To investigate the current status of dental caries and gingivitis of pupils from 6 secondary schools in Gialai province in 2017. Subjects and methods: A cross-sectional study was used. Data were collected from clinical examination for dental caries and gingivitis of 1,992 pupils at 6 secondary schools in Gialai province. Results: The prevalence of pupils with dental caries, gingivitis and periodontal diseases were 71.18%, 66.72%, and 66.62%, respectively. The dental lesions were various, including advanced dental caries (S2), root present and severe dental caries (S3) were 73.95%, 35.04% and 58.94%, respectively. The indices of detached dental caries in pupils with permanent teeth was higher than that of pupils with deciduous teeth (2.61 compare to 1.47). Conclusions: Prevalence of dental caries, gingivitis and periodontal disease of pupils from 6 secondary schools in Gialai province was high.
Journal of military pharmaco-medicine no7-2019 DENTAL CARIES AND GINGIVITIS OF PUPILS FROM SECONDARY SCHOOLS IN GIALAI PROVINCE IN THE YEAR 2017 Dao Long Duc 1; Nguyen Khang 2; Tuan Ngoc Tran3 SUMMARY Objectives: To investigate the current status of dental caries and gingivitis of pupils from secondary schools in Gialai province in 2017 Subjects and methods: A cross-sectional study was used Data were collected from clinical examination for dental caries and gingivitis of 1,992 pupils at secondary schools in Gialai province Results: The prevalence of pupils with dental caries, gingivitis and periodontal diseases were 71.18%, 66.72%, and 66.62%, respectively The dental lesions were various, including advanced dental caries (S2), root present and severe dental caries (S3) were 73.95%, 35.04% and 58.94%, respectively The indices of detached dental caries in pupils with permanent teeth was higher than that of pupils with deciduous teeth (2.61 compare to 1.47) Conclusions: Prevalence of dental caries, gingivitis and periodontal disease of pupils from secondary schools in Gialai province was high * Keywords: Dental caries; Gingivitis; Secondary school; Gialai province INTRODUCTION Dental caries is a common public health condition wordwide, especially in developing countries [5] In Vietnam, the prevalence of dental caries is still high and increasing in remote areas where low socio-economical conditions, lack of knowledge about dental hygene and insufficient dental services are prevailing [1] Gialai is a poor province in Tay Nguyen highland, where ethnic minorities are main occupants, most of them are Jrai people who are poor and lacking education Therefore, primary healthcare, including oral health care, does not get sufficient attention [4] The National School Dental Program has been launched in all primary schools, but not in many secondary schools [4] Besides, pupils of these ages are not capable of managing their oral health properly, leading to the increase in dental caries and gingivitis As such, the number of pupils requiring dental care in medical services increases, affecting their quality of life, family and community’s expenses Therefore, this study was carried out with the aim: To investigate the current status of dental caries and gingivitis of pupils in secondary schools in Gialai province in 2017 Vietnam Military Medical University 103 Military Hospital National Institute of Burn Corresponding author: Dao Duc Long (duclong080675@gmail.com) Date received: 15/07/2019 Date accepted: 27/08/2019 101 Journal of military pharmaco-medicine no7-2019 SUBJECTS AND METHODS Subjects - 1,992 pupils in secondary schools in Gialai - Inclusion criteria: All pupils in this study were allowed to participate by either parent or legal guardian of pupils * Location and time: - Place of study: secondary schools in Chu Pah and Duc Co districs, Gialai province including Ia Nan, Ia Pnon, Ia Kla, Ia Mo Nong, Ia Nhin and Ia Ka secondary school - Time of study: From - 