An epidemiological study of dental disease and dental health behaviour of school children 6-7 and 13-14 years of age in rural Newfoundland, Canada

Doshi, Sharat (1990) An epidemiological study of dental disease and dental health behaviour of school children 6-7 and 13-14 years of age in rural Newfoundland, Canada. Masters thesis, Memorial University of Newfoundland.

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Abstract

KEYWORDS: epidemiology; oral; behaviour; prevalence; dental caries; DMF index; rural Canada; ethnicity; socioeconomic factors; utilization of services; periodontal disease -- A cross-sectional epidemiological study was carried out in 1985 to investigate the prevalence of and risk factors associated with dental disease in school children aged 6 - 7 and 13 - 14 years living in Coastal Labrador and remote parts of the Island of Newfoundland. -- The participants were selected by means of a stratified two-stage probability cluster sampling design. Strata consisted of seven geographic areas. Schools within each area were the primary sampling units. Within the schools selected for the study, a sample of school children within each of the relevant grades was selected. -- Information about the relevant clinical, sociodemographic and behavioural data was gathered through an oral examination of the children and a questionnaire administered either to the children or their parents. Data concerning the dependent variable, oral health status, included measurement of decayed, missing and filled tooth surfaces (DMFS), orthodontic status and prevalence and severity of periodontal disease (Russell's PI). -- Response to request for participation in the study was 285 (82.9%) in the 6 - 7 year olds and 294 (86.7%) in the 13 - 14 year olds. The number and (%) of the consented that were examined, recorded and subsequently analysed was 244 (85.6%) in the younger age group and 229 (77.9%) in the older students. -- The analyses of data from 473, 6 - 7 and 13 - 14 year old school children residing in remote districts of the Province of Newfoundland, Canada, resulted in the following conclusions: -- 1. In both 6 - 7 and 13 - 14 year age groups, increased parental education level was associated with a significant decrease in DMFS index, largely due to decrease in decayed and missing surfaces. In addition, in 13 -14 year olds, increased parental education level also indicated a significant increase in level of treatment. -- 2. Compared with students having little or no exposure to fluoridated water, the 13 - 14 year old students with histories of one or more years of residence in fluoridated communities had significantly less caries experience and significantly lower levels of treatment manifested by restorations; the 6 - 7 year olds with similar histories of residence in fluoridated communities had significantly less filled surfaces. -- 3. Compared with similar aged school children living in other areas of the province, remote children had a greater average number of teeth decayed and missing due to caries, and a lower average number of teeth filled; remote children had a greater need for treatment as measured by the mean number of teeth per student needing various types of treatment; and remote children had a greater proportion of students requiring various dental services. -- 4. Russell's periodontal index (PI) was higher in remote children in both 6 - 7 and 13 - 14 year age groups than similar aged children residing in less remote parts of the province. -- 5. Compared with 6 - 7 and 13 - 14 year old Native Indian children, settler (predominantly Caucasian) children in remote areas in both age groups had significantly greater caries experience and significantly more missing surfaces. -- 6. No significant difference in caries experience was found between Inuit and settler (predominantly Caucasian) children in remote areas in the 13 - 14 year old age group. -- In remote areas of the Province of Newfoundland, the risk of developing dental caries (tooth decay), the most prevalent of the chronic oral diseases, appears to be low for those children having a history of exposure to fluoridated water and for those children indicating a high parental education level. The data from this study support the notion that water fluoridation is the principal choice among the alternatives available for the prevention and control of this main dental disease. In future studies, the effectiveness and efficacy of diet, education, tooth-brushing, water fluoridation and other preventive programs in reducing the incidence and prevalence of dental caries, and in erasing the differences in dental caries rates between the different social classes, should be examined.

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