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Year : 2005  |  Volume : 23  |  Issue : 3  |  Page : 115-118

Risk factors for dental caries in Turkish preschool children

1 Istanbul University, Cerrahpasa, Faculty of Medicine, Department of Public Health, Istanbul, Turkey
2 Istanbul University, Child Health Institute, Department of Family Health, Istanbul, Turkey

Correspondence Address:
Necmi Namal
Atakoy 9 - 10, Kisim D-20 C - D.21, 34750 Istanbul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-4388.16881

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The aim of this study was to evaluate risk factors of dental caries in preschool children in Istanbul. Five nursery schools in Istanbul were included and results of 598 students' were collected. Subjects were orally examined. Socio-demographic data were obtained from the records and from parents. Oral examination data were recorded on examination forms in accordance with the WHO criteria. Bivariate analyses were conducted using chi-square test Multivariate analyses were then performed to estimate the simultaneous impact of the independent variables on dft. Logistic regression analysis was performed in stages. In the study, while although the percentage of children had 60% caries and 0 results at the age of 3, this percentage drops to 15.3% at the age 6. 36%Thirty-six percent of the students have insufficient oral hygiene. Statistically meaningful difference was ascertained in chi-square analysis related to age, mother's education level, and father's occupation. When the variables with statistically meaningful difference are estimated with logistic regression analysis, the age and father's father's occupation turned out to be the risk indicators that affect dft level.

Keywords: Children, Dental caries, Risk factors

How to cite this article:
Namal N, Vehit H E, Can G. Risk factors for dental caries in Turkish preschool children. J Indian Soc Pedod Prev Dent 2005;23:115-8

How to cite this URL:
Namal N, Vehit H E, Can G. Risk factors for dental caries in Turkish preschool children. J Indian Soc Pedod Prev Dent [serial online] 2005 [cited 2022 Nov 30];23:115-8. Available from: http://www.jisppd.com/text.asp?2005/23/3/115/16881

Different countries have released many publications about the indicators that affect dental caries prevalence in preschool children.[1],[2] While some of these publications were published in developed countries,[3],[4] some of them were published in developing countries.[5],[6] Age variable is the common denominator of all articles as the most important indicator that affects dental caries. [4],[5],[6] The higher the age, the higher the dental caries and results.[7] Socio-demographic factors, mother's education, parental smoking practices, oral health behavior, oral hygiene level, dietary habits, Streptococci mutans and gender are reported to be other indicators that affect dental caries.[5], [8],[9],[10],[11],[12],[13] The children of high-level income parents are reported to have more dental caries.[8] The report on the UK National Diet and Nutrition Survey (NDNS) emphasized the association between decay experience in the preschool child and social inequalities.[14],[15]

Publications have been made on mother's education and the dental caries and results of preschool children.[1] The children of the mothers with a high level of education are reported to have lower level of dental caries.[7],[8]

Maternal smoking and parent's low occupational status characterized 5-year-old children in Scotland at high caries risk, but the interaction of these two factors with caries prevalence was not explored.[1]

Tooth brushing is associated with a significantly reduced risk of caries.[16]. The more frequent brushing is performed, the less caries children experience.[17],[18]

Consumption of sugar has long been seen as a cause of caries within a multifactorial context.[11],[19] Caries increment was significantly associated with the weight of sugar consumed, although the correlation coefficient was small.[20] Another study puts forth that the amount of sugar constitutes a risk factor in only susceptible children for new approximal caries.[21]

Mutans streptococci and poor oral hygiene are both powerful predictions of caries risk.[10] A longer prospective study has recently reported the most significant predictors of caries at 3-5 years to be M. streptococci .[3]

Apart from studies reporting that gender is not a risk indicator for the dental caries,[6] there are also studies which report the dental caries and results are more prevalent in girls.[13]

The main purpose of this study is to evaluate the risk indicators associated with dental caries, and to establish baseline data about teeth in Turkish preschool children. The results of this study were compared with the results in other nations with regard to dental caries.

   Materials and Methods Top

The study was carried out in Bagcilar and Gaziosmanpasa districts of Istanbul. Among 10 nursery schools in the above districts, the study was carried out on all students that attended five of the schools, which were determined randomly. The survey was performed on 598 students in nursery schools'and were divided as who paid the fee ( n = 351) and who were enrolled free ( n = 247) affiliated with the Social Services and Children Protection Agency and Gaziosmanpasa Municipality. Oral examinations were carried out in classrooms with the help of a dental mirror and explorer under day light or, where necessary, by using a portable source of light. Only one examiner performed all examinations. Dental caries and results (dft) were ascertained in primary teeth. In the study, according to the dental caries and results, children with '0' dft value were grouped as one, and children with '1 or higher' dft value were considered as another group. Oral examination data were recorded on examination forms in accordance with the WHO criteria. The data used in the survey were obtained from the existing files of the students. Oral hygiene data were ascertained by interacting with the parents of the children. This method was applied in case the children may not be able to give correct answers because of their young age. Data were recorded in one sheet and entered into a computer file. Bivariate analyses were conducted using chi-square test.[22] Multivariate analyses were then performed to estimate the simultaneous impact of the independent variables on dft. Logistic regression analysis was performed in stages.[22]

   Results Top

The mean age of the preschool children attending the study ( n = 598) was 5.33 ± 0.78, and the ages varied between 3 and 6. A 56.9% of the children were boys, and 431.1% were girls.

