Dental Caries (DMFT/dmft) and Oral Hygiene (OHI-S) Among 6–12-Year-Old Government School Children: A Survey

Dental caries is the most common chronic disease of childhood, and in India it often goes untreated in children attending government schools, where families have limited access to dental care. School surveys are the standard way public health dentistry departments measure the problem and plan preventive programmes such as supervised tooth-brushing, pit-and-fissure sealant camps and oral-health education.

This project is a cross-sectional school-based oral-health survey of about 300 children aged 6–12 years in government primary and higher-primary schools near the dental college. Two BDS students, trained and calibrated by the guide, examine each child under natural light with plane mouth mirrors and CPI probes, following the WHO Oral Health Surveys: Basic Methods (5th edition) diagnostic criteria. Caries experience is recorded as dmft for primary teeth and DMFT for permanent teeth, and oral hygiene is measured with the Simplified Oral Hygiene Index (OHI-S) of Greene and Vermillion. A short questionnaire records brushing frequency, dentifrice use, snacking between meals and previous dental visits.

Results are analysed in SPSS to report caries prevalence, mean dmft/DMFT, the care index, OHI-S grades and their associations with age, gender and oral-hygiene habits. Every child receives oral-health education, and those needing treatment are referred to the college's Department of Pedodontics with a referral card. The study fits the DCI BDS Public Health Dentistry community-survey slot and can also be submitted as an ICMR-STS proposal.

Abstract

A cross-sectional survey will be carried out among 300 children aged 6–12 years in government schools to assess the prevalence of dental caries and oral-hygiene status. Examinations will follow WHO Basic Methods (5th edition) criteria by two calibrated examiners. Caries will be recorded with dmft and DMFT and oral hygiene with OHI-S. Associations with age, gender and oral-hygiene practices will be tested with chi-square, t-test and ANOVA.

Introduction

Caries in primary teeth causes pain, infection, missed school days and early loss of space for permanent teeth. The first permanent molars erupt around six years of age and are highly vulnerable in the following years. Oral hygiene is closely linked to caries and gingivitis, and school-age children are an ideal target for prevention because habits are still forming and schools provide organised access.

Review and gap

Indian school surveys report widely varying caries prevalence depending on region, diet, fluoride exposure and examination criteria. Many studies do not state examiner calibration or use non-standard criteria, making comparison difficult. There is no recent local data for the schools in the college's outreach area.

Proposed work

• Calibrate two examiners against the guide using WHO criteria and calculate kappa.
• Examine children by stratified random sampling across age groups.
• Record dmft/DMFT, OHI-S and a short behaviour questionnaire.
• Provide oral-health education and referral for treatment needs.

Expected outcome

The survey will give school-wise and age-wise estimates of caries prevalence, mean dmft and DMFT, the care index and OHI-S grades, identify habits linked with poor oral health, and produce a referral list so that affected children actually reach treatment at the college.

Feasibility

• Access: schools in the outreach area already cooperate with the department's camps.
• Resources: mirrors, probes, gloves and sterilisation from the department; forms printed in-house.
• Time: 25–30 children per school day; data collection in four weeks.
• Ethics: IEC approval, Block Education Officer and headmaster permission, parental consent and child assent.

Government schools in the dental college's outreach area serve children from low-income families who rarely visit a dentist until they are in pain. The Department of Public Health Dentistry conducts camps, but it has no recent, standardised data on how many children have caries, how much of it is untreated, and how poor their oral hygiene is. Without such baseline figures, preventive programmes cannot be prioritised or evaluated.

This study aims to measure the prevalence and severity of dental caries (dmft/DMFT) and oral-hygiene status (OHI-S) among 6–12-year-old government school children using WHO-standard methods, to identify associated behaviours such as brushing frequency and between-meal snacking, and to provide treatment referral and education, giving the department and schools a baseline for targeted preventive action.

In scope

• Children aged 6–12 years in selected government schools with parental consent and child assent.
• Clinical examination for caries (WHO Basic Methods 5th ed.) and OHI-S; a short behaviour questionnaire answered by the child with teacher support.
• Descriptive and analytic statistics; education and referral.

Out of scope

• Radiographs, caries-activity tests or salivary analysis.
• Treatment within the survey (children are referred to the college).
• Private schools and children under 6 years (future comparison).

Study design: descriptive cross-sectional school-based survey.

Setting and duration: government primary and higher-primary schools in the outreach area of the dental college; 12 weeks (weeks 1–3 approvals and calibration, weeks 4–8 examinations, weeks 9–12 analysis and report).

Sample size: assuming caries prevalence of 55% from Indian school studies, absolute precision of 6% and 95% confidence, n = Z²pq/d² = (1.96² × 0.55 × 0.45)/0.06² ≈ 264. Adding 10% for absentees and refusals gives about 290; the study examines 300 children.

Sampling: list of government schools from the Block Education Office; four schools selected by simple random sampling; within each school, children stratified by age (6–8, 9–10, 11–12 years) and selected by systematic random sampling from class registers.

Inclusion criteria: children aged 6–12 years present on the examination day, with signed parental consent and verbal assent.

Exclusion criteria: children with systemic illness or special health-care needs requiring a different examination setting, those undergoing orthodontic treatment, and uncooperative children.

Examiner calibration: both examiners are trained by the guide and examine 20 children twice, one week apart; intra- and inter-examiner agreement assessed with Cohen's kappa (target ≥ 0.8).

Examination: child seated on an ordinary chair facing natural light; plane mouth mirror and CPI probe; WHO 5th-edition codes for crown status; dmft for primary and DMFT for permanent teeth. OHI-S: debris and calculus index on six index teeth (16, 11, 26, 36 buccal/labial; 31 labial; 46 lingual), scores 0–3 each; OHI-S = DI-S + CI-S; graded good (0.0–1.2), fair (1.3–3.0), poor (3.1–6.0).

Questionnaire: brushing frequency, aid and dentifrice, between-meal sweets, previous dental visit.

Ethics: IEC approval; permission from the Block Education Officer and headmasters; written informed consent from parents in the local language and verbal assent from children; only a study number is recorded; infection control per standard precautions; ICMR National Ethical Guidelines (2017) for research with children.

Statistical analysis: SPSS. Prevalence with 95% CI; mean ± SD of dmft, DMFT and OHI-S; care index = F/DMFT × 100; independent t-test (gender), one-way ANOVA (age groups), chi-square (caries vs practices), Pearson or Spearman correlation between OHI-S and DMFT; p < 0.05.