摘要
Objective: To assess the prevalence, extent and risk factors of enamel defects in the primary dentition of 4-year-old Nigerian children.
Methodology: Three hundred and two healthy 4-year-olds were divided into 4 groups according to fluoride concentration in ground water supplies. Clinical dental examinations were undertaken under field conditions using dmft, modified Developmental Defects of Enamel (DDE) and Thystrup and Fejerskov indices. Samples of toothpaste, drinking and cooking water were analysed for fluoride concentration. Parents/legal guardians provided information on infant/childhood diseases, infant feeding and tooth cleaning practices. Descriptive analyses were undertaken and association between categorical variables were performed using chi-square. Differences between means (> 2 groups) were performed using ANOVA. Correlation and binary regression were also used as appropriate.
Results: The overall mouth prevalence of DDE was 77.8%, which was high. The mean (SD) number of teeth affected was 4.0 (3.33) teeth. Dental fluorosis mouth prevalence was 5.6% with a mean (SD) of 0.24 (1.26) teeth affected. Prevalence and extent of DDE and dental fluorosis were greater in higher water F area than lower water F area (p<0.001). A weak positive correlation was seen between extent of dental fluorosis and drinking water F concentration (ρ = 0.12). The amount of toothpaste used per brushing and fluoride toothpaste exposure were statistically significant predictors of dental fluorosis with Odd Ratio of 9.66 (CI = 1.28 – 73.16) and 0.03 (CI = 0.02 – 0.70) respectively.
Conclusion: The overall mouth prevalence of DDE was 77.8%, which was high. The mean (SD) number of teeth affected was 4.0 (3.33) teeth. The corresponding figures for dental fluorosis and dental caries were 5.6% and 0.24 (1.24) and 10.6% and 0.29 (1.07) respectively. There was an association between prevalence of DDE and dental fluorosis and fluoride concentration in water and a weak relationship between extent of dental fluorosis and fluoride exposure in drinking water. Other environmental factors such as a history of infant/childhood disease and fluoride toothpaste use were positive predictors of DDE and dental fluorosis respectively.
Keywords: Developmental enamel defects, dental fluorosis, dental caries, primary teeth, children, Nigeria
Résumé
Objectif: Pour évaluer la prévalence, l’étendue et les facteurs de risque de défauts d’émail dans la dentition primaire des enfants nigérians âgés de 4 ans.
Méthodologie: Trois cent deux enfants de 4 ans en bonne santé ont été divisés en 4 groupes en fonction de la concentration de fluorure dans les eaux souterraines. Des examens dentaires cliniques ont été entrepris sur le terrain en utilisant les indices dmft, de défauts du développement de l’émail (DDE) et de Thystrup et Fejerskov. Des échantillons de dentifrice, d’eau de boisson et de cuisson ont été analysés pour déterminer leur concentration en fluorure. Les parents / tuteurs légaux ont fourni des informations sur les maladies infantiles, l’alimentation de l’enfant et les pratiques de nettoyage des dents. Des analyses descriptives ont été entreprises et l’association entre les variables qualitatives a été réalisée à l’aide du chi-carré. Les différences entre les moyennes (> 2 groupes) ont été réalisées à l’aide d’une ANOVA. La corrélation et la régression binaire ont également été utilisées, le cas échéant.
Résultats: La prévalence globale du DDE dans la bouche était de 77,8% , ce qui était élevé. Le nombre moyen (ET) de dents touchées était de 4,0 (3,33) dents. La prévalence buccale de fluorose
dentaire était de 5,6% avec une moyenne (ET) de 0,24 (1,26) dents affectées. La prévalence et l’étendue de la DDE et de la fluorose dentaire étaient plus élevées dans les zones F à fort débit d’eau que dans les zones F à faible débit d’eau (p<0,001). Une faible corrélation positive a été observée entre l’étendue de la fluorose dentaire et la concentration de F dans l’eau de boisson (ρ = 0,12). La quantité de dentifrice utilisée par brossage et l’exposition au dentifrice au fluorure étaient des facteurs prédictifs statistiquement significatifs de la fluorose dentaire avec un rapport impair de 9,66 (IC = 1,28 - 73,16) et 0,03 (IC = 0,02 - 0,70) respectivement.
Conclusion: La prévalence globale du DDE dans la bouche était de 77,8% , ce qui était élevé. Le nombre moyen (ET) de dents touchées était de 4,0 (3,33) dents. Les chiffres correspondants pour la
fluorose dentaire et les caries dentaires étaient de 5,6% et 0,24 (1,24) et 10,6% et 0,29 (1,07) respectivement. Il existait un lien entre la prévalence du DDE et la fluorose dentaire et la concentration de fluorure dans l’eau et une faible relation entre l’ampleur de la fluorose dentaire et l’exposition au fluorure dans l’eau de boisson. D’autres facteurs environnementaux tels que des antécédents de maladie infantile / infantile et l’utilisation de dentifrice au fluorure étaient des prédicteurs positifs de la DDE et de la fluorose dentaire, respectivement.
Mots-clés: Défauts développemental de l’émail, fluorose dentaire, carie dentaire, dents primaires, enfants, Nigeria
Correspondence: Dr. O. Ibiyemi, Department of Periodontology and Community Dentistry, College of Medicine, University of Ibadan, Ibadan, Nigeria. Email: shola_ibiyemi@yahoo.com
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