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Int Poster J Dent Oral Med 12 (2010), No. 2     15. June 2010

Int Poster J Dent Oral Med 2010, Vol 12 No 2, Poster 493

Analysis of oral health data from 13-15-year-olds from the ELSPAC study

Language: English
 

Authors:
Prof. Dr. Martina Kukletová, Dr. Kristína Musilová,
Masaryk University, Faculty of Medicine, Stomatological Clinic, Brno, Czech Republic
Prof. Dr. Zdenek Broukal,
Charles University, 1st Faculty of Medicine, Prague, Czech Republic
Prof. Dr. Lýdie Izakovicová Hollá,
Masaryk University, Faculty of Medicine, Department of Pathophysiology, Brno, Czech Republic
Assoc. Prof. Lubomir Kukla,
Masaryk University, Faculty of Medicine, Department of Social Medicine and Health Care Administration, Brno, Czech Republic

Date/Event/Venue:
September 3rd-5th, 2009
14th Annual Congress of the EAPD, European Association of Dental Public Health
Tromso, Norway
 

Introduction

The aim of our study was to analyze oral health state data obtained from 13-15 year old children from the ELSPAC group (European Longitudinal Study of Pregnancy and Childhood) monitored in Brno city which comprises over 5000 children and their families. The ELSPAC is a prospective study in several European countries where the chosen group of children and their families are examined from pregnancy of the mother, birth of the child, up to his/her 18 years of age. Pediatric-anthropological-psychological examinations have already taken place in the 8th, 11th, 13th and currently the examination in the 15th year of age of subjects is in progress. These age phases were chosen in order to record developmental and health changes associated with the prepubertal, pubertal and postpubertal phases of child development. Part of the ELSPAC group was examined to assess oral health in this case-control study.
 

Objectives

Lack of information on oral health state of children of the ELSPAC group Brno.
 

Material and Methods

The total number of 780 Caucasian adolescents of Czech nationality, aged 13 to 15 years, selected from the ELSPAC Brno study (children participating in our study) underwent a dental examination at the Clinics of Stomatology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University.
The clinical assessment was carried out by one investigator. The following clinical parameters were assessed: DMFT (WHO 1997 criteria) score, gingival index (GI), plaque index (PI) and calculus index (CSI). Presence/absence of orthodontic anomalies and its severity was recorded (ortho0 = no anomaly, ortho1 = mild anomaly, ortho2 = severe anomaly). Gingivitis was measured using the modified Löe-Silness GI index on teeth 16, 12, 24, 32, 36, 44. This index uses a 0 to 3 scale to assess gingivitis on or adjacent to 6 sites (mid-buccal, mesio-buccal, disto-buccal and mid-lingual, mesio-lingual and disto-lingual) of the individual tooth according to the following criteria: The complete absence of visual signs of inflammation was scored 0. A slight change in color, slight oedema and no bleeding on probing was scored as 1. Visual inflammation, redness, oedema, glazing and bleeding on pressure was scored as 2. Finally, severe inflammation, marked redness, oedema, ulceration and tendency to spontaneous bleeding was scored as 3. The GI for the patient was obtained by adding the indices for the teeth and dividing by six (number of teeth examined). From all individual scores, mean GI scores ± standard deviations (SD) were calculated. The presence of plaque and calculus was recorded according Silness-Löe (PI) and calculus surface index (CSI), respectively without any disclosing agents. The study was performed with the approval of the Committee for Ethics of the Medical Faculty, Masaryk University Brno and informed consent was obtained from all parents (in case of children), in line with the Helsinki declaration before inclusion in the study.
 

Results

The results are summarized in Tables 1-11 and Graphs 1-8.
Comparison of the DMFT index scores with GI index values provided very interesting results. Significant difference in GI scores (p < 0.01) was found between the group in need of treatment and both the other groups (Table 7, Figures 1,2) and in GI to DMFT index (Table 8, Figures 3,4). In D component reciprocally significant differences versus GI values (p < 0.01) between groups occurred (Table 9, Figures 5, 6). The difference in GI values between the group ortho=1 and the both other groups (Table 10, Figures 7,8) was also significant (p < 0.01). PI values between the control group and the group with gingivitis were significant (p < 0.05) while no significant difference was found in CS index (Table 11).

