An Analysis of Gender Differences and Assessment of Oral Health Status among the General Population Residing in Kanyakumari District: A Pathfinding Scientific Study

ABSTRACT

Aim:

The aim of this study is to assess the prevalence oral health status among the general population residing in Kanyakumari district, Tamil Nadu, India.

Materials and Method:

A descriptive cross-sectional study was conducted among the general public of index age groups to analyze the oral health status in the Kanyakumari district. A total number of 400 samples were selected and were equally divided among urban (200 samples) and rural areas (200 samples). The samples were further divided randomly based on the index age groups 5, 12, 15, 35–44, and 65–74 years using the multistage random sampling method. The data regarding oral health status was recorded using the World Health Organization’s (WHO’s) Oral Health Assessment Form 2013 and 1997. Collected data were tabulated and analyzed using descriptive statistics and the Chi-squared test.

Results:

The prevalence of periodontal diseases (88.75%) was found to be highest in Kanyakumari district, followed by dental caries (63.7%) and malocclusion (63.1%). There was a statistically significant difference found between oral health status and index age groups.

Conclusion:

Oral disorders such as dental caries, periodontitis, and dental fluorosis are more prevalent among the Kanyakumari district population. Oral health policies should be targeted to the populations in the Tamil Nadu region.

INTRODUCTION

Oral health is crucial to general health and well-being. The oral cavity connects the external environment to the internal body environment. Oral disorders such as dental caries, periodontitis, oral cancer, malocclusion, and dental traumatic injuries have a significant influence on an individual’s general well-being.[1] Dental disorders are initially mild, but eventually become chronic and devastating, wreaking havoc on the body’s vital organs. Dental caries is one of the predominant biofilm mediated multi-factorial disease which formed dueto the demineralization of tooth surface.[2] It is increasingly essential to educate people on the preventative and therapeutic elements of oral health in order to improve their quality of life.[3] Kanyakumari district was formed November 1, 1956. It has an area of 1729.270352 km², with a population of 18,70,374 and with its district headquarters in Nagercoil.[4] Dental caries is an old illness that dates back to when agriculture supplanted hunting and gathering as the primary source of food, although its frequency and severity were far lower than what we see now. Despite recent data indicating a drop in the trend of dental caries throughout many developed countries, mostly due to the usage of fluorides in various forms. Due to a lack of public knowledge and motivation, insufficient resources for modern dental treatments, and changing food patterns, it remains a disease with a high tendency in many undeveloped and emerging nations of Africa and Asia, including India. Indeed, fluoride usage is regarded as one of the most effective caries prevention strategies in public health history .However, “fluoride is commonly referred to as a double-edged weapon” since optimum and sensible administration provides maximum caries prevention, but injudicious and excessive systemic absorption can lead to chronic fluoride toxicity, manifesting as dental and skeletal fluorosis.[5] According to the World Health Organization (WHO) statistics, caries prevalence among 12-year-old children in numerous countries in the European Union (EU) has reduced significantly between 1970 and 2006. This decrease in caries prevalence among EU nations during a 35-year period may be linked to improved knowledge of oral hygiene and the use of fluoridated toothpaste.[6] Periodontal disease trends have changed rapidly across the world. Periodontitis is one of the most common chronic disorders in the world. Personal risk factors, like a sedentary lifestyle and bad psychosocial situations, have been implicated in the genesis of adult periodontitis.[7] The age group 35–44 years was taken for the present study, indicating that this age was suitable for the surveillance of oral health conditions in adults, and also the full effect of the level of severe periodontal disease could be assessed. Malocclusion is “any deviation from normal tooth occlusion.” The teeth are in an aberrant position in regards to the alveolar process’s basal bone, neighbouring teeth, and/or opposing teeth.[8] The etiology of malocclusion is multifactorial: hereditary factors affect dentofacial anatomy, and environmental variables such as habits can cause malocclusion during growth and development.[9] A previous study conducted in Kanyakumari district among the 6–12 years group reported that 77% of the children were affected by dental caries.[10] Another study reported the prevalence of dental fluorosis among 11–15-year-old school children of Kanyakumari district to be 15.8%.[11] Data are available only for dental fluorosis and dental caries only in the age group varying between 6 and 15 years. The general population has not been of focus yet; hence this study aimed to assess the prevalence of oral health status among the general population residing in Kanyakumari district, Tamil Nadu, India.

