RIGA STRADINS UNIVERSITY
Sandra Bērziņa
Prevalence of Dental Caries
and Periodontal Status in
Children and Adolescents in Latvia
Speciality - general dentistry
Summary of the Promotion Paper
Advisor: Rūta Care,
Dr.med.sc.,professor
Riga, 2004
Abstract
Dental caries is spread all over the world and humanity has known it for centuries
{Clement A.J., 1958). Still it is regarded as a considerably new disease and its rapid
spread is linked with the growth of industrialism and growing consumption of products
containing sugar (Marthaler T.M., 1990). In the course of time dental caries has become
a serious health problem for the majority of people. Firstly, it is a personal problem pain, feeling of discomfort, chewing disorder, appearance and, secondly, it is also an
economic problem.
During the last 30 years in many industrialized countries the rates of dental caries
and periodontal diseases in children and adolescents have decreased. According to the
DMF index the mean number in children at the age of 5-6 and 12 have decreased 40-60%
(von der Fehr F.R., 1994, Marthaler T., 1996., Vanobbergen J., 2001). As the main
reason for the decrease of caries incidents is considered regular and excessive use of
fluoride which was introduced in 70ies in Europe and the USA (Koch G., 1982). In Latvia
fluoride tablets were introduced in 80ies as the medium fluoride content in water supplies
was very low (0,2-1,09 mg/1). Local and short-time activities to distribute fluoride tablets
at several kinder-gardens and schools in 80ies were not sufficiently evaluated and
continued. Till the beginning of 90ies fluoride-containing toothpaste was not available
in the Baltic States and, consequently, compared with the other European countries, the
caries rates in the Baltic states are higher (Urtāne I., 1994., Aleksejuniene J., 1996.,
WHO, 1997., Haugejorden O., 2002).
In Latvia dental caries is a problem of national scale and it is relevant to all age
groups (Kadnikova G.I., 1988., Care R., 2002). The research shows that 2% of 1year-olds have had dental caries (Care R., 1988). Dental caries prevalence in 4-5
years old children was 94,25%, but at the age of 12 it reached 100% (Kadni-kova G.I.,
1989). The first large-scale study since 1991 when Latvia regained its independence was
International Collaborative Study (1CS-2) in 1993 which revealed the results of dentistry
performed in the Soviet Socialist system. DMF value in children at the age of 12 was 5,8
(Urtāne I., 1994). The study carried out in Riga in 1998 revealed considerable reduction
of caries in children between age 6 and 15. DMF value in children of the age
12-13 in 1993 in Riga was 5,52 (Urtāne I., 1994) and in 1998 - 3,95 (Care R., 1999).
Alongside with dental caries the high prevalence of periodontal disease is one of the
most acute problems in dentistry. 80% of children of the world have gingivitis and the
periodontal disease prevalence reaches almost 100% in adults (WHO, 1978). The scores of
periodontal disease in adolescents in Latvia are very high. An earlier study carried out in
Riga in 1978 revealed that 92,2% of adolescents at the age of 11 and 84,8% at the age of
12 suffered from periodontal disease (Pahomovs G., 1972). The study carried out in Latvia
in 80ies confirmed the high prevalence of periodontal diseases in adolescents. The research
done in 1983 showed that only 15% of adolescents had healthy periodontal tissue (Baron
L.H., 1989). The high rates of periodontal disease are explained by inadequate oral
hygiene. The data from the International Collaborative Study in 1993 revealed that 15% of
adolescents at the age of 12 had healthy periodontal tissue and more than half- 58% - had
gingival bleeding (Urtāne I., 1994). The research done in Riga in 1998 showed
considerable decrease of periodontal disease in children and adolescents between 6 and
15 years of age (Care R., 1999).
