|Year : 2018 | Volume
| Issue : 6 | Page : 283-286
Dental caries experience and oral hygiene status among hearing and speech impaired children of Karad city, Maharashtra, India
KM Shivakumar1, Vaishali Raje2, Vidya Kadashetti3
1 Department of Public Health Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
2 Department of Community Medicine, Krishna Institute of Medical Sciences, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
3 Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
|Date of Web Publication||24-Dec-2018|
Dr. K M Shivakumar
Professor and Head, Department of Public Health Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to be University, Malkapur, Karad - 415 110, Satara (Dist.), Maharashtra
Source of Support: None, Conflict of Interest: None
Introduction: Disability has often been described as a physiological deficit. Children with hearing impairment constitute one of the major population groups of physically challenged children. In India, the people are suffering from one or the other kind of disability which is equivalent to 2.1% of the country's population. Aims and Objectives: This study aims to assess the caries experience and oral hygiene status among the hearing and speech impaired children's. Materials and Methods: A cross-sectional survey was conducted among 100 participants aged 5–18 years attending a school for the sensory impaired children of Karad city, India. The participants were examined using Type III clinical examination. Oral hygiene status by oral hygiene index-simplified (OHI-S), Plaque index status and decayed, missing, and filled teeth/surface (DMFT/S) index were assessed. ANOVA, Chi-square test were used and P < 0.05 was considered statistically significant. Results: The largest component of DMFT/dmft was the decayed component, with a mean of 2.83 ± 0.94. P < 0.05 showing that this was statistically significant. The simplified calculus index and OHI-S index showed a significant difference between males and females of the study population (P < 0.05, S). Conclusion: There is an alarming situation for dental diseases among these hearing and speech impaired children. Hence, efforts should be made to encourage the parents and school teachers of these children to promote and improve their oral health.
Keywords: Decayed, missing and filled teeth/surface, disability, hearing and speech impaired, oral hygiene index-simplified
|How to cite this article:|
Shivakumar K M, Raje V, Kadashetti V. Dental caries experience and oral hygiene status among hearing and speech impaired children of Karad city, Maharashtra, India. J Int Oral Health 2018;10:283-6
|How to cite this URL:|
Shivakumar K M, Raje V, Kadashetti V. Dental caries experience and oral hygiene status among hearing and speech impaired children of Karad city, Maharashtra, India. J Int Oral Health [serial online] 2018 [cited 2022 Jun 26];10:283-6. Available from: https://www.jioh.org/text.asp?2018/10/6/283/248428
| Introduction|| |
Disability has often been described as a physiological deficit. More specifically, the disability can be defined as ‘anyone who has or had an impairment causing a long-term adverse effect on his or her ability to perform daily activities typical for the person's stage of development and cultural environment., The disabled people form a substantial section of the community, and it is estimated that there are about 500 million people with disabilities worldwide., Children with hearing impairment constitute one of the major population groups of disabled children. Nearly one in 600 neonates have a congenital hearing loss., As per the report given by the World Health Organization (WHO) in 1980, the main causes of hearing impairment in India were; infections such as bacterial meningitis, mumps and measles, neglect, and ignorance. There are three levels of prevention of hearing impairment; primary, secondary, and tertiary. The measurement of hearing loss can be made using various techniques such as otoacoustic emission measurement being particularly accurate. The primary target of a nation should be to improve the health and social functioning of deprived people. Hearing disorders affect general behavior and impair the level of social functioning. This group is often neglected because of ignorance, fear, stigma, misconception, and negative attitudes. Disability affects a wide segment of the population of all ages and social classes, According to the WHO, an estimated 650 million people live with disabilities around the world, and census 2001 has revealed that over 21 million people in India are suffering from one or the other kind of disability. This is equivalent to 2.1% of the country's population. According to the National Sample Survey Organization, India in 2002, 0.4% of 1065.40 million children (Census 2002) suffered from hearing impairment.
