https://imcjms.com/public Ibrahim Medical College Journal of Medical Science https://imcjms.com/public/registration/journal_full_text/147 Sun, 13 Nov 2016 09:48:46 +0000 Though early diagnosis and intervention of gingivitis in school children can eliminate progression to frank periodontal diseases, no such measures in Bangladesh are in place to detect gingivitis at an early stage in school children. This survey was conducted in 2007 in the primary schools of rural, suburban and urban areas of Bangladesh to evaluate oral hygiene with special emphasis on gingivitis prevalent among 6-13 years school children. The clinical examination of the gingiva was carried out using a mouth mirror and a periodontal probe. A total of 1,820 primary school students (m/f = 946/873) took part in the investigation. The crude prevalence of gingivitis, AS* and plaque were 17.5%, 9.2% and 56.0% respectively. The prevalence of gingivitis was significantly higher in males than females (20.3 vs. 14.3%, p<0.001), lower than upper social class (21.1 vs. 12.6%, p<0.001) and in rural than urban plus suburban children (22.5 vs. 15.1%, p<0.001). Likewise, the prevalence of AS was higher in females, lower social class and rural children. Significantly lower prevalence of gingivitis, AS and plaque was found among those who used tooth brush and tooth paste than those who did not (15.4% vs 22.4%, p<0.001). The study concludes that the prevalence of oro-dental diseases is high in Bangladeshi children. The male children of low social class of rural communities are the most vulnerable group. Address for Correspondence: Dr. Mahfujul Haq Khan, Assoc. Prof., Dept of Dentistry, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) & Ibrahim Medical College, 122 Kazi Nazrul Islam Avenue, Shahbagh, Dhaka-1000, Bangladesh. e-mail: mahtink@yahoo.com   In many developing countries, the prevalence of dental caries and periodontal diseases are increasing, thereby constituting a public health problem.1 To control such diseases, good oral and dental health should be achieved at both public and personal levels. People in developing countries are burdened excessively by oral disease, particularly periodontal disease. This is aggravated by poverty, poor living conditions, ignorance concerning health education, lack of government funded policies to provide sufficient oral health workers.2 Few published studies have described the trends in the prevalence of dental caries and periodontal disease in children.3,4    The survey was conducted among primary school children of Bangladesh from 20 June to 31 July in 2007. The survey was constructed in a simple block design, each group of children being divided according to their residence in urban, suburban, or rural area. Seven locations were purposively selected within 3 hours drive of Dhaka city and 3 were selected in areas outside of Chittagong. Overall, 3 urban, 3 suburban and 4 rural schools were included.   A total of 1,820 primary school students (m/f = 946/873) of age 6 to 13 years took part in the investigation. The characteristics of the participants were shown in Table 1. Their mean (SD) age was 8.83 (2.0) years. The mean (SD) values for ht, wt, HC, MUAC were 125.6 (11.9) cm, 23.5 (6.7) kg, 50.0 (1.8) cm and 17.4 (1.9) cm, respectively. The mean BMI was 14.6 (2.1). These anthropometric measures did not differ between male and female students. Adjusted for age and sex, the BMI significantly correlated with HC and MUAC and also with height and weight (Table 2). Table-1: Characteristics of the Children (n=1803) Range Age (y) 8.83 (2.0) 87.5 – 168.0 Weight (kg) 23.5 (6.7) 40.0 – 57.5 Mid-upper arm circumference (cm) 17.42 (1.9) 8.76 – 29.8       Variables MUAC Height HC 0.34 0.33   Ns p<0.001 MUAC - 0.38     p<0.001 BMI - –0.35     p<0.001       * Chi-square and p values are shown for the association with risk variables. For the social class comparison, the prevalence of gingivitis (21.1 vs. 12.6%), AS (12.4 vs. 4.8%) and plaque (61.6 vs. 48.1%) were significantly higher in the students from lower social class than students from upper social class (for all, p<0.001). Compared with other devices of cleaning teeth, tooth brush was found to have reduced chances of gingivitis (p<0.001), AS (p<0.001), and plaque (p=0.02). Likewise, using tooth paste as a teeth-cleaning substance, compared with other substances like charcoal, salt, ash was found to have beneficial effect against gingivitis, AS and plaque (Table 3). Discussion  The prevalence rates of gingivitis, AS and plaque were significantly higher in the poor social class than their rich and middle-class counterparts. These findings are inconsistent with Marisa et al. who reported no correlation between gingivitis and the studied socioeconomic variables.9 On the other hand the findings are very much consistent with the Adenubi’s observation among Nigerian children, who found that calculus and gingivitis in the private school children of higher social class had significantly lower prevalence than that found in the government school children.7 They suggested that better oral hygiene practices in the higher socioeconomic group of private school children might have reduced the incidence of oro-dental disorders. Similar findings were also reported by Ta’ani in her study in Jordanian school children.5 She found that bleeding and calculus score were prevalent in pupils of both types of schools though slightly higher in pupils of public schools than that of private schools. This is also consistent with other reports.10,11   There is scarcity of population based study on oral heath of primary school children in Bangladesh. This study explored the higher prevalence of gingivitis, angular stomatitis and dental plaque among primary school children. It also determined the significant associations of these oro-dental diseases with sex, social class, geographical sites and the use of tooth cleaning devices and tooth cleaning substances. These findings may be of importance for oral health education at primary school level in our country. Acknowledgment   1.    Sheiham A. Changing trends in dental caries. Int J Epidemol 1984; 13: 142-147. 3.    Cahen P M, Obry Musset A M et al. Caries prevalence in 6-15 year old French children based on the 1987 and 1991 national surveys. J Dent Res 1993; 72: 1581-1587. 5.    Quteish Ta’ani D. Caries prevalence and periodontal treatment needs in public and private school pupils in Jordan. Int Dental J 1997; 47: 100-104. 7.    Adenubi J O. The Gingival health of eight year old Nigerian children. J of Public Health Dentistry 1984; 44(2): 61-72. 9.    Marisa M, Berenice B, Silva. Relationship between caries, gingivitis and flurosis and the socioeconomic status among school children. Rev Saude Publica 2001; 35(2): 170-176. 11.  Athanassouli I, Mamai-Homata E, Panagopoulos H et al. Dental caries changes between 1982 and 1991 in children aged 6-12 in Athens, Greece. Caries Res 1994; 28: 378-382. 12.           Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963; 21: 533-551. 2026 Ibrahim Medical College. All rights reserved.