Table 1: Dental status of the cohort
  Number of childeren GI – mean/tooth SE
Caries free 188 0.128 0.017
Treated 329 0.150 0.014
At need of treatment 263 0.326 0.024
No significant difference between caries free and treated children. Significant difference (p < 0.01) in childeren at treatment need in comparsion to caries free and treated.
 
Table 2: DMFT index of the cohort
  Number of childeren GI – mean/tooth SE
DMFT = 0 188 0.128 0.017
DMFT = 1, 2 233 0.192 0.020
DMFT = 3, 4, 5 221 0.216 0.022
DMFT > 5 138 0.308 0.033
No significant difference between groups DMFT = 1, 2 and DMFT = 3, 4, 5.. Significant lower value in the group DMFT = 0, significantly higher value in the group DMFT > 5 (they differ reciprocally – Bonferonni correction).
 
Table 3: DT component of the cohort
  Number of childeren GI – mean/tooth SE
DT = 0 517 0.142 0.011
DT = 1, 2 209 0.257 0.022
DT > 2 54 0.591 0.074
Significant difference (p < 0.01) between groups reciprocally.
 
Table 4: Orthodontic anomalies in the cohort
  Number of childeren GI – mean/tooth SE
Ortho = 0 428 0.145 0.013
Ortho = 1 283 0.266 0.021
Ortho = 2 69 0.315 0.044
No significant difference between groups ortho=1 and ortho=2. Significant difference (p < 0.01) between the group ortho=1 and the both other groups.
 
Table 5: GI – mean values
  Number of childeren GI – mean/tooth SE
Cohort 780 0.204 0.011
 
Fig. 1: Mean GI vs dental status Fig. 2: Distribution of GI vs dental status
Fig. 3: Mean GI vs caries experience Fig. 4: Mean GI vs caries experience
Fig. 5: Mean GI vs DT Fig. 6: Distribution of GI vs no. of decayed teeth
Fig. 7: GI vs ortho. anomalies
 
Fig. 8: Distribution of GI vs. ortho anomalies
 
Table 6: GI – distribution according to the highest value
  Number of childeren GI values in %
G = 0 G = 1 G = 2
All children 780 36.9 43.6 19.5
 
Table 7: GI in relation to the treatment need
  Number of childeren Number of children in %
G = 0 G = 1 G = 2
Caries free 188 47.9 40.4 11.7
Treated 329 41.0 42.9 16.17
At need of treatment 263 24.0 46.8 29.3
No significant difference between caries free and treated children.
Significant difference (p < 0.01) between the group at need of treatment and the both other groups.
 
Table 8: GI in relation to DMFT index
  Number of childeren Number of children in %
G = 0 G = 1 G = 2
DMFT = 0 188 47.9 40.4 11.7
DMFT = 1, 2 233 37.8 44.2 18.0
DMFT = 3, 4, 5 221 32.6 48.0 19.5
DMFT > 5 138 27.5 39.9 32.6
Significant difference (p < 0.05) between groups DMFT=3,4,5 and DMFT > 5.
Significant difference (p < 0.01) between groups DMFT=0 and/or DMFT=1,2 versus DMFT > 5.
No significant difference between other groups reciprocally (DMFT=0 versus DMFT=1,2).
 
Table 9: DT component in relation to GI
  Number of childeren Number of children in %
G = 0 G = 1 G = 2
DT = 0 517 43.5 42.0 14.5
DT = 1, 2 209 27.3 49.3 23.4
DT > 2 54 11.1 37.0 51.9
Significant difference (p < 0.01) between groups reciprocally.
 