In London, the Court report says, “fit for the future” recommended that the dental health of physically challenged children should be brought up to and maintained at the level of that provided for other children. Children and adolescents with disabilities appear to have poorer oral health than their nondisabled people. Individuals with disabilities or illnesses receive less general care as well as oral care than the normal population. Dental caries is one of the most prevalent disease among mentally retarded children worldwide, and dental treatment is the greatest unattended oral health need of the physically challenged people. The reasons that can contribute to the care of disabled children may be inadequate call systems, practical difficulties during treatment sessions, socioeconomic status, and underestimation of treatment needs, communication problems, and poor cooperation.,,
In developing countries such as India, this is quite a serious issue. Patients with such disorders consisted of a unique population deserving special attention. Disabled individuals, oral health may be influenced by age, severity of impairment, and living conditions. This group of individuals may not also understand and assume responsibility or cooperate with preventive dental health practices. Very young and those who are living in various institutional homes are mainly dependent on parents, siblings or caregivers for general care including maintenance of oral hygiene. Most of the caretakers do not have the required knowledge to recognize the importance of oral hygiene and proper diet to these disabled. These children's may be more susceptible to dental caries if they reside at home and are pampered with cariogenic snacks and other unhealthy eating habits. Some studies have reported a high caries experience in physically challenged children, while other studies describe comparable or even lower disease levels.,
Hence, the present study was designed to gather the baseline data and to determine the oral health status and risk predictors for dental caries among hearing and speech impaired children of Karad city, India.
The objective of the study is to assess the dental caries experience, oral hygiene status and plaque index (PI) status among the hearing and speech impaired children of Karad city, India.
| Materials and Methods|| |
A survey was conducted among 100 participants aged 5–18 years attending a special school for the hearing and speech impaired children of Karad city. A pilot study was conducted to assess the sample size of the study population, and the participants of the pilot study were not included in the main study. Permissions to conduct the survey were obtained by the school authorities. An ethical approval was obtained from the concerned authorities (KIMSDU/IEC//2013-14/ 06/12/2013). Informed consent was obtained from all the study participants or parents or by their caretakers. All hearing and speech impaired children attending special schools were all included for the study.
The children under medication, systemic diseases or uncooperative and those who do not provide consent were excluded from the study. Twenty-three participants were aged between 5 and 8 years, 32 were aged 9–12 years and 45 were in 13–18 years. As per the WHO criteria for the diagnosis of dental caries, the participants were examined using necessary instruments. All instruments were sterilized, and Type III clinical examination procedure was followed to assess the oral health status of the study population. For the purposes of communication with the study participants, teachers were asked to help during the recording of case history and clinical examination. Decayed, missing and filled teeth/surface (DMFT/S) index, oral hygiene status oral hygiene index-simplified (OHI-S), and PI status were recorded followed by case history and clinical examination. Those children in need of emergency treatment were referred to nearby dental hospital. Along with oral examination, four degrees of hearing loss were assessed: mild (26–40 db), moderate (41–70 db), severe (71–90 db), and profound (>90 db). Descriptive statistics was used to assess all the parameters. ANOVA and Chi-square test was applied using the SPSS software package (version 21.0, Inc., and Chicago, IL, USA). P < 0.05 was considered as statistically significant.
| Results|| |
[Table 1] shows the mean level of caries prevalence (DT/dt, MT/mt, FT/ft, and DMFT/dmft) for the different age groups with standard deviation. Mean DMFT/dmft was 0.53 ± 0.79 for the 5–8 years of age group, 1.59 ± 1.73 for the 9–12 years of age group, 2.49 ± 1.81 for the 13–18 years of age group, clearly demonstrating an increase in caries prevalence with age. Adults had a greater number of decayed teeth. The largest component of DMFT/dmft was the Decayed component, with a mean of 2.83 ± 0.94. P < 0.05 showing that this was statistically significant. The M and Filled components had very low mean values of 0.19 ± 0.73 and 0.21 ± 0.83, respectively. For comparison of means, one-way ANOVA was used. The highest mean DMFS/dmfs (3.52 ± 2.61) was recorded for the 13–18 years of age group. In the younger age groups (9–12 and 5–8), decayed surfaces showed high values of 2.15 ± 2.19 and 0.5 ± 0.85, respectively. Missing surfaces and filled surfaces did not account for a major proportion in any of the age groups except the 13–18 years of age group. Statistically significant differences have been observed in the DMFS/dmfs index also (P < 0.01, S).
