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Chapter One

1.0 Introduction

1.1 Background of study

Dental caries according to Sturdevant (2013) is an infectious microbiologic disease of the teeth that results in localized dissolution and destruction of calcified tissues.

While according to the World Health Organization (2013), it is defined as localized post eruptive pathological process of external origin involving softening of the hard tissue.

According to American Academic of Periodontology (2012), tooth decay is an erosive process that begins with the action of bacteria on fermentable carbohydrates in the mouth, which produces acid that dissolves tooth enamel. Dental erosion occurs due to several reason, or contributing factors such as nutrition, consumption of sweet things, soft drink taking and genetic predisposing factor.

Dental caries tend to form small hole, usually in a fissure (a break in the tooth’s enamel) or in an area that is hard to clean, left unchecked, the decay extends into the dentine. Because dentine is not as enamel, decay progresses more rapidly and in time reaches the pulp of the tooth. Dentist can determine the extent of damage and the type of treatment for dental caries includes; fillings, dental implants, extraction (Folayan et al., 2012).

Dental caries is a chronic disease of hard tissues of the tooth, characterized by alternating phases of demineralization and re-mineralization, which can lead to cavitation and eventually tooth loss. Dental caries affects 60% - 90 % of school children and a vast majority of adults across the globe and is known to restrict activities in schools, at work and at home, causing millions of school and work hours to be lost each year all over the world. Moreover the physical, functional, social, psychological and emotional impacts of dental caries have been well documented to diminish the quality of life (Shamsher et al, 2012).

Dental caries, or “tooth decay” as it is more colloquially known, is a microbiologic diseasethat has implications both local to the oral cavity and in extreme cases, systemically. While other conditions, such as cancer, diabetes, and cardiovascular disease garner much attention in the scientific community and public, dental caries continues to quietly manifest with alarming prevalence. Indeed, dental caries has been identified as the most common chronic childhood disease in the United States, more common than asthma and hay fever. Globally, 60-90% of children and nearly 100% of adults have teeth affected by dental caries (Ryan, 2015).

Dental caries is the most prevalent oral disease and it remains the single most common disease of childhood that is not amenable to short-term pharmacological management1. More than eighty percent of the pediatric population is affected by dental caries by age seventeen1. It’s very high morbidity potential has brought this disease into the main focus of the dental health profession. There is practically no geographic area in the world whose inhabitants do not exhibit some evidence of dental caries. It affects both gender, all races, all socioeconomic status and all age groups. It does not only cause pain and discomfort, but also in addition, places a financial burden on parents of affected children (B.O. Popoola, et al, 2013).

In most developing countries prevalence of dental caries is on the rise, probably because oral diseases are the fourth most expensive diseases to treat and the access to services is very limited. According to World Health Organizations pathfinder survey which examined over nine thousand individuals in twenty one districts of Pakistan, dental caries was found the single most common chronic childhood disease in the country being 5 times more common than Asthma and 7 times more common than hay fever. Khan reported that more than 50% of children between ages of 12-15 years are caries free however on the negative side 97% of all carious lesions are untreated. Unfortunately no study regarding prevalence of dental caries has been conducted in Lahore specifically targeting the large amount of children studying at poor locality schools. (Shamsher et al, 2012).

According to WHO’s Global Data for the year 2000 on decayed, missing and filled teeth (DMFT Index), the level of dental caries in Africa is low relative to the findings in the Americans3. In the 60’s, the prevalence of dental caries in developed countries was found to be generally higher than that in the developing countries with a mean DMFT range of 4.5 – 6.5 in 12 year old in developed countries and 0.1 – 1.1 in the same age group in developing countries Meanwhile, Petersen in his review of various studies on dental caries noticed two distinct trends in the prevalence of the disease.

First is the decline in the prevalence of dental caries in developed countries over the past 30 years and second is the increase in the prevalence of the disease in some developing countries. A decrease in mean DMFT as low as 2.6 in some developed countries and an increase in mean DMFT up to 1.7 in some developing countries has been reported (b.o. Popoola, et al, 2013).

Beside the implications for personal and public health, dental caries has a strong economic impact. Oral diseases are the fourth most expensive to treat in the industrialized world.An estimated 5-10% of public health expenditures in these countries are for oral health.It should be noted that not all patients who would benefit from dental treatment in industrialized countries seek it, likely influenced by economics as well.And in various developing nations treating dental caries is often cost prohibitive; treating caries in children would exceed the entire allocated national children’s health care budget (Ryan, 2015).

