THE PREVALENCE OF DENTAL CARIES AMONG CHILDREN IN ORPHANAGES IN IBADAN

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O.E. Ayebameru¹, B.O. Popoola², O.O. Denloye²

1. Paediatric Dentist, University College Hospital, Ibadan and University of Ibadan, Ibadan.
2. Paediatric Dentist, Lagos State University Teaching Hospital, Lagos.

Abstract

Background: A number of challenges are being faced by children in orphanages, a major one being their oral health as a common unmet need. Studies have shown high prevalence of dental caries and oro-facial trauma. This has been attributed to overcrowding, lack of adequate staff, poor oral hygiene, improper dietary habits, inadequacies in the orphanage system, as well as inadequacies in the healthcare system. This study aimed at assessing the prevalence and factors affecting dental caries and trauma among children in orphanages in Ibadan.

Materials and Method: All the children within the age group (7 – 15 years) in all the 18 registered orphanages in the 5 Local Government Areas within Ibadan metropolis were recruited into the study. Intra-oral examination was done under natural light and caries detection was done using tactile and visual method. Sterile mouth mirrors and CPI probes were used for this purpose. Dental caries status and the predisposing factors in each child were assessed. Presence of dental trauma and the predisposing factors were also assessed. Data processing was carried out with the aid of SPSS version 21.

Results: One hundred and forty-six children participated in the study, 51.4% of them were males while 48.6% were females. The age range and the mean age of the children were 7 – 15 years 9. 69 ± 3.78 respectively. The prevalence of dental caries among the children was 17.8% while that of dental trauma was 7.5%. The mean DMFT/dmft was found to be 0.42 ± 1.06. Gender and the presence of deep pits and fissures were the statistically significant predictors of dental caries.

Conclusion: Oral health is of utmost importance across all ages, much more pertinent among institutionalized children who are prone to dental caries and trauma as revealed by this study. An average child in an orphanage may be affected by both dental caries and trauma, but appears to be more prone to dental caries in this environment.

Keywords: Orphanage, Dental caries, Dental trauma

Introduction

Oral health care is one of the common unmet health care needs of institutionalized children and therefore, they are at increased risk of developing oral diseases. They are likely to experience untreated dental caries usually compounded by poor oral hygiene due to neglect.² Children from orphanages have shown a high prevalence of dental caries and dental trauma.³ This has been attributed to overcrowding, lack of adequate staff for supervision, poor oral hygiene, improper dietary habits, inadequacies in the orphanage system, as well as inadequacies in the healthcare system.³

Researchers have consistently documented the poor health of institutionalized children, which is characterized by high instances of infectious diseases which may be due to low caretaker-to-child ratio in the institutions.¹ These children face a number of challenges including high risk of poor general and oral health.

Earlier studies have shown caries experience to be high in some children in Mashhad orphanages in terms of prevalence and severity with most of these children having varying types of treatment needs.⁴ In the documented health status of United States of America (US) adopted Eastern Europe orphans, dental caries was found to be common⁵. Khareet et al.⁶ studied the prevalence of dental caries in orphans in India and reported a prevalence of 49.6% and 41% in primary and permanent teeth respectively. However, a prevalence of 96% of dental caries among orphans between the ages 4-12 years was reported in a study carried out in Saudi-Arabia⁷. Shanbhog et al³, in their study, used the PUFA (Pulp visualization, Ulcer, Fistula, and Abscess) index to assess untreated dental caries among children in orphanages in India, and found a prevalence of 37.7%.

Studies have been reported among children in orphanages in this environment, but none has been specific for dental caries² . Meanwhile, the prevalence of dental caries among school children in this environment is 11.2%.⁸

Also, orphan children are said to have high prevalence of dental trauma alongside dental caries and gingivitis^9,10. However, there is dearth of information on the prevalence of dental trauma among these children in this environment. Meanwhile, researchers have reported a varying range of prevalence among other children who are not in orphanages in Nigeria.^11,12 This present study was aimed at assessing the oral health of children in orphanages in Ibadan focusing on dental caries and dental trauma.