Influence of socio-economic status on caries experience to schoolchildren from mining areas

Introduction Oral health is a crucial component of general health, because of the major impact of oral diseases on individuals, communities and society as a whole in terms of morbidity, mortality, quality of life and associated costs (Ţigăniuc et al 2011). The impact of oral diseases on individuals is reflected in their days lost at school and work, difficulty with eating, reduced self-esteem, poor quality of life, among other consequences (Lisboa et al 2013). Dental caries is the most prevalent oral disease and it remains the single most common disease of childhood that is not amenable to short-term pharmacological management (Katikireddi 2014). Dental caries are defined as a chronic destructive process which is developing lacking typical inflammatory phenomenon, resulting into necrosis of dental tissues, infection of dental pulp and apical area and possibly determining broad repercussions (Cocârlă 2000). Many factors influence the risk of developing dental caries, including environmental agents such as bacterial flora and fluoride exposure; behavioral factors including diet and oral hygiene; endogenous features such as tooth position and morphology, enamel composition, saliva composition and flow rate; and demographic characteristics such as age, sex, race, ethnicity, socio-economic status, parental education and access to oral health care (Shaffer et al 2012; Popoola 2013). In developed countries, higher prevalence of dental caries was found among the children of lower social class and lower prevalence in children of high socio-economic class (Malach et al 1995). As a general trend of the last decades a decrease in caries in the heavily industrialized country was observed. The presence of caries stays at significant levels within the disadvantaged social groups and some ethnical minorities (Luca 2003). In Romania, systematic information on the occurrence of oral diseases in children was considered in 1992 as being scarce (Petersen 1994). Some studies completed between 1986 to 1992, for children of 6 to 12 years old had shown that, for children of 7 years old, the prevalence of caries in temporary dentition was of 86%, whilst the prevalence of caries in permanent dentition was of 39%; contrariwise, the caries in permanent dentition of 12 years old children was of (Petersen 1994). A study completed more recently in Iaşi county established a prevalence of caries of 66,7% in adults of ages ranging from 35 to 44 year old. The highest caries index was observed in adults from rural areas or presenting low incomes. The study was completed in 2007 (Senciuc 2012). Most of the studies completed in Romania regarding oral health and the frequency of caries in school children have been Abstract. Objective: to determine the prevalence of caries in children of school age from rural, poor mining areas, from Western Romania and to highlight the impact of socio-economic status on caries experience in school children from areas as described above. Material and Method: the mining area of Roşia Montană was established as studying area. Roşia Montană mining area is an area situated in Western part of Alba County and is consisting of Roşia Montană Commune (16 villages), Abrud town and Bucium commune (29 villages). For comparison purposes another mining area namely Băiţa Bihor was considered, which encompasses the town of Nucet, Bihor county Romania. The study was a cross-sectional one comprising of 960 subjects with ages ranging from 7 to 14 years old, selected from the schools of the above mentioned mining areas. The children were dentally examined in the schools using a dental single use kit, in order to determine the DMFT index value. Individual data of each subject were collected on the basis of prior written agreement of parents or trustees to whom we have informed on the strictly scientific purpose of the whole approach. Likewise parents and/or trustees had filled in questionnaires regarding their education and standard of living. Results: we determined the values of DMFT index varying from 0 to 16 at an average value of 5.1. We observed significant ethnical variances regarding the DMFT index vales, as these values had higher values for minority (Romani) subjects compared with majority (Romanians) subjects. We observed that subjects without caries (DMFT=0) represented 1.15% of the whole batch and they were all majority (Romanian) population. If considering the influence of income level / standard of living on DMFT index evolution, we observed a decrease in index value as the level of income is higher, for subjects from majority population (Romanian); whilst for Romani population the level of income does have a minimum influence in DMFT index value. We observed that for most of the subjects, a lower family income level had a negative impact on dental caries prevalence to subjects. Conclusions: We emphasize the family environment and its socio-economic status as indicators of oral health in schoolchildren.