|Table 1: Age-wise distribution of decayed, missing and filled teeth and decay-missings-filled surface index of the study population|
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[Table 2] shows the distribution of OHI-S and Silness and Loe PI. The simplified calculus index and OHI-S index showed a significant difference between males and females of the study population (P < 0.05, S). The mean values of PI show more in males (0.91 ± 1.47) when compared with females (0.81 ± 1.13). However, there was no statistically significant difference between males and females for PI.
|Table 2: Gender wise distribution of oral hygiene index-simplified index and plaque index in hearing and speech impaired children|
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| Discussion|| |
In our study, the major finding was that there is high prevalence of dental caries among disabled subjects with hearing difficulties. The older the age groups more permanent teeth at risk and the higher incidence risk for oral diseases. The mean DMFT and the mean number of decayed teeth in the 9–12 years of age group were 1.59 ± 1.73 and 1.53 ± 1.29, respectively, which are higher than the corresponding figures for the general population likely because of ignorance and poor oral hygiene habits as per the study conducted by the National Oral health survey and fluoride mapping by Dental Council of India. Dental caries prevalence in the 9–12 and 13–18 years of age groups was 91.2% and 86.8%, respectively, being higher than the general population, likely because of ignorance on the part of school teachers and parents. Whereas the corresponding figures for the general population were 39.1% and 33.1% for 12 and 15 years of age groups, respectively. Shaw et al. conducted a study in Birmingham, UK, and reported a mean DMFT score of 1.76 in 5–15-year-old physically challenged children. In our study, the figure was 2.74 for 5–18 years of age group children with hearing impairment, may be due to lack of parental care as parents were ignorant about dental health. Shyama et al. conducted a study to demonstrate a higher prevalence of caries, 86%, with a mean DMFT score of 5.0 in participants aged 3–29 years with hearing impairment probably due to changes in lifestyle and dietary habits. In our study, the prevalence of untreated tooth decay was 81.2% and the mean DMFT was 2.74 ± 1.58, probably due to poor oral hygiene habits and barriers health education.
In a study conducted by Rao et al. in Mangalore, Karnataka and Alvarez-Arenal et al. in Spain, showed a higher caries prevalence with a mean DMFT of 2.48 and 3.30, respectively. The results of our study were in consistent with scores of 2.74 which emphasized the need to reorganize preventive as well curative care and improve dental care, particularly with the disabled children. Our study results show that the mean OHI-S score among these hearing and speech impaired children was found to be 1.63 ± 0.84; that among males and females was 1.67 ± 0.91 and 1.52 ± 0.72, respectively. The OHI-S score among males was higher when compared to females, and the difference was statistically significant (P < 0.05). These findings are in consistent with the other studies conducted in different parts of the world,, In our study, the mean Loe and Sillness PI score was 0.85 ± 1.29 The Mean Loe and Sillness PI score among male these hearing and speech impaired children was found to be 0.91 ± 1.47, and that among these female children (0.81 ± 1.13). However, there were no statistically significant differences have been observed among the study population. These results were in consistent with the studies conducted by Rawlani et al. in warora.
| Conclusion|| |
The present findings demonstrated a high caries prevalence, poor oral hygiene, increased risk of periodontal diseases, and extensive unmet needs for dental treatment indicating that these children were neglected and less treatment priority is offered to these children. In fact, this is a highly alarming situation which needs immediate attention. Hence, it is recommended that prevention-based intervention program is much needed for these special groups of participants involving voluntary health agencies. Effort must be taken to encourage the parents of these children to promote and improve their oral health.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Chand BR, Kulkarni S, Swamy NK, Bafna Y. Dentition status, treatment needs and risk predictors for dental caries among institutionalised disabled individuals in central India. J Clin Diagn Res 2014;8:ZC56-9.
Bindu VB, Chandrashekar J, Joe J. Access to dental care among differently abled children in Kochi. J Indian Assoc Public Health Dent 2016;14:2934.
Jain M, Mathur A, Kumar S, Dagli RJ, Duraiswamy P, Kulkarni S, et al.
Dentition status and treatment needs among children with impaired hearing attending a special school for the deaf and mute in Udaipur, India. J Oral Sci 2008;50:161-5.
