Prevalence of First Permanent Molar Caries and its relationship to the Dental Knowledge of 712 Years Old children

from Panipat District, Haryana.

Abstract:
Background : Dental caries is one of the most prevalent chronic diseases affecting children. The first permanent molar is most important tooth and more susceptible to caries because of its morphological and functional characteristics as well as to the surrounding conditions the newly erupted permanent molars have to face. Aim : The purpose of the present study was to determine prevalence of first permanent molar (FPM) and its relationship to the Dental Knowledge of 712 Years Old from Panipat. Materials and Methods : This cross-sectional study was carried out on 840 children, selected randomly and examined for fpm caries using WHO(World Health organization criteria)1997 criteria . Data was analyzed using ANOVA, and Chi-Square test. Results : The prevalence of dental caries in first permanent molar was recorded to be 65.1%. The children who knew the age of eruption of the FPMs or who had received advice regarding oral hygiene from a dentist or parent had more sound FPMs. Conclusion : High fpm caries prevalence shows that consideration must be given to preventive measures and the need to emphasize oral hygiene measures as all these have significant impact on future dental health of children. Keywords: dental caries, first permanent molar, dental knowledge, oral hygiene

INTRODUCTION Dental caries is one of the most highly prevalent diseases in children 11, The etiology of caries is multifactorial and complex. 4 Caries process is initiated in the biofilm or dental plaque (Fejerskov and Manji, 1990; Manji et al., 1991; Fejerskov and Thylstrup, 1994)5 and it progresses as oscillation between hard tissue demineralization and remineralization.4 It is considered as primary cause of oral pain and tooth loss.313 The permanent first molars are usually the first to erupt in secondary dentition. 11 and are most important teeth, with a key role in occlusion7. An early loss of FPM can have a significant impact on the future dental health of the child.15 Loss of first permanent molars because of dental caries, negatively affects both arches and has adverse effects on occlusion.
27

Gaglaroglu

concluded skeletal and dental asymmetries occurs after an early extraction of a first permanent molar.
17

Fpm is the most susceptible tooth to carious attack.7due to its morphologic and functional characteristics, and early eruption in the posterior area of oral cavity. 11 11pits and fissure on occlusal surfaces of fpm make them susceptible to dental caries7 McDonald (1992) concluded occlusal caries occurs in highest frequency on the permanent first molar for all age groups, 315 a high incidence of caries lesions in permanent first molars is seen during and shortly after the eruption process [3] 15 Carvalho et al. (1989) [5] concluded that permanent first molars are more likely to develop dental caries during the eruption process, due to favourable conditions for plaque accumulation.14 fpm is frequently affected by carious lesions at an early stage due to its onset of calcification and little interest for oral hygiene exisisting at the time of its eruption1 12 the caries susceptibility of erupting teeth is related

to pre- and post-eruptive maturation of enamel [4]. 7 Hescot and Roland (1993) report that by the age of six 4.9%of the children already have caries on first permanent molar. [4] Thus, these factors require adequate education planning emphasizing preventive methods effective in controlling and reducing disease progression.2 No study have been reported on prevalence of first permanent dental caries in Panipat region thus the present study was carried out to provide data regarding prevalence of FPM caries in this region.

AIM The aim of the study was To determine the prevalence of dental caries in the first permanent molars among 712 Year old children from the Panipat district, Haryana. The second aim was to correlate the prevalence of caries in relation with the dental knowledge.

MATERIALS AND METHODS The present study was carried out by National Dental college, Derabassi and the approval for study was obtained from.. authority. A cross-sectional analytical study design was used to determine the prevalence of dental caries in the FPMs. 840 children (437 male and 403 female) including 140 children from each age group of 7, 8, 9, 10, 11, and 12 years were randomly selected and examined for FPM caries using WHO 1997 criteria.. Consent for examination of children was taken from parents. The examination was conducted on a simple sitting chair in normal day light with the help of mouth mirror. No radiographs were taken. A questionnaire was designed that consisted of two simple questions that were answered as yes/no by children and were recorded by assistant. These questions provided information regarding children knowledge of eruption of first molar and the advice received from parents/dentist for cleaning teeth and this was checked for relation if any, with carious status of FPM. Data was processed and analyzed using statistical software namely SPSS. p level less than 0.05 was considered significant.

