The caries prevalence, def–t index and DMF–T index of deaf children at the primary school (Mellisa May

Joe et al.)

The caries prevalence, def–t index and DMF–T index of deaf

children at the primary school of special education Kota
Kinabalu in Sabah

Mellisa May Joe, Eka Chemiawan, Jakobus Runkat

Department of Pediatric Dentistry Faculty of Dentistry Universitas Padjadjaran

ABSTRACT

Deaf is the loss of hearing partially or even totally and could happen congenitally or acquired. The
purpose of this research was to find out the information of the caries prevalence, def-t and DMF-T index
of Deaf children at the Primary School of Special Education in Kota Kinabalu, Sabah year 2008. This study
was a description research with survey technique. All samples, 43 primary students of Primary School of
Special Education in Kota Kinabalu, Sabah from kindergarten to primary six. The def-t and DMF-T index
standard used the WHO criteria, namely, very low (0.1-1), low (1.2-2.6), moderate (2.7-4.4), high (4.5-
6.5), and very high (>6.5). The results of this research indicates that the caries prevalence of the Deaf
children year 2008 was 95.3%. def-t index was 2.81 and DMF-T index was 1.67. The conclusion of this
research was that the average def-t index included in moderate criteria and the DMF-T index was low.

Key words: Caries prevalence, def-t and DMF-T index, deaf children

INTRODUCTION of adequate communication abilities.

Its is obvious that deaf children have serious
The disabled people form a substantial problems with communication and understanding
section of the community, and it is estimated that which may leads to dental management problems
there are about 500 million people with disabilities with the dentist and child’s misunderstanding
worldwide.1 Children with hearing impairment about dental hygiene instructions.2 This can cause
constitute one of the major population groups problem to routine oral hygiene care and various
of disabled children; about one in six hundreds diseases can occur in their oral and teeth for
neonates has congenital hearing loss.2 Hearing example tooth caries. It is important for the dentist
impairment includes children with either partial or to investigate how the child communicates. It is
total loss of hearing and is genetically determined useful to learn some basic sign language. If child
in 30-70% of the cases. Remaining cases are due lip reads, face the child and talk slowly and clearly.
to prenatal causes infections like rubella or drugs If the child uses sign-language, communication
during pregnancy, perinatal causes jaundice, via the parents may be necessary.3 To facilitate
prematurity and postnatal. Most deaf children have communication, pictures or written descriptions
delayed speech development.3 Hearing aid, sign- are useful tools. Likewise it is valuable to learn at
language and lip reading are tools for development least a few dental related sign.

Correspondence author: Mellisa May Joe, Department of Pediatric Dentistry Faculty of Dentistry Universitas Padjadjaran
Jl. Sekeloa Selatan No. 1 Bandung, West Java-Indonesia, Tel./Fax: +6222-2504985/2532805

