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Indian Journal of Community Medicine

A Cross-Sectional Study of Factors Related to Oral Health in Rural Area of Loni, Western Maharashtra

Author(s): Jayashree D. Chatufale, R.C. Goyal

Vol. 27, No. 2 (2002-04 - 2002-06)

Deptt. of Preventive and Social Medicine, Rural Medical College, Loni-413736, Tal Rahata, Maharashtra


Research question: What are the various factors which determine oral health?

Objective: To find out relation between various oral hygiene practices and oral health.

Study design: Cross-sectional.

Setting: Rural.

Participants: 1230 study subjects from 15 villages under field practice area of Rural Medical College, Loni.

Statistical analysis: Chi-square test.

Results: Oral health varies significantly with variation in practices related to cleaning of mouth. Conclusion: Oral diseases are strongly related with frequency of mouth washing, type of cleaning aids, rinsing of mouth.

Keywords : Dentition status, Cleaning aids, Cleaning materials


General health and oral health are inseparable, oral cavity is the mirror which reflects general health1. Oral diseases are topping the list of some common diseases in the world. The chronic, recurrent, irreversible cumulative and prevalent nature of oral diseases have contributed to wrong belief that oral problems are inevitable and not preventable.

In India, the prevalence of dental caries is 80% with 5 decayed teeth per child on an average at the age of 16 years. In some populations, the prevalence rate of periodontal diseases approach 90-100%2. It is a fact that oral hygiene is seen as a natural part of total body cleanliness and that people desire fresh and healthy mouth with good smelling breath.

Material and Methods:

Study area: Randomly selected 15 villages under three primary health centres namely Loni, Talegaon and Guha which form the field practice area of Rural Medical College of Pravara Medical Trust, Loni, Maharashtra.

Study population: Comprised of 1,00,792 population from 15 villages.

Study sample: Considering prevalence rates of common oral diseases to be 53% with a maximum allowable error of 5% a minimum of 1200 sample size was calculated. Therefore, 1230 subjects were selected from 15 villages as follows, 300 subjects each from the age of 5 and 12 years and 105 subjects each from the age groups 15-24, 25-34, 35-44, 45-54, 55-64 and 65-74 years.

Significance of each age group3.

5 year: This age is of interest in relation to level of caries in primary dentition which may exhibit changes over a shorter time span than the permanent dentition at other index ages.

12 year: At this age all permanent teeth except third molar will have erupted. It is the global monitoring age for international comparison.

15-24 years: At this age permanent teeth have been exposed to oral environment for more than 3-9 years. The assessment of caries prevalence is, therefore, more meaningful than 12 years of age. Age groups from 25-34 years to 55-64 years: These age groups are standard monitoring age groups for health conditions of adults. The full effect of dental caries and general effect of care provided can be observed.

65-74 years: Data for this age group is needed both for planning appropriate care for the elderly and for monitoring overall effects of oral care.

Data Collection: A pilot study was done in a village on 25 subjects and necessary modifications in the questionnaire were made before conducting the final survey. A house to house visit was made by the team consisting of investigator and two interns. After reaching the center of the village the roads were given numbers (1-4). A random number between 1 to 4 was selected from the currency note and that numbered road was selected for house to house data collection. After visiting all households from that road, houses on next consecutive numbered road were visited. If any house was found to be locked, a subsequent visit was made to same house on next day. In this way 80 subjects from each village were selected.

Oral examination: Only clinical oral examination of every subject was done in the house or outside the house of the subject with subject seated. Examination was done with the help of torch or in the natural light (if examination was done outside the house). Prior to the start of the study, the investigator was posted for 15 days in extension O.P.D. of Rural Dental College of Pravara Medical Trust.

Instruments required for examination: Plain mouth mirror, periodontal probes, two containers (one for used instruments and one for sterilized instruments), concentrated sterilizing solution, soap and water. With proper use of mouth mirror and periodontal probe all areas of oral cavity could be fully examined without the need for digital manipulation of the oral tissues hence reducing the risk of cross infection.

Duration of study: Time required for conducting house to house visit for oral examination and to analyze the results took 9 months, i.e., from April to December 1998.

Terminologies used: Mishri: Burnt form of powdered tobacco.

Datun: Small stem of neem tree.

Dentition status: For assessment of dental caries - a microbial disease of the calcified tissues of teeth, characterised by demineralisation of the inorganic portion and destruction of the organic substance of the tooth.

Results and Discussion:

Table I: Age and sex distribution of subjects with dentition status.

