Rajiv Gandhi University of Health Sciences, Karnataka s12

Rajiv Gandhi University of Health Sciences Bangalore, Karnataka

M.D.S Public Health Dentistry

Synopsis for the Registration of Dissertation

M.R. Ambedkar Dental College & Hospital # 1/36, Cline Road, Cooke Town Bangalore – 05 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECT FOR DESSERTATION

1. Name of the candidate and the Dr. PALLAVI V. JUGALE address Dept. Of Public Health Dentistry M. R. Ambedkar Dental College & Hospital #1/36, Cline Road ,Cooke Town Bangalore-560005 2. Name of the institution M. R. Ambedkar Dental College and Hospital No. 1/36 Cline road, Cooke Town Bangalore – 560005 3. Course of study and subject M.D.S (Public health Dentistry)

4. Date of admission to the course 9nd June , 2010

5. Title of the topic “TO ASSESS AESTHETIC PERCEPTION

OF DENTAL FLUOROSIS AND DENTAL

CARIES PREVALENCE AMONG 13-15

YEAR SCHOOL CHILDREN OF

SATHANUR, KANAKAPURA.”

6. Brief resume of intended work:

6.1. Need for Study Fluorine, a member of halogen family, is essential for normal growth and development of human body. But excessive intake leads to skeletal and dental fluorosis.

Dental fluorosis affects color and form of teeth, leading to feeling of unattractiveness or negative perception among the affected.1

Perception is a psychology and cognitive science. Thus, negative perception of dental fluorosis has an ill impact on psychosocial well-being of the children.2

The dissatisfaction for appearance of teeth due to dental fluorosis increased with severity of discoloration1. The ratio was greater in children than their parents (1.7 times) and dentists (3.7 times). 3 Also, the acceptance of unsatisfactory looks may grow with age.4

Moreover, fluorosis indices do not focus on aesthetic perception; the major consequence of dental fluorosis.3

Fluoride is said to have cariostatic potential.5-6 Children residing in non-fluoridated area and entering their teenage, showed increase in caries level. Thus, the difference between fluoridated and non- fluoridated groups became more pronounced.7 However some epidemiological studies have not determined the prevalence of dental caries in relation to fluoride exposure.8-9

Hence a study to assess the aesthetic perception of dental fluorosis and prevalence of dental caries among 13-15 year old school children in Sathanur, Kanakapura is undertaken.

6.2. Review of Literature

Selwitz Robert et al10 (1998) A convenience sample (n=495) of age specific children (8-

10 year and 13-16 year old) was taken for the study. The mean DMFS was significantly lower in Kewanee (1.8) than Holdrege (2.9) and Broken Bow (3.6). Similarly, the mean DS score showed the same increasing trend; Kewanee (0.8, P=0.000), Holdrege (1.0, P=0.004) and Broken Bow (1.6). The percentage of children caries- free in permanent dentition varied from Kewanee (51.9%), Holdrege (39.8%) and Broken Bow (25.2%). Findings of this study suggest that water fluoridation is beneficial. Shulman JD et al3 (2004) In a longitudinal study among 8,281 children, dental examination was done to score TFI. A reference statement was asked to the subjects, dentists (raters) and parents to know the aesthetic appearance of anterior teeth of the subject. Of 2,495 subjects, 789 (31.6%) were dissatisfied with their tooth colour. Fluorosis was cited as a reason for dissatisfaction by 92 subjects (11.7%), whereas 71 (9%) were uncertain of the reason. Of 2,495 parents, 479 (19.2%) were dissatisfied with their child’s tooth colour. The dissatisfaction ratio of children was greater than their parents (1.7 times) and dentists (3.7 times). Girls were more critical about their colour of teeth than boys.

Dentists appeared to be less critical of mild to moderate degrees of fluorosis by threefold.

Leuckel Meyer11 (2006) A cross sectional study to investigate the caries and fluorosis in 3 communities, Tehran (higher SES), Semnan (lower middle class) and Dibaj (village) was conducted. Data was obtained from 523 dental examinations. A higher prevalence of dental fluorosis (TSIF score 3-7) was observed in naturally fluoridated towns as compared with lower- fluoridated communities. The deciduous molars accounted for increased dmfs/dfs score (occlusal=35-55%, buccal/ lingual=35-40%). The ingestion of naturally fluoridated water (1.3mgF/L) seemed to have negligible effect on caries prevalence, but resulted in higher prevalence of dental fluorosis.

Marcelo et al12 (2007) has showed in his study among school children that the children did not show negative perception of dental fluorosis, except for dental fluorosis at severe level.

(TF score 7-9). The sample consisted of 401 school children selected by random sampling at 2 stages. Firstly, clinical examination was performed followed by self administered perception questionnaire consisting of 3 questions. The prevalence rate of fluorosis was

18.2%. Almost 48.9% school children had self perception of having oral health problems; of which 15.4% reported that it was due to stained teeth; even though they were not able to correlate it to dental fluorosis

6.3 Objectives of the Study

 To assess the aesthetic perception of dental fluorosis and caries prevalence among

13-15 year school children of Sathanur, Kanakapura Taluk.