85
Padjadjaran Journal of Dentistry 2007;19(3):85-89.

Caries is a destructive process causing oral health care knowledge and practices of a
decalcification of the tooth enamel and leading to group of deaf adolescents in Malaysia, so this made
the continued destruction of enamel and dentin the writer interested in doing research about the
and cavitations of the tooth.4 prevalence of caries, def-t index, and DMF-T index
According to Richard5, caries is a among deaf children at Primary School of Special
fermentation of dietary sugars to organic acids by Education Kota Kinabalu in Sabah.
micro-organisms in plaque on the tooth surface.
Today, all experts on dental caries generally agree METHODS
that it is an infectious and communicable disease
and that multiple factors influence the initiation This research was a descriptive with survey
and progression of the disease.2 technique. The population of this research was
The disease is recognized to require a the deaf children at Special Education Primary
host; tooth in the oral environment, a dietary School in Kota Kinabalu, Sabah. The research
substrate, and aciduric bacteria. The saliva also subjects were deaf children that study in Special
considered a host component, the substrate, and Education Primary School Kota Kinabalu in Sabah.
bacteria form a biofilm; plaque that adheres to The population of this research was deaf student,
the tooth surface. Over time the presence of kindergarten to primary six, age 5 to 13 years old.
substrate serves as a nutrient for the bacteria, and The total of the sample were 43 students. The
produce acids that can demineralize the tooth.2 result of the research data will be presented in
This caused cavitation on the tooth surface and it tabulation. The data was collected between July
should be treat to prevent further destruction by and August 2007.
restoration. There were 3 students in kindergarten:
According to Bali6, prevalence of caries was primary 1 zero; primary 2 consists of 16 students;
very high in young people with hearing difficulties. primary 3 zero; primary 4 consist of 9 students;
The mean DMFT and decayed teeth in 9-12 year age primary 5 consists of 6 students; and primary 6
group were 1.76 and 2.18, respectively, which are consist of 9 students. The school consists of 20
higher than the general population (0.9 and 0.9), male and 23 female students at the age of 5 to 13
likely because of ignorance and poor oral hygiene years old.
habits. Caries prevalence in 9-12 and 13-17 year Equipment used are mouth mirror, explorers,
age groups was 93.33 and 88.37, respectively, cotton forceps, mask, gloves, research form,
being higher than the general population, likely question form, pen and alcohol 70%. Examination
due to ignorance on the part of parents and school were performed base on research variable that is:
teachers. caries; def-t; def-t index is the sum of: deciduous
In another study conducted in Kuwait in tooth that infected by caries (d). Note: d (decay),
2001, Shyama7 demonstrated a higher prevalence if deciduous teeth had one or more untreated
of caries, 86%, with a mean DMFT score of 5.0 caries, but still can be treated. Deciduous tooth
in subjects aged 3-29 year olds with hearing indicated for extraction (e). Note: e (extraction)
impairment, due changes in lifestyle and dietary is a deciduous teeth infected by caries that cannot
habits. In the study of Manish8, a mean DMFT restore and have to extract. Deciduous tooth that
score was 2.61 for 5-22 year-olds with hearing been restored (f). Note: f (filled), deciduous
impairment, probably due to lack of parental care teeth have one or more restoration that are still
as parents were ignorant about dental health. good. When there is no deciduous tooth during
This highly alarming situation needs immediate examination, it will not counted because the
attention, a prevention-based intervention cause of missing are not sure whether the tooth
program is recommended for these special groups exfoliated itself and replaced by permanent teeth
of subjects involving voluntary health agencies. or extracted due to caries. DMF-T Index is the sum
Effort must be made to encourage the parents of of: Permanent tooth infected by caries (D) Note: D
these children to promote and improve their oral (decay), permanent tooth had one or more caries
health. that not treated, but still can be treat. Although
There is no study sought to determine the there are several caries on the tooth still count as

86
 The caries prevalence, def–t index and DMF–T index of deaf children at the primary school (Mellisa May Joe et al.)

one. Secondary caries also count one D. Permanent Table 1. Caries Prevalence of deaf children at the Primary
missing tooth or indicated to extract (M). Note: School of Special Education in Kota Kinabalu, Sabah.

M (missing), tooth that have been extracted or

destroy itself due to caries or tooth that have Total Student with
Percentage
been extracted due to caries. Permanent tooth of student caries
that been restored (F). Note: F (filled), tooth that 43 41 95,3%
has one or more restoration that are still good.
The steps of this research were as follows: Table 2. def-t Index of deaf children at the Primary School
students asked to be sited; filled students’ data in of Special Education in Kota Kinabalu, Sabah.

the form; explained the inspection procedure to

the student, helped by the teacher; do inspection d e f def Total of student Index
and count caries, def-t and DMF-T index; students 43 42 36 121 43 2.81
are asked to gargle and leave the examination
room. Table 3. DMF-T Index of deaf children at the Primary School
of Special Education in Kota Kinabalu, Sabah.

Data analysis
D M F DMF Total of student Index
The obtained data were analyzed to get the
41 15 16 72 43 1.67
result and conclusions.

Total of children that infected with caries of Special Education in Kota Kinabalu, Sabah was
Caries prevalence =------------------------------------------- X 100% very high and DMF-T index were 1.67. According
Total of children that examined to World Health Organization, the classification.
standard degree of tooth caries of this research
Total of def-t was low (1.2–2.6), This is like due to frequency of
def-t index =------------------------------------------ X 100% tooth brushing. Ling Zhu9 mention that frequency
Total of children that examined of tooth brushing has impact on dental caries
experience. Result of the questioner shows that
Total of DMF-T 51.2% of student brush their teeth twice a day,
DMF-T index =-------------------------------------------- X 100% but 58.1% student brush their teeth on only during
Total of children that examined bathing. According to Harris10, children are more
likely to be caries free if their teeth are brushed
RESULTS from an early age, twice daily with fluoride
toothpaste after eating and before sleeping.
From the clinical observation, data obtain Brushing and other aid example, flossing
were caries prevalence, def-t and DMF-T index can remove and prevent the formation of plaque.
shown in tabulation below: Table 1 shows tooth Result of the questioner shows that 79% student
caries prevalence of deaf children at the Primary did not use any aid to clean their teeth. Fifty
School of Special Education in Kota Kinabalu, eight point one percent of student brush their
Sabah was 95.3%. teeth with combination of vertical and horizontal
Table 2 display the def-t index of deaf movement and 62% students brush all surfaces of
children at the Primary School of Special Education their teeth.
in Kota Kinabalu, Sabah were 2.81. Children like to eat sweets or candy and
Table 3 display the DMF-T index of deaf chocolate. That kind of food consist large amount
children at the Primary School of Special Education of sucrose. Sucrose includes cariogenic substance.
in Kota Kinabalu, Sabah were 1.67. Minimizing consumption of cariogenic substance is
one of the efforts to prevent formation of caries,
DISCUSSION and brushing teeth after meals is recommended.11
Thirty nine point five percent students admit they
The research result showed caries like to eat sweets and 60.5% of student did not
prevalence of deaf children at the Primary School rinse their teeth after consuming sweets.

