Year : 2007 | Volume
: 25 | Issue : 2 | Page : 103--105
Prevalence of gingival diseases, malocclusion and fluorosis in school-going children of rural areas in Udaipur district
V Dhar1, A Jain1, TE Van Dyke2, A Kohli3,
1 Clinical Research Center, Darshan Dental College, Loyara, Udaipur, India
2 Clinical Research Center, Goldman School of Dental Medicine, Boston, USA
3 Dental Council of India, Clinical Research Center, Udaipur, India
Clinical Research Center, Department of Pedodontics and Preventive Dentistry, Darshan Dental College and Hospital, Loyara, Udaipur - 313 011, Rajasthan
High prevalence of dental diseases has been recorded in Rajasthan, however, not much work has been done to ascertain the prevalence of dental diseases in Udaipur district. This study was conducted among 1,587 government school children of Udaipur district in the age group of 5-14 years for recording the prevalence of gingival diseases, fluorosis and malocclusion. Gingivitis was found in 84.37% of children, malocclusion in 36.42% and fluorosis in 36.36%.
|How to cite this article:|
Dhar V, Jain A, Van Dyke T E, Kohli A. Prevalence of gingival diseases, malocclusion and fluorosis in school-going children of rural areas in Udaipur district.J Indian Soc Pedod Prev Dent 2007;25:103-105
|How to cite this URL:|
Dhar V, Jain A, Van Dyke T E, Kohli A. Prevalence of gingival diseases, malocclusion and fluorosis in school-going children of rural areas in Udaipur district. J Indian Soc Pedod Prev Dent [serial online] 2007 [cited 2021 Jun 20 ];25:103-105
Available from: https://www.jisppd.com/text.asp?2007/25/2/103/33458
The common dental diseases tormenting mankind are gingival diseases, malocclusion and fluorosis. Higher prevalence of dental diseases has been reported on different occasions in developing countries like India. Among dental diseases, gingivitis is seen to be the most prevalent. In Rajasthan, highly rich fluoride groundwater, exceeding 10 mg/L, has been reported to exist in the districts Ajmer, Barmer, Bharatpur, Bhilwara, Bikaner, Churu, Dungarpur, Jaipur, Jodhpur, Jhunjhunu, Kota, Pali, Nagur, Sikar, Sirohi, Tonk and also in some parts of Udaipur. So fluorosis is also among the major dental issues. However, not much data is available on prevalence of dental diseases in children in Rajasthan, especially in Udaipur district.
The purpose of this study was to find the prevalence of gingivitis, malocclusion and fluorosis in school-going children of Udaipur district, Rajasthan.
Materials and Methods
This study was carried out in the Pediatric and Preventive Dentistry wing, Clinical Research Center, Udaipur, Rajasthan.
A sample size of 1,587 school-going children was examined over a time span of 1 year (January 2005-December 2005), involving a total of 23 schools in this study. The Department of Pediatric Dentistry acquired official permissions from the State government, District Education Office and Anandwadi for conducting "School Health Programs" in all the government schools of rural areas in Udaipur district. This study was cleared by the Institutional Ethics Committee of Darshan Dental College and Hospital.
In this program after obtaining consent from parents and teachers, 20-25 children were brought from different schools to the hospital regularly, examined and given free dental treatment. In this manner, all the students in the age group of 5-14 years were examined from all the schools. The schools were all from rural areas and selected randomly.
The children was examined by a single examiner who was trained to record the WHO oral health assessment  form to avoid inter-examiner variations. WHO indices were used for recording fluorosis and malocclusion and Loe and Silness index was used for recording gingival status.
All data were compiled and subjected to statistical analysis using chi square test for deriving results.
A total number of 1,587 children were examined, out of which 827 were boys and 760 were girls. One hundred eighty-eight children belonged to the age group of 5-7 years and 587 and 812 to age groups of 8-10 and 11-14 years respectively [Table 1].
