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“ASSESSING THE LEVEL OF DENTAL CARE TO THE PREVALENCE OF DENTAL CARIES AMONG SCHOOL CHILDREN IN CENTRAL BOSNIA CANTON”

Title“ASSESSING THE LEVEL OF DENTAL CARE TO THE PREVALENCE OF DENTAL CARIES AMONG SCHOOL CHILDREN IN CENTRAL BOSNIA CANTON”
Publication TypeJournal Article
Year of Publication2014
AuthorsRidic, O, Saban, A, Karakas, S, Dzananovic, N, Sarac, MDelic -, Svrakic, S
Tertiary AuthorsSaban, O
JournalMedical Journal
Volume20
Issue2
Abstract

ABSTRACT
Introduction: Oral health of school children is a significant social and economic value of the modern world. At today's level of development of science and technology, it is possible to move forward, unless the individual and the population as a whole, taking responsibility, actively involved in the protection and improvement of overall health, including oral health. Caries as a pathological process in the teeth is an important issue in international medicine.
Methods: The study was designed as a cross-sectional study. The survey instrument was used for the survey interview and clinical examination of the mouth and teeth to provide data on the oral health of children examined. The survey was conducted in all units of observation in selected schools in the stage of choice within these departments-selected groups of students.
Results: Dental examination was made and survey of 804 primary school students, where 355 students from urban schools and 449 students from rural schools. The obtained results show that the DMFT indexes in elementary schools in Central Bosnia Canton are fairly uniform.
Conclusion: Factors that are predominantly in relation to the place of residence and appearance of caries are eating poor quality food during the big break at school and it is more in urban areas then in rural areas. One of the important factors of consuming sweets and snacks is equally represented in all areas. Taking diet that improves teeth nutrition, for example drinking a glass of milk, gives no statistically significant result in both groups. According to the results, we can see that the socioeconomic status of patients affected by the occurrence of dental caries and oral hygiene in patients in relation to rural and urban areas, because we can see that by the number of respondents governments greater unemployment in both parents in rural areas than urban, which causes a host of other factors who are directly and indirectly connected with the development of caries.

Full Text

INTRODUCTION
Oral health of school children is a significant social and economic value of the modern world. At today's level of development of science and technology, it is possible to move forward, unless the individual and the population as a whole, taking responsibility, actively involved in the protection and improvement of overall health. Important role of oral health in maintaining good overall health, it is completely recognized and accepted. Therefore, the care and treatment of teeth gives a lot of specialists within the general population of health care.