Alongside with the ICS-2 research in 1993, the World Health Organisation project
Cross - National Study of Health Behaviour in School Age Children was carried out with
26 countries participating in it. The project focused on the children of the age of 11, 13 and
15. The study took place during the times of great changes in the state system - the system
of the Soviet Socialism collapsed. The situation in health care system become uncertain
due to the changes introduced in the ways of providing health care services. Privatisation
and transition to paid treatment started. Dental services were not free of charge any more.
The dental care which was formerly provided at schools, kinder-gardens and specialised
clinics ceased to exist. The programmes of preventive measures carried out at schools and
kinder-gardens were suspended. Consequently, the research carried out in 1993 on dental
caries prevalence and periodontal condition in adolescents in the former socialistic health
care system was one of the last studies done in Latvia and showed the achievement of
dentistry performed under the system the Soviet socialism.
The research done in 1993 was followed by several oral health promotion activities:
distribution of fluoride tablets to the school children in Riga schools, training of dental
hygienists had been started, the system of public oral health counselling was established
(Senakola E., 1998). Starting from 1991 the state funding is allocated to the Basic
Programme of Dentistry for children under age of 18 in Latvia. Nowadays it is parents'
responsibility to take charge of dental health of their children as there are no state financed
preventive dental health examinations carried out in pre-schools and schools followed by
planned dental care treatment.
The aim of the research carried out in 2001 was to assess the impact of the public oral
health counselling including oral health promotion activities on the prevalence of dental
caries and periodontal disease in adolescents in Latvia in 2001. The study shows objective
data about the changes in the rates prevalence of dental caries and periodontal disease in
adolescents over the period of 8 years.
Description of the Problem
Dental caries and periodontal disease are the most severe diseases in children and
adolescents all around the world. In Latvia dental caries is a problem of whole population
and is relevant to all age groups. Such treatment like filling and extraction as the only
means of teeth treatment have not been sufficient to advance reduction of the prevalence of
dental caries and periodontal disease. Exploration of the conditions of social
environment is crucial before preventive programmes on oral health are worked out and
implemented. The experience of the developed countries implies mat planned preventive
measures based on profound awareness of oral health situation is the only means to
advance decrease of caries and periodontal disease.
The Aim of the Promotion Paper
To assess prevalence of dental caries and periodontal diseases in children and
adolescents at the age of 11, 12, 13, and 15 in different regions of Latvia in 8 year
longitudinal study. To assess oral hygiene and dietary habits of children at the age of 11,
12,13, and 15 over the period of 8 years.
The Tasks of the Promotion Paper
1. To assess prevalence of dental caries in children and adolescents at the age of
11,12,13, and 15 in 1993 and 2001 in different regions of Latvia.
2. To assess separately each component of DMF index (D, M, F)
3. To assess periodontal condition in 11, 12, 13, and 15 year-old children and
adolescents in 1993 and 2001
4. To assess the frequency of the use of restorative materials in children and
adolescents in 1993 and 2001.
5. To assess the frequency of the use of sealants in children and adolescents in
different regions of Latvia.
6. To assess oral hygiene and dietary habits of children at the age of 11,12,13, and 15
in 1993 and 2001.
Hypothetical Assumptions
1. Prevalence of dental caries in U, 12, 13, and 15 year old children and adolescents
over the period of 8 years remains high.
2. The rates of prevalence of periodontal disease in 11, 12, 13, and 15 year old
children and adolescents over the period of 8 years have not changed.
3. Oral hygiene and dietary habits in 11, 12, 13, and 15 year old children and
adolescents over the period of 8 year have not changed.
Novelty of the Results
The study results are:
- assessment dental caries prevalence in children and adolescents at the age of 11,
12,13, and 15 over the period of 8 years,
- assessment of the mean DMFS values for teeth surfaces and the separate
components of DMFS structure of children and adolescents at the age of 11, 12,
13, and 15 in different regions of Latvia,
- assessment of clinically detectable initial caries in children and adolescents at the
age of 11,12,13, and 15 over the period of 8 years,
- for the first time in Latvia the frequency of the use of different rest orative
materials has been assessed over the period of 8 years,
- for the first time in Latvia the frequency of the use of sealants in children and
adolescents in different regions of Latvia has been assessed,
- assessment of prevalence and severity of periodontal disease in children and
adolescents at the age of 11, 12,13, and 15 over the period of 8 years in different
regions of Latvia,
- assessment of oral hygiene and dietary habits among children and adolescents at
the age of 11,12,13, and 15 over the period of 8 years .