The overall prevalence of gingivitis was 84.37% (mild gingivitis 57.66%, moderate 22.99% and severe 3.72%). Gingivitis prevalence in the age group 5-7 years was 78.72% (mild gingivitis 64.89%, moderate 11.17% and severe 2.66%); 8-10 years, 85.01% (mild gingivitis 61.16%, moderate 19.08% and severe 4.77%); and 11-14 years, 85.22% (mild gingivitis 53.45%, moderate 28.57% and severe 3.20%). The difference between age groups was highly significant. Boys showed gingivitis prevalence of 83.31% (mild gingivitis 55.50%, moderate 23.46% and severe 4.35%); and girls, 85.53% (mild gingivitis 60%, moderate 22.50% and severe 3.03%); and the difference was also found to be highly significant [Table 2]. Total prevalence of malocclusion was seen to be 36.42% (mild to moderate 29.74% and severe 6.68%). In the age group 5-7 years, 26.06% had malocclusion (mild to moderate 22.87% and severe 3.19%); among 8-10 years, 36.29% ) had malocclusion (mild to moderate 30.15% and severe 6.13%); and among 11-14 years, 38.92% had malocclusion (mild to moderate 31.03% and severe 7.88%). 36.40% of the boys had malocclusion (mild to moderate 29.99% and severe 6.41%) and 36.45% of the girls had malocclusion (mild to moderate 29.47% and severe 6.97%). Age-wise the difference was significant, whereas there was no significant difference in boys and girls [Table 3].
Fluorosis was seen in 36.36% of children (questionable 18.90%, very mild 10.59%, mild 4.98%, moderate 1.70%, severe 0.19%). In the age group 5-7 years, fluorosis prevalence was 18.09% (questionable 13.30%, very mild 2.66%, mild 1.06%, moderate 1.06%, severe 0%); in 8-10 years group, it was 36.46% (questionable 19.76%, very mild 10.56%, mild 4.43%, moderate 1.36%, severe 0.34%) and in 11-14 years group, it was 40.52% (questionable 19.58%, very mild 12.44%, mild 6.28%, moderate 2.09%, severe 0.12%). Boys had total prevalence of 37.73% (questionable 19.23%, very mild 10.40%, mild 6.05%, moderate 1.93%, severe 0.12%) and girls had total prevalence of 34.87% (questionable 18.55%, very mild 10.79%, mild 3.82%, moderate 1.45%, severe 0.26%). The difference between age groups and also between boys and girls was statistically significant [Table 4].
School-going children were targeted in this study because of the ease of accessibility.  Loe and Silness index was used as it gives the severity of gingivitis present, i.e., mild, moderate or severe. The overall gingivitis prevalence was found to be 84.37% in the present study. Overall prevalence was found to increase with age. Similar findings were seen in a study conducted by Jose et al. in 2003  and Kumar et al., in 2005.  Mild gingivitis was more prevalent in the 5-7 years age group and moderate and severe gingivitis were more prevalent in age groups 8-10 and 11-14 years. This could be explained due to the presence of mixed dentition, varied food habits, shedding of primary teeth, improper and unsupervised oral hygiene practices and malocclusions. More females were affected by gingivitis, which could be related to pubertal changes and the fact that the girl child in rural areas is being given lesser oral hygiene facilities and priority compared to boys. Total prevalence of malocclusion was seen to be 36.42%. Though there was no significant difference between boys and girls, malocclusion was found to be the highest in the age group of 11-14 years, which is similar to the finding of Bhalaji.  Overall prevalence of fluorosis was seen to be 36.36%. Prevalence of 33% has been reported in Junagadh, 17.75% in Ahmedabad, 22% in Surendranagar, all in Gujarat; and about 77% in village Sotai in Haryana.  Age group of 5-7 years showed minimum prevalence due to higher number of primary teeth and only few erupted permanent teeth. All the cases were seen in the permanent dentition only, as explained by the fact that very high fluoride levels are required in drinking water for it to cross placental barrier and affect primary dentition. Highest prevalence was found in the age group 11-14 years as maximum number of permanent had erupted. Though fluorosis is very high in Rajasthan, Udaipur district is not among the worst-affected areas and maximum cases were seen of questionable or very mild fluorosis.
This data of existing dental health problems shows that necessary dental health programs needs to be implemented to attain the required oral care among the school-going children of Udaipur.
|1||World Health Organization oral Health Survey, Basic methods, 4th ed. WHO: Geneva; 1999.|
|2||Holm AK. Caries in preschool children-international trends. J Dent 1990;18:291-5.|
|3||Jose A, Joseph MR. Prevalence of dental health problems among school going children in rural Kerala. J Indian Soc Pedo Prev Dent 2003;21:147-51.|
|4||Mahesh Kumar P, Joseph T, Varma RB, Jayanth M. Oral health status of 5 years and 12 years school going children in Chennai city: An epidemiological study, J Indian Soc Pedo Prev Dent 2005;23:17-22.|
|5||Bhalaji SI. Orthodontics-The Art and science. 1 st ed. Arya (Medi) Publishing House: New Delhi; 1999. p. 115-6.|
|6||Susheela AK. Dental fluorosis. A treatise on fluorosis. 2001. p. 59.|