CHAPTER ONE

INTRODUCTION

Background of the Study

Dental caries is a disease with multi-factorial causes the prevalence and incidence of dental cares in a population is influenced by a number of risk factors such as age, set, ethnic group, dietary patterns and oral hygiene habits.

Diet has been associated with the prevalence of dental cares for centuries. In the field of research into caries– etiology, diet has probably received more attention than any other subjects. The Vipehoan Study (1954) perhaps, is the best known research project about diet and caries concluded that the frequency nature of sugar intake had marked influence on caries activity. There is to doubt, that dietary and oral hygiene habits are affected by income, education, and social, environments.

Hunt (2013) had shown convincingly that in Western Countries people, whose socio-economic status is low, tend to have more caries.

Despite great achievements in oral health of populations globally, problems still remain in many communities all over the world particularly among under privileged groups in developed and developing countries. Dental cares and periodontal diseases have historically been considered the most important global oral health burden. At present, the distribution and severity of oral diseases vary among the same country or region. In light of changing living conditions, however, it is expected that the incidence of dental cares will increase in many developing countries in Africa, particularly due to a growing consumption of sugars and inadequate exposure to fluorides.

The prevalence of dental cares has been reported to vary between 60 to 90% in industrialized countries. The disease is less common and less severe in African countries. Though a nationwide oral health survey has not been carried in Rimingado Local Government Area of Kano State, there have been a number of studies carried out. A study by Ngang (2014) among school going children reported that 52% had dental cares, while a study by Noor (2015) reported a prevalence of 78.5% among females and 55.7% among males in an adult urban Somali country in Nairobi.

A recent study in Ghana among 9-12 and 15 year olds showed a caries prevalence of 37.5% for an urban setting with a Decayed Missing Filled Teeth (DMFT) 0.76, while a rural setting had a prevalence of 24% and a DMFT of 0.36 (Combs, 2012).

Another Kenyan study among rural Population showed 43.3% cares prevalence and a DMFT of 3.4 in participants with age ranging from 18-65. Cares experience has been reported to be higher in developed countries cares than developing countries. At the same time cares experience in developed countries is comparable to urban settings in developing countries. Rural areas tend to have a lower cares prevalence compared to urban settings. The prevalence of dental cares and the DMFT were significantly higher in an urban setting 37.5% (DMFT 0.76) compared to rural 24.0% (DMFT 0.36) according to Gathecha et al (2014).

In a study by Combs (2013) in South Africa, rural 12- year olds had a cares prevalence of 22% compared to 54% of the urban population. Philips (2014) found cares prevalence in South Africa 12-year olds to have been 40% with a DMFT of 1.19, showing a high disease burden despite low the DMFT. While in Suburban Liberia Afoland (2014) showed cares experience of 12 year olds was 13.9% and a mean DMFT of 0.14.

The prevalence of cares has been reported to vary from one country to another due to differences in socio-economic patterns and demographic factors. A national oral health survey in Portugal by Margret (2013) found the prevalence proportion rates of dental cares was 46.9% in 6-year olds and 52.9% in 12 year olds in a developing country, due to the number of participant requited in the study and national coverage.

While in Australia, prevalence of cares was found to have been 34% in 3-6 year olds by Hallet in 2011, with DMFT at 2.28. In a national survey in 2007 in the United Kingdom, 34% of 12 year olds and 49% of 15 year olds had obvious decay.

WHO (2015) data shows developing countries to have a lower cares experience than developed countries.

Risk factors for dental cares include diet of refined carbohydrates, poor oral hygiene, use of non- fluoridated tooth paste, poor oral health seeking behaviour and tooth morphology among others. A study by Kyale (2014) found that 97. 8% of 2 year old children brushed their teeth using a tooth brush and tooth paste. In the same study, 77% of the children had visited a dentist, however, 48.4% of the children only visited a dentist when there was something wrong.

