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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 5  |  Issue : 1  |  Page : 11-15

Dental caries-related quality of life and socioeconomic status of adult population in Perambur, Chennai


1 Graduate Student, Thai Moogambigai Dental College and Hospital, Mogappair, Chennai, Tamil Nadu, India
2 Department of Public Health Dentistry, Chettinad Dental College and Research Institute, Tamil Nadu, India

Date of Submission06-Oct-2021
Date of Acceptance08-Oct-2021
Date of Web Publication29-Nov-2021

Correspondence Address:
Dr. N Nagappan
Reader, Department of Public Health Dentistry, Chettinad Dental College and Research Institute, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijosr.ijosr_20_21

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  Abstract 


Introduction: Oral health has a major role in the general well-being of a person. Oral health problems can have wider social, economic, and psychological concerns, thereby affecting the quality of life. Oral health-related quality of life indicates an individual's perception of how their well-being and quality of life is influenced by oral health. The aim of the study is to determine the oral health-related quality of life and the association between dental caries socioeconomic status (SES) of adult population in Perambur, Chennai. Materials and Methods: The study sample consists of 200 adults and a questionnaire comprised ten questions related to oral habits and Kuppuswamy scale (modified for year 2015) to evaluate oral health-related quality of life and SES of adults in Chennai. Results: The oral health of an individual and their SES was analyzed and found that upper middle class females were commonly affected with dental caries than other class females. The most commonly affected tooth with dental caries was upper right 1st molar followed by lower left and right 1st molar. Conclusion: This study showed that there is a strong relationship between the SES and oral health. The main purpose of this study is to highlight the importance of assessing oral health-related quality of life in the clinical practice so that the clinicians can easily identify the actual difficulties faced by the patients due to oral problems and formulate appropriate treatment plan and goals.

Keywords: Dental caries, Kuppuswamy scale, oral health, quality of life, socioeconomic status


How to cite this article:
Soniya H, Nagappan N. Dental caries-related quality of life and socioeconomic status of adult population in Perambur, Chennai. Int J Soc Rehabil 2020;5:11-5

How to cite this URL:
Soniya H, Nagappan N. Dental caries-related quality of life and socioeconomic status of adult population in Perambur, Chennai. Int J Soc Rehabil [serial online] 2020 [cited 2024 Feb 29];5:11-5. Available from: https://www.ijsocialrehab.com/text.asp?2020/5/1/11/331467




  Introduction Top


Dental caries is a multifactorial infectious disease throughout the world leading to pain, chewing difficulties, speech problems, general health disorders, psychological problems, and lower quality of life. The prevalence and incidence of dental caries in a population is influenced by a number of risk factor such as sex, age, socioeconomic status (SES), dietary patterns, oral hygiene habits, salivary immunoglobulins, bacterial load, and fluoride intake. Diet plays an important role in the development of dental caries. Many previous studies showed that the consumption of foods with high carbohydrate content constitutes an important risk factor for the development of dental caries. Frequency of sugar intake increases the risk for caries development.[1]

Oral health is a state, in which the oral tissues contribute positively to an individual's well-being in all dimensions of health allowing them to eat, speak, and socialize with others without any discomfort. Thus, oral health has an important role in the general well-being of a person.[2] Oral health problems have been increasingly recognized as important factors causing a negative impact on daily performance and quality of life.

Oral health problems have wider social, economic, and psychological concerns, thereby affecting the quality of life. Oral health-related quality of life denotes a person's perception/concern of how oral health influences life quality and overall well-being. It comprises individual's satisfaction with oral health, self-esteem, and the ability to eat, speak, and engage in social interactions.

SES refers to the placement of persons, families, households, and census tracts or other aggregates with respect to the capacity to create or consume goods that are valued in our society.[3] Indicators of SES, such as household income or education level, are important factors that have an impact on oral health. Several reports have shown that low SES groups exhibited worse oral health and a higher prevalence of caries compared with high SES groups. To reduce these socioeconomic inequalities, many countries have endeavored to improve the oral health of their citizens through health promotion programs such as public health campaigns promoting brushing with fluoride toothpaste, school programs of rinsing with fluoride solution, and water fluoridation.

Low SES, low monthly household income, and low educational level are associated with less access to dental services and oral hygiene products, poorer knowledge regarding oral health and oral hygiene, and consequently, a greater frequency and severity of dental caries.