MATERIAL AND METHODS
Selection of the School Children
Sample group of school children is a group of children selected according to certain
criteria and principles which represent a particular part of population (country, particular
region, age group or profession) and are examined for a particular purpose.
According to the official data of die Education Ministry of Latvia there were 926
schools in Latvia in 1993 with 89 862 children between the age of 11 and 15. In 2001 there
were 905 schools in Latvia with 138 809 adolescents aged 11, 12, 13, and 15. In order to
select sample groups students were randomly selected according to age and regions. To
carry out research schools were categorised into 5 sections according to their geographical
location - Vidzeme, Kurzeme, Latgale, Zemgale and Riga. The number of students in each
region were scored in per cent. The school and the four classes were chosen by a simple
random method in each geographic area to make up the corresponding number of children.
Only those students were involved in the research who agreed to participate, and whose
parents gave a written consent for dental examinations.
The scheme of the selection of children
1. The number of schools and children
(The Ministry of Education of the Republic of Latvia)
2.Regions
(Vidzeme, Kurzeme, Latgale, Zemgale, Riga)
3.Number of schools and children in the region.
4.School
5.Class (1993)
Four Classes (2001)
6.Every third student of the class (1993)
Students who agreed to participate and whose parents gave a written
consent (2001)
Clinical examination
Clinical examinations were performed tinder the same conditions in classroom
settings or medical or dental offices. Dental examinations were conducted under fibre-optic
light source (ROR Int ApS), using dental mirrors, blunt caries explorers and periodontal
probes (CPITN type E). The data obtained were documented in WHO Oral Health
Assessment Form.
Dental examinations in 1993 and 2001 were performed by the author of this research
work.
No intra-oral radiographs were taken.
Assessing of prevalence and severity of dental caries
Several criteria were used to assess prevalence and severity of dental caries in both
teeth and teeth surfaces.
Prevalence of dental caries is estimated in percentage (%): it is correlation between
the subjects with decayed teeth and the overall number of participants multiplied by 100.
Index of dental caries (DMF) shows severity of caries of one person or a group of
people. DMF for a person is the sum of decayed, filled and extracted teeth. The mean value
of DMF of the group of people is the sum of DMF divided with the total number of the
examined children.
In order to assess dental caries severity in 1993 and 2001 DMFT index for teeth and
DMFS index for teeth surfaces were used with the DMF mean value = DMF sum of
adolescents / number of adolescents.
DMFT and DMFS specific caries data were recorded according to the following
criteria:
• Initial caries (Ci) - white or brown spot non cavity lesion in enamel,
• Caries (C) - carious lesion of dental hard tissues,
• Secondary caries (Crec) - carious lesion on previously restored tooth surface,
• Filled (F) - tooth is restored with amalgam or 'tooth coloured' material. The
quality of filling during the dental examinations in 1993 and 2001 was not
assessed,
• Extracted (E),
• Premolars/molars and incisors/canines contributed to the DMFS score 5 and 4
surfaces.
Assessment of Periodontal Condition
Periodontal condition was assessed using Community Periodontal Index of
Treatment Need (Picture 1).
CPITN was applied to measure 3 sextants in the upper and 3 sextants in the lower
jaw. Sextants with one tooth were not included. Probing was done on the 6 smooth tooth
surfaces.
Assessment of Oral Hygiene
For estimation of oral hygiene Silness & Loe (1964) plague index was used (Picture2).
Plaque was assessed on 8 teeth surfaces - first molars and central incisors of both jaws.
