CLINICAL CONSEQUENCES OF UNTREATED DENTAL CARIES IN CHILDREN

Abstract

Aim: Most dental caries in developing countries remains untreated especially in children. Only limited data are available on the clinical consequences of untreated dental caries because there is no measure to quantify the prevalence and severity of oral conditions resulting from untreated dental caries. Recently, the PUFA index has been used to display the severity of oral health neglect. Therefore, the aim of this crosssectional study was to assess the odontogenic infections in primary teeth of 4- and 12-year-old children.

Methods: Data from oral examinations provided from the Marmara University, Dental School during the months of December 2015 - January 2016. A total of 124 children aged 4-12 were included in this cross-sectional epidemiological study. This study was performed with ethical approval by the ethics committee of the Marmara University (registration number 22.02.2016-24).The clinical consequences of untreated primary molar were recorded by using the PUFA index The PUFA index per child represents the number of teeth meeting the following diagnostic criteria: Decayed teeth with visible pulpal involvement (P/p) was recorded when the open pulp chamber was visible or the clinical crown was destroyed and only root fragments were left. Ulceration (U/u) of the soft tissue surrounding the tooth was scored when caused by dislocated tooth fragments. Fistula (F/f) was diagnosed when a pus-releasing sinus tract was related to the tooth with pulpal involvement. Abscess (A/a) was scored when a pus-containing swelling was related to the tooth. The diagnosis of the PUFA index was performed visually, without the use of a dental probe.

Results: 122 (58 boys and 66 girls) children 4-12 year-olds were examined, a 98% response rate. Mean age was 7.6 ± 3.2. The mean PUFA was 1.10 ± 1.49. The prevalence of PUFA was 19 (15%) and exclusively concentrated on pulpal involvement (p) with a mean PUFA of 0.1±0.5. Pulpal involvement (p) was scored most frequently 118 (95%). Virtually all PUFA scores were concentrated on primary molars with pulp involvement. Boys had a higher PUFA (1.26 ± 1.69) than girls (0.97± 1.29) and mean PUFA score was higher in the population under 6-year- olds.

Conclusion: The PUFA index highlights relevant information by assessing the severity of untreated dental caries. This data might be used by dentists and decision makers to promote oral health care programs for children at high caries risk.