Dental caries, Oral health and lifestyle variables – reflection from Qatar Mohammed Sultan Al-Darwish BDS, MSc, GBOI, DICOI President, Qatar Dental Society
Qatar Geodemographical features • Qatar is a peninsula located halfway down the west coast of the Arabian Gulf. • The total land area of Qatar is approximately 11,521 square kilometers. • The total population were 1,920,798. Qatar
Dental caries • Dental caries currently represents the most common chronic disease among children. • It is defined as a multi-factorial infectious disease caused by plaque bacteria, as a by-product of their metabolism of fermentable carbohydrates, which then diffuse into dental hard tissues and dissolve their mineral contents (Featherstone et al., 2008). • It is five times more common than asthma and seven times more common than hay fever (Report of the surgeon General, 2000). Dental Caries
Study • Between September 2011 till March 2012 the first to study the prevalence of dental caries was conducted. • The study showed a data on dental caries among 12-14 years school children in Qatar. • Three dentists with previous experience in epidemiological surveys of dental caries were invited to participate in this study. • Inter and intra-examiner reliability was measured through Kappa statistics between the three dentist.
Study • A total of 2113 school children out of 2200 completed the study, 1125 (53%) were males and 988 (46.8%) were females. Out of the study population 698 (33%) belong to the age 12 years, 706 (33.4%) belong to the age 13 years and 709 (33.6%) belong to the age 14 years. About 1293 (61.2%) were Qatari and 820 (38.8%) were Non-Qatari.
Dental caries in Qatar • In Qatar, the oral health system is in transitional development stage, despite the great expansion in the dental services, dental caries still remain a problem in the large section of the population. • The study shows that the prevalence of dental caries among 12-14 years old school children in Qatar 85%. Indicating that the caries free children is only 15%.
Dental caries in Qatar • The mean DMFT value is 4.62 (±3.2), 4.8 (±3.5), and 5.5 (±3.7) for the 12, 13 and 14 years children respectively. This is indicated that as the age of the children increased from 12 to 14 years, dental caries increased. • The DMFT values in Qatar reaches a very serious level, it falls within a “high” category (DMFT 4.5-6.5) as define by the WHO (1988), and are greater than the global goal “recommended level of the WHO of three or less decayed, missing or filled teeth for the year 2000”.
Dental caries in Qatar • Furthermore, female children had a higher mean DMFT value 5.23 (±3.6) than male children 4.74 (±3.4). This could be due to dietary habits and frequent snacking of female children during food preparation. The observation of higher caries risk among females could be also related to fluctuating hormonal levels during puberty (Lukacs et al., 2006).
Bar diagram showing mean DMFT among 12-14 year old school children across male and female. Dental caries in Qatar
Moreover, the decay component (DT) was the major contributor in the DMFT value in this population. This is in consistent with the results of other studies conducted on similar age groups (Al-Sadhan et al.,2006; Nurelhuda et al., 2009). Dental caries in Qatar
Oral health attitude • Majority of the children 99.4% consuming sugar containing snacks (candy, soft drinks, chocolate, jelly, ice cream, cookies) in-between meals. • Almost 32.5% of the children only visited their dentist when they had dental pain. • Parents are the most popular 69% source of oral health information for the children followed by dentists 8.6%, school teacher 5 % and media 3%.
Oral health attitude • A large number of children were not aware of the cariogenic potential of soft drinks 824 (39%). • Less than half 822 (39%) of the children actually had heard about fluoride and only 506 (24%) correctly identified the action of fluoride as preventing tooth decay.
Oral health attitude • Slightly less than half 1022 (48.4%) of the children couldn’t define the meaning of the plaque and only 761 (36%) could recognized that the dental plaque can lead to tooth decay. • In all, 1037 (49.1%) of the children skipping eating breakfast on daily basis.
Recommendation • Implementation of community-based preventive oral health programs on healthy diet and practices of adequate oral hygiene should be promoted in schools through integration into the school curriculum and services to combat the growing problem of dental caries.
Recommendation • The dental profession has an important role to play in shaping the future of oral health. The profession intervention is needed for development of healthy lifestyles, such as healthy diet low in sugars and personal hygiene, effective use of fluoride, and development oral health system that is oriented toward oral disease prevention and health promotion.
Recommendation • Awareness on the importance of oral health need to be enhanced among school children in Qatar. The optimal way to raise children’s oral health awareness would be to furnish accurate information to parents and school teachers. Parents and school teachers should be invited regularly for presentations on oral and general health.
Recommendation • The need to reduce sedentary behaviors and to promote a more active and healthy lifestyle becomes essential. Clinicians and public health interventionists should encourage active lifestyles and healthy environments to balance the energy intake of children.