Plaque was recorded as follows:
• No plaque (0),
• Plaque is visible only when scraped with a probe (1),
• Moderate amount of plaque (2),
• Heavy plaque accumulation (3).
Assessment of oral hygiene took place during the dental examination and without
previous notice.
In 2001 plague index was not used in oral hygiene assessment.
■
Dental Survey of Children
The survey was carried out with the aim to obtain information about adolescents' oral
hygiene and dietary habits. The children completed modified International Collaborative
Study and Health Behaviour in School - Aged Children; A WHO Cross-National Survey,
HBSC questionnaire. It included several sets of questions:
5) Socio-demographic indicators,
6) Oral hygiene habits,
7) Dietary habits,
8) Information about dental services.
The survey was carried out in the classroom prior to the dental examination.
Questionnaires were filled out by children themselves without parents' assistance.
Statistical Analysis
The data were processed and analysed using SPSS-PC software version 9.05 (Statistical Packag
for the Social Sciences). Data analysis was done using descriptive statistical methods. T-test and Pearso
x2 Test were used to compare mean values between different age groups and regions. Mean values betwee
data obtained inl993 and 2001 were compared using the Wilcoxon Test. The level of significance was set a
5%.
Results
Analysis of the Research Data of 1993 and 2001.
Caries
In the eight year period of time compared to the data gathered in 1993 the increase in
healthy teeth rates with no clinically detectable caries was observed, In 1993 only 12,3%
(45) eleven year-old children had healthy teeth with no clinically detectable caries as to
compared with year 2001 when 27,36% (110) children had no carious lesions. In the age
group of thirteen 5% (17) and 19,16% (91) adolescents had healthy teeth with no clinically
detectable caries and in the age group of fifteen - correspondingly 2,4% (12) and 19,18%
(97) adolescents. Twelve year-old children who in 1993 did not undergo dental examination
and were not included in the research in 2001 contributed to 23,9% (117) adolescents with
healthy teeth with no clinically detectable caries (Fig. 1., 2., 3., 4.).
Figure 1.
Figure 2.
Figure 3.
Figure 4.
Mean values of DMFT and DMFS in the age group of 11, 13, and 15 in 1993 and
2001 were similar without statistically significant difference. Dental caries prevalence over
the period of 8 years in 13 and IS year-old children has decreased, but in the group of 11
years old - increased. DMFT scores in the age group of 12 in 2001 were similar with the
results of ICS-2 research carried out in 1993 (I. Urtāne, 1994). The mean DMFT and DMFS
values in 11, 12, 13, and 15 year-old children in Latvia inl993 and 2001 are shoPwn in
Table 1.
Table 1. The mean DMFT and DMFS values in children and adolescents at the
age of 11,12,13, and 15 in Latvia in 1993 and 2001.
The analysis of DMFS index structure revealed that over the period of 8 years the
mean number of decayed surfaces in the age groups of 11 and IS has increased but in the
age group of 13 - decreased. In all age groups over the period of eight years the mean
number of filled surfaces and surfaces with recurrent caries has decreased.
The observed differences were not statistically significant. The mean values of the compone
DMFS index in the age groups of 11, 12, 13, and 15-years-old in Latvia in 1993 and 2001 are demon
in Table 2.
Table 2. The mean values of the components of DMFS in children and adolescents at the age
of 11,12,13, and 15 in Latvia in 1993 and 2001.
In Riga in 1993 the mean DMF scores m all age groups were lower than in the
regions of Latvia. In the 11 year-old age group the DMF value in Riga was 5,4 but in the
regions of Latvia - 7,4 (p<0,01). In the 13 year-old age group the DMF value in Riga was
10,1, but in the regions - 12,2 (p<0,05). In the 15 year-old age group correspondingly 12,5
and 14,9 (p<0,01). The mean values of DMFT and DMFS in 2001 in Riga and in the
regions of Latvia in all age groups were similar without statistically significant difference.