Problems such as tooth decay, pulpitis, and periodontitis causes pain. Loss of tooth structure can interfere with proper chewing, speaking, and esthetic appearance. Craniofacial disorders, malocclusion, appearance of teeth or denture significantly affect self-esteem, social relationships, and communication capability.[4] Hence, these problems cause considerable distress to individuals and affecting their quality of life. The association between SES and dental caries prevalence has been evaluated in this study using indices among adult population in Perambur alone.


  Materials and Methods Top


The study sample consists of 200 adults and the decayed, missing due to caries, and filled teeth (DMFT) index was adopted for the assessment of dental caries in accordance with the standards recommended by the World Health Organization (WHO).

A questionnaire comprised 10 questions related to oral habits and Kuppuswamy scale (modified for year 2015) to evaluate oral health-related quality of life and SES of adults in Chennai. The data were analyzed, and results were tabulated.


  Results Top


The study was conducted among 200 adults, in which females were dominant than males and in the age group of 34–44 years. Majority of them were graduate and postgraduate. From the study, it was observed that majority of the adults cleaned their teeth with toothbrush and paste once daily and visited dental office in 6 months for regular dental checkup. Most of them also had previous experience of tooth ache due to dental caries and difficulty in consuming hot and cold food items. The oral health of an individual and their SES were analyzed and found that upper middle class females were commonly affected with dental caries than other class females. The most commonly affected tooth with dental caries was upper right 1st molar followed by lower left and right 1st molar.

The relationship between the prevalence of dental caries and occupation of the adults was assessed. The unemployed adults were commonly affected with dental caries than any other profession. Thus, occupation and SES of the subjects had a greater impact on the prevalence of dental caries.

[Figure 1] shows that oral health of the adults and their SES did not have any significant effect on their quality of life like trouble in pronouncing words (99%), avoidance of social gathering (97%), embarrassed about smiling (94.5%), and absent for work (92.5%).
Figure 1: Oral health related quality of life

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[Table 1] shows the demographic status of the adults and majority of adults were between the age group of 35–44 years. Females were dominant than males in this study.
Table 1: Demographic distribution of subjects

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[Table 2] shows education status of the subjects and majority of them were graduate/postgraduate (49%), followed by high school (21%).
Table 2: Education statuses of subjects

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[Table 3] shows the relationship between the prevalence of dental caries and occupation of subjects. Unemployed adults (22%) were commonly affected by dental caries than any other profession.
Table 3: Mean value of decayed, missing due to caries, filled teeth score and occupation of subjects

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[Table 4] shows the relationship between the SES and prevalence of dental caries. It is shown that upper middle (II) class (39%) adults were more commonly affected by dental caries than other classes.
Table 4: Socioeconomic statuses and mean value decayed, missing due to caries, filled teeth score

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This table shows that females (51.5%) were more commonly affected by dental caries than males (48.5%).


  Discussion Top


Oral health and the lifestyle of an individual influences the oral health-related quality of life. To evaluate the prevalence and severity of dental caries according to WHO recommendations, this study used DMFT score. The study included 200 adults from Perambur region in Chennai, among which 103 were females and 97 were males between the age group of 18–85 years. In the present study, it was observed that females (51.5%) were more commonly affected by dental caries than males (48.5%) [Table 5]. This result was similar to the studies done by Lawrence et al.[5] and Ingle et al.[6]
Table 5: Mean value of decayed, missing due to caries, filled teeth score among gender

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Occupation of an individual also has an influence on the prevalence of dental caries. In this study, unemployment (22%) was associated with higher incidence of dental caries than other occupations such as clerical/shop owner, profession, and semi profession [Table 3]. The second most common occupation associated with the incidence of dental caries was skilled workers (19%).[7]

The association between oral health and SES of adults has been well established in this study using Kuppuswamy scale. The upper middle class (II) was found to be more prone to dental caries (39%) than other classes [Table 4]. This high rate of dental caries is due to their rich lifestyle. This result was different from the study done by Jain R et al.[8] and Deva Priya Appukuttan et al. in 2016,[8],[9] which showed more prevalence of dental caries in lower SES. The prevalence of dental caries was high in the low SES because of their poor oral hygiene practice, lack of awareness, improper food intake, and family status.[10] According to study done Evans et al.,[11] low family income may affect food selection and nutrient intake by mothers and also infants during the tooth development period. It may also affect the degree of education, health values, life style, and access to health-care information. As a consequence, family income can be an indirect factor for tooth susceptibility to caries.[12] It is also possible that mothers completing higher levels of education are more responsible regarding health, more likely to maintain good dietary and hygiene behaviors, and are likely to have more positive health attitudes. Moreover, the widespread belief that primary teeth are temporary and not as important as permanent teeth are likely to be higher among mothers with low levels of education.[13] The recognition that maternal education is a strong determinant of childhood caries confirms that oral health cannot be achieved without educational policies in developing countries. Such programs may have an impact on the health of infants and preschoolers including dental caries.

