such as organic, social, psychological, and behavioral factors which are communicated in a profoundly compound and associated form.[1]

The intellectual status of a person shows his/her own hereditary prospective and his/her observational capacity.[2] A unfavorable psychological situation reduces the intelligence quotient (IQ) and impairs intellectual development and behavioral and cognitive skills. Low cognitive ability in early life may have lesser understanding about the dietary awareness, brushing habit, and proper maintenance of oral health, which in turn has a direct impact on dental caries.[3]

The latest work illuminates the possible contribution of psychosocial elements to understand the occurrence of disease and to upgrade the knowledge of caries-causing factors.[4] Several researches carried out to identify the relation between IQ and dental caries showed varied results.[5],[6] A study carried out in an orphanage showed higher caries scores in average IQ individuals. In other studies, the prevalence of caries was maximum among those with borderline intelligence in normal children.[7] High IQ may be more effective than a low IQ in moderating the level of cooperation during dental treatment of children.

Thus, a study was aimed at investigating the association between the intellectual ability of children with dental caries by using Raven's Coloured Progressive Matrices as a testing tool for intelligence.


   Materials and Methods Top


The research was reviewed and accepted by the Institutional Ethical Panel for research of AME's Dental College and Hospital, Raichur, and written informed parental consent was obtained from each participant. The current study was conducted on 240 children aged 7–11 years from government schools of Hyderabad–Karnataka region. The selection of children was carried out on the basis of the following criteria.

Inclusion criteria

  • Should not be with any history of severe illness and trauma to the head-and-neck region
  • Should be free from developmental deformity associated with psychiatric disorder
  • Children from the same family members having common characteristics such as education, occupation, standard of living, and geographical distribution.


Exclusion criteria

  • Children with a history of head-and-neck trauma or any other neurological illness
  • Any congenital or acquired illness affecting the intelligence capacity of a person
  • History of any systemic illness or any type of hypersensitivity reactions or consumption of antibiotics
  • Children with speech or hearing or visual impairment.


Estimation of intelligence quotient level

Estimation of IQ status had been checked by using “Raven's Coloured Progressive Matrices 1998 edition”[8] in each child aged 7–11 years. It is a most acceptable test for measuring cognitive abilities and is largely used to assess the normal function of brain.[9],[10] It contains 36 problems divided into three segments such as A, Ab, and B. It is a nonverbal test form; questions were framed in a geometrical pattern, with a section missing. The children need to choose the missing cell from the six given choices and were given a test form and requested to answer every one of the inquiries in the particularly composed answer paper. They were also given a 30-min time to complete the test as per the test manual's guidelines. The acquired data were changed over into percentile, and the assessment of overall score was graded according to the Raven's Coloured Progressive Matrices manual.

Raven's Colored Progressive Matrices grading criteria

  • Grade I: “Intellectually superior,” if a score lies at or above the 95th percentile for people of that age group
  • Grade II: “Definitely above the average in intellectual capacity,” if a score lies at or above the 75th percentile
  • Grade III: “Intellectually average,” if a score lies between the 25th and 75th percentiles
  • Grade IV: “Definitely below average in intellectual capacity” if a score lies at or below the 25th percentile
  • Grade V: “Intellectually impaired,” if a score lies at or below the 5th percentile for that age group.


Clinical examination

Recording of dental caries was done with the help of Decayed, Missing, and Filled Teeth (DMFT)/dmf Index. DMF index was introduced by Henry Klein, Carrole, Palmer, and Knutson in 1938; in this index, all the permanent teeth are examined with the help of a mouth mirror, and WHO Probe. ‘def index’ was described by Gruebbel in 1944, as an equivalent index to DMF index, for measuring dental caries in the primary dentition.[11]

Calibration of the investigator

The investigator first received training for appropriate application and analyzing the score of the above-mentioned tests from a clinical psychologist. After receiving the training, the investigator was tested for the estimation of IQ by frequent sessions. Intraexaminer reliability was determined by using Kappa coefficient which was found to be 0.8.

Statistical analysis

The obtained data were fed into a personal computer using Microsoft Excel. The data were analyzed using IBM SPSS Statistics for Window, version 19 (IBM Corp, Armonk, NY, USA). Descriptive and inferential statistics were used wherever required. The study employed unpaired t-test and Chi-square test to test the significance. The level of statistical significance was set to 95%.


