Evaluation of the Dental Health of the Young Adult Male Population in Turkey

Military Medicine, Nov 2004 by Ceylan, S�leyman, A�ikel, Cengiz Han, Ok�u, Kemal Murat, Kili�, Selim, Et al

This study aimed to determine the prevalence of dental caries in military recruits and to assess the relation of dental caries with socioeconomic and demographic factors, and sugar consumption behavior, and to generalize the findings for the young adult male population to draw a picture of dental health status of this population segment in Turkey. In this cross-sectional study conducted between August and October 2000 in a military basic training center in Turkey, 2,766 male recruits of the age of 20 were examined by dental specialists to determine their mean number of decayed, missing, or filled teeth (DMFT) scores and were administered a questionnaire for capturing their demographic characteristics and sugar consumption behavior. The mean DMFT score for the 20-year-old male population in Turkey was found to be 5.97. DMFT scores were weakly correlated with income level and urbanization. Sugar consumption was strongly correlated with DMFT scores. The mean number of teeth with fillings component was strongly correlated with income level, moderately with the subject's education, and weakly with the mother's education, father's education, and urbanization. DMFT scores for the young adult male population in Turkey were strongly associated with sugar consumption behavior, whereas they were weakly or not at all associated with demographic factors such as education level, income level, and urbanization.

Introduction

Diseases of the teeth and the adjacent structures continue to be among the most common maladies affecting human beings. Because they are so common and are seldom life threatening, they usually do not receive the attention they deserve, either from those directly affected or from health officials, health planners, or others concerned with improving a population's health status.1

Oral diseases are important considerations in public health and preventive dentistry for several reasons. First, they are of almost universal prevalence. Rarely if ever does anyone go unaffected by at least one of these diseases, and most people are affected by several during their lifetime. second, most oral dis eases do not undergo remission or termination if left untreated, as do many diseases, but accumulate a backlog of unmet needs that can ultimately end in the loss of teeth. Third, these diseases usually require technically demanding, expensive, and time-consuming professional treatment. Finally, oral diseases are important for consideration in public health because they are, in large measure, preventable.2

The World Health Organization (WHO) proposes to use the mean number of decayed, missing, or filled teeth (DMFT) or the mean number of decayed, missing, or filled surface (DMFS) values to assess the prevalence of dental caries. DMFT and DMFS describe the amount-the prevalence-of dental caries in an individual. DMFT and DMFS are means to numerically express the caries prevalence and they are obtained by calculating the number of decayed (D), missing (M), filled (F), teeth (T), or surfaces (S). Thus, they are used to get an estimation illustrating how much the dentition has become affected by dental caries until the day of examination.3

A number of studies show that prevalence of dental caries varies by several factors. One of these factors is age. In the United States, although approximately 50% of U.S. schoolchildren are considered to be caries free, by the age of 17 years, only 15% of these young adults have not experienced caries.4 In a study carried out in the Republic of Niger, although the mean DMFT score of 1.3 was observed among the 12 year olds, the 35 to 44 year olds had an average DMFT score of 5.7.5 Among Greek adolescents, it was found that the percentage of caries-free adolescents varied from 24.3 in the age group of 12 to 13 years to 13.2 in the age group 16 to 17 years; mean DMFT values were 3.7 in the younger age group and 5.9 in the older age group.6

A relationship between a population's level of socioeconomic development and dental caries is often assumed. Caries is a good proxy measure for socioeconomic development. Countries in the throes of socioeconomic transition have the highest DMFT scores.7 Among the primary school students in United Kingdom, it was found that children in the highest income group had a mean DMFT of 1.83 compared with 2.56 in the middle group, and 3.43 in the lowest income group.8

Dental caries levels vary by countries in respect to socioeconomic indicators. In a study investigating the association between some factors and caries levels in 109 countries, it was found that the highest correlation coefficients were those between the DMFT and public expenditures, sugar consumption, and urbanization.9

In some studies, there was an inverse relationship between education level and dental caries. For example, a study conducted among Lithuanian adults reported that participants with more years of education had lower DT and MT values, and higher FT values.10 In another study from Israel, it was reported that negative associations were detected between education levels and untreated and extracted components, and a positive association was detected between education levels and the treated caries component." In addition to this, there are some studies showing that parents' education levels are important factors in children's dental caries. In Abu Dhabi, among the preschool children, it was found that higher parental educational attainment was related to a lower number caries.12