The prevalence of dental caries based on tooth type was also evaluated in this study. From the study, it was observed that the upper right first molar (16) was more commonly affected by dental caries (25%) than other teeth [Figure 2].[14] In general terms, the canines and incisors demonstrated fewer dental caries. From the anatomical point of view, such occurrences have been attributed to the anatomical oral position of the teeth, making them accessible to fluoride exposure and hygienic habits. Caries is much more frequent in sites of food retention and bacteria accumulation. Forty to fifty percent of the cavities are normally found on the grooves and cracks of occlusal molar surfaces.[15]
Figure 2: It shows that upper right 1st molar (25%) was most commonly affected by dental caries, followed by lower left 1st molar (23%) and lower right 1st molar (21.5%)

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In a study by Li et al.[16] showed that the permanent teeth, particularly the first and second molars are more susceptible to cracks formation, making the adhesion and colonization of cariogenic microorganisms possible. As a result, the dental caries on the occlusal surface are higher than on other surfaces.[17] Naturally, any alteration in oral habits such as oral hygiene, topical fluoride exposure, and changes in dietary habits will influence the cariogenic indices in any of the socioeconomic population categories.[18],[19]

Oral hygiene practices, teeth problems, and oral health-related quality of life were also evaluated in this study and found that majority of adults cleaned their teeth with tooth brush (98.5%), once daily (76.5%), and visited dental office once in 6 months (68%) [Figure 3].[20],[21]
Figure 3: It shows that majority of the adults cleans their teeth with toothbrush and paste once daily and visits dental office once in 6 months

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Among teeth problems, tooth ache (71%) was most commonly experienced by all adults, but tooth ache during night (34%) was least experienced by them. It was also found that oral health had least effect on oral health-related quality of life [Figure 4].[22] Individuals did not face any trouble in pronouncing words, embarrass about smiling nor avoid any social and peer gathering because of their oral health problems [Figure 1].[23] Adults who visit dentist regularly have better oral health status and better oral health-related quality of life, requiring less emergency treatment.[24]
Figure 4: It shows that majority of adults had previously experienced tooth ache due to dental caries and had difficulty while eating hot or cold foods and tooth ache during night

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  Conclusion Top


This study showed that there is a strong relationship between the SES and oral health. The main purpose of this study is to highlight the importance of assessing oral health-related quality of life in the clinical practice so that the clinicians can easily identify the actual difficulties faced by the patients due to oral problems and formulate appropriate treatment plan and goals.[25]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Lawrence HP, Thomson WM, Broadbent JM, Poulton R. Oral health-related quality of life in a birth cohort of 32-year olds. Community Dent Oral Epidemiol 2008;36:305-16.  Back to cited text no. 5
    
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Devishree RA, et al. The role of social economic status on dental caries and its prevention among outpatients visiting private Dental college hospital. Int J Pharm Sci Res 2018;10:369-71.  Back to cited text no. 9
    
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Li Y, Navia JM, Bian JY. Caries experience in deciduous dentition of rural Chinese children 3-5 years old in relation to the presence or absence of enamel hypoplasia. Caries Res 1996;30:8-15.  Back to cited text no. 16
    
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Jain R, Dupare R, Chitguppi R, Basavaraj P. Assessment of validity and reliability of Hindi version of geriatric oral health assessment index (GOHAI) in Indian population. Indian J Public Health 2015;59:272-8.  Back to cited text no. 17
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Sakthi DS. Dental caries experience and treatment needs among construction workers of Chennai city, India. J Oral Health Res 2010.  Back to cited text no. 18
    
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Kumar RP, John J, Saravanan S, Arumugham IM. Oral health knowledge, attitudes and practices of patients and their attendants visiting college of Dental surgery, Saveetha University, Chennai. J Ind Med Assoc 2009;13;43-53.  Back to cited text no. 19
    
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Paulander J, Axelsson P, Lindhe J. Association between level of education and oral health status in 35-, 50-, 65- and 75-year-olds. J Clin Periodontol 2003;30:697-704.  Back to cited text no. 22
    
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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