RESULTS Of the total 840 children examined 65.1% had caries in first permanent molar.65.4% male and 64.7% female children were affected by FPM caries and this difference obtained was statistically not significant. The carious status of all FPMs increased significantly with an increase in age of the children. It was observed that 35.1%, 62.1%, 65.7%,70.7%,77.1% and 79.3% of children in age groupof 7,8, 9,10,11 and 12 yr respectively had carious FPM. The point prevalence of Dental caries in first permanent molar in different age groups was ..for 7, 8, 9, 10,11and 12 years age group respectively indicating that as age increased the DMFT also increased

correspondingly. Mandibular first permanent molar exhibiting statistically significant higher Decayed and filled component of DMFT than their Maxillary counterpart and the comparison is shown in tables.

Graph.

80
Percentage

60 %

40
20 0 caries caries free

caries caries free

Number

of

children

with

and

without

caries

in

first

permanent molar.

Percentage%

80.00% 60.00% 40.00% 20.00% 0.00%

65.4 %

64.7 %

34.6 %

35.3 %

caries
caries free

male

female

Number of (N =840).

of the

children first

who permanent

presented molar

with in

and relation

without to

caries gender

80.00%
64.3 %

65.7 %

70.7 %

77.1 %

79.3 %

60.00% 40.00% 35.7 % 20.00% 0.00%

34.3 %

caries
29.3 % 22.9 % 20.7 % caries free

10

11

12

Number of children who presented with and without caries of the first permanent molar in relation to age (N = 840).

3 2.5
1.89 2.19 2.01 2.41

2 1.5 1 0.5 0 7 8 9 10 11 12 DMFT (MEAN)

DMFT(mean) in permanent first molar,by age

40.00% 35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% MAXILLARY MANDIBULAR
.12 % .83 % 1.8 % .3 %

DECAYED
MISSING FILLED

DMFT in Maxillary and Mandibular permanent first molar

100.00% 50.00% 0.00% YES NO YES NO

80% 60% 40% 20% 0% YES NO CARIES FREE CARIES

Caries status of first permanent molars in relation to knowledge of eruption time of the first permanent (N = 840). molars

DISCUSSION Present study recorded high prevalence of caries in FPM . Noronha et al.1999, Wyne 2004 and Rafi Ahmad Togoo et al 2011 reported high prevalence of caries. Increase in age is accompanied with increase of the caries prevalence of the FPMs among children. M.l Hunter et al 1991No significant difference was noted between the genders in terms of caries status . Similar result were reported by Mostafa Sadeghi 2007 and Khalid Al-Samadani 2012. However study by Ebrahimi et al. 2010 concluded girls have significantly higher DMFT as compared to boys. The present study revealed that Mandibular first permanent molar exhibited statistically significant higher Decayed and filled component of DMFT than their Maxillary counterpart. This finding is in concurrent with that of studies conducted by Serban, Maxim and Balan 2009.The present study revealed that Children, who visited the dentist and received advice from them or their parents regarding oral hygiene, had less caries compared to those who did not. These findings are consistent with the study conducted by M. L. Hunter et al 1991 and G. A. Chukwu et al 2004. An early preventive program like application of fissure sealants and the use of fluoride could help reduce the prevalence of caries Ghanim et al 1998,and M Ebrahimi et al 2010 .The use of pit and fissure sealants35,36 and application of fluoride varnish37,38 help in slowing down the development of caries. Preventive restorations should be carried out39,40 and atraumatic restorative treatment (ART) should be used as a community-based approach for the treatment and prevention of dental caries.414310 studies [3, 4] have stressed the importance of oral hygiene instruction, the regular use of topical and systemic fluoride, and the application of fissure sealants in the prevention of dental caries especially on the first permanent molars.11

CONCLUSION High caries prevalence in permanent first molars shows that dental caries is still an important problem in the children of our society. Therefore it becomes the responsibility of dentist and related dental health personnel to educate and motivate parents, teachers and children regarding importance of first molar, maintenance of oral hygiene and importance of regular visit to dentist so that he can ensue preventive measures like sealants and fluoride application at an appropriate time as all these have significant impact on future dental health of children