|Year : 2020 | Volume
| Issue : 2 | Page : 85-89
Prevalence of premature loss of primary teeth among children in Dammam city and parents' awareness toward space maintainers
Laila Abdulwahab AlMeedani1, Hebah Zaki Al-Ghanim2, Noor Ghazi Al-Sahwan3, Sukainah Abdulwahab AlMeedani4
1 Department of Pediatric Dentistry, Dammam Medical Complex, Ministry of Health, Al-Khobar, Saudi Arabia
2 Department of Dental, Private Dental Clinic, Al-Khobar, Saudi Arabia
3 Department of Dental, Private Dental Clinic, Dammam, Saudi Arabia
4 Department of Dental, King Abdullah Medical Complex, Jeddah, Saudi Arabia
|Date of Submission||02-Feb-2019|
|Date of Decision||17-Jun-2019|
|Date of Acceptance||18-Feb-2020|
|Date of Web Publication||16-Jun-2020|
Dr. Sukainah Abdulwahab AlMeedani
Dammam Medical Complex, Ministry of Health, P. O. Box 91261, Dammam 32632
Source of Support: None, Conflict of Interest: None
Context: Premature loss of primary teeth is one of the most prevalent dental problems affecting children worldwide. It is commonly caused by dental caries and trauma. Parents are responsible for their children's oral health and should pay close attention to the consequences of space loss.
Aims: The aim of this study is to assess the prevalence of premature loss of primary teeth among children in Dammam city, Saudi Arabia and evaluate the parents' awareness toward space maintainers.
Settings and Design: A cross-sectional study was planned to randomly select children aged between 4 and 9 years who attend governmental and private clinics in Dammam city.
Materials and Methods: WHO criteria (WHO 1997) were used to examine decay-missing-filled index and premature loss of primary teeth. Questionnaires were distributed by hand to the parents of selected children to explore their demographic data and their awareness toward space maintainers.
Statistical Analysis: Descriptive statistics were used to describe and summarize data collected numerically by SPSS version 20.0. The level of statistical significance was set at P < 0.05. Data from the questionnaires were analyzed using the following: frequencies, percentages, cross-tabulation, and Chi-square tests.
Results: The mean dmf of the participated children in the study was 2.24 (standard deviation = 2.08). The prevalence of premature loss of primary teeth of the selected children was 20%. Only 37 (18.5%) out of 200 parents were aware about space maintainers.
Conclusions: The current study revealed a high prevalence of premature loss of primary teeth among children in Saudi Arabia. The parents were unaware about the space maintainer, its used, maintenance, and benefits.
Keywords: Awareness, premature loss of primary teeth, Saudi Arabia, space maintainer
|How to cite this article:|
AlMeedani LA, Al-Ghanim HZ, Al-Sahwan NG, AlMeedani SA. Prevalence of premature loss of primary teeth among children in Dammam city and parents' awareness toward space maintainers. Saudi J Oral Sci 2020;7:85-9
|How to cite this URL:|
AlMeedani LA, Al-Ghanim HZ, Al-Sahwan NG, AlMeedani SA. Prevalence of premature loss of primary teeth among children in Dammam city and parents' awareness toward space maintainers. Saudi J Oral Sci [serial online] 2020 [cited 2020 Jul 10];7:85-9. Available from: http://www.saudijos.org/text.asp?2020/7/2/85/286577
| Introduction|| |
Premature loss of primary teeth has been considered a widespread problem in oral health practice., The most common reasons for premature loss of primary teeth are dental caries, trauma, periodontal diseases, and premature root resorptions., An early loss of primary teeth leads to a lack of space, malocclusion, and midline discrepancies in permanent dentition., Parents are in charge of their children's oral health. They are responsible for their children's oral hygiene habits and regular dental visits in the 1st year of infancy. Children with a high rate of dental caries and periodontal diseases are greatly affected by the occurrence of premature teeth loss. Inappropriate oral hygiene has been identified as a key behavioral risk factor for premature loss of primary teeth., Many parents believe that losing primary teeth prematurely is of no importance. They assume losing primary tooth is not as significant as the loss of the permanent tooth. Primary teeth act as placeholders for permanent teeth. Parents' awareness on the importance of primary teeth and preventive oral hygiene care influences their children's oral health.
Premature teeth loss in children needs to be treated immediately to prevent or reduce the severity of developing malocclusion. Early detection of malocclusion development eliminates complexity of treatment, treatment time, and cost., Space maintainers are preventive measures treatment used to reduce malocclusion problems in the primary or early mixed dentition. Dentists place space maintainers following premature tooth loss or elective primary tooth extraction to preserve arch length. Loss of arch length brings on different problems such as crowding, ectopic eruption, dental impaction, crossbite formation, and dental centerline discrepancies. Thus, dentists must take early management of premature loss of primary teeth comprising corrective as well as preventive measures to avoid worsening of malocclusion.,
| Materials and Methods|| |
A cross-sectional study was planned to randomly select children aged between 4 and 9 years who attend governmental and private clinics in Dammam city, Saudi Arabia. After consulting a statistician regarding the necessary sample size and statistical power, 200 children were randomly selected from two hospitals; Dammam Medical Complex, Ministry of Health (governmental hospital) and Siwak Dental Complex (private clinic).