Barriers WN. Discrimination and prejudice. In: Nune JH, editor. Disability and Oral Care. London: FDI World Dental Press; 2000. p. 15-20.
McDonald RE, Avery DR, Dean JA. Dentistry for the child and adolescent. 8th
ed. St. Louis: Mosby; 2004.
Moshourab R, Bégay V, Wetzel C, Walcher J, Middleton S, Gross M, et al.
Congenital deafness is associated with specific somato sensory deficits in adolescents. Sci Rep 2017;7:4251.
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.
Bekiroglu N, Acar N, Kargul B. Caries experience and oral hygiene status of a group of visually impaired children in Istanbul, turkey. Oral Health Prev Dent 2012;10:75-80.
Court SD. Fit for the Future. Report of the Committee on Child Health Services. London: HMSO; 1976.
Papagno C, Cecchetto C, Pisoni A, Bolognini N. Deaf, blind or deaf-blind: Is touch enhanced? Exp Brain Res 2016;234:627-36.
Sharma A, Glick H, Campbell J, Torres J, Dorman M, Zeitler DM, et al.
Cortical plasticity and reorganization in pediatric single-sided deafness pre- and postcochlear implantation: A case study. Otol Neurotol 2016;37:e26-34.
National Oral Health Survey and Fluoride Mapping. An Epidemiological Study of Oral Health Problems and Estimation of Fluoride Levels in Drinking Water. Vol. 32. New Delhi: Dental Council of India; 2004. p. 67-78.
Hennequin M, Faulks D, Roux D. Accuracy of estimation of dental treatment need in special care patients. J Dent 2000;28:131-6.
Boj JR, Davila JM. Differences between normal and developmentally disabled children in a first dental visit. ASDC J Dent Child 1995;62:52-6.
Anzil KS, Kiran M, Keerthi L, Diny D, Sudeep CB, Aravind A. Dental care utilization and expenditures on children with special health care needs – A review. Int J Appl Dent Sci 2017;3:258.
Sandeep V, Kumar M, Vinay C, Chandrasekhar R, Jyostna P. Oral health status and treatment needs of hearing impaired children attending a special school in Bhimavaram, India. Indian J Dent Res 2016;27:73-7.
] [Full text]
Bartolomé-Villar B, Mourelle-Martínez MR, Diéguez-Pérez M, de Nova-García MJ. Incidence of oral health in paediatric patients with disabilities: Sensory disorders and autism spectrum disorder. Systematic review II. J Clin Exp Dent 2016;8:e344-51.
Bali RK, Mathur VB, Talwar PP, Chanana HB. National Oral Health Survey and Fluoride Mapping 2002-2003 Rajasthan. New Delhi: Dental Council of India; 2004. p. 96.
Shaw L, Maclaurian ET, Foster TD. Dental study of handicapped children attending special schools in Birmingham, UK. Community Dent Oral Epedemiol 1986;14:24-7.
Shyama M, Al-Mutawa SA, Morris RE, Sugathan T, Honkala E. Dental caries experience of disabled children and young adults in Kuwait. Community Dent Health 2001;18:181-6.
Rao DB, Hegde AM, Munshi AK. Caries prevalence amongst handicapped children of South Canara district, Karnataka. J Indian Soc Pedod Prev Dent 2001;19:67-73.
Alvarez-Arenal A, Alvarez-Riesgo JA, Peña-Lopez JM, Fernandez-Vazquez JP. DMFT, Dmft and treatment requirements of schoolchildren in Asturias, Spain. Community Dent Oral Epidemiol 1998;26:166-9.
Kumar S, Dagli RJ, Mathur A, Jain M, Duraiswamy P, Kulkarni S, et al.
Oral hygiene status in relation to sociodemographic factors of children and adults who are hearing impaired, attending a special school. Spec Care Dentist 2008;28:258-64.
Rawlani S, Rawlani S, Motwani M, Bhowte R, Baheti R, Shivkumar KM. Oral health status of deaf and mute children attending special school in Anand-Wan, Warora, India. J Kor Dent Sci 2010;3:20-5.
[Table 1], [Table 2]