Clearly dental caries is a disease whose prevalence and resulting economic burden merit attention. Because dental caries implicates the wider public, this article aims to provide a concise overview of the current understanding of dental caries, with those outside the dental field as its primary audience. This will be accomplished by reviewing the etiology of dental caries and highlighting implications for its management, with special attention given to disease prevention and/or arrest (Ryan, 2015).

In some countries in Africa, the prevalence of caries in young children is increasing. In these countries, dental caries is associated with an increase in sugar consumption from food, beverages and sweets, while it remains low in countries where poor economy restricts refined sugar consumption6. Incidence of caries has been on the increase in some rapidly industrializing African communities particularly in the urban communities (b.o. Popoola, et al, 2013).

In Nigeria, studies have shown that dental caries prevalence is on the increase although low compared with findings in developed countries. A mean DMFT of between 1.9 and 2.7 had been reported8. In a national survey on dental caries status and treatment need in Nigeria that the proportion of the decayed component of DMFT was 30%, 43% and 45% among subjects aged 12, 15 and 35 - 44 years, respectively. Compared the caries prevalence of urban and rural primary school children between 4 and 16 years of age and found the prevalence of 14.4% in urban area and 5.7% in rural children. Furthermore, Okeigbeme10 in a cross sectional survey of school children aged 12-15 years in Egor district of Edo State found a prevalence of 33% among the studied children. Also, a caries prevalence of 11.2% was found in 12-14 year-old school children in Ibadan, Oyo State (b.o. Popoola, et al, 2013).

Folayan et al., in 2012 showed that the incidence for caries was 9.9% in a population of primary school children with caries incidence higher in primary teeth than in the permanent dentition. Understanding caries pattern, its epidemiology and how the epidemiologic profile changes over time‑is important because caries is the primary pathological cause of tooth loss in children in many African countries including Nigeria. Also, an understanding of the caries profile, that is, where new caries emerges, can be useful in proper planning for the utilization of scarce resources. It will also help maximize the potential outcome of resources available for preventive programs, including oral health prevention programs.

The health of the teeth and gum along with general health will improve only when people take the lead to care for their teeth. Simple affordable prices and resources like chewing stick; salt for mouth wash solution can be used to prevent dental caries. Attitude by people toward eating of food that tend to affect the teeth like biscuit, sugar, chocolate, ice cream, honey, chewing gum, soft drinks should be taken with very serious caution and not frequently to avoid dental caries.

1.2 statement of the problem

This study is carried out to know the prevalence of dental caries among school age. The recent increase   in number of dental caries among school age children is giving a concern to those in the health sector and the society at large.

The intention of the knowledge and study is to bring to the understanding and the knowledge of pupils on some factors contributing to dental caries.

1.3 Research questions

What is the prevalence rate of dental caries among children 2-12 years at Kaduna dental center, within the period of 2012-2016?

What are the common causes of dental caries?

What sex is mostly affected by dental caries?

What age group is mostly affected by dental caries?

1.4 Objective of the study

      I.          To find out factors responsible for dental caries.

    II.          To create awareness about the adverse effect of dental caries.

  III.          To find out actions taken when having dental problem.

  IV.          To identify some of the eating habits that facilitates dental caries among school age children.

    V.          To fulfil the requirement for final qualifying examination

1.5 significance of the study

The findings of this research will help to;

      I.          Identify factors responsible for dental caries.

    II.          Educate the peoples on the ways of preventing dental caries.

  III.          Create awareness on the effect of dental caries on the health of the people.

  IV.          Help the parents realize the consequences of dental caries on this children’s health.

1.6 scope of study

This research is based on the prevalence of dental caries among school age children in Kaduna dental center.

1.7 operational definition of term

School age children: children of age 2-12years.

Calculus: Abnormal concretive composed of mineral substances formed in the cavities which act as reservoir

Caries: a microbial disease of the calcified tissue of the teeth characterized by demineralization of the substance of the tooth.

Cementum: the yellowish bonelike tissue which fix the tooth in the socket of the alveoli ridges’

Enamel: the hardest translucent substance.

Peridontitis: inflammation of the periodontal tissue or supporting structure resulting to gradual loss of supporting membrane and bone around the tooth.

Plague: is a thin film composed of mucin (saliva composition) food debris and materials.

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