All parents who agreed to participate in their children received and signed an informed consent demonstrating their approval to participate in the research investigation.
Clinical examinations were carried out in the dental clinics by two examiners who were calibrated for purposes of internal validity. They used sterilized examination kits that contain dental mirror, explorer, gauze and tweezers. Cross infection protocols were strictly observed. WHO criteria (WHO1997) were used to examine decay-missing-filled index (DMFT) and premature loss of primary teeth.
The questionnaires were distributed by hand to the parents via the same two examiners of the selected children. The questionnaires were completed by parents before examining their children.
Participating children were required to be Saudi male or female, aged between 4 and 9 years old, cooperative, and have fully erupted teeth in the primary dentition. Only children that meet the inclusion/exclusion criteria were included in the study.
The questionnaire consists of three primary sections. The first section gathered demographic characteristics of the parents: age, gender, educational level, and income. The second section surveyed parents' knowledge of oral health; the importance of primary teeth, the frequency of dental visits, and the parents' role regarding children brushing care. The third section surveyed parents' awareness toward space maintainers; the previous children's experience with space maintainers uses of space maintainers, type of food avoided with space maintainers, and brushing care of space maintainers.
[Additional file 1]
The principle investigator designed section one of the questionnaire: demographic characteristics of parents. For the second and third section of the questionnaire, the principle investigator modified exiting, separate, valid, and reliable measures of parents' knowledge of oral health and awareness toward space maintainers (Linjawi, A. I., Alajlan, S. A., Bahammam, H. A., Alabbadi, A. M., and Bahammam, M. A., 2016).
Data from questionnaires were processed using the Statistical Package for the Social Science (SPSS version 20.0; SPSS Inc., Chicago, IL, USA). Descriptive statistics were used to describe and summarize data collected numerically. All categorical variables were presented into frequencies and percentages.
Cross-tabulation and Chi-square tests were obtained to examine the relationships between parents' knowledge about oral health and awareness of space maintainers. A value of P = 0.05 was used to determine the level of significance.
Six questions have been asked to the parents to survey their awareness toward space maintainers. Parents who selected 4 correct answers out of 6 questions were considered aware about space maintainers.
| Results|| |
The mean dmf of the participated children aged between 4 and 9 years was 2.24 (standard deviation [SD] = 2.08). In the present study, the prevalence of premature loss of primary teeth of children was 20%. Thirty-one children were from government clinics and 9 children were from private clinic.
Of 200 parents who were answered and retained the questionnaires; 104 (52%) were male and 96 (48%) were female. Age varied considerably, with the majority (86%) being 20–40 years of age.
Most parents were in university level of education (48.5%), had more than three siblings (71%), and with family income 10,000–20,000 Saudi Riyals per month (46.5%). The demographic information of the sample study is shown in [Table 1].
Regarding parents' knowledge of oral health, more than 60% of parents reported primary teeth are important as permanent teeth.
Over 75% of parents revealed children should be taken to the dentist every 6 months.
When asked about parents' role regarding children brushing care, only 13 parents answered they brush their children's teeth. 174 parents selected they supervised their children [Table 2].
Parents' awareness toward space maintainers data revealed 37 (18.5%) out of 200 parents were aware about space maintainers, it used, maintenance, and benefits.
Only 22.5% of those parents affirmed their children had been treated with space maintainers, 21.5% knew when space maintainers are used, 18% selected sticky sugary food as a type of food should be avoided when having space maintainers, and 19.5% selected space maintainers required special care with brushing. Regarding the frequency of dental visits for space maintainers, more than 70% selected every 6 months, and 90% selected the correct answer; immediately as the proper time to go to the dentist when space maintainer is lost or broken [Table 3].
Parents whose children had been treated with space maintainers were significantly more likely to have a higher level of awareness toward space maintainers than those whose children had not previous experience of space maintainers (P < 0.001).
The parents' awareness toward space maintainers and those who considered primary teeth as important as permanent teeth were participants were statistically significantly correlated (P = 0.010) [Table 4].
|Table 4: correlation between parent's awareness toward space maintainer and parent's knowledge of oral hygiene|
Click here to view
| Discussion|| |
Based on the SD, a total score of dmf ranged between 0.16 and 4.32. This result provided powerful data on a high prevalence of missing teeth among children in Dammam city.
