.Caries index, Root caries index and gingival index in immigrants at the camp of Arbat on Sulaimania city,Iraq.
Abstract:
Objective: we examined the oral health from the point of crown caries ,root caries ,and gingival inflammation among immigrants who live in the camp of Arbat on Sulaimania .
methods :
Examination of coronal , root caries and gingivitis were performed on 200 immigrants male and female who lives in the camp of Arbat to summaries the oral health from the examined points by using DMFT index ,RCI and GI. Cross-sectional studies used to assess the prevalence of caries ,root caries and gingival inflammations in these group. The statistical analysis was done by statistical
package of SPSS-24.
Results: there is a significant increase in DMF Mean”SD for male 10.3”3.2,for female 11.2”3.5.The RCI Mean”SD for male 0.4”0.3, for female 0.4”0.4.The GI Mean”SD for male 0.8”0.6,for female 0.8”0.7.
Conclusions..
Health for All from this concept we planned to do this study. After reach to the results this study improved that the immigrants needs for more instructions and motivations about the personal oral health care that impact immigrants' oral health.
Introduction
Immigration means everyone who leaves their house or town under different and difficult causes (1). The migration lead to stressful events result from leaving their place and entering another (2)The worst oral health state often found on Immigrants [3,4]. The stress will lead to Sadness, psychological proplems,lack of personal health care which include oral health [5,6] .
The most important problems of oral health state that the immigrant complain from them are:
1-caries. caries, is a bacterial destruction of tooth structure (7).The index used for measuring experience of dental caries in populations called DMF index propped by the World Health Organization (WHO). The (DMF) index Mean Decayed, Missing, Filled which used in measuring caries epidemiology for many years ago(8). Teeth that excluded are unerupted teeth, congenitally missing teeth or supernumerary teeth, teeth removed for reasons other than dental caries, and primary teeth retained in the permanent dentition. The third molar counted or not depend on the researcher himself . D recorded when the tooth caries or filled .M recorded when the tooth lost due to caries. F recorded When a permanent or temporary filling is present, or when a filling is defective but not decayed. When the tooth filled not due to caries but for another causes it's not consider as an F(9).
2 – Root caries is a weakening dental disease among older adults this will lead to loss the tooth (10,11).Its reflect the oral health related to elderly peoples (12). Root caries difficult to examine due to the variety of the lesion either small or irregular lesions and The prevalence of root caries increases with age (13). Root caries is a preventable disease. The root caries are not respond to the preventable method in the same degree ,these preventable methods e.g. fluoridation ,fluoridated tooth paste (10).
3-Gingivitis ; inflammation of the tissues, it's a non-destructive periodontal disease(14). Bacterial biofilms also called plaque when its adhere to the tooth surface forming plaque induce gingivitis which cause gingivitis and then periodontitis. Gingivitis is reversible with good oral hygiene, while when the gingivitis left without treatment it will progress to periodontitis, in which tissue loss occur and bone loss, at the end lead to tooth loss (15). The Gingival Index (16) was assessed of the gingival condition , records qualitative changes in the gingival, prevalence and severity of gingivitis. It scores the marginal and interproximal tissues separately on the basis of 0 to 3. The criteria are: 0= Normal gingiva; 1= Mild inflammation ‘ slight change in color and slight edema but no bleeding on probing; 2= Moderate inflammation ‘ redness, edema and glazing, bleeding on probing; 3= Severe inflammation ‘ marked redness and edema, ulceration with tendency to spontaneous bleeding. The bleeding is assessed by probing gently along the wall of soft tissue of the gingival sulcus. The Gingival Index may be scored for all surfaces of all or selected teeth or for selected areas of all or selected teeth. A score from 0.1-1.0 = mild inflammation; 1.1-2.0 = moderate inflammation from, and 2.1-3.0 signifies severe inflammation. Moreover, for the same study like this work we need ideal descriptive data for the oral health of immigrant , in order to change the behavior inveterate in these different immigrants study by Zini and colleagues (17,18). Study the Oral health status among immigrant is important in assessing and planning all community dental health programs [19,20].
Materials &Method :
When we planned to do the research to study the influence of leaving the person his usual home or place enforcedly on oral health from the main objectives of the present study were to assess the prevalence and severity of coronal , root caries and gingival state .The epidemiological study carried out in 200 immigrants male and female between 25-65 years old located at camp of Arbat on Suleimania. Ordinary examination for the caries in the tooth from crown to the root and the state of gingiva by the uses of diagnostic instruments(probe, mirror) , cotton rolls,, and portable light ,then record it by the uses of caries index for the crown and root in addition to gingival index. The coronal caries index is based on simply counts the number of decayed, missing (due to caries only) and restored teeth. The DMF Index is total number of teeth or surfaces that are decayed (D), missing (M), or filled (F) in an individual.
RCI by calculating the ratio of the number of decayed and filled root surfaces to the number of exposed root surfaces[21].
Then calculated by the following formula; (Figure 1)
FIGURE 1. Formula for calculating root caries index percentages
The condition of each root surface was analyzed according to the following criteria:
a)The gingival recession occur when the cement_enamel junction was visible (22).
b) Signe of root caries the exploratory probe easy to penetrate a root surface, change in the color of tooth surface(darkened ,chalky) (23).
c) All the restored root surface was consider as filled such as abrasion, erosion or caries result (24).
