title: A vicious cycle in the oral health status of schoolchildren in a primary school in rural Cambodia.
abstract: OBJECTIVE
  To investigate the oral health status and the risk factors contributing to dental caries and gum disease of schoolchildren in Cambodia.
  
  
  METHODS
  A cross-sectional survey was conducted in a primary school in the Puok District, Siem Reap Province of Cambodia. An oral examination and self-reported questionnaire were used to evaluate oral health status of schoolchildren, ranging in age from 6-16. Of the 512 children that were enrolled in first through sixth grade at the primary school, 332 children (62.8%) participated.
  
  
  RESULTS
  Of the schoolchildren that were involved in this study, the prevalence of dental caries in permanent dentition was 53.5% and gum disease was present in 46.2%. Among the participants 80% had plaque, 68.6% suffered from tooth pain and only 44.2% of the schoolchildren owned their own toothbrush. There was an association between the schoolchildren that suffered from tooth pain and those that had dental caries (P < 0.03). Plaque was related to dental caries in permanent dentition (P < 0.003), calculus (P < 0.0001) and gum disease (P < 0.0001) and was linked to the schoolchildren who did not own a toothbrush (P < 0.03) and who suffered from tooth pain (P < 0.03).
  
  
  CONCLUSIONS
  The following sequence of events may result in a vicious cycle in the oral healthcare of schoolchildren in rural Cambodia: the lack of a personal toothbrush leads to plaque buildup, which may increase the incidence of dental caries, which has been linked to tooth pain and gum disease. Ultimately, this poor oral healthcare impacts an individual's quality of life and can lead to more serious health issues later in life.
authors.affiliation: Department of International Community Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Emiko Koito
authors.initials: EK
authors.lastname: Shidara
authors.forename: James D
authors.initials: JD
authors.lastname: McGlothlin
authors.forename: Seigo
authors.initials: S
authors.lastname: Kobayashi
mesh_terms: D000293:Adolescent; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D003728:Dental Calculus / Q000453:epidemiology; D003731:Dental Caries / Q000453:epidemiology*; D003753:Dental Health Surveys; D003773:Dental Plaque / Q000453:epidemiology; D005260:Female; D005891:Gingivitis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012423:Rural Health; D012571:School Dentistry; D011795:Surveys and Questionnaires; D014098:Toothache / Q000453:epidemiology; D014099:Toothbrushing / Q000706:statistics & numerical data