   Results Top


Among the 240 children (males: 113, females: 127), those who fulfilled the inclusion and exclusion criteria were selected. Children's age ranged from 7 to 11 years.

Majority of the children had intellectually impaired scores (47.1% – Grade V), followed by those having definitely below-average intellectual capacity scores (35.4% – Grade IV), definitely above-average intellectual capacity scores (9.2% – Grade II), intellectually average (7.1% – Grade III), and intellectually superior (1.2% – Grade I). The overall mean IQ score was 17.57 ± 7.60 [Table 1].
Table 1: Distribution of the study participants according to intelligence quotient

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On evaluating the distribution of children according to their IQ scores for the two genders, trends similar to those obtained for combined evaluation (irrespective of gender) were observed, with the majority of children in both the genders having IQ Grade V and IQ Grade IV followed by IQ Grade II, IQ Grade III, and least in IQ Grade I. When comparing the data statistically, no significant difference in the mean IQ scores of two genders was observed (P = 0.867) [Figure 1].
Figure 1: Association of gender with intelligence quotient of the study participants

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More than half of the patients (n = 140, 58.3%) had dental caries. The remaining (100 [41.7%]) patients had their teeth intact. The overall mean DMFT score was 1.68 ± 1.95. Among boys, the prevalence of caries was 56.6%, whereas among girls, this prevalence was 59.8% [Figure 2]. Mean DMFT of boys was 1.68 ± 2.00, whereas the corresponding score among girls was 1.67 ± 1.92. [Figure 3] shows the prevalence of caries which was maximum among those with intellectually impaired IQ score (43.6% – Grade V) and minimum among those with intellectually superior IQ score (0.7% – Grade I). Statistically, no significant association was observed between the level of intelligence and caries prevalence (P = 0.202).
Figure 2: Association of gender with dental caries among the study participants

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Figure 3: Association of dental caries with intelligence quotient of the study participants

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   Discussion Top


IQ is defined as the “Relative intelligence of an individual expressed as a score on a standardized test of intelligence.”[12] There are various IQ testing scales, such as Stanford–Binet IQ test, Kaufman Tests, Cognitive Assessment System, Differential Ability Scales, Sternberg Triarchic Abilities Test, Turing test, Wechsler Intelligence Scale, and Raven's Coloured Progressive Matrices.

Raven's Coloured Progressive Matrices is a nonverbal group of test commonly used in instructive settings. In comparison with other IQ testing scales, this scale was initially created for use in examination into the hereditary and environmental origins of cognitive capacity, typically used in educational settings. The Matrices are accessible in three distinct structures for the members of various capacity, namely Standard Progressive Matrices, Colored Progressive Matrices, and Advanced Progressive Matrices.

The present study utilizes Raven's coloured progressive matrices, which is designed for children aged 5 through 11 years-of-age, the normal, and mentally and physically impaired individuals. Test components are organized to evaluate mental improvement up to the phase when a human is adequately ready to reason by correlation with embrace along these lines of reasoning as a predictable strategy for induction. This apparently decisive moment in intellectual development has all the earmarks of being one of the most punctual to decline as the result of organic dysfunction.[8]

Dental caries is one of the most common oral diseases and is highly prevalent and largely attributable to unhealthy self-care behavior (diet and oral hygiene). Exploring the available literature, only few studies related to dental caries with IQ were found. Many studies have tried to assess the relation between sociobehavioral factors and dental caries.[13] Studies done in the past differ in terms of samples as mentally disabled children, with distinct investigation model and distinctive IQ scales.

The present cross-sectional comparative study had been conducted to determine the relation between IQ of a child with dental caries and normal children with similar standard of living and geographical distribution. Rather than assessing qualitatively different types of intellectual functioning only Intelligence testing is considered.

Valid comparison could not be drawn from the available literature because the methodology, sample size, and the target population varied. Nevertheless, a sincere attempt has been made to correlate the results of the present research with the most closely related literature and the methodology employed in their studies. The current research helps to decide the thinking ability and perceptions of children with dental caries. This will help the clinician to give more preference to the children those who are in need of counseling, which in turn will alter the level of intelligence of children so that it will help to manage the children by understanding their personality level.

