Zahngesundheit bei 12-Jährigen und Zusammenhänge mit unabhängigen Variablen unter Berücksichtigung zweier unterschiedlicher Indizes zur Kariesdiagnose

Ziel der vorliegenden Studie war es zu überprüfen, wie sich verschiedene unabhängige Variablen auf die Entstehung von initialkariösen Läsionen und von Dentinkaries bei 12-Jährigen aus Schulen des Landkreises Marburg-Biedenkopf (Hessen) auswirken. 270 Schüler wurden durch einen kalibrierten Zahnarzt...

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Bibliographic Details
Main Author: Petrakakis, Pantelis
Contributors: Jablonski-Momeni, Anahita (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2012
Online Access:PDF Full Text
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Table of Contents: The objective of this study was to assess how various independent variables would influence incipient and established carious lesions in 12-year old pupils of schools in the district of Marburg-Biedenkopf (Hassia). The sample of the study consisted of 270 pupils and the participation was 51.4 %. The children were clinically examined by a calibrated dentist after they and their parents both had given their informed consent for the participation in the study. Caries scores were recorded using the DMF-T-Index and the ICDAS-II-Score on the following levels: D3+4MF-T, D1+2F-S (incipient caries), D1-6F-S (incipient and dentinal caries), D3-6F-S (dentinal caries according to ICDAS-II-Score) and D5+6F-S (dentinal caries according to the WHO-Index). Teeth with pit and fissure sealants also were recorded. Preventive measures with effects on dental health were as follows: dental health and nutritional behavior and also dental health and nutritional knowledge of parents and children, migration and socioeconomic status and school based preventive measures carried out in the past. Information about these variables was collected using a structured questionnaire. Mann-Whitney U-Test was used to evaluate differences of the mean caries scores. Bivariate and binary logistic regression analyses were performed to estimate the effects of the independent variables on the different caries values. The level of significance was set on α=0.05. 75.6 % of the children were recorded as caries-free on the D3+4MF-T level. The mean ICDAS-II D1+2-S score were 0.77 and the mean D1-6-S score were 0.88. The mean D3+4MF-T score was 0.56. 69.6 % of the 12-year-olds had at least one tooth provided with a pit and fissure sealant. Children with pit and fissure sealants and children attending the Gymnasium had significantly less incipient and dentinal carious lesions than children without sealants and children attending schools with a lower educational level. Bivariate analysis showed no significant correlations between the frequency of daily oral hygiene and the beginning of tooth-brushing in infancy. The intake of fluoride supplements, fluoridated salt and the local application of fluoride varnishes also had no significant effect on the permanent dentition’s health. Children whose parents showed good health and nutritional literacy had less carious lesions (D1+2F-S: p=0.049; D1-6F-S: p=0.043). Socio-economic status also had a significant influence on both incipient and incipient/dentinal carious lesions (D1+2F-S: p=0.003; D1-6F-S: p=0.003). Ethnical back-ground showed a significant influence on incipient and dentinal caries (D1+2F-S: p=0,033; D1-6F-S: p=0,025; D3-6F-S: p=0,011; D5+6F-S: p=0,021; D3+4MF-T: p=0,021). Binary logistic regression analysis also revealed significant associations between eth-nical background, socio-economic status and caries prevalence in the permanent dentition (ethnical background: D3+4MF-T: p=0.005; OR=0.35; D3-6F-S: p=0.004; OR=0.39; D5+6F-S: p=0.017; OR=0.46; socio-economic status: D1+2F-S: p=0.005; OR=0.47; D1-6F-S: p=0.005; OR=0.47). The findings of the current study implicate the utilization of sensitive caries scoring-systems in populations with low caries prevalence to enable the recording of caries in an early stage of development. By means of the assessment of early carious lesions and the determination of group-specific risk-factors appropriate preventive measures can be planned in a medically sensible manner and be already implemented at an early stage of caries formation.