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INTRODUCTION
      The WHO has declared that every human being has the right to access
adequate, sufficient and healthy nutrition. However, social inequalities, changes in
life style, the process of industrialization & other factors have had a negative
influence on the spread of this fundamental right1.
      Today the world faces two kinds of malnutrition, one associated with hunger
or nutritional deficiency and the other with dietary excess. Urbanization and
economic development has resulted in rapid changes in diet and lifestyles2. The
World Bank estimates that India is ranked 2nd in the world of the number of
children suffering from malnutrition, after Bangladesh (in 1998), where 47% of the
children exhibit a degree of malnutrition. The prevalence of underweight children
in India is among the highest in the world, and is nearly double that of Sub-
Saharan Africa with dire consequences for mobility, mortality, productivity and
economic growth. Simultaneously, there are a small, but increasing percentage of
overweight children who are at a greater risk for non-communicable diseases such
as diabetes and cardio-vascular heart disease later in life3.
      With regard to dental caries global weighted mean DMFT value for 12 year
old age group was 1.61 in 2004. In India, data from the National Oral Health
Survey (2002-2003) states that in children aged 12 years, the caries prevalence was
53.8% and the mean DMFT was 1.84.
      According to the available literature, nutritional deficiencies may impair not
only the tooth structure but also the development of salivary glands. During the
formation of teeth the physical and chemical properties of enamel could be altered
in the direction of increased dental caries susceptibility. There may be a greater
prevalence of dental caries because the excessive consumption of sugary foods1.
Studies are sparse in this region of the country on nutritional status and prevalence
of dental caries. Hence the present study was undertaken to assess the nutritional
status and prevalence of dental caries among 12-15 year old children of public
schools of Lucknow, India.


Materials and methods
      The present cross- sectional study was carried out to assess the nutritional
status and caries experience among 12-15 years old school going children of
Lucknow, India. Data collection was carried out in the month of August and
September 2010.
      A pilot study was conducted using the proforma on 30 school going children
to assess the operational feasibility of the study. Needful changes in the proforma
were made from time to time.
      Sample size was calculated using the standard formula seeking results at
95% Confidence Interval for which the value of z=1.96, the allowable error (e)
taken as 0.05. Thus using the above mentioned formula, pilot study conducted and
the prevalence of the disease, sample of 600 school going children was obtained.
Multistage cluster random sampling was done. In the first stage, Lucknow city of
India was divided geographically into 5 areas i.e. East, West, North, South and
Central. In the second stage, 1 ward was randomly selected from each geographic
area. In the third stage 120 individuals, aged 12 to 15 years were examined from
each 5 ward.
      A written consent was obtained from the school authorities before the
commencement of this study. Approval to carry out the study was obtained from
the Ethical Committee of the Institution. To assess the intraexaminer agreement,
the examiner investigated 10% of the sample on the second occasion. The kappa
statistical test evidenced a near- perfect agreement between the measurements
(0.94). Two interns from the department were taken as recording assistants who
were also trained.
       The proforma had two parts: the first part was a structured interview with 15
questions. Demographic data was collected. The socioeconomic status was elicited
through father’s and mother’s education, their occupation, family income and
number of siblings. Personal information regarding oral hygiene practices was
collected. Frequency of snacking and their attitude towards dental visit was also
elicited.
       Second part of the proforma consisted of clinical assessment through
anthropometric measurement for recording nutritional status using BMI index (for
Asians) and Dental caries experience using DMFT index (Henry T. Klein, Carrole
E. Palmer and Knutson J.W. in 1938). Type III examination was done. The
instruments used for dental caries recording included plane mouth mirror and
sickle cell explorer and cold sterilization procedure was followed.
       The statistical analyses were performed using the Statistical Package for the
Social Sciences, version 12 for Windows. Chi square test was used to find
association between dental caries and Nutritional status .Pearson’s correlation
coefficient was used to find any possible relationship between BMI and DMFT. P
< 0.05 was considered to be statistically significant.