The current research showed the prevalence of IQ among 240 study participants as follows: 1.2% of participants were in Grade I IQ level, 9.2% participants were in Grade II, 7.1% participants were in Grade III, 35.4% participants were in Grade IV, and the highest number of participants were in Grade V (47.1%) IQ level, so on analyzing the IQ levels, the highest number of participants affected by dental caries was present in intellectually impaired (43.6% – Grade V); the findings were in accordance with those of Navit et al. (90.9% in borderline intelligence).[7] [Table 2] shows the correlation between the current study results and similar studies carried out in different places.
Table 2: Comparison of similar studies results conducted in various places along with the current study

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However, high IQ levels were observed in studies conducted by Shanker et al. in 1983 (117.5 ± 19.4),[2] and Bruckner and Hill in 1952 (121.6 ± 14.7)[5] in normal children. Whereas the study conducted by Virk et al.[14] found reduced score of IQ (88.75 ± 8.41) in socially handicapped orphan children. Intelligence is of great practical and social importance, and that genetics plays a bigger role than does environment in creating IQ differences among individuals.[13] According to literature review, various studies have been conducted with IQ testing as the main focus and correlating with other parameters, such as a correlation between dental fluorosis and intellectual ability.[15],[16] IQ with caries and gingivitis, IQ Score with dentoskeletal malocclusion under orthodontic treatment had showed conflicting results.[17] Children with probable developmental coordination disorder showed higher risk of mental health problems, and they were arbitrated through the related developmental complications such as reduced verbal IQ, low self-esteem, and bullying.[18] IQ is a standardized measure to detect human intelligence that takes into account a broad range of cognitive skills.[19] These skills are essential for the maintenance of oral hygiene, to become co-operative during treatments, to be attentive to communication, and respond and follow the counseling procedures.

In the present study, caries was more among Grade V IQ cases and the level of caries decreases in the Grade IV IQ cases and further decreases in Grade III and Grade I IQ cases. But the caries incidence increased in Grade II IQ cases, which is not statistically significant. However, there is a promising correlation between IQ and dental caries. On the other hand, Shanker et al. showed a varied relation that, whenever the IQ level increases, the level of dental caries also increases.[2] Our study results were similar to that of Bruckner and Hill and Navit et al. in normal children[5],[7] and Virk et al. in orphan children.[14] Steinberg and Zimmerman stated that institutionalized subnormal person with less IQ (20–49) had significantly reduced caries score than those with more IQ (≥50), and when graphed from lowest to highest IQ, the caries score showed bellshaped curve. The factors, genetic or environmental, responsible for a brain abnormality may operate at the same time that enamel organ is developing, thereby, affecting the protein synthesis of the enamel organ resulting in the deposition of a modified enamel sheet. that could create a resistant enamel.[6] Contradictory to our study, the results of Shanker et al.[2] and Steinberg and Zimmerman[6] stated that, the higher the IQ level, the higher the caries score, but lower IQ group was acquiring cavities at a faster rate than the higher IQ group.[6] The present study results may be due to lack of cognitive skills, which are low in intellectually impaired levels, leading to noncompliance with oral hygiene maintenance and abnormal dietary habits. The results may also be attributed to lack of trained staff and insufficient health education; therefore, the variation in caries could have been due to lack of knowledge, encouragement, and unavailability of health care combined with high cost of dental health care. Various studies have been conducted on people with low IQ levels and poor oral health status.[20],[21] Hence, further studies with more samples, including two or more groups, with other psychological factors on oral health status, with multichannel studies, should be carried out to have a wider perception of the impact of IQ on dental caries.


   Conclusion Top


This study was carried out to check the correlation between IQ and dental caries, which revealed that an increase in IQ causes a decrease in dental caries and vice versa; however, no significant association was observed between the level of intelligence and caries (P = 0.202). Children's oral health promotion and oral health programs should incorporate IQ testing approaches to promote better oral health and better child–clinician relationship.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

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1 Zero DT. Dental caries process. Dent Clin North Am 1999;43:635-64.  Back to cited text no. 1
    
2.
Shanker B, Tewari A, Jain RL, Verma SK. A study of prevalence and severity of dental caries in children of different intelligence quotient levels. J Indian Dent Assoc 1983;55:413-7.  Back to cited text no. 2
    