Dental caries and periodontal disease are two of the most troublesome ailments affecting mankind. While their incidence has varied over both time and geography, in modern industrialized nations they are among the most common chronic diseases. Few individuals escape either caries or periodontal disease at some time during their lifetimes. Although death is rarely a complication of either disease, the sequellae of pain, discomfort, and tooth loss are well known. In addition, once past the initial stages of attack, the damage is largely irreversible; the body cannot heal itself. Professional intervention can prevent further deterioration in most cases, but becomes increasingly costly and time-consuming as either disease advances. As an

example, in calendar year 1978, dental expenditures in the United States were 13.3 billion dollars (1), primarily for restorative and rehabilitative care.

The tragedy of this situation is that both diseases can be prevented or controlled by the application of relatively simple measures. Primary and secondary prevention can result in a very large percentage of our population retaining most of their teeth for their normal life spans, with little disease and discomfort and, therefore, an improved quality of life. Primary prevention of caries can be achieved, in large part, by the application of community and mass measures requiring little, if any, individual activity or behavior change. Prevention of periodontal disease, on the other hand, requires active participation by the individual with an acceptance of

responsibility for maintaining oral cleanliness.

Statement of the Problem          

Dental caries and periodontal disease are two of the most troublesome ailments affecting mankind. While their incidence has varied over both time and geography, in modern industrialized nations they are among the most common chronic diseases. Few individuals escape either caries or periodontal disease at some time during their lifetimes. Although death is rarely a complication of either disease, the sequel of pain, discomfort, and tooth loss are well known . In addition, once past the initial stages of attack, the damage is largely irreversible; the body cannot heal itself. Professional intervention can prevent further deterioration in most cases, but becomes increasingly costly and time-consuming as either disease advances. As an

example, in calendar year 1978, dental expenditures in the United States were 13.3 billion dollars (1), primarily for restorative and rehabilitative care.

The tragedy of this situation is that both diseases can be prevented or controlled by the application of relatively simple measures. Primary and secondary prevention can result in a very large percentage of our population retaining most of their teeth for their normal life spans, with little disease and discomfort and, therefore, an improved quality of life. Primary prevention of caries can be achieved, in large part, by the application of community and mass measures requiring little, if any, individual activity or behavior change. Prevention of periodontal disease, on the other hand, requires active participation by the individual with an acceptance of

responsibility for maintaining oral cleanliness. Even though dental caries is high in some parts of the country, much is not known about the extents and factors affecting it in the study area.

Purpose of the Study

The purpose of study is find out the Prevalence of dental caries among primary school children in Rimingado Local Government Area of Kano State.

Specifically, it seeks to:

(1) Assess the level of knowledge regarding oral hygiene among primary school children in Rimingado Local Government Area of Kano State.

 (2) To determine the risk factors for Dental caries among primary school children     

       in Rimingado Local Government Area of Kano State..         

(3).To ascertain the strategies that can reduce the risk factors for Dental caries

among primary school children in Rimingado Local Government Area of Kano State.

Significance of the Study                                                             

The research is expected to be of great importance to parents and the general public in risk factors of dental caries in Rimingado Local Government Area of Kano State. The study conducted was done to aid the following group of people, the mothers, the health centres and Ministry of Health.

-         The findings will be importance to mothers within the study area.

-         The Health Centres: The suggestions made will be used as a source of corrective measures to health personnel.

-         Ministry of Health: The findings may serve as a clue to Rimingado Local Government Area of Kano State to make better planning and adequate provision of adequate measures to correct the risk factors of dental caries to promote the health of primary school children.

Research Questions

The following research questions will be investigated in the course of this study:

(1)  What is the level of knowledge regarding oral hygiene among primary school        

       children in Rimingado Local Government Area of Kano State?

 (2) What are the risk factors for Dental caries among primary school children     

       in Rimingado Local Government Area of Kano State?    

(3).What strategies could be adopted to reduce the risk factors for Dental caries

among primary school children in Rimingado Local Government Area of Kano State?

Scope of the Study

The research work is focused on the Prevalence of dental caries among primary school children in Rimingado Local Government Area of Kano State. It is delimited to the primary school children within the study areas.

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