Prevalence of dental caries among learners with disabilities attending special education schools in the eThekwini District, KwaZulu-Natal

Abstract

IntroductionIndividuals with special healthcare needs may have poororal health as a result of systemic and structural issues that make it more difficult to maintain optimal oral healthstatus. As such, these individuals may require specialised, multidisciplinary oral healthcare. Furthermore, determiningthe severity of oral conditions among these people isnecessary to establish the number of people affected and the services required to improve oral healthcare for these affected populations. Aims and objectivesTo determine the prevalence of dental caries among learnerswith disabilities attending special schools education in theeThekwini district, using DMFT/dmft and PUFA/pufa indices.DesignA cross-sectional descriptive study design.MethodsA proportional stratified random sampling method was usedto select learners from 22 special schools in the eThekwinidistrict (n=435). The sample was divided into subgroups known as strata (schools) and a systematic sampling technique was used in each school. The learners were further categorised according to the classification of Special Health Care according to the Individuals with Disabilities Education Act (IDEA). Data collection comprised an intraoral examination to determine the prevalence of dental caries (using the DMFT/dmft index) and the extent of untreated dental caries using the PUFA/pufa index. ResultsOut of the 488 students in the special schools approached, 435 consented to participate in the study giving a response ate of 89.14%. The prevalence of dental caries in the permanent and primary dentition was 53.6% and 22.5% respectively. The overall D (decayed) component recorded in permanent teeth was 740 (88%), the F (filled) component was 30 (4%) and M (missing) component was 77 (9%). Females had higher mean DMFT and PUFA scores while males had higher dmft and pufa scores. The DMFT and dmft scores recorded were highest in the 18-20 years age group at 3.70 ± 3.83 and the 6-8 years age group at 4.31 ± 4.00 respectively. The relationship between the DMFT and dmft scores and participants’ age was seen as statistically significant, as these increased with age (p <0.001). The highest caries prevalence was found in the intellectual disability group (46.4%; n=393). The “untreated caries to PUFA ratio” was 2.5 to 1, indicating that 26% of the D + d component (in DMFT/dmft) had progressed mainly to pulpal involvement. The PUFA/pufa scores were higher in the 12- 14 years age group at 0.46 ± 1.33 and 6-8 years age group at 2.06 ± 3.45 respectively when compared to the other age groups in the study sample.ConclusionThe high number of dental caries recorded in the permanent and primary dentition and the low number of restored teeth in the study sample highlight the need for promotive, preventive and restorative oral healthcare programmes within this population.