2017 to 10 - 2017 Methods This study was approved by schools, local department of health and authorities The study was also approved by the Ethical Committee of the Gialai Department of Health RESULTS Our data from the investigation on oral hygiene of 1,992 pupils from secondary schools in Chu Pah and Duc Co districs of Gialai province showed that most of subjects were 14 years old (655 pupils = 32.88%) The distribution of ages was similar among schools The proportion of female pupils were higher than male (54.12% vs 45.88%, respectively), and similar among all schools * The distribution of parents of pupils according to occupation (n = 1,992): - A cross-sectional study - All pupils were examined by dentists to diagnose dental disease * Data analysis: All data were coded and managed using Microsoft Excel software Data were analyzed using SPSS software version 20.0 * Research ethics: Public servants: 125 (6.28%); famer: 600 (30.12%); worker: 586 (29.42%); freelance work: 344 (17.27%); others: 337 (16.91%) The number of pupils with parents of farmer (30.12%), worker (29.42%) was greater than those with parents of public servants (6.28%), and freelancer (17.27%) Table 1: The distribution of pupils by ethnicity Ethnic n Jrai (%) Kinh (%) Other (%) Phan Boi Chau 431 13.92 84.69 1.39 Luong The Vinh 255 92.55 7.45 0.00 Ly Tu Trong 320 73.75 26.25 0.00 Ia Mo Nong 150 98.67 1.33 0.00 Ia Nhin 456 15.57 84.43 0.00 Ia Ka 380 94.74 5.00 0.26 1,992 55.77 43.88 0.35 School Total 102 Journal of military pharmaco-medicine no7-2019 Ethnic minorities were mainly Kinh, Jrai, in which Jrai pupils were dominant in Luong The Vinh (92.55%), Ia Mơ Nông (98.67%), Ia Ka (94.74%) schools, whereas Kinh pupils were dominant in Phan Boi Chau (84.69%), and Ia Nhin (84.43%) schools These distributions reflect the education levels of people in Tay Nguyen, where most of Tay Nguyen ethnic minorities did not receive education at the secondary level, and many of them quit school before graduation, leaving a high prevalence of uneducated children People in Tay Nguyen pay little attention for education, but more to basic skills in farming Table 2: The prevalence of dental caries and gingivitis in schools Conditions Dental caries n School Gingivitis Number % Number % Phan Boi Chau 431 314 72.85 304 70.53 Luong The Vinh 255 190 74.51 168 65.88 Ly Tu Trong 320 222 69.38 211 65.94 Ia Mo Nong 150 110 73.33 103 68.67 Ia Nhin 456 316 69.30 297 65.13 Ia Ka 380 266 70.00 246 64.74 1,992 1,418 71.18 1,329 66.72 Total The prevalene of dental caries and gingivitis was high in all schools, in which dental caries was 71.18% and gingivitis was 66.72% There was no significant difference in dental caries and gingivitis among schools A study by Dao Thi Ngoc Lan (2002) [1] about dental cariess in secondary pupils in Gialai showed the dental cariess proportion of 80%, which was higher than our result WHO has reported that approximately bilion people worldwide have dental cariess, mainly in Asian and South American countries However, high prevalence of dental cariess (60 - 90%) is also reported in school-aged children in developed countries [5] Table 3: The prevalence of dental caries and gingivitis in different ages Dental caries Conditions Ages (years) Gingivitis n % n % ≤ 11 292 73.74 272 68.69 12 308 70.32 286 65.30 13 359 71.37 333 66.20 ≥ 14 459 70.08 438 66.87 Total 1,418 71.18 1,329 66.72 The prevalence of oral diseases was high in all age groups, in which dental caries was 71.18% and gingivitis was 66.72% There was no significant difference in oral 103 Journal of military pharmaco-medicine no7-2019 diseases between age groups Currently, dental cariess is a matter of concern worldwide A survey by WHO in a period from 1994 to 2008 showed very high prevalence of dental cariess (80%) in children aged from to 12 Table 4: Prevalence of periodontal diseases in different schools Disease Normal Gingivial