Abstract
BackgroundThe aim of this survey was to evaluate the severity of dental caries among children living in Zanskar Valley (Ladakh, India) and its association with anthropometric and background variables.MethodsThis cross‐sectional survey was conducted on schoolchildren divided into four age groups (< 6, ≥ 6 < 11, ≥ 11 < 14 and > 14 years of age). A total of 1474 schoolchildren (607 males, 41.2%) were examined. Actual caries prevalence (dt/DT) and gingival bleeding were recorded by four calibrated dentists. An ad hoc questionnaire evaluated general health, eating habits, oral hygiene and the self-perception of oral conditions. Height, weight, waist circumference, heart-rate and oxygen-saturation were also collected directly by examiners. Responses to questionnaire items were treated as categorical or ordinal variables. The relationship between children’s caries data, gingival bleeding, gender, Body Mass Index (BMI) following the International Obesity Task Force, waist circumference and questionnaire items was assessed using the Kruskal–Wallis test and Pearson correlation. Conditional ordinal logistic regression was used to analyse associations among caries severity, gender, BMI, waist circumference, oxygen saturation and questionnaire items. A forward stepwise logistic regression procedure was also carried-out to estimate the ORs of gingival bleeding prevalence and the covariates derived from examination or questionnaire.ResultsCaries was almost ubiquitarian with only 10.0% of caries-free children (dt/DT = 0). Caries severity, in both primary and permanent dentitions, was statistically significantly related to gender, waist circumference, BMI, oral hygiene frequency and self-reported chewing problems (p < 0.01 in both dentitions). An increasing relative risk for caries in permanent dentition compared to caries-free subjects was observed in children with a low BMI (RRR = 1.67, 95%CI = 1.54/2.83 for subjects with 1–3 caries lesions and RRR = 1.52, 95%CI = 1.36/1.74 for subjects with > 3 caries lesions); also, children with reduced waist circumference had a higher relative risk to have 1–3 caries lesions (RRR = 2.16, 95%CI = 1.84/2.53) and an even higher risk to have more than 3 caries lesions (RRR = 4.22, 95%CI = 3.33/5.34).ConclusionsA significant impact of untreated caries lesions was observed in Ladakh schoolchildren; low BMI values and reduced waist circumference showed to be the main caries risk predictors. Preventive and intervention programmes should be implemented to improve children's oral health.
Highlights
The aim of this survey was to evaluate the severity of dental caries among children living in Zanskar Valley (Ladakh, India) and its association with anthropometric and background variables
The highest mean number of caries lesions affecting primary dentition was recorded in younger groups, as in permanent dentition the highest values were observed in the oldest age group
An increasing relative risk for caries in permanent dentition compared to caries-free subjects was observed in children with a low Body Mass Index (BMI)
Summary
The aim of this survey was to evaluate the severity of dental caries among children living in Zanskar Valley (Ladakh, India) and its association with anthropometric and background variables. Ladakh is an Indian region, comprising two districts: Leh, with a Buddhist majority, and Kargil, with a Muslim majority, and a population of around 280 thousand. The Indian Government reports Ladakh to be one of the districts below standards in term of health services and conditions [1, 2]. The high altitude, above 9000 ft, is responsible for cold and an oxygen content equivalent to two thirds of that at sea level, limited diet, limited availability of drinking water with a low fluoride content (≤ 0.02 ppm/l) and poor socio-economic conditions [3,4,5,6]. Socio-environmental factors play a strong role on oral health: they can produce damage to oral functions as well as affect the quality of life especially of disadvantaged groups of population. Diet transition and inadequate exposure to fluorides are the main reasons for the growth of caries burden in these areas [11]
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