Oral Health Status Of Orphan Children And Adolescents Of Chongqing And Evaluation Of Comprehensive Dental Health Interventions

Background Orphans are children and adolescents aged from0-18-year-old who have no parents, the later neither had dead or don’t havethe ability to bring their children up. In Asia, a total orphan population is57million accounting to5.8%of the world population. Until2011, the numberof orphans in China is509,000. There are10080orphans in Chongqing,and1699are living in welfare institution，accounting for16.8%of theorphans.Oral health is an important part of human health. Over the pastdecades, our country has done a lot of work in oral disease prevention, andit had made a great development. But for the orphans, because of thecrowded living environment, the lack of adequate staff, little oral healtheducation accessed, orphans themselves have a poor oral habits and poororal hygiene, besides, the neglect of the importance of oral health, all ofthese lead to the prevalence of dental caries and periodontal disease. Andbecause of the limitation of objective factors such as economic condition,orphans’ dental treatment rate is low. Oral disease has become one of themost important health problems affecting orphans.Implementation of comprehensive dental health interventions (CDHI)can improve the oral hygiene status and the level of oral health effectively. At present, few literature have reported about the oral health status oforphans, especially in our country. Therefore, it is particularly important toknow the oral health status among orphans in assisting in planning properoral health programs for this group.Objective The purpose of this study was to find out the oral healthstatus and oral health behaviors among orphans of Chongqing via Oralhealth examination and questionnaire, by Simple random sampling. At thesame time, comprehensive dental health interventions (CDHI)was taken,and then to evaluate the effect of CDHI, so as to assist in planning of theoral health programs.Methods According to the World Health Organization： HealthSurveys．Basic Methods(4thed Genneva:WHO,1997) and the third nationaloral health investigation of epidemiology, the dental caries, gingivalbleeding and calculus was examined among317orphans living in thewelfare institution of Jiangbei district, Chongqing, by Simple randomsampling. At the same time, a questionnaire is adopted for children over6-year-old to investigate their oral health knowledge and oral healthbehavior. And the comprehensive dental health care program including oralhealth education, application of fluoride, pit and fissure sealing, earlypermanent tooth caries filling was carried out to improve oral health statusand oral health behavior, and to evaluate its effect. The statistical software,SPSS17.0was used for the data analysis.Results1. In primary and permanent teeth,the prevalence of dentalcaries and mean DMFT (dmft) were found to be50.00%,1.94±2.81and39.53%,0.90±1.38. There were no significant difference between female and male（P>0.05）. But there was significant difference of the prevalenceof permanent tooth caries between the age group under12（include12）andabove12(P<0.05). And neither of the decayed teeth above was treated.The prevalence rate of gingival bleeding was78.22%, there was nosignificant difference between female and mal（eP>0.05）and between theage group under12（include12） and above12(P>0.05), and the calculusrate was67.66%, there was no significant difference between female andmale（P>0.05）and there was a significant difference between the age groupunder12（include12） and above12(P>0.05).2. The awareness rate of oral health knowledge among Orphans is52.80%and the appropriate oral health behavior report at a rate of32.36%.About70%of them have a low frequency (less than or equal to once aweek) of taking Sugary foods such as Biscuits, cakes, candy, carbonateddrinks, fruit juice and so on. There are only14.53%of the orphans havehad a dental visit experience.3. CDHI is effective in overall improvement oral health. The cariesincidence rate of deciduous teeth and permanent teeth are1.85%and1.38%.A significant decrease in the mean number of decayed teeth (DT) and anincrease in the filled (FT) components of the DMFT index per child wasnoted (P＜0.05).48.89%decayed permanent tooth was filled. Theawareness rate of oral health knowledge had increased by36.59%and theproper oral hygiene behavior report rate increased by55.57%.Conclusion The oral status of the orphans is poor, and this communityhas experienced a low utilization of preventive or therapeutic oral healthservices. Implementation of CDHI can improve the oral hygiene status andthe level of oral health effectively. In the future work, more attentions should be paid to the oral health of this group, orphans should beconsidered as a priority group when make plans for oral health care.