Oral health and the impact of socio-behavioural factors in a cross sectional survey of 12-year old school children in Laos.
BACKGROUND
In recent decades low-income countries experienced an increasing trend in dental caries among children, particularly recorded in 12-year olds, which is the principal WHO indicator age group for children. This increases the risks of negative affects on children's life. Some data exist on the oral health status of children in low-income countries of Southeast Asia. However, information on how oral health is associated with socio-behavioural factors is almost not available. The aims of this study were to: assess the level of oral health of Lao 12-year-olds in urban and semi-urban settings; study the impact of poor oral health on quality of life; analyse the association between oral health and socio-behavioural factors; investigate the relation between obesity and oral health.


METHODS
A cross sectional study of 12-year old schoolchildren chosen by multistage random sampling in Vientiane, Lao P.D.R (hereafter Laos). The final study population comprised 621 children. The study consisted of: clinical registration of caries and periodontal status, and scores for dental trauma according to WHO; structured questionnaire; measurement of anthropometric data. Frequency distributions for bi-variate analysis and logistic regression for multivariate analysis were used for assessment of statistical association between variables.


RESULTS
Mean DMFT was 1.8 (SEM = 0.09) while caries prevalence was 56% (CI95 = 52-60). Prevalence of gingival bleeding was 99% (CI95 = 98-100) with 47% (CI95 = 45-49) of present teeth affected. Trauma was observed in 7% (CI95 = 5-9) of the children. High decay was seen in children with dental visits and frequent consumption of sweet drinks. Missed school classes, tooth ache and several impairments of daily life activities were associated with a high dD-component. No associations were found between Body Mass Index (BMI) and oral health or common risk factors. The multivariate analyses revealed high risk for caries for children with low or moderate attitude towards health, a history of dental visits and a preference for drinking sugary drinks during school hours. Low risk was found for children with good or average perception of own oral health. High risk for gingival bleeding was seen in semi-urban children and boys.


CONCLUSIONS
Although the caries level is low it causes considerable negative impact on daily life. School based health promotion should be implemented focussing on skills based learning and attitudes towards health.
Jürgensen
Nanna
N
Department for Community Dentistry and Graduate Studies, Faculty of Health Sciences, University of Copenhagen, Oester Farimagsgade 5, Copenhagen K, Denmark. nan@odont.ku.dk
Petersen
Poul Erik
PE
D000203:Activities of Daily Living; D001294:Attitude to Health; D002648:Child; D003430:Cross-Sectional Studies; D004245:DMF Index; D003729:Dental Care / Q000706:statistics & numerical data; D003731:Dental Caries / Q000453:epidemiology / Q000523:psychology*; D019422:Dietary Sucrose; D005260:Female; D015438:Health Behavior; D006801:Humans; D007812:Laos / Q000453:epidemiology; D008297:Male; D009909:Oral Health; D009910:Oral Hygiene / Q000706:statistics & numerical data; D010510:Periodontal Diseases / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012647:Self-Assessment; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D018677:Tooth Injuries / Q000453:epidemiology / Q000523:psychology*; D014505:Urban Population
D019422:Dietary Sucrose