 To assess the prevalence of dental caries.

 To correlate the relationship between dental fluorosis and dental caries.

7. Methodology

7.1. Source of Data Higher secondary school children in all the schools from selected 7 villages of Sathanur hobli are the source of data.

7.2. Methods of Collection of Data

In a cross sectional study among 1002 children of age 13-15 year old from all the schools of Sathanur Hobli are selected by area sampling technique. A self administered questionnaire will be used to collect data regarding their aesthetic perception of dental fluorosis. A pilot study in a sample of 52 students has already been conducted to validate the designed questionnaire.

Dental examination will be conducted in daylight. TSIF (Tooth Surface

Index of Fluorosis) will be scored to grade the severity of dental fluorosis. The presence or absence of dental caries will be assessed by DMFT/DMFS scores. The results will be analyzed using appropriate statistical analysis (Descriptive and Inferential statistics).

7.2. Does the study require any investigations to be conducted on patients or other human/animals? NO.

7.3. Has ethical clearance been obtained from your institution in case of 7.3?

8. List of References

1) Alkhatib N, Holt R, Bedi R. Aesthetically Objectionable Fluorosis in United Kingdom. Int Dent J 2004; 197:325-28. 2) Whelton HP, Ketley CE, McSweeny F et al. A review of fluorosis in the European Union: Prevalence, risk factors and esthetic issues. Community Dent Oral Epidemiol 2004; 32 (suppl-1): 9-18. 3) Jay D Shulman, Gerardo Maupome, D Christopher Clark, Steven M Levy. Perceptions of Desirable tooth color among parents, dentists and children. J Am Dent Assoc 2004; 135: 595-604. 4) Van Palestein Helderman WH, Mkasabuni E. Impact of dental fluorosis on the perception of wellbeing in an endemic fluorosis area in Tanzania. Community Dent Oral Epidemiol.1993; 21: 243-4 5) Richards LF, Westmoreland WW, Tashiro M, McKay CH, Morrison JT. Determining Optimum Fluoride Levels for Community Water Supplies in Relation to Temperature. J Am Dent Assoc 1967; 74:389-397. 6) Driscoll WS, Horowitz HS, Meyers RJ, Heifetz SB, Kingman A, Zimmerman ER. Prevalence of Dental Caries and Dental Fluorosis in areas with optimal and above- optimal water fluoride Concentrations. J Am Dent Assoc 1983; 107: 42-47. 7) E Crowley, D. O’Mullane, M Donaldson, V. Kelleher, H Whelton and M. Cronin. Dental Caries and Enamel Fluorosis among the fluoridated and non- fluoridated populations in the Republic of Ireland in 2002. Community Dent Health 2004; 21: 37- 44. 8) Ismail A I, Bordeur JM, Kavanagh M, Boisclair G, Tessier C, Picotte L. Prevalence of Dental Caries and Dental Fluorosis in students, 11-17 years of age, in fluoridated and non- fluoridated Cities of Quebec. Caries Res 1990; 24:290-297. 9) Riordon PJ. Dental fluorosis, dental caries and fluoride exposure among 7-year-olds. Caries Res 1993; 27:71-77. 10) Robert H.Selwitz, Ruth E.Nowjack-Raymer, Albert Kingman, William S.Driscoll. J Public Health Dent 1998; 58(1):28-35. 11) Meyer Lueckel H, Paris S, Shirkhani B, Hopfenmuller W, Kielbassa AM. Caries and fluorosis in 6- and 9-year-old children residing in three communities in Iran. Community Dent Oral Epidemiol 2006; 34:63-70. 12) Marcelo C. Meneghim, Fabio C. Kozlowski, Antonio C.Pereira, Andrea V.Assaf and Elaine P.S.Tagliaferro. Perception of dental fluorosis and other health disorders by 12 year old Brazilian children. Int J Paediatr Dent 2007; 17:205-210.

SIGNATURE OF THE CANDIDATE

REMARKS OF THE GUIDE NAME AND DESIGNATION OF DR. PRAMILA M. THE GUIDE PROFESSOR AND HEAD, DEPARTMENT OF COMMUNITY DENTISTRY, M.R. AMBEDKAR DENTAL COLLEGE, BANGALORE SIGNATURE OF THE GUIDE

CO-GUIDE (if any) DR. UMASHANKAR G.K READER, DEPARTMENT OF COMMUNITY DENTISTRY, M.R. AMBEDKAR DENTAL COLLEGE, BANGALORE SIGNATURE

HEAD OF THE DEPARTMENT DR. PRAMILA M. PROFESSOR AND HEAD, DEPARTMENT OF COMMUNITY DENTISTRY, M.R. AMBEDKAR DENTAL COLLEGE, BANGALORE SIGNATURE

REMARK OF THE CHAIRMAN & PRINCIPAL

SIGNATURE