In Riga over the period of 8 years the mean DMFT and DMFS scores in the 11 age group
(p>0,05) and 13 increased. The mean values of DMFT and DMFS in the 15 age group
were not statistically significant. In Vidzeme over the period of eight years the mean value
of DMFT in the age group of 11 and 15 (p<0,05) increased but the DMFS scores in the age
group of II and 13 (p>0,01) decreased. However, in the age group of 15 the mean number
of DMFS increased. In Latgale over the period of eight years the mean value of DMFT and
DMFS index in all age groups decreased. The changes of DMFS scores in the age groups
of 13 and 15 were statistically significant (p<0,05). In Zemgale over the period of eight
years the mean value of DMFT index increased in the age groups of 11 and 13 (p<0,05)
but decreased in the age group of 15. The differences were not statistically significant. The
mean DMFS value decreased in all age groups and particularly in the age group of 15 with
statistically significant difference (p<0,01). In Kurzeme over the period of eight years the
mean values of DMFT and DMFS index decreased in all age groups (p>0,05). The mean
DMFT and DMFS values in the children and adolescents of the age of 11,12,13, and 15 in
the regions of Latvia in 1993 and 2001 are shown in Table 3-7.
Table 5. me mean values of DMFT and DMFS in Hit children and adolescents at the age 01
11,12,13, and 15 in Riga in 1993 and 2001.
Table 4. The mean values of DMFT and DMFS in the children and adolescents at the age of
11,12,13, and IS in Vidzeme in 1993 and 2001.
Table 5. The mean values of DMFT and DMFS in the children and adolescents at the age of
11.12,13, and 15 in Latgale in 1993 and 2001.
Table 6. The mean values of DMFT and DMFS in the children and adolescents at the age of
11,12,13, and 15 in Zemgale in 1993 and 2001.
Table 7. The mean values of DMFT and DMFS in the children and adolescents of the age of
11,12,13, and 15 in Kurzeme in 1993 and 2001.
The analysis of DMFS index structure reveals that compared with other regions there
were lower rates of initial caries and caries but higher rates of filled teeth in all age groups
in Riga in 2001. Differences were not statistically significant. The structure of the DMFT
index of children and adolescents aged 11, 12, 13, and 15 in Riga and the regions of Latvia
are shown in Tables 8-11.
Table 8. The structure of the DMFT index of the children and adolescents aged 11 in Riga and in
the regions of Latvia in 2001.
Table 9. The structure of the DMFT index of the children and adolescents aged 12 in Riga and in
the regions of Latvia in 2001.
Table 10. The structure of the DMFT index of the children and adolescents aged 13 in Rica and in
the regions of Latvia in 2001.
Table 11. The structure of the DMFT index of the children and
adolescents aged 15 in Riga and in the regions of Latvia in 2001.
Even though females of all age groups had higher mean DMF value than males in
1993 and 2001, the differences were not statistically significant. In 1993 only in the age
group of 15 the difference of the DMFT value (p<0,01), DMFS (p<0,05) and secondary
caries (p<0,01) of females were statistically significant, but the mean number of decayed,
filled and extracted teeth and teeth surfaces was similar. In 2001 higher incidence rates for
initial caries lesion in males were found in the age group of 13 (p<0,05) and the age group
of 15 (p<0,01). The mean number of decayed, filled and extracted teeth and teeth surfaces
among males and females in all age groups was similar without statistically significant
differences.
The changes in the mean values of the DMFT and DMFS indexes of males and
females over the period of 8 years had no statistically significant difference (Table 12).
Tabkl2. The mean values of DMFT and DMFS of the 11,12,13,
and 15 year-old girls and boys in 1993 and 2001.
In both baseline and follow-up dental examinations the highest number of DFS in all
age groups was diagnosed on occlusal surfaces. The mean DFS of approximal surfaces
increased with age (p<0,001). The mean DFS of different tooth surfaces in all age groups
over the period of 8 years were similar without statistically significant deference.). The
mean DFS values of different tooth surfaces in the 11, 12, 13, and 15 age group in 1993 and
2001 are presented in Table 13.