87
Padjadjaran Journal of Dentistry 2007;19(3):85-89.

Questioner results show that 60.5% students CONCLUSION

have experience toothache and 97.6% students
experience toothache due to tooth decay or cavity. The prevalence caries of deaf children at
To relieve the pain, 86% students went to visit the the Primary School of Special Education in Kota
dentist. Dental caries is a disease that damages Kinabalu, Sabah was very high. Whereas def-t
tooth structures, resulting in what is commonly index was moderate high and DMF-T was low.
called tooth decay or cavity, which is a hole in the
teeth. This damage first affects the hard tissues REFERENCES
of the teeth (enamel, dentin and cementum). As
the destruction progresses, these tissues begin to 1. Barriers WN. Discrimination and prejudice. In:
break down, which can eventually lead to holes Disability and oral care. London: Nune JHed,
in the teeth. If left untreated, the disease can FDI World Dent Press; 2000. p. 15-20.
lead to pain, tooth loss and infection. Visit the 2. McDonald RE, Avery DR, Dean JA. Dentistry for
dentist to preserve tooth structures and prevent the child and adolescents. 8th ed. St. Louis:
further destruction of the tooth. The treatment Mosby Co.; 2004. p. 548.
for dental caries, dentist perform indicated 3. Goran K, Sven P. Pediatric dentistry. In:
treatment depend on the case, for example dental A Clinical approach. 1st ed. Copenhagen:
restoration, root canal therapy, and extraction.12 Munksgaard; 2001. p. 455-6.
The questioner result showed that 72.1% 4. Dorland Pocket medical edition. W.B.
students visited the dentist more than 1 year Saunders; 2001.
ago. The frequency of student went to dentist if 5. Welbury RR. Pediatric dentistry. 2nd ed. New
toothache occurred was 79% student. To maintain York: Oxford University Press; 2001. p. 95.
a good oral hygiene or to prevent dental caries, 6. Bali RK. National oral health survey and
visit the dentist minimally twice a year even fluoride mapping 2002–2003 in Rajasthan. New
though there is no toothache13, but there were Delhi: Dent Council of India; 2004. p. 96.
37.2% student seldom go to dentist because of no 7. Shyama M. Fundamentals of operative
toothache. dentistry. In: A contemporary approach.
Oral health education models have Chicago: Quintessence Publishing Co., Inc.;
dominated the majority of caries prevention 2001. p. 70-80.
strategies. Oral health information may have 8. Manish J. Dentition status and treatment
modified or improved the health behavior of needs among children with impaired hearing
children.14 About 72.1% students never joined oral attending a special school for the deaf and
health program beside at the school. mute in Udaipur, India. J Oral Science 2008;
The result of research shows that def-t index 50(2):161-5.
of deaf children at the Primary School of Special 9. Ling Z. Oral health knowledge, attitudes and
Education in Kota Kinabalu, Sabah were 2.81. This behavior of children and adolescent in China.
result obtained from the deciduous teeth that Int Dent J 2003:289-98.
have caries, extracted and restored. According to 10. Harris. Risk
����������������������������������������
factors for dental caries in young
WHO classification this categorize moderate high children: a systematic review of the literature.
(2.7–4.4). Com Dent Health 2004:������
71–85.
Oral health care can be supported by self 11. Samuel B. Medical microbiology. 4th ed.
motivation. Oral hygiene educations have given London: A Harcourt Health Sciences Co.;
emphasis to prevent oral care in order to improve 2001. p. 67,103.
oral health behaviour. The responses concerning 12. Wikimedia foundation. Dental caries. Inc.,
treatment for deaf children oral have to focus and U.S registered 501© (3) tax-deductible
improved as in quality so they can achieve good nonprofit charity. 2008. [cited 2008
oral hygiene optimally.13 September 24]. Available from: http;//www.

88
 The caries prevalence, def–t index and DMF–T index of deaf children at the primary school (Mellisa May Joe et al.)

wikimediafoundation.org. Faculty of Dentistry Universitas Padjadjaran;

13. Yenny L. The caries prevalence, def-t index 2005. p. 41.
and DMF-T index of deaf children at the 14. Quteish T. Oral health in Jordan. Int Dent J
special school (SLB-B) Minor thesis. Bandung: 2004:395-400.

89