hemorrhage Plaque n School Number % Number % Number % Phan Boi Chau 431 128 29.70 69 16.01 234 54.29 Luong The Vinh 255 87 34.12 53 20.78 115 45.10 Ly Tu Trong 320 109 34.06 51 15.94 160 50.00 Ia Mo Nong 150 47 31.33 31 20.67 72 48.00 Ia Nhin 456 160 35.09 81 17.76 215 47.15 Ia Ka 380 134 35.26 66 17.37 180 47.37 1,992 665 33.38 351 17.62 976 49.00 Total The prevalence of gingivial hemorrhage in all schools was 17.62%, the highest in Luong The Vinh (20.78%) and Ia Mo Nong (20.67%) where pupils were mainly Jrai The prevalence of dental plaque was 49.0%, which was the highest in Phan Boi Chau school (54.29%) and Ly Tu Trong (50%) This student group had a higher proportion of dental plaque than gingivial hemorrhage (49%) Table 5: The distribution of periodontal diseases of pupils by ages Normal Age (years) Gingivial hemorrhage Plaque n Number % Number % Number % ≤ 11 396 124 31.31 71 17.93 201 50.76 12 438 153 34.93 75 17.12 210 47.95 13 503 171 34.00 77 15.31 255 50.70 ≥ 14 655 217 33.13 128 19.54 310 47.33 1,992 665 33.38 351 17.62 976 49.00 Total The prevalence of pupils with dental plaque and gingivitis was 66.62%, in which the prevalence of plaque was higher than gingivial hemorrhage (49.0% vs 17.62%, respectively) There was no significant difference in dental plaque and gingivial hemorrhage among age groups 104 Journal of military pharmaco-medicine no7-2019 Table 6: The indices of dental caries, dental loss, restoration and detachment of deciduous and permanent teeth Conditions n n Caries Dental loss Restoration Detachment Desiduous teeth 817 Index 991 103 108 1,202 1.21 0.13 0.13 1.47 Permanent teeth n Index 1,374 2,997 271 315 3,583 2.18 0.20 0.23 2,61 Pupils of the permanent teeth group had higher indices of caries, missing, restoration and detachment than those in the deciduous group A study by Hua Thi Minh Hue (2014) about current conditions of oral health in some primary and secondary schools in Tay Nguyen showed some dental diseases popular among primary and secondary pupils Including desiduous dental cariess (53.2% and 50.2%, respectively), followed by dental plaque (60.2% vs 53.1%), and permanent dental cariess (29.3% and 26.9%) [4] These data were different from out results, the detachment index of permanent teeth was higher than desiduous teeth, showing poor knowledge about dental hygien in Gialai schools, especially in schools where pupils of ethnic minorities are dominant A study in 2000 of Dental and Maxilofacial Institute on Hanoi pupils showed that proportion of dental cariess in - 12 years old pupils of 57.2%, years old of 64.95% (for desiduous teeth), and the detachment index of permanent teeth of 5.4 [3] Our lower detachment index could be due to the fact that pupils in 2017 have better oral care than those in 2000 * Characteristics of dental caries in pupils (n = 1,992): Normal: 574 pupils (28.82%); root present: 698 pupils (35.04%); restoration: 423 pupils (21.23%); missing: 374 pupils (18.78%); advanced dental cariess (S2): 1,473 pupils (73.95%); severe dental caries (S3): 1,174 pupils (58.94%); pulpitis: 288 pupils (14.46%); carious incidence: 1,418 pupils (71.18%) The proportion of dental caries was high (71.18%), in which S2 (73.95%) and S3 (58.94%) were higher than other conditions The dental caries proportion in grade to grade pupils was from 59% to 58.1%, which was higher than dental plaque and gingivitis For grade and pupils, dental plaque was higher than dental caries and gingivitis and ranged from 60.6% to 59.5% Pupils from grade to in the study area were most affected by dental plaque (78.1% to 65.9%), followed by dental caries (51.4% to 42.2%) and gingivitis (47.5% to 45.5%) [4] Studies were conducted in Europe, America and Asia showed high prevalence of more than 90% of dental caries and periodontal inflammation Peridontal diseases are very common in children [6] Some reports showed that the proportion