Table 13. The mean DFS values of different tooth surfaces in die 11,12,13,
and 15 age group in 1993 and 2001.
The survey also showed that amalgam was the most frequently used filling material in
1993 and 2001 in all age groups. Compared to the data of 1993 amalgam was more
frequently used filling material in children and adolescents in 2001.
Figure 5.
Secondary caries in the 1993 study was mainly diagnosed in relation to amalgam (p<0,001), but in
2001 it was mainly related to the 'tooth coloured' material (p<0,05) (Fig. 5., 6.).
Figure 6.
Oral Hygiene
Oral hygiene was assessed in the 1993 study. The results showed that only one 11
year-old (0,3%), three 13 year-olds (0,9%), and eight 15 year-olds (1,6%) had no visible
plaque on the examined teeth. The majority of adolescents were found to have moderate
amount of plaque on the most of the teeth surfaces. Among 11 year-olds 94% of children
had heavy dental plaque deposits (score 3) on the 5,4 (68%) surfaces out of 8 examined. In
the 13 age group 92% of adolescents had heavy plaque accumulation (score 3) on the 5,0
(63%) surfaces. In the 15 age group 88% of adolescents were observed to have heavy
plaque on 4,5 (56%) surfaces. There were no significant differences between males and
females for oral hygiene.
Oral hygiene assessment is found in Table 14.
Table 14. Oral hygiene assessment (Silness & Loe,l964.) in 1993.
Periodontal condition
Over the period of eight years the good periodontal condition scores in all age groups increased
(Fig. 7.).
Figure 7.
In 1993 only 9,3% (34) children aged 11 had healthy periodontal condition whereas in
2001 the number of healthy periodontal condition increased to 46,4% (186) (p<0,001).
In 1993 among 13 year-olds 11,5% (39) were found to have healthy periodontal
condition which grew up to 40,5% (193) (p<0,001) in 2001 study. In the 15 year
age group the scores correspondingly were 9,3% (47) and 39,2% (202)
(p<0,001). Gingival bleeding was the most frequently encountered deviation in all age
groups. However, over the period of eight years a decline of gingival bleeding in all age
groups was observed. In 1993 study 74,9% of children aged 11 had gingival bleeding
recorded whereas in 2001 only 49,2% (p<0,001). In the 13 age group gingival bleeding in
1993 was found in 65,2%, of adolescents but in 2001 study - 52,9%. In the 15 age group
the scores correspondingly were 84% and 48,7% (p<0,001). The mean number of sextants
with healthy periodontal condition, gingival bleeding and calculus in children and
adolescents in 1993 and 2001 is presented in Table 15.
Table 15. The mean number of sextants with healthy periodontal condition (0), gingival
bleeding (1) and calculus (2) in children and adolescents in 1993 and 2001.
In the 1993 study the rates of periodontal disease prevalence (p<0,001) and the mean
number of sextants with healthy periodontal condition and gingival bleeding in Riga were
lower (p<0,01) than in the regions of Latvia. Table 16 shows the mean number of sextants
with healthy periodontal condition (0), gingival bleeding (1) and calculus (2) in children
and adolescents in all age groups in Riga and the regions of Latvia.
Table 16. The mean number of sextants with a healthy periodontal condition (0), gingival
bleeding (1) and calculus (2) in children and adolescents in all age groups in Riga and the
regions of Latvia.
Dental Survey of Children
Children were asked to fill out special questionnaires prepared for dental
survey. They included questions about age, gender, family situation parents'
education and occupation, oral hygiene habits, attitude to dental visits, selfevaluation of oral health and dietary habits.
