Evaluation of Oral Health Status and Dietary Habits in School Children among age 12-14 years; A Cross-Sectional Study

is rising. Current epidemiological statistics are required to determine treatment needs. These numbers are not presently accessible for elementary school students. Objectives: To assess the Oral health status of secondary school children 12 – 14 years through DMFT index and to determine the relationship between dietary habits and Dental caries of secondary school children aged 12 – 14 years via questionnaire. Methods : A cross-sectional study was conducted through interviews and clinical examinations in three Secondary schools of children based in Lahore. Number of participants were 398 children aged 12 to 14 years, encompassing both males and females. Oral health status and Dietary habits were evaluated through DMFT Index and Self-administered WHO Approved Questionnaire. Correlation of Demographic variables and Dietary habits of participants with High DMFT was observed. Results: The DMFT percentage was found to be 76% among 398 participants, indicating a signi�cant burden of dental carries in our population. The Correlation between poor dietary habits and Dental caries was established through Chi square test. A statistically signi�cant correlation (p<0.05) was noted among Dental caries and high sugary intake. No signi�cant relation was observed among other variables and Dental Caries. Conclusions: Unsatisfactory Oral health status and poor food habits among school-aged youngsters. It calls for urgent action to improve oral health status and promote healthier dietary choices, seeking to minimize tooth decay frequency while improving general dental hygiene.


PAKISTAN JOURNAL OF HEALTH SCIENCES
Farwa Shahid , Farrah Pervaiz , Muhammad Farrukh Habib , Maryam Masood , Azka Naseem and Humaira Mahmood [ 7 ] .T h e s e i s s u e s we r e i d e n t i e d a m o n g p o o r socioeconomic strata throughout developed and emerging countries.Dental well-being is associated with dental health, healthy tissues, and mouth delicate tissues.Education holds signi cant importance as a platform for learning, not only in terms of knowledge acquisition but also for overall health and associated with health habits [8].
To improve opportunities for increasing dental hygiene, the ideas of a healthy educational environment and an overall wellness promoting institution have evolved throughout Europe [9].The World Health Organization (WHO) has introduced the "educational institutions health lessons program" to support for the establishment of "healthpromoting schools" and has provided strategies to encourage oral hygiene practices within educational institutions [10].Integration of oral health and dental camps into the school syllabus has become essential.Study focusing on the success of numerous styles of Dental hygiene lectures and their effectiveness in enhancing oral hygiene among kids has increased signi cantly during the last few years [11].
The aim of present study was to determine the oral health status and dietary habits in school children among age 12-14 years.

M E T H O D S
This cross-sectional study was carried out on 398 individuals, with ages ranging from 12 to 14 years, from three private schools in Lahore for 6 months between June 2023 to Dec 2023.Since no data on dietary habits was available, we assume prevalence 50% and using WHO calculator sample size was 385 and we increase to 398 for generalizability of results.