Age (years) Sex Total No.
of subjects
of dental
5 Male 150 95
  Female 150 83
12 Male 150 80
  Female 150 86
15-24 Male 53 20
  Female 52 26
25-34 Male 53 26
  Female 52 22
35-44 Male 53 24
  Female 52 34
45-54 Male 52 20
  Female 53 28
55-64 Male 52 31
  Female 52 36
65-74 Male 52 36
  Female 53 33

Table I indicates that prevalence of dental caries at 5 years age was higher (59.33%) than at 12 years age (55.33%) and at 15-24 year age group (43.8%) because primary dentition has higher susceptibility for caries than permanent dentition. Prevalence of caries in males and females was 58.98% and 53.98% respectively.

Bhowate R.R. et al4 reported prevalence rate of dental caries as 53.5% for 11-15 years age group which is similar to present study. Goyal R.C. et al5 showed prevalence of dental caries as 53.18% which is similar to present study.*

Table II: Distribution of subjects as per type of cleaning aids and dentition status.

Type of cleaning aids Dental caries Total
Absent Present
Finger 352 496 848
Tooth-brush 180 120 300
Datun 08 14 22
Plain water 10 50 60
Total 550 680 1230

Table II shows that more than two third of the subjects used finger as cleaning aid of which 59% had dental caries compared to only 40% of those who used tooth brush. This was statistically significant (p<0.05). Bhowate R.R. et al4 reported from his study that 26.31% of subjects used toothbrush, which is similar to present study. Chakraborty M et al6 showed maximum prevalence of dental caries (72.38%) among those who used fingers for cleaning their teeth followed by datun users (67.5%). Goyal R.C. et al5 reported that dental caries was less (46.63%) with brushing of teeth than other methods of cleaning (53.37%).

Table III: Distribution of subjects as per cleaning material used and dentition status.

Cleaning material aids Dental caries Total
Absent Present
Mishri 402 329 731
Tooth paste 40 69 109
Tooth powder 99 66 165
Tooth paste+Mishri 08 11 19
Tooth powder+Mishri 54 31 85
Others 38 35 73
Nil 39 09 48
Total 680 550 1230

Table III shows that out of 1230 subjects 680 had dental caries, 402 subjects having dental caries used mishri and out of 48 subjects in the study who did not use any cleaning material 39 has dental caries.

Table IV: Distribution of subjects as per frequency of tooth cleaning and dentition status.

Frequency Dental caries Total
Absent Present
Once 427 569 996
Twice or more 116 70 186
Nil 07 41 48
Total 550 680 1230

Table IV indicates that majority (62%) of those cleaning their teeth twice or more per day were caries free as compared to those who were cleaning once per day (42%). The difference was significant statistically (p<0.05). The figures are similar to Goyal R.C.5, who reported the prevalence of dental caries to be low (31.46%) in children who cleaned their teeth twice a day than those who cleaned only once a day (68.81%).

Table V: Distribution of subjects as per rinsing of mouth and dentition status.

Rinsing of mouth
after meals
Dental caries Total
Absent Present
Once 462 394 856
Twice or more 88 286 374
Total 550 680 1230

Table V shows that 394 subjects who practiced rinsing of their mouth after consumption of food had dental caries in contrast to 286 who did not practice rinsing after consumption of food. The difference was found to be statistically significant (p<0.05). Chakraborty M et al6 also reported the similar results.

Limitation of the study:

The previous contact of the subjects with the dentist, which might have helped to improve their dental hygiene was not taken into consideration.


  1. WHO. Oral health for healthy life. Leaflet press release on World Health Day, 7th April, Geneva (1994): 1-2.
  2. Kulkarni AT, Sachdeva NL. The problems of oral health in India. Swasth Hind, 1995 XXXIV (5,6): 62-4.
  3. WHO. Basic Oral Health Surveys, 4th edition, Geneva (1997): 6-20.
  4. Bhowate RR, Borle SR. Dental health amongst 11-15 year old children in Sewagram, Maharashtra. Indian Journal of Dental Research. Apr-June 1994: 5-6.
  5. Goyal RC, Sachdeva NL, Somsundaram KV. Oral Health Status of rural community in Western Maharashtra. Indian Journal of PSM. July-Dec 1994; 25(3): 138-45.
  6. Chakraborti M, Saha JB, Bhattacharya RN. Epidemiological correlates of dental caries in an urban slum of West Bengal. Indian Journal of Public Health. 1997; XXXXI: 56-67.
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