of children in Switzeland in 2007 with gingivitis was 61% [7] and in Malaysia was 75.5% [8] 105 Journal of military pharmaco-medicine no7-2019 Data from the report by Dao Thi Ngoc Lan and our study showed that the prevalence of dental caries in secondary pupils had no tendency to decrease, despite measurements to re-inforce prevention of oral diseases in the community This study also showed the various types of dental injuries, including dental caries (71.18%), advanced dental caries (S2) (73.95%), root present (35.04%), severe dental caries (S3) (58.94%) As such, various types of dental caries can be diagnosed under normal light by dentists The proportion of advanced dential caries was high, leading to a risk of further destruction of the underlying layers of the teeth, and subsequent severe dental caries and pulpitis, dental missing, and other severe dental complications These results were higher than those from a report by Dao Thi Dung (2007), with advanced dental caries proportion of 46.47% [2] In summary, pupils from secondary schools in Gialai province, where Jrai pupils were dominent, had a high proportion of dental caries and gingivitis, and even a higher proportion of detachment index in permanent teeth Therefore, appropriate measurements should be required to prevent oral diseases in secondary schools in mountainous provinces, especially in Tay Nguyen area, including Gialai CONCLUSIONS Data from investigation on dental caries and gingivitis in pupils from secondary schools in Gialai in 2017 showed that the prevalence of pupils with oral diseases was high, including dental caries (71.18%), gingivitis (66.72%), periodontal disease (66.62%), in which dental plaque was higher than gingivitis (49.00% vs 17.62%) 106 The prevalence of periodontal diseases in schools was similar among age groups The dental injuries were various, including advanced dental caries (S2) (73.95%), root present (35.04%), severe dental caries (S3) (58.94%) The indices of dental detachement in pupils with permanent teeth were higher than those in pupils with desiduous teeth (2.61 vs 1.47) REFERENCES Đào Thị Ngọc Lan Nghiên cứu thực trạng bệnh miệng học sinh tiểu học dân tộc tỉnh Yên Bái số biện pháp can thiệp cộng đồng Luận án Tiến sỹ Y học Trường Đại học Y Hà Nội 2002 Đào Thị Dung Đánh giá hiệu can thiệp chương trình Nha học đường số trường trung học sở quận Đống Đa Hà Nội Luận án Tiến sỹ Y học Trường Đại học Y Hà Nội 2007, tr.95-105 Nguyễn Lê Thanh Bệnh miệng học sinh tiểu học từ đến 11 tuổi thị trấn Thứa, huyện Gia Lương yếu tố nguy Tạp chí Y học Việt Nam 1999, tr.240-241 (10 - 11), tr.119-121 Hứa Thị Minh Huệ Thực trạng bệnh miệng kiến thức, thái độ, thực hành chăm sóc miệng học sinh số trường tiểu học, trung học sở tỉnh Tây Nguyên Luận văn Thạc sỹ Y học 2014 Manchin J West Virginia Oral Health Plan 2010 - 2015 Health Human Resource 2010, pp.1-40 Do L.G, Spence A.J Oral health of Australian children The National Child Oral Health Study (2012 - 2014) The University of Adelaide 2016 Schwendicke F, Dörfer C.E, Schlattmann P et al Socio-economic inequality and caries: A systematic review and meta-analysis Journal of Dental Research 2015, 94(1), pp.10-18 Andaleeb U, Afsheen U Oral health care in Malaysia: A review Pakistan Oral & Dental Journal 2011, Vol 31, No ... Data from investigation on dental caries and gingivitis in pupils from secondary schools in Gialai in 2017 showed that the prevalence of pupils with oral diseases was high, including dental caries. .. showing poor knowledge about dental hygien in Gialai schools, especially in schools where pupils of ethnic minorities are dominant A study in 2000 of Dental and Maxilofacial Institute on Hanoi pupils. .. pupils from secondary schools in Gialai province, where Jrai pupils were dominent, had a high proportion of dental caries and gingivitis, and even a higher proportion of detachment index in permanent