Their presence and function of the teeth, among other things, contribute to good nutrition, proper pronunciation and aesthetic appearance. Although, for the most part, made up of hard, seemingly resistant tissue, dental diseases are very common, and complications of these diseases often threaten the function of certain organs, including the entire organism. (1)
Dental caries is the most widespread disease in humans. In addition to tooth decay and endangers the health of the mouth and digestive tract and reduces quality of life. The main cause of tooth decay is dental plaque. In addition to the plaque role in the development of dental caries and tooth morphology has, the amount and composition of saliva and diet. (2)
Plaque is soft sediments, sticky and invisible to the naked eye, a tooth surface is not smooth on the tongue. Soft and mushy food favours plaque formation, whereas solid and raw foods (fruits and vegetables) to its mechanical action of consistency and reduces plaque. The plaques are inhabited by many bacteria in contact with sugar from food acids that lead to demineralization of enamel. (3)
Saliva plays an important role in protecting teeth from cavities, because after a meal stimulates the secretion of saliva, which facilitates the process of swallowing, on the other hand washes and removes food residues. Since the basic drivel, it neutralizes acids that lead to demineralization.
The first visible sign of caries is a discoloration of the teeth, and reviewing and certifying probing caries. If the decay is rehabilitated while localized in the enamel, continued progress in the deeper layers of the tooth, or the dentin, which is manifested as voids, darker colour, and tooth pain react to hot, cold, sweet, sour. (4)
The progress of disease-pulp is accompanied by pain that continues after the action of stimuli and can also occur spontaneously, i.e. without irritation. The absence of pulp diseases result in the death of the pulp and the occurrence of gangrene.
The progress of the infection process penetrates into the tissue around the tooth root and develops periodontitis. Each hole in the tooth represents an additional place for keeping food, plaque formation and propagation of a large number of bacteria. (5)
Treatment consists in preventing caries and plays a significant role in way to take care of the mouth and teeth. Wash your mouth and teeth toothbrush and toothpaste, a bar in the morning and evening, preferably after each meal. It is useful to know that if sugar remains long in contact with the teeth, to caries. The preventive measures include early detection of initial damage, which is why it is recommended dental check-up every six months or at least once a year. (6)
The treatment actually consists in detecting caries damage and removing softened dentin, then the appropriate treatment and disinfection of the oral cavity and eventually sealing.
While there are many theories about the origin of caries or one does not give a complete answer to all the questions that come to mind when it comes to the etiopathogenesis of dental caries. According to contemporary views, some factors greater importance, namely:
1 - The structure and roughness of enamel,
2 - Dental plaque,
3 - Properties of saliva,
4 - Carbohydrates.
Profilometric enamel roughness tests have shown that there is a difference between the surface roughness between the individual teeth, but also between the surfaces on one tooth. Thus explaining the presence of caries predilection of the teeth (where it is more common).
Dental plaque is of great importance, both in the development of caries, as well as in the pathogenesis parodonpatije. It consists of desquamated epithelium of the oral mucosa, microorganisms and mucin (constituents of saliva). (7)
The accumulation of plaque on the tooth surfaces on which the physiological self-cleaning and cleaning with a brush inefficient, caries precedes and follows it. Microorganisms that are found in plaque, it is paid a special attention, especially cariogenic strains of streptococci (Streptococcus mutans and sangus). Their biochemical activities they carry out decomposition of carbohydrates to simple acid and synthesize different polysaccharides (dextran, levan and amylopectin). (8)

 


METHODS

The study was designed as a cross-sectional study. The survey instrument was used for the survey interview and clinical examination of the mouth and teeth to provide data on the oral health of children examined. The survey was conducted in all units of observation in selected schools in the stage of choice within these departments-selected groups of students. This also means that two phase stratified sample of compatible groups. 804 students were surveyed in elementary schools, where 355 students were from urban schools and 449 students from rural schools.
Planned pattern in all municipalities was achieved satisfactorily.
All units elections in general are covered by the sample. The units of analysis, as seen from the sample project, envisaged as a random expected size, and therefore the realization of samples of special importance for each analytical unit. In addition to numerical methods in the analysis of the results of this study were used and graphical analysis methods, namely:
- Bar charts, horizontal and vertical parallel to the presentation of the structure and characteristics within and between individual municipalities,
- Circular charts for displaying the structure,
- Combined graphs to show the structure of those units of analysis that have analyzed characteristic,
- Graphs to show the confidence interval for the probability p = 95, in which we should expect that it will move its value in the basic group, the obtained values from the sample.
METHODS AND ACTION PLAN

1. Creating questionnaires and publicity materials.
2. Working team members’ education.
Members are familiar with the available data on oral hygiene habits and their impact on oral health, various techniques and tools for proper oral hygiene, and tools and techniques for the determination of OHI (index oral hygiene). Further, are familiar with the survey and how the survey.
3. Data were collected by conducting surveys on classrooms (one class from each age group selected primary schools) and filling out questionnaires with the assistance of members of the survey team, and help determining the status and oral hygiene index.
4. At the end will be carried out data analysis and evaluation of the project.

