Oral health status, knowledge of dental caries aetiology, and dental clinic attendance: A comparison of secondary school students in the rural and urban areas of Lagos

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Background: Dental caries is painful, expensive to treat and can harm nutrition and overall health. Good oral hygiene, regular utilization of dental health facilities, dietary habits and knowledge of determinants of dental caries play important role in the prevalence of dental caries among school children. Tooth loss, sequelae to untreated dental caries is higher among urban school children than their rural counterparts. Aim: To compare and determine the oral health status and investigate dental clinic attendance and knowledge of students in rural and urban secondary schools in Lagos on the aetiology of dental caries. Methods: Using stratified and proportionate to size sampling techniques, a random sample of 598 students aged 12-26years from rural and urban local government areas were examined for dental caries and gingivitis. Questionnaires were administered to elicit information on frequency of consumption of refined sugar, parents' educational status, knowledge of dental caries aetiology and dental clinic attendance. The decayed, missing and filled tooth index (DMFT) was measured according to the WHO caries diagnostic criteria for epidemiological studies and the clinical oral hygiene status measured with the gingival index (GI) of Loe and Silness, Plague index and the Simplified Oral Hygiene Index. Results: There was a statistically significant difference between urban and rural students in caries experience in permanent teeth (mean DMFT = 0.26 in urban areas; 0.11 in rural areas), More of the parents of students in the urban schools are educated than those in rural schools. The decayed (D) and missing (M) components were higher in the rural area, indicating a high level of restorative treatment need among the students in rural area. The urban participants had better oral hygiene and the gingival index was higher among rural students. Dental clinic attendance was higher among the urban participants than the rural participants. Conclusion: The students in urban secondary schools had better oral health status and make use of dental facilities more than their rural counterparts. The knowledge of aetiology of dental caries is poor among both the rural and urban school students.