A similar study of the prevalence of premature loss of primary teeth in the eastern province of Saudi Arabia was conducted by Al-Shahrani et al. The dmf mean was 5.61 (SD = 3.01). Of the 307 children, 66.4% had a maximum DMFT score, which was above 4. 156 out of 307 (51%) children had premature loss of primary teeth. The researchers concluded a high prevalence of premature tooth loss.
The current survey revealed parents were unaware about the space maintainer and its used. Only 37 (18.5%) out of 200 parents of the selected children were aware about space maintainers. Most answers related to the type of food that should be avoided when having space maintainers (82%), the appropriate time to use space maintainers (87.5%), and the special care with space maintainers (90.5%) were incorrect.
The results of the current study are reflective and similar to a recent study conducted in 2016 among the Saudi adult population. Linjawi et al. assessed the level of respondents' awareness toward space maintainers. The respondents showed an unsatisfactory level of awareness in the timing of space maintainers' usage (57.5%), and the types of food that should be avoided when having space maintainers (60.7%). The researchers concluded the level of awareness about the usage, maintenance, and advantages of space maintainers was very low.
Parents' awareness toward space maintainers was statistically significant in the correlation related to the previous experience of space maintainers (P < 0.001); parents whose children had been treated with space maintainers had a higher level of awareness toward space maintainers than those whose children had not. Justification for this outcome may be in the history effect. Simply, by the experience of having children applied space maintainers, parents were better and more aware on space maintainers. They have already been familiar with that device and its uses and importance. They know how to take care of the space maintainers and what to do when it is broken. This study also finds a statistically significant correlation between the parents' awareness toward space maintainers and those who considered primary teeth as important as permanent teeth. This result might be explained by the parents' concerns of their children oral health.
| Conclusions|| |
This study revealed a high prevalence of premature tooth loss among children in Saudi Arabia. The majority of parents were unaware of space maintainer, its usage, maintenance, and benefits.
In order to lower the rate of dental caries and premature loss of primary teeth, parents should be encouraged to take their responsibilities in brushing their children's teeth. Educational lectures and workshops are highly recommended to be initiated to disseminate information related to children's oral hygiene care among parents.
Findings from this study give direction to changes needed in learning strategies and methods. Oral health professionals are required to be trained in new effective learning strategies to spark parents' interest and motivation. This study suggests an increased awareness level of space maintainers is necessary in Saudi Arabian people. Future research is also required to further replicate this study in different environments, settings, and sample populations.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ahamed SS, Reddy VN, Krishnakumar R, Mohan MG, Sugumaran DK, Rao AP. Prevalence of early loss of primary teeth in 5-10-year-old school children in Chidambaram town. Contemp Clin Dent 2012;3:27-30.
] [Full text]
Al-Shahrani N, Al-Amri A, Hegazi F, Al-Rowis K, Al-Madani A, Hassan KS. The prevalence of premature loss of primary teeth and its impact on malocclusion in the Eastern Province of Saudi Arabia. Acta Odontol Scand 2015;73:544-9.
Borum MK, Andreasen JO. Sequelae of trauma to primary maxillary incisors. I. Complications in the primary dentition. Endod Dent Traumatol 1998;14:31-44.
Heilborn J, Kuchler E, Fidalgo T, Antunes L, Costa M. Early primary tooth loss: Prevalence, consequence, and treatment. Int J Dent 2011;10:10-3.
Pedersen J, Stensgaard K, Melsen B. Prevalence of malocclusion in relation to premature loss of primary teeth. Community Dent Oral Epidemiol 1978;6:204-9.
Alamoudi N. The prevalence of crowding, attrition, midline discrepancies and premature tooth loss in the primary dentition of children in Jeddah, Saudi Arabia. J Clin Pediatr Dent 1999;24:53-8.
Nagarajappa R, Kakatkar G, Sharda AJ, Asawa K, Ramesh G, Sandesh N. Infant oral health: Knowledge, attitude and practices of parents in Udaipur, India. Dent Res J (Isfahan) 2013;10:659-65.
Linjawi AI, Alajlan SA, Bahammam HA, Alabbadi AM, Bahammam MA. Space Maintainers: Knowledge and Awareness among Saudi Adult Population. J Int Oral Health 2016;8:733-8. [Full text]
Kumari NR, Sheela S, Sarada PN. Knowledge and attitude on infant oral health among graduating medical students in Kerala. J Indian Soc Pedod Prev Dent 2006;24:173-6.
] [Full text]
Alshehri A, Nasim V. Infant oral health care knowledge and awareness among parents in Abha city of Aseer Region, Saudi Arabia. Saudi J Dent Res 2015;6:98-101.
Wyne AH. Caries prevalence, severity, and pattern in preschool children. J Contemp Dent Pract 2008;9:24-31.
[Table 1], [Table 2], [Table 3], [Table 4]