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Dietary practice of school going children

  • 1. INTRODUCTION The WHO has declared that every human being has the right to access adequate, sufficient and healthy nutrition. However, social inequalities, changes in life style, the process of industrialization & other factors have had a negative influence on the spread of this fundamental right1. Today the world faces two kinds of malnutrition, one associated with hunger or nutritional deficiency and the other with dietary excess. Urbanization and economic development has resulted in rapid changes in diet and lifestyles2. The World Bank estimates that India is ranked 2nd in the world of the number of children suffering from malnutrition, after Bangladesh (in 1998), where 47% of the children exhibit a degree of malnutrition. The prevalence of underweight children in India is among the highest in the world, and is nearly double that of Sub- Saharan Africa with dire consequences for mobility, mortality, productivity and economic growth. Simultaneously, there are a small, but increasing percentage of overweight children who are at a greater risk for non-communicable diseases such as diabetes and cardio-vascular heart disease later in life3. With regard to dental caries global weighted mean DMFT value for 12 year old age group was 1.61 in 2004. In India, data from the National Oral Health Survey (2002-2003) states that in children aged 12 years, the caries prevalence was 53.8% and the mean DMFT was 1.84. According to the available literature, nutritional deficiencies may impair not only the tooth structure but also the development of salivary glands. During the formation of teeth the physical and chemical properties of enamel could be altered in the direction of increased dental caries susceptibility. There may be a greater prevalence of dental caries because the excessive consumption of sugary foods1.
  • 2. Studies are sparse in this region of the country on nutritional status and prevalence of dental caries. Hence the present study was undertaken to assess the nutritional status and prevalence of dental caries among 12-15 year old children of public schools of Lucknow, India. Materials and methods The present cross- sectional study was carried out to assess the nutritional status and caries experience among 12-15 years old school going children of Lucknow, India. Data collection was carried out in the month of August and September 2010. A pilot study was conducted using the proforma on 30 school going children to assess the operational feasibility of the study. Needful changes in the proforma were made from time to time. Sample size was calculated using the standard formula seeking results at 95% Confidence Interval for which the value of z=1.96, the allowable error (e) taken as 0.05. Thus using the above mentioned formula, pilot study conducted and the prevalence of the disease, sample of 600 school going children was obtained. Multistage cluster random sampling was done. In the first stage, Lucknow city of India was divided geographically into 5 areas i.e. East, West, North, South and Central. In the second stage, 1 ward was randomly selected from each geographic area. In the third stage 120 individuals, aged 12 to 15 years were examined from each 5 ward. A written consent was obtained from the school authorities before the commencement of this study. Approval to carry out the study was obtained from the Ethical Committee of the Institution. To assess the intraexaminer agreement, the examiner investigated 10% of the sample on the second occasion. The kappa statistical test evidenced a near- perfect agreement between the measurements
  • 3. (0.94). Two interns from the department were taken as recording assistants who were also trained. The proforma had two parts: the first part was a structured interview with 15 questions. Demographic data was collected. The socioeconomic status was elicited through father’s and mother’s education, their occupation, family income and number of siblings. Personal information regarding oral hygiene practices was collected. Frequency of snacking and their attitude towards dental visit was also elicited. Second part of the proforma consisted of clinical assessment through anthropometric measurement for recording nutritional status using BMI index (for Asians) and Dental caries experience using DMFT index (Henry T. Klein, Carrole E. Palmer and Knutson J.W. in 1938). Type III examination was done. The instruments used for dental caries recording included plane mouth mirror and sickle cell explorer and cold sterilization procedure was followed. The statistical analyses were performed using the Statistical Package for the Social Sciences, version 12 for Windows. Chi square test was used to find association between dental caries and Nutritional status .Pearson’s correlation coefficient was used to find any possible relationship between BMI and DMFT. P < 0.05 was considered to be statistically significant.