Association des variables socio-économiques avec la prévalence de la carie dentaire chez les écoliers québécois de deuxième et sixième année en 1989–1990

Geo-Mapping of Early Childhood Caries Risk: A Community Oriented Preventive Oral Health Promotional Approach

Context:

Given the uneven distribution of dental caries, there is an exigent need for a database of dental caries and its spatial distribution for better planning and efficient delivery of health promotional and preventive programs. Geo-mapping is a helpful tool for policy makers/administrators for efficient allocation of limited resources.

Aims:

To geo-map spatial distribution of caries risk in preschoolers of Lucknow and to identify associated predisposing factors.

Settings and design:

A cross-sectional study was done among 1000 preschool children (3-5 years of age) attending pediatrics, outpatient department at a medical college in Lucknow, Uttar Pradesh.

Methods and Material:

Children were enrolled using the systematic random sampling. Each child was geo-coded with respect to his/her residence, clinically examined for dental caries and given a Decayed Missing Filled Tooth (DMFT) index score. A pre-tested questionnaire was used to collect socio-demographic data. Caries prevalence was geo-mapped using color codes.

Statistical Analysis Used:

Median DMFT scores were compared using Mann-Whitney and Kruskal-Wallis test. QQ plot/Shapiro-Wilk's test was used to check the normality of data.

Results:

Prevalence of caries was found to be 76%. 10% children had DMFT score of 4 and more. A significant difference in distribution of DMFT score was observed for gender, income levels and between wards. Wards closer to the center of Lucknow district had a higher prevalence of caries.

Conclusions:

Geo-mapping of caries prevalence gives a quick visual glance of specific areas vulnerable to caries and help deliver specific tailor-made services.

[Development and validation of a questionnaire on knowledge and personal hygiene habits in childhood (HICORIN®)]

OBJECTIVE

To develop and validate a questionnaire on the integral assessment of the habits and knowledge in personal hygiene in children between 7 to 12 years old in the educational, social and health environment.

DESIGN

Cross-sectional study for the validation of a questionnaire.

LOCATION

One primary and secondary school and one children's home in the Region of Murcia, Spain.

PARTICIPANTS

A total of 86 children were included (80 from a primary and secondary school; 6 from a children's home), as well as 7 experts.

MAIN MEASUREMENTS

Content validation by experts; qualitative assessment; identify difficulties related to some questions, item response analysis, and test-retest reliability.

RESULTS

After the literature search, 20 tools that included items related to child body hygiene were obtained. The researchers selected 34 items and drafted 48 additional ones. After content validity by the experts, the questionnaire (HICORIN®) was reduced to 63 items, and consisted of 7 dimensions of child personal hygiene (skin, hair, hands, oral, feet, ears, and intimate hygiene). After with the children some terms were adapted to improve their understanding. Only two items had non-response rates that exceeded 10%. The test-retest showed that 84.1% of the items had between very good and moderate reliability.

CONCLUSIONS

HICORIN® is a reliable and valid instrument that integrally assesses the habits and knowledge in personal hygiene in children between 7-12 years old. It is applicable in educative and social and health environments and in children from different socioeconomic levels.

Oral health care for children - a call for action

Oral health is a fundamental component of overall health. All children and youth should have access to preventive and treatment-based dental care. Canadian children continue to have a high rate of dental disease, and this burden of illness is disproportionately represented by children of lower socioeconomic status, those in Aboriginal communities and new immigrants. In Canada, the proportion of public funding for dental care has been decreasing. This financial pressure has most affected low-income families, who are also less likely to have dental insurance. Publicly funded provincial/territorial dental plans for Canadian children are limited and show significant variability in their coverage. There is sound evidence that preventive dental visits improve oral health and reduce later costs, and good evidence that fluoridation therapy decreases the rate of dental caries, particularly in high-risk populations. Paediatricians and family physicians play an important role in identifying children at high risk for dental disease and in advocating for more comprehensive and universal dental care for children.