Out of 1876 questionnaires 369 were not valid (wrongly filed out, no
reference to age, incompletely filled out). Only 1507 questionnaires were approved
to be valid for the research. There were 775 (51%) males and 732 (49%) females
with the total number of 1507 participants. The number and distribution of children
surveyed in 2001 by region is shown in Table 17.
Table 17.The number and distribution of children surveyed in 2001 by region.
Seventy per cent of respondents came from nuclear families with two children in a
family. Forty per cent of respondents pointed out that their parents had secondary
education but twenty seven per cent - higher education. Seventy six per cent of parents
were employed. Comparing with the regions the lowest unemployment level was in Riga
(7%), but the highest in Latgale (21%).
More than half of sample (58%) were informed that dental services are free of charge
till the age of 18. Fifty two per cent of respondents had their teeth treated in clinics, 34% in private clinics and 12% - at school. As the main reason preventing children from
attending dentist 45% of respondents mentioned fear of pain and teeth treatment. As
another important reason (20%) was mentioned lack of time. Among 15 year-olds 24%
admitted having no time to go to the dentist, but in the group of 11 year-olds - 17% had no
time to see dentist. However, 35% of respondents admitted that they had no reason not to
visit the dentist.
In the group of 1 lyear-olds 1% assessed their teeth to be in a bad condition, whereas
in the group of 15 years-olds - 3%. Majority of respondents (57%) assessed their teeth to
be in a good condition, 33% - average and 8% - in a very good condition. (The number of
students considering their teeth to be in a good or very good condition decreased with age)
The perception of a good or very good dental health among respondents decreased with
age (p<0,001) and the number of respondents assessing their teeth as average increased
(p<0,001). Oral health self-evaluation is shown in Table 18.
Table 18. Oral health self-evaluation in various age groups (%) in 2001.
In assessing oral hygiene the majority of adolescents (45%) brushed their teeth more
than once a day, 37% once a day. Only 1% had never brushed their teeth. In all age
groups females brushed their teeth more often than males (p<0,001). Frequency of teeth
brushing in various age groups is shown in Table 19.
Table 19. Frequency of teeth brushing (%) in various age groups among males and
females in 2001.
Consumption of fluoride tablets among adolescents reduced with age (p<0,001).
La the group of 11 year-olds 47% of respondents took fluoride tablets, whereas in the
group of 15 year-olds only 27% had regular intake of fluoride tablets. According to
regions, the highest intake of fluoride tablets were observed in Vidzeme (43%), but the
lowest (29%) in Latgale. Only 25% of respondents flossed their teeth.
Snacking between meals was acknowledged by 49% of respondents. Snacking
rates were the highest (55%) in the 13 year group (p<0,01). Compared with other
regions 59% of respondents of Riga admitted snacking between meals. The dietary
habits of various age groups in different regions are shown in Table 20.
Table 20. Dietary habits in various age groups in different regions (%) in 2001.
In all age groups 44% of respondents consumed sugary products. Similarly
with the data on snacking between meals, the rates of consumption of
confectionary on daily basis in Riga were higher than in regions (57%). The
frequency of consumption of sugary products in different age groups and in
different regions is demonstrated in the Table 21.
Table 21. The frequency of consumption of sugary products {%) among adolescents in
different age groups in different regions
Conclusions
1. The dental caries incident rates in children and adolescents at the age of 11,13, and
15 over the period of 8 years have decreased.
2. The statistically significant decline of dental caries prevalence in children and
adolescents at the age of 11,13, and 15 over the period of 8 years was not observed
and according to the World Health Organization classification the dental caries
rates can be regarded as high.
3. In Riga in all age groups the highest score of DMF consisted of filled teeth (F) but
in the regions of Latvia - decayed teeth (D).
4. In all age groups the highest number of dental caries was diagnosed on occlusal
surfaces. The dental caries rates diagnosed on approximal surfaces increased with
age.
5. Females in all age groups had higher DMFT and DMFS scores than males. The
data do not confirm the fact of the gender role in dental caries increment as the
differences recorded were not statistically significant.
