Kamran Ramsha, Farooq Warda, Faisal Mehreen Riaz, Jahangir Faisal
Margalla Institute of Health Sciences, Quaid-e-Azam Avenue, Gulrez III, Rawalpindi, Pakistan.
Department of Community & Preventive Dentistry, Margalla Institute of Health Sciences, Quaid-e-Azam Avenue, Gulrez III, Rawalpindi, Pakistan.
BMC Oral Health. 2017 Jul 11;17(1):108. doi: 10.1186/s12903-017-0399-9.
The purpose of this study was to determine the prevalence and clinical effects of untreated dental caries in Pakistani children residing in orphanages using the DMFT and PUFA index; association of decay and untreated dental caries with demographics including type of orphanage; behavioural and dental visiting pattern; and association of dental pain experience and type of orphanage with dental visiting.
A cross-sectional survey was conducted on a total of 753 orphan children belonging to 4-17 years of age group residing in twin cities of Rawalpindi and Islamabad, Pakistan. Clinical examination of children was performed using the DMFT and PUFA index for the assessment of dental caries and untreated decay, followed by questionnaire enquiring about eating and oral hygiene habits, dental visiting pattern and dental pain and swelling experience. Association between dental decay, child's dental visiting and pain as a consequence of untreated decay was carried out using chi square test and logistic regression analysis.
The overall caries prevalence was 34.8% and overall prevalence of PUFA/pufa was 15.9%. The mean score of DMFT and dmft was 1.18 (SD 0.39) and 1.04 (SD 0.23), and mean PUFA was 1.18 (SD 0.57) and mean pufa score 1.14 (SD 0.35). Untreated caries ratio was found to be 49.1% indicating half the decay had progressed to involve the pulp. No significant association of gender was found with DMFT, dmft, PUFA and pufa (p > 0.05), however, when analysed individually, the 'D' component of DMFT was significantly associated with male gender (p = 0.05). Furthermore, no significant association of DMFT/dmft or PUFA/pufa in either dentition was found with behavioural characteristics such as dietary and oral hygiene habits. Also, 66.2% children who experienced pain had not been to the dentist in the past year (p = 0.013) and 52.6% children who mentioned experiencing pain at night had not been to the dentist in the past year (p = 0.009). Children with decay were more likely to have visited the dentist (OR 3.3, 95% CI 1.42-7.6, p = 0.006). However, children who reported to have experienced pain were less likely to have visited the dentist in the past year (OR 0.53, 95% CI 0.32-0.88, p = 0.014).
Moderate levels of decay were found in the sample with 'd' component majorly responsible for the cumulative DMFT index. However, alarmingly almost half of the decay component (49.1%) had progressed to involve the pulp. Experiencing pain in teeth prompted dental visits. Initiation of preventive services for children residing in orphanages in Pakistan would help greatly towards reducing the burden of untreated decay.
本研究旨在使用DMFT和PUFA指数确定居住在孤儿院的巴基斯坦儿童中未经治疗的龋齿患病率及其临床影响；龋齿和未经治疗的龋齿与人口统计学因素（包括孤儿院类型）、行为和看牙模式之间的关联；以及牙齿疼痛经历、孤儿院类型与看牙之间的关联。
对居住在巴基斯坦拉瓦尔品第和伊斯兰堡双城的753名4至17岁的孤儿进行了横断面调查。使用DMFT和PUFA指数对儿童进行临床检查，以评估龋齿和未经治疗的龋齿，随后通过问卷调查询问饮食和口腔卫生习惯、看牙模式以及牙齿疼痛和肿胀经历。使用卡方检验和逻辑回归分析来研究龋齿、儿童看牙与未经治疗的龋齿导致的疼痛之间的关联。
总体龋齿患病率为34.8%，PUFA/pufa的总体患病率为15.9%。DMFT和dmft的平均得分分别为1.18（标准差0.39）和1.04（标准差0.23），平均PUFA为1.18（标准差0.57），平均pufa得分为1.14（标准差0.35）。发现未经治疗的龋齿比例为49.1%，这表明一半的龋齿已发展到累及牙髓。未发现性别与DMFT、dmft、PUFA和pufa有显著关联（p>0.05），然而，单独分析时，DMFT的“D”成分与男性显著相关（p=0.05）。此外，在任何一种牙列中，均未发现DMFT/dmft或PUFA/pufa与饮食和口腔卫生习惯等行为特征有显著关联。此外，66.2%经历过疼痛的儿童在过去一年中未看过牙医（p=0.013），52.6%提到夜间疼痛的儿童在过去一年中未看过牙医（p=0.009）。有龋齿的儿童更有可能看过牙医（比值比3.3，95%置信区间1.42-7.6，p=0.006）。然而，报告有疼痛经历的儿童在过去一年中看牙医的可能性较小（比值比0.53，95%置信区间0.32-0.88，p=0.014）。
样本中发现龋齿程度中等，“d”成分是累积DMFT指数的主要原因。然而，令人担忧的是，几乎一半的龋齿成分（49.1%）已发展到累及牙髓。牙齿疼痛促使儿童去看牙医。在巴基斯坦为居住在孤儿院的儿童开展预防服务将大大有助于减轻未经治疗的龋齿负担。