RESULTS
Analysis of the data that we got after interviewing 804 students in elementary school, where 355 students from urban schools and 449 students from rural schools, I got the following results:
Assessment of socioeconomic status in children from urban and rural areas was carried out on the basis of the group questions the application form, which are related to employment and qualifications father / mother, manner and place of residence, and on the basis of their financial status were obtained responses from this group questions, and then the following results:
Assessment of socioeconomic status
Rural areas 1-10 % 2- 25% 3 – 45 % 4 – 15% 5 – 5%
Urban areas 1–15% 2 – 15% 3 – 55 % 4 – 15% 5- 10%


Assessment of the recommended dietary habits we received on the basis of groups of questions that are related to the number and amount of meals per day, most of the food we consume, which they favourite type of food, sweets, snacks, fruit. Based on responses to a given set of questions we get the following results:


Rural areas 1 – 15% 2- 25% 3 – 35 % 4 – 10% 5 – 15%
Urban areas 1 – 20% 2 – 30% 3 – 35% 4 – 10% 5- 5%

 


DISCUSSION
When defining socioeconomic status can clearly see that the majority of respondents from rural and urban areas said that their father is employed, a small number of states that is unemployed as a direct impact on the socio-economic status of respondents, as well as the position of the mother's employment where it is clear that there is a difference between respondents in urban and rural, where a much larger number of respondents answered that the mother is not employed, which is not the case in the urban environment. Accordingly, in the city centre have a larger number of respondents who report that their parents are employed compared to rural. (9)
Most of the respondents in urban and rural areas said to have their own house / apartment while in the middle of both have the same number of responses for respondents who are living as tenants. The largest number of respondents shared my room with some brother / sister, while in rural areas had a higher number of respondents who had their own room, but in the city, although the higher the number of rural areas, statistically speaking there is some difference in favor of the respondents’ rural areas. (10)
The second group of questions relating to hygiene and diet, nutrition in relation to the hypotheses of this study gave some interesting answers. When asked “how often they were having breakfast on weekends, most of the respondents answered that “they had breakfast both days of the weekend, in the city, as well as in the rural areas. (11)
Most of the respondents stated that “they were pleased with their weight and that there was no need or feeling the need to dedicate a diet if you tangle, and that a large number of respondents regularly consumed meals. A large number of respondents said “that the most commonly consumed fast food at its composition, was the predictor for the occurrence of various diseases, including dental caries.
It is important to note that this factor has an impact on the status of oral hygiene in our patients, and that a very large number of respondents who daily consume sweets and snacks several times a day. Encouraging responses are the fruits consumed more than three times in the last three days, although it is directly linked with socio-economic status of respondents. (12)
The high prevalence of dental caries is caused by certain factors safe, so in this case we consider diet and place of residence (rural and urban environment), respondents from urban areas are more susceptible to the influence of factors that lead to tooth decay, such as fast food and sugary treat , 64.48% of the urban environment usually takes fast food during the big break at school, but also a large number of children from rural areas 80.95%, which means that the predominant factors are no longer tied to regional - geographical determination (rural and urban communities). (13)
45.25% of respondents from urban areas is taken daily candy, while 68.5% of them from rural areas also takes sweets every day, which indicates that the predominant factors are not specific geographical locality. (14)
CONCLUSION
On the basis of this research the following conclusions can be carried out:
Conditions of the oral hygiene habits among school children were on a satisfactory level and no large differences were observed between respondents in urban and rural areas.
The age group that comes to improving oral hygiene in the second half of elementary education, with a number of information, etc.
Factors that are predominant in relation to residence and caries are eating poor quality food during the big break at school, and in urban areas more than in rural areas, one of the essential factors of consuming sweets and snacks is equally represented in all areas. Regular brushing is the factor that has an impact on the formation of cavities, but it cannot be correlated with geographic distribution. Taking diet that improves nutrition tooth such as drinking glasses of milk, gives no statistically significant result in both groups, but in favour of rural areas.
According to the results, we can see that the socioeconomic status of patients affected by the occurrence of dental caries and oral hygiene in patients in relation to rural and urban areas, because we can see that by the number of respondents governments greater unemployment in both parents in rural areas than in the city, which causes a host of other factors that are directly and indirectly connected with the development of caries.
According to the type of food we see in urban and rural responses are fairly balanced, with the city in the middle of a larger number of respondents use foods that pose a risk factor for tooth decay and deterioration of an oral hygiene than in rural areas, while the answers to the sample size and the use of a healthy diet conditioned and geographical position, (i.e. housing in rural areas where fruits and vegetable were more available than in the city centre).
CONFLICT OF INTEREST:
The authors have declared that there is no conflict of interest.
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