6. The practice of using sealants to cover teeth fissures and pits in children and
adolescents in Latvia is rarely used.
7. Dental amalgam is the most frequently used restorative material in posterior teeth
in 1993 and 2001 in all age groups. Secondary caries was mostly diagnosed in
relation to 'tooth coloured' material.
8. Comparing with the research data of 1993 the prevalence of periodontal disease in
children and adolescents at the age of 11, 13, and 15 in Latvia has decreased. The
most widespread periodontal disease in children and adolescents in La tvia is
gingival bleeding. Prevalence of periodontal diseases increases with age.
9. In Riga the rates of periodontal disease in all age groups are lower that in the
regions of Latvia.
10.Frequency rates of teeth brushing and dietary habits of the children and adolescents
of the age of 11, 13, and 15 in 1993 and 2001 are similar.
Publications
1. S-Bērziņa, R. Care. "Periodonta patologiju izplatība pusaudžiem Latvija 1993. un
2001. gada". RSU Zinātnisko rakstu krajums 2003. gada (in press).
2. S. Bērziņa, R. Care, Dental Health in 11 and 13 year old Children in Latvia. Baltic
Dental and Maxillofacial Journal "Stomatoloģija", 2003, Vol5., N.2, 62 - 65.
3. R. Care, I. Urtāne, R. Rastipa, S.Bērziņa. Zobu kariess, sociālā vide un zināšanas
par mutes higiēnu 12-13 gadus veciem bērniem Latvija 1993 gada. RSU Zinātniskie raksti 2002, 328 -331.
4. S. Bērziņa, R. Care. Mutes higiēnas un ēšanas ieradumi pusaudžiem Latvija. RSU
Zinātniskie raksti, 2002, 323 - 327.
5. I. Rence-Bamblte, S. Bērziņa, R. Care. Augstas intensities kariesa raksturojums
12 - 13 gadus veciem pusaudžiem Rīgā. RSU Zinātniskie raksti, 2002, 332 - 335.
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6. R. Care, S. Bērziņa, I. Grīnvalde, E. Senakola. Periodonta slimību izplatība Latvijā.
AML/RSU Zinātniskie raksti 2000, Riga, 2001,175-1791pp.
7. S. Bērziņa, R. Care. Kariess un periodonta patologijas pusaudžiem Latvijā.
AML/RSU "Zinātniskie raksti"2000, Riga, 2001,171 - 1741pp.
8. R. Care, S. Bērziņa, I. Rence - Bambīte et al "Efficacy of a new caries - inhibitory
restorative material and amalgam as cntrol in 12-13 year old Latvian a doles cents
with high caries prevalence - Results after 12 months" - American Journal of
Dentistry,- 1999. Vol. 12, special Issue, November, 1999-SI-S20,17-18.
9. S. Bjarnason, R. Care, S. Bērziņa - "Caries Epidemiology in Latvian nursery school
children. Com. Dent. Oral Epidemiol. 23,138-141,1995.
10.S. Bjarnason, R. Care, S. Bērziņa. - "Oral health in Latvian 15 - year - olds". Eur
jOralSci 103,274-279, 1995.
11.I. Urtāne, A. Brinkmane, E. Senakola, S. Bērziņa. "ICS - 2" projekta gaitaun zobu slimību
epidemiologiskie dati Latvijā. Zobarstniecības menešraksts 1, 36-40, 1994.
Reports about the results of the present thesis:
1.
2.
3.
4.
5.
6.
7.
NOF Congress, Goteborg, Sweden, 1994
NOF Congress, Oslo, Norway, 1995
3rd World Congress of Latvian physician and dentists, Riga, Latvia, 1997
AMLI Scientific conference, Riga, Latvia, 1999
Promoting Oral Health in the 21st Century, Cork, Ireland, 2000
RSU Scientific conference, Riga, Latvia, 2002
RSU Scientific conference, Riga, Latvia, 2003