R E S U L T S
The study consisted of a total of 208 male participants and 190 female participants.Among them, the 12-year age group comprised 84 males and 56 females, the 13-year age group included 70 males and 65 females, and the 14-year age group consisted of 54 males and 69 females.In terms of geographical distribution, there were 106 males and 89 females from rural areas, while 102 males and 101 females were from urban areas (table 2).index, while other subgroups did not exhibit any signi cant differences.Patients in the 12-year cohort were identi ed to have a substantial DMFT score in the DMFT index high range, and had a notably higher prevalence rate (46%) compared to other age groups.Furthermore, males exhibited a higher prevalence rate (38%) in comparison to females.Similarly, participants with parents who had a low educational status, both fathers (54%) and mothers (62%), demonstrated higher prevalence rates.Additionally, individuals who did not maintain regular tooth brushing habits (69%) and those who initiated tooth brushing at a later age (38%) also showed higher prevalence rates within this group.These ndings suggest that age, gender, parental education, and oral hygiene practices are key variables in uencing the rising frequency of issues with teeth within the high DMFT index group.The lowest range, from 0 to 1.1, accounted for approximately 24% of the participants, indicating a relatively low severity of dental caries in this subgroup.Moving up to the next range, which spanned from 1.2 to 2.6, approximately 26% of the participants had slightly higher DMFT scores, suggesting a moderate level of dental caries prevalence.The range of 2.6 to 4.4 encompassed the largest proportion of participants, approximately 43%, who had higher DMFT scores.This suggests a greater percentage of decaying, missing, or lled teeth and a heavier load of tooth decay in this group of people.Inside the limits of 4.5 to 6.5, a smaller percentage (approximately 3.5%) of participants exhibited even higher DMFT scores, indicating a signi cant dental caries had a greater frequency and greater quantity of tooth decayed.This range represents a higher severity of oral health problems among these individuals.Finally, the category of >6.5 included another 3.5% of participants who had the highest DMFT scores, indicating the most severe cases of dental caries and the greatest number of affected teeth.The average DMFT value computed for the total sample size of 398 students was 2.36.The mean gure gives a snapshot of the participant population's general incidence and extent of tooth decay.Nevertheless, it is vital to highlight that examining the variation of DMFT values across various categories offers a broader overview of the individuals' different degrees of decay intensity in their teeth.This research aimed to investigate children's perceptions of oral hygiene practices and attitudes, particularly focusing on their age when they started tooth brushing and their regular visits to the dentist.Despite this, since the research we conducted exclusively addressed youngsters between 12-14 years, our conclusions on the frequency of tooth decay might vary signi cantly from those ndings.This research discovered that a considerable 76% of youngsters aged from twelve to fourteen had cavities in their teeth, representing roughly three-fourths of the examined population.These were not in accordance to a study carried out by Habib et al.,where 59.7% were healthy between age 13-17 years, this may be due to difference in population being studied and sample size [12].These ndings did not align with the goals set forth by the World Health Organization and the International Federation of Dentists [13], which sought to achieve a caries-free rate of 60% among children aged 12 to 14, along with a global average DMFT score of 3 or lower by the age of 12.The mean DMFT of the present study was 2.36 which shows the emergency treatment needs.Present study was in accordance to a study between 6-12 years carried out by Habib et al., where mean DMFT index was 2.28+0.907,where more than 2/3 of children age between 6-12 years needs urgent dental care [14].Still, in terms of education, the ndings revealed an opposite relationship between level of education and DMFT.The aforementioned ndings support the ndings.In this investigation, we looked at the relationship amongst gender, years of age, parents' education, and place of residence, in addition to their effect on DMFT [15].Surprisingly, no signi cant correlations were found between these variables and high DMFT scores.However, we did observe a high incidence of

D I S C U S S I O N
dental caries associated with the consumption of sugars and snacks.This nding is in line with previous studies that have consistently demonstrated a strong correlation between sugar consumption and caries incidence in both children and adults [16].The results of this study emphasize the necessity for boosting dental awareness and implementing prevention techniques that involve frequent teeth cleansing and mouthwash use, to improve oral health outcomes.Because dental health is inextricably related to entire physical well-being, and oral disorders are common globally.The frequency of dental illnesses is i n c r e a s i n g , e s p e c i a l l y b et we e n k i d s i n s c h o o l .Implementing strict brushing and ossing behaviors is critical in avoiding the development from these disorders [17].Regular application of toothpaste that contains uoride is suggested, and brushing regularity is important for preserving good oral health.Brushing multiple times, a day is more e cient than brushing less often in eradicating tooth bacteria [18].These factors can signi cantly impact the prevalence of dental issues among individuals [19].Contrary to other studies, our ndings revealed that there existed little variation in dental health condition among males and females (74% vs. 79%) [20].

Table 1 :
DMFT Index Classi cation providing essential data on the subjects' general dental condition (table 1).Ethical permission was taken from Armed Forces Post Graduate Medical Institute, Rawalpindi.The dental examination conducted in this study followed the guidelines provided by the American Dental Association (ADA), speci cally Type III examination protocols.disposable mouth mirrors, dental explorers, and torchlights.The patients sat properly on conventional chairs with backrests, while the examiner sat in front of each youngster.The emphasis of the oral exam was on assessing tooth decay in all teeth.
Pilot research was previously carried out on 30 participants to check the validity and reliability of the questionnaire.Using kappa statistics, 0.84 was discovered.Data was collected entered and analyzed using SPSS version 26.0 Descriptive analysis, mean and percentage calculations, and statistical analysis were performed using SPSS version 26.0, and chi square test was applied between groups.

Table 3
shows the outcomes of the chi-square test, which revealed that subgroups within variables demonstrated signi cant differences within different groups of the DMFT Shahid F et al., DOI: https://doi.org/10.54393/pjhs.v5i03.1326Oral Health Status and Dietary Habits in Children PJHS VOL. 5 Issue.3 March 2024 Copyright © 2024.PJHS, Published by Crosslinks International Publishers

Table 3 :
The Correlation between Dietary Habits Variables and DMFT (Chi Square Test)