International Poster Journal of Dentistry and Oral Medicine



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Int Poster J Dent Oral Med 8 (2006), No. 2     15. June 2006

Int Poster J Dent Oral Med 2006, Vol 8 No 02, Poster 318

State of the oral health in non-cooperative children

Language: English

Prof. MUDr. Martina Kukletová, CSc.,
Ass.Prof. MUDr. Zdenka Halacková, CSc.,
MUDr. Jarmila Kuklová,
MUDr. Marta Svobodová,
Stomatological Clinic, Faculty of Medicine, Masaryk University, Brno

October 12-15, 2005
Prague Dental Days


Treating non cooperative children makes high demands on a dentist and his/her team. These demands are related to psychological,physical and time aspects. For these reasons non-cooperative children are referred by their treating general dentists to specialized work-places such as the Stomatological Clinic of Masaryk University, Faculty of Medicine & Saint Anne's Faculty Hospital in Brno. These children are treated by the implementation of psychological approaches, under premedication and, if necessary, under general anesthesia (GA).
The aim of this work was to gather the data on the dentition state in children treated under GA in the year 2002, and to determine the level of the oral health state of non cooperative children.


Lack of relevant data on the oral health state and treatment need in non-cooperative and handicapped children.

Material and Methods

Dental records of 51 children treated under GA in the year 2002 were analysed and DMF-T, DMF/T (%) , RI indices and treatment degree were calculated. The obtained data were compared with those of the countrywide survey (12yr-old). (Krejsa, Broukal, Mrklas 2001)


With regard to the low number of children the trial was evaluated as a unit without gender differentiation. Children below 6 years of age are not treated under GA at the Stomatological Clinic, this care is provided by the Children's Pediatric Hospital Brno.
The results are summarized in tables and graphs.

  Number of Children Mean SE
Age 51 9,73 -
Permanent teeth 15,51 0,87
D-teeth 3,82 0,34
F-teeth 0,29 0,09
M-teeth 0,18 0,10
DMF-teeth 4,29 0,42
DMF/T (%) 28,00 2,50
Table 1: The main data on the trial

  Age DMF/T(%)
Diagnosis Number of Children Mean SD Mean SE
Epilepsy 4 8,63 2,18 42,7 20,9
Mental retardation 17 10,18 2,02 28,8 3,6
Cerebral palsy 2 9,32 1,10 21,4 21,4
Cardiovascular diseases 1 8,82 - 31,2 -
Oncological diseases 1 7,62 - 40,0 -
Phobia 26 9,58 1,63 26,2 2,8
Other 2 10,25 1,83 5,8 5,8
Table 2: Dental status and caries experience

Diagnosis Number of Children RI+ri (%)F/DMF*100 Treatment grade (%) F+M*100
Epilepsy 4 48,5 53,0
Mental retardation 17 48,5 52,8
Cerebral palsy 2 34,0 35,8
Cardiovascular diseases 1 50,0 50,0
Oncological diseases 1 46,2 53,8
Phobia 26 48,8 52,0
Other 2 55,6 55,6
Table 3: State of the treatment - permanent teeth

Fig. 1: Values of DMF/T, Ri+ri (%) and treatment grade (%) in different diagnoses.

  Children treated under GA National-wide data
DMFT 4,29 3,09
D 3,82 (81%) 0,84 (27,18%)
F 0,29 (6,8%) 2,24 (72,49%)
M 018 (4,2%) 0,01 (0,32%)
RI 47,37 72,85
Table 4: The comparison to national-wide data

The results have shown that caries prevalence is much higher if compared to a normal healthy population and that more than 80% of carious lesions are not treated. Even the contribution of extracted teeth is higher, and due to the implementation of more radical treatment procedures it will continue to rise. The restorative index value in non-cooperative children stands for 47.37 vs 72.85 in the healthy population.


In recent decades, a substantial decline in caries prevalence was documented in highly industrialized countries, while in the Central and Eastern Europe caries prevalence remained on a higher level (Marthaler 2004, Pieper, Schulte 2004). Epidemiological data on the dental status of handicapped or non cooperative children suggest a lack of oral health care even in industrialized countries (Choi, Yang 2003, Franklin et al 2000, Martens 1997). The results of our study have demonstrated that caries experience in non-cooperative children was higher than that in a common Czech population (Krejsa, Broukal, Mrklas 2001)) . More than 80% of decayed teeth were not treated. The restorative index value was 47.37%, while in a common population it was 72.85%. The number of extracted teeth was high, and with regard to more radical therapy further increase would be expected. Moreover,in the group of non-cooperative children suffering from phobia (children without any mental or physical handicap) there were recorded similar values as those in children affected by mental retardation. It is obvious from the obtained data that the dental treatment of handicapped and non-cooperative children is not sufficient, and there is a strong need for mouth hygiene instructions programs for educators, parents and dentists involved in the special care of these children.
Supported by grant No NR 8215-3/2004 from the Grant Agency of the Czech Ministry of Health.


  • Choi NK., Yang KH.: A study on the dental disease of the handicapped. Journal of Dentistry for Children 2003, 70(2), 153158
  • Franklin D., Senior N., James I., Roberts G.: Oral health status of children in a paediatric intensive care unit. Intensive Care Medicine 2000, 26(3), 319-324
  • Krejsa O., Broukal Z., Mrklas L.: Oral health state of children aged 5, 12, and 15 years in the Czech republic 1998. ( Czech) Ces. Stomat. 2001, 101,(2), 43-50
  • Martens LC.: Dental care for the handicapped: general problem ( French). Revue Belge de Medecine Dentaire , 1997,52(2), 9-26
  • Marthaler, T.M.: Changes in dental caries 1953-2003. Caries Research, 2004, 38(3), 173- 181
  • Pieper K., Schulte A.G.: The decline in dental caries among 12-year-old children in Germany between 1994 and 2000. Community Dental Health. 2004, 21(3), 199-206


GA = general anesthesia

This Poster was submitted by Prof. MUDr. Martina Kukletová.

Correspondence address:
Prof. MUDr. Martina Kukletová
CSc., Stomatological Clinic
Faculty of Medicine
Masaryk University
Pekarská 53 656 91 Brno