Table 10: Orthodontic anomaly severity in relation to GI
  Number of childeren Number of children in %
G = 0 G = 1 G = 2
Ortho = 0 428 45.3 40.7 14.0
Ortho = 1 283 26.9 48.4 24.7
Ortho = 2 69 26.1 42.0 31.9
No significant difference between groups ortho=1 and ortho=2.
Significant difference (p < 0.01) between groups ortho=0 and both other groups.
 
Table 11: Plaque and calculus indices
Group HYGI_PI
N
HYGI_PI
mean
HYGI_PI
SD
HYGI_PI
median
HYGI_PI
25% quartile
HYGI_PI
75% quartile
Control 287 0.233449 0.589414 0.000000 0.00 0.000000
Gingivitis 489 0.901840 1.095154 1.000000 0.00 1.000000
Total 776 0.654639 0.993815 0.000000 0.00 1.000000
Group CSI
N
CSI
mean
CSI
SD
CSI
median
CSI
25% quartile
CSI
75% quartile
Control 288 0.666667 2.753522 0.000000 0.000000 0.000000
Gingivitis 493 0.681542 2.780230 0.000000 0.000000 0.000000
Total 781 0.676056 2.768653 0.000000 0.000000 1.000000
Significant difference in mean values of PI index (but not of CSI index) between both groups.
 

Conclusions

On the basis of our results we can conclude that DMFT score of the ELSPAC group has not reached the level suggested by WHO (WHO goals for 2010). The results have demonstrated relationship between GI and DMFT especially in D component, and between GI and orthodontic anomalies. The results suggest that early caries treatment and maintenance of oral hygiene are important for gingival health especially in children with orthodontic anomalies. Our results cannot be compared with those of ELSPAC studies performed in other countries because no results on oral health state have been reported.

Supported by the project 1M0528 and grant IGA NR-8394.
 

Literature

  1. Birkeland, J. M., Haugejorden, O. and Ramm, F.: Some factors associated with caries decline among Norwegian children and adolescents: age-specific and cohort analyses. Caries Research 2000, 34, 109-116.
  2. Cypriano, S., Hoffmann, R. H. S., Sousa, M. L. R. and Wada, R. S.: Dental caries experience in 12-year-old schoolchildren in South-eastern Brazil. Journal of Applied Oral Sciences 2008, 16, 286-292.
  3. Edelstein, B. L.: Pediatric caries worldwide: implications for oral hygiene products. Compendium of Continuing Education in Dentistry 2005, 26, (Suppl I), 4-9.
  4. El-Quaderi, S. S., Quteish, Taani, D.: Dental plaque, caries prevalence and gingival conditions of 14-15-year-old schoolchildren in Jerash District, Jordan. International Journal of Dental Hygiene 2006, 4, 150-153.
  5. Lang, N. P., Schatzle, M. A. and Löe, H.: Gingivitis as a risk factor. Journal of Clinical Periodontology, 2009, ( Suppl. 10), 3-8.
  6. Löe, H. and Silness, J.: The gingival index, the plaque index and the retention index systems. Journal of Periodontology 1967, 38, 610-616.
  7. Rebelo, M. A. B., Lopes, M. C., Vieira, J. M. R. and Parente, R. C. P.: Dental caries and gingivitis among 15 to 19 year-old students in Manaus, AM, Brazil. Brazilian Oral Research 2009, 23, 248-54.
  8. Sagheri, D., Hahn, P.and Hellwig, E.: Assessing the oral health of school-age children and the current school-based dental screening programme in Freiburg (Germany). International Journal of Dental Hygiene 2007, 5, 236-241.
  9. Silness, J. and Löe, H.: Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontologica Scandinavica 1964, 22, 112-35.
     

Abbreviations

ELSPAC = European Longitudinal Study of Pregnancy and Childhood
 

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

Correspondence address:
Prof. Dr. Martina Kukletová
Masaryk University
Medical Faculty, Stomatological Clinic
Pekarska 53
656 91 Brno, Czech Republic