The evaluations pertaining to 598 preschool children that constitute the study group are indicated in [Table - 1]. The parents of the children reported that 64.0% of the children brush their teeth 1 or 2 times a day regularly. While the children who fail to brush their teeth regularly are 34.5% (less than once a day), the percentage of children that never brush their teeth is 1.5%.

It was ascertained that more than half of the mothers of the children received a low level of education or no education at all (84.3%). Additionally, approximately one sixth of the mothers (15.7) have received schooling for 9 years and more. When the education levels of the mothers are evaluated according to dft level, a meaningful difference was found. The dft occurs as the education level reduces [Table - 1]. In our study, the fathers were classified according to their occupations. While nearly half of the fathers were workers, approximately one sixth of the fathers were observed to have an occupation that required a high level of education such as doctor, engineer, lawyer, etc. A meaningful reduced dft level depending on the father's occupation was observed [Table - 1].

In the evaluation according to number of siblings, it was observed that more than half of the children (60.7%) had no sibling [Table - 1].

About 74.1% of children had experienced dental caries. A meaningful difference is observed between age and dft level arising from the increase in age [Table - 1]. No difference is observed by sex.

The variables of age, mother's education and father's occupation, which were ascertained to be an indicator of dental caries and its results, were evaluated with logistic regression analysis. As a result, it was ascertained that age and father's occupation are factors affecting dental caries and its results (dft) [Table - 2].

   Discussion Top

No study is available that is associated to the indicators of dental caries and its results (dft) in preschool Turkish children. This survey can be helpful in designing prospective studies.

In Turkish preschool children with a dft more than '0' and 40% for children aged 3, the value is different compared to those from some developed and developing countries. The value in Turkish children is close to the value of USA, which is 35%.[23] It is more than twice the example of England, and more than three times the example of Australia.[24],[25] It is half the value reported by Philippines.[26] The 50% value for 4-aged children with a dft other than '0' is almost equal to the USA value, which is 49%.[23] While our value is half the value of Philippines,[26] it is better than the value reported by Scotland, which is 86%.[27] For 5-year-old children, while our value of 69% with dft other than '0' is more than twice the 29.1% value of Denmark,[28] it is less than the 94% value of Philippines.[26] For 6-old children, the value ascertained as 84.7% with dft other than '0' is almost equal to 83.8% value, which is the value reported in Turkey in 1990.[29] These results demonstrate that our values, which are far better relative to the values in developing countries like Philippines at the age of 3, become worse with the increase in age, and approximate the values of this country. If the target of 50% individuals with no dental caries for 5-6 years children put forth by WHO in 2000 is recalled,[30] it is noted that our values display a very negative perspective. The 6-year age target of WHO for European Region in 2020 are 80% individuals with no dental caries.[31] Our values for age 6 are also noted to be far from this target.

Age is commonly declared an important factor that influences the dental caries on children.[7] The results of our study agree with this finding. In our study, there was no difference based on sex. This result does not agree with some other surveys[17],[33],[34] but did agree with another survey.[6]

Many researchers have reported that the prevalence of regular tooth brushing has a positive impact on dental caries.[17],[18],[35] No such effect was observed in our study. Mother's education level has affected the dental caries and results of the children to a very meaningful degree. The low level of mother's education level, 84.3% of which is 8 years or less, may have an impact on the tooth-brushing habits of the children. The fact that the values according to tooth-brushing frequency in our study did not turn out meaningful was due to the failure to perform tooth-brushing effectively and correctly. It is possible to associate this as a result of the mother's having low levels of education. These results are correlated with the results of the study that puts forth that the increase in the education levels of the mothers have a positive impact on the dental caries and results.[7],[8]

As the education level of the father increases depending on the occupation, the dental caries and results are reduced. There is a negative correlation between them. This result does not agree with another survey.[8] However, it agrees with another study reporting that there is a direct relation between caries prevalence and the father's occupation, the age of the first dentist experience of the child and the frequency and the income level of the family.[36]

In our study, although it is ascertained that the number of siblings does not increase dental caries and results in a meaningful manner, there is still a slight increment. In this evaluation, it must be taken into consideration that the mean number of children of the parents in nursery schools is 1.4 and this rate is far less than 2.49 value, which is the mean Turkish value (TNSA).

The studies generally examine one or more factors related to dental caries and results. Most of these studies use bivariate relation of risk indicators. In this study, several risk indicators of dental caries and results have been taken into consideration. Age, gender, tooth-brushing, mother's education level, father's occupation, number of siblings are evaluated within the scope of dental care together with the simultaneous impact (estimated).

The results of this study have shown that age and father's occupation have an impact on the dental caries and results. According to the result of the study, the increase in the education level of the father's occupation has a positive impact on the dental health of the children. The father's being a non-professional rather than and professional increased dft level by 2.516 times, and the father's being a civil servant increased this factor by 2.003 times. In children of 5 years age group rather than 3 years the dft increasesed by 1.569 times, and the child's being aged 6 increases the factor by 5.868 times. Health improvement program placement is among the targets of WHO for year 2015 in 95% of all schools and 50% of all nursery schools.[31] It is obvious that programs in line with such targets are a requirement for the children of our country where our study takes place.

   References Top

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[Table - 1], [Table - 2]

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