MATERIALS AND METHODS

A study on the prevalence of oral health status among the general population of Kanyakumari district was conducted. Ethical approval for the study was obtained from the Department of Public Health Dentistry, SRM Dental College, Ramapuram, Chennai. A total of 400 members of the general population were taken for the study, with the age group of 5, 12, 15, 35–44, and 65–74 years. In each age group, the sample was divided into rural and urban, which was further divided into male and female. Consent was obtained from the participants in the written form. The subjects were examined in adequate natural light. Intra-examiner reliability was >0.81 using kappa statistics. Sample size calculation was done using G Power software with effect size of 0.5 and the power of the study at 80%. The samples were obtained from various parts of urban and rural areas in Kanyakumari district based on multistage random sampling method and for a period of two months between April 2022 and May 2022.The inclusion criteria of this study were those who resided in Kanyakumari district for more than seven years and who were physically and mentally fit. The subjects who were not interested in participating and those who were not ready to give the consent form were excluded from the study. Oral health status was examined using the WHO proforma of 1997 and 2013 with the age significance for all the disease. Malocclusion was evaluated for the age group of 12 and 15 years. Dental caries and dental trauma were evaluated for all the age groups. Periodontitis was evaluated for the age group 35–44 years. Oral mucosal lesion (OML) was evaluated for the age group 65–74 years. Fluorosis was evaluated for the age group of 12 and 15 years. Dental erosion was evaluated for the age group of 12, 15, 35–44, and 65–74 years. Statistical analysis was done using IBM SPSS Statistics version 26. The data were then analyzed using descriptive statistics and the Chi-squared test.

RESULTS

Table 1 represents the distribution of oral health status among the index age groups and their gender. Statistically significant differences were found between oral health status and index age groups.

Table 1.

Prevalence of oral health status among the index age groups and the gender

Oral health status	Dental caries	Dental trauma	Dental erosion	Periodontitis	Malocclusion	OML	Dental fluorosis
Gender
Male	121 (60.5)	47 (23.5)	84 (42)	35 (17.5)	90 (45)	9 (4)	26 (13)
Female	134 (67.0)	35 (18.5)	95 (47.5)	36 (18)	99 (49.5)	8 (4.5)	27 (13.5)
P	0.176	0.369	0.269	0.896	0.367	0.589	0.451
Index age groups
5 years	46 (57.5)	19 (23.75)
12 years	47 (58.75)	13 (16.25)	17 (21.25)		49 (61.25)		26 (32.5)
15 years	42 (52.5)	13 (16.25)	57 (71.25)		52 (65)		27 (33.75)
35-44 years	56 (70)	19 (23.75)	51 (63.75)	71 (88.75)		8 (10)
65-74 years	64 (80)	16 (20)	54 (67.5)			9 (11.25)
P	0.002*	0.045*	0.0001*	0.0001*	0.0001*	0.001*	0.0001*

*P<0.05 is considered as statistically significant

DISCUSSION

With the age significance, we evaluated the oral health status among index age groups. In the current study, the prevalence of malocclusion was found among children aged 12 years (61.25%). This was similar with the study by Hemapriya et al.[12] that stated that 75% of children belonging to the age group of 10–12 years had malocclusion. The current study states that the prevalence of periodontal disease was found to be 88.75% among people belonging to the age group 35–44 years. This was found to be highest when compared to the study conducted by Malakar et al.[13] that discussed the prevalence of periodontal disease and oral hygiene practices among people in the Kanchipuram district and concluded that the prevalence of periodontal disease was 36%, which was lowest when compared with the present study. Another study conducted by Vishnuprasad et al.[14] stated that periodontal disease was 39.3%, which was also lower compared with the current study. The prevalence of periodontal disease was highest in the current study compared with other districts in India. The study conducted by Janakiram C et al.[15] stated that the overall prevalence of periodontal disease in India was found to be 51%, which was the lowest when compared with the present study. The current study states that the prevalence of dental caries was 63.75% and the prevalence of dental caries was found to be highest among the index age group 35–44 years (70%), and it was low among the age group 65–74 years (80%). This was in contrast with the study conducted by Pandey et al.[16] that stated that the prevalence of dental caries was found to be 62% among people aged 18 years and above. Prevalence of dental caries in the aforementioned study was lowest when compared with the current study. Another study conducted by Parasuraman et al.[17] discussed the distribution of dental caries among people in Tamil Nadu and concluded that prevalence of dental caries was 63.9%. However, the study results were found to be the lowest compared with the present study. The overall prevalence of dental caries among all age group in the present study was 63.75%, which is in contrast with the systematic review and meta-analysis conducted by Pandey et al.[16] that stated the overall distribution of dental caries in the Indian population to be 54.16%. The prevalence of dental fluorosis in the current study among 12- and 15-year-old children was 33.125%, which was in contrast with the study conducted by Baskaradoss JK et al.[11] and their prevalence rate was 15.8% among 11–15-year-old children in Kanyakumari district. The prevalence of OML in the present study was 10.62% which was closely related to the study conducted by Vijayabala et al.[18] and their prevalence rate of OML in dental patients in Tamil Nadu was 12.31%. Fluorosis affects approximately 62 million individuals in India, with dental fluorosis affecting 80%. Tamil Nadu is one of the 18 impacted states by fluorosis.[19]

CONCLUSION

Oral diseases such as dental caries, periodontitis, and dental fluorosis are more prevalent among the Kanyakumari district population. Oral health policies should targeted these populations in the Tamil Nadu region. Hence the public health dentist should be recruited as a district oral health officer for formulating a meticulous plan to solve the community dental problem.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.