Gingival index calculated by : The scores of the four areas of the tooth can be summed and divided by four to give the GI for the tooth. The GI of the individual can be obtained by adding the values of each tooth and dividing by the number of teeth examined.
GI=score for 4area/4 ( for one tooth)
Cross sectional study used to know the prevalence of dental caries and gingivitis in the immigrants whom live in camp of Arbat. statistical analysis done by the using of available statistical package of SPSS-24 (Statistical Packages for Social Sciences- version 24).
Analysis of data (DMF,RCI and GI) were presented in simple measures of frequency, percentage, mean, standard deviation, and range (minimum-maximum values).
The significance of difference of different means (quantitative data) were tested using Students-t-test for difference between two independent means or ANOVA test for difference among more than two independent means. Statistical significance was considered whenever the P value was equal or less than 0.05.
.
Results:
The results of this study according to table(1) which take male and female range between 25 and 65and the Mean”SD 43.0”10.3 for male , Mean”SD for
female 43.2”10.5.the higher number of male 38 for interval between 40_49 ,while the higher number of female 34 for the same interval.
Age (years) Gender
Male Female Total
No % No % No %
<30 11 45.8 13 54.2 24 12.0
30—39 26 60.5 17 39.5 43 21.5
40—49 38 52.8 34 47.2 72 36.0
50—59 23 50.0 23 50.0 46 23.0
=>60 7 46.7 8 53.3 15 7.5
Total 105 52.5 95 47.5 200 100.0
Mean”SD
(Range) 43.0”10.3
(25-65) 43.5”10.7
(25-65) 43.2”10.5
(25-65)
The distribution of the DMF value among the immigrants was shown in (figure2) ,the greater distribution of it 11 then 10 and 12 in second degree until reach to 1 and 2 in the last degree.
(Figure 2)
The distrbutions of RCI value among immigrant group shown in figure (3).
(Figure 3)
The distribution of GI value was shown in figure(4).
(figure 4)
The result of table No.(2)show that all the variables measured for male and female in immigrants are nearly the same value.
Table No.(2)
Gender P value
Male Female Total
DMF (Decayed, Missed, Filled Index) 10.3”3.2
(1-19) 11.2”3.5
(2-19) 10.7”3.3
(1-19) 0.074
RCI (Root Caries Index) 0.4”0.3
(0-1.0) 0.4”0.4
(0-1.0) 0.4”0.6
(0-7.0) 0.379
GI (Gingival Index) 0.8”0.6
(0-2.7) 0.8”0.7
(0-2.5) 0.8”0.7
(0-2.7) 0.764
Data were presented as Mean”SD (Range)
Table No.(4) in this table showed significance different among each age groups in DMF index and gingival index ,while no significance in RCI.
Age (years) P value
<30 30—39 40—49 50—59 =>60
DMF (Decayed, Missed, Filled Index) 8.8”3.9
(3-18) 10.4”3.0
(5-19) 11.2”2.6
(3-19) 11.2”4.2
(1-19) 11.1”3.0
(6-16) 0.026*
RCI (Root Caries Index) 0.5”0.4
(0-1.0) 0.3”0.3
(0-1.0) 0.4”0.3
(0-1.0) 0.4”0.3
(0-1.0) 0.6”0.3
(0-1.0) 0.090
GI (Gingival Index) 0.7”0.7
(0-2.1) 0.6”0.6
(0-2.1) 0.8”0.6
(0-2.3) 1.0”0.7
(0-2.5) 1.3”0.8
(0-2.7) 0.001*
Data were presented as Mean”SD (Range)
*Significant difference among independent means using ANOVA test at 0.05 level.
Discussion:
The compare of the results of this study with another studies for another immigrants were very difficult because of the sample size, the environment of the immigrants and to standardization of the indicators used. The social condition is the main causes for reach to inequalities in the oral health maintenance that found in Previous studies (25,26,27,17).
The associated factors of migration are related to social determinants of health that leads to increase the health outcomes which consider the stronger factors from individual variable age, sex or race [18].
In 1999 to 2004 the third National Health and Nutrition Examination Survey reach to the facts that 30.8% the rate of root caries in persons between 50 and 64, while 10.4% the prevalence of root caries for adult between 20 to 34(28).when use the same criteria and indicators to evaluate root caries for teeth of adults and elderly people permitting comparisons between places and over time(29). The upper molars more prevalence by root caries than other upper teeth ,the upper teeth more affected by root caries than lower teeth(30). The prognosis and prevalence of root caries cannot be correctly expected due to the presence of restoration for abfraction or root sensitivity. The results of this study suggest the importance of studies of root caries using uniform criteria which cover it form diagnosis, studies on associated factors and appropriate treatment recommendations.
The overall health status of the country significantly affected by oral health care services used for the immigrants this will lead to increase the number of these population, because they consider as a part of country population(31,32).
(The most common oral pathologies are Caries and periodontal diseases, that effect on all stage of life of all population [3].
The long ‘standing gingivitis with GI scores of 2 or more ,will lead to periodontitis .persistent of periodontitis for long time will lead to increase the risk factor for the loss of the tooth which proved by Recent research(33).
To prevent the periodontitis we must decrease or prevent gingivitis in population ,which is consider the first step on avoidance of periodontitis (34).
Important information provided by examining adults' perception that encourage public oral health promotion .we must know the way that the immigrant groups take care of their oral [4,35,36,37,8,38)
The dental care according to Numerous studies will increase due to health insurance ,the dental care consider as a supporting factor toward seek health care services (39,40)
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