3.
Sabbah W, Sheiham A. The relationships between cognitive ability and dental status in a national sample of USA adults. Intelligence 2010;38:605-10.  Back to cited text no. 3
    
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Reisine S, Litt M, Tinanoff N. A biopsychosocial model to predict caries in preschool children. Pediatr Dent 1994;16:413-8.  Back to cited text no. 4
    
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Bruckner RJ, Hill TJ. Intelligence quotient and dental caries experience. J Dent Child 1952;19:64-8.  Back to cited text no. 5
    
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Steinberg AD, Zimmerman S. The Lincoln dental caries study. I. The incidence of dental caries in persons with various mental disorders. J Am Dent Assoc 1967;74:1002-7.  Back to cited text no. 6
    
7.
Navit S, Malhotra G, Singh J, Naresh V, Anshul, Navit P, et al. Interrelationship of intelligence quotient with caries and gingivitis. J Int Oral Health 2014;6:56-62.  Back to cited text no. 7
    
8.
Raven J, Raven JC, Court JH. Coloured Progressive Matrices. 7th ed. Oxford Psychologists Press; 1998.  Back to cited text no. 8
    
9.
Li Y, Jing X, Chen D, Lin L, Wang Z. Effects of endemic fluoride poisoning on the intellectual development of children in Baotou. Chin J Public Health Manage 2003;19:337-8.  Back to cited text no. 9
    
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Kargul B, Caglar E, Tanboga I. History of water fluoridation. J Clin Pediatr Dent 2003;27:213-7.  Back to cited text no. 10
    
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Peter S. Essential of Preventive and Community Dentistry. 3rd ed. New Delhi: Arya Publishing House; 2006. p. 148-9, 177-85.  Back to cited text no. 11
    
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Definition From: Psychological Index Terms Via Unifi Ed Medical Language System at the National Library of Medicine. Available from: https://www.nlm.nih.gov/research/umls/.  Back to cited text no. 12
    
13.
Furnham A. Thinking about intelligence. Psychologist 2000;13:510-4.  Back to cited text no. 13
    
14.
Virk P, Jain RL, Pathak A, Sharma U, Rajput JS. Inter-relationship of intelligence-quotient and self-concept with dental caries amongst socially handicapped orphan children. J Indian Soc Pedod Prev Dent 2012;30:127-32.  Back to cited text no. 14
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15.
Ding Y, YanhuiGao, Sun H, Han H, Wang W, Ji X, et al. The relationships between low levels of urine fluoride on children's intelligence, dental fluorosis in endemic fluorosis areas in Hulunbuir, Inner Mongolia, China. J Hazard Mater 2011;186:1942-6.  Back to cited text no. 15
    
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Shivaprakash PK, Ohri K, Noorani H. Relation between dental fluorosis and intelligence quotient in school children of Bagalkot district. J Indian Soc Pedod Prev Dent 2011;29:117-20.  Back to cited text no. 16
[PUBMED]  [Full text]  
17.
Shafiee HA, Seifi M, Badiee M, Aref D. The intelligence quotient (IQ) score in patients aged 12-18 yrs. with dentoskeletal malocclusion under orthodontic treatment in Shahid Beheshti Dental School during 2008-2009. Shahid Beheshti Univ Dent J 2012;30:106-12.  Back to cited text no. 17
    
18.
Lingam R, Jongmans MJ, Ellis M, Hunt LP, Golding J, Emond A, et al. Mental health difficulties in children with developmental coordination disorder. Pediatrics 2012;129:e882-91.  Back to cited text no. 18
    
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Ramsden S, Richardson FM, Josse G, Thomas MS, Ellis C, Shakeshaft C, et al. Verbal and non-verbal intelligence changes in the teenage brain. Nature 2011;479:113-6.  Back to cited text no. 19
    
20.
Jain M, Mathur A, Sawla L, Choudhary G, Kabra K, Duraiswamy P, et al. Oral health status of mentally disabled subjects in India. J Oral Sci 2009;51:333-40.  Back to cited text no. 20
    
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Ulseth JO, Hestnes A, Stovner LJ, Storhaug K. Dental caries and periodontitis in persons with Down syndrome. Spec Care Dentist 1991;11:71-3.  Back to cited text no. 21
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2]



 

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