PREVALENCE OF DENTAL CARIES, SALIVARY LACTOBACILLUS LEVEL AND ASSOCIATED FACTORS AMONG PRIMARY SCHOOL CHILDREN IN HARAR, EASTERN ETHIOPIA

Abstract

Background: Dental caries (decay or cavities) is a breakdown of teeth as a result of bacterial activity. Lactobacillus bacteria play a major role in dental caries. The number of Lactobacillus is related to the activity of another cariogenic bacteria, whose major role in initiating the caries process. Caries is associated with pain, sepsis and reduced learning ability. Although effective methods are known for prevention and management of the disease, the prevalence of dental caries is increasing among school age children, predominantly in middle income countries. Despite the fact that dental caries is affecting majority of the Ethiopian children, much is not known about the extents and factors influencing the occurrence. Objective: The main aim of this study was to determine the Prevalence of dental caries, salivary Lactobacillus level and associated factors among primary school children in Harar, Eastern Ethiopia from February 7 to March 14, 2018. Methods: School-based cross-sectional study was conducted on 407 primary school children in Harar, Ethiopia. The schools were selected by lottery method and study participants were selected using systematic random sampling technique. The data were collected using structured questionnaires to assess factors associated with dental caries and clinical examination was conducted. Saliva samples were collected and transported to Medical Laboratory Science department laboratory following the standard procedures. Microbiological saliva culture and identification were conducted using de Man, Rogosa and Sharpe agar media and anaerobic 24hrs culture. Data was entered into Epi data software version 3.1 and exported to Statistical Package for Social Science software version 25.0 for analysis. Odds ratio was used to determine the predictors of the outcome. Statistical significance was defined at a p value of less than 0.05. Result: The prevalence of dental caries was 36.9%. The mean Decayed, Missing and Filled Teeth value of the participants was 0.95 (SD±1.57). The decayed component accounted for 84.6% of the total. About 67.1% of the saliva culture revealed significant Lactobacillus count. The mean bacterial count was 14.92 x 105 (SD±22.92 x 105 ). Previous year average academic score less than fifty percent (AOR=3.68 95%, C.I=1.10-12.29), grade levels of children 1-4 (AOR = 1.73, 95% CI = 1.02 – 2.92), sweet food consumption habit (AOR =4.08, 95%CI=1.62-10.25), absence of daily teeth cleaning habit (AOR = 2.23, 95% CI = 1.32 – 3.78), absence of toothpaste use (AOR = 3.05, 95% CI: 1.69-5.49 P=0.001), dental ache history (AOR = 2.95, 95% CI = 1.78 – 4.89), significant salivary Lactobacillus count (AOR = 4.01, 95% CI = 2.24-7.18), acidic and basic salivary pH with (AOR = 1.93, 95% CI = 1.07-3.48) (AOR = 0.38, 95% CI = 0.17-0.88) respectively were significantly associated with dental caries. Conclusion: Dental caries is a common chronic infection among school children. Poor oral hygiene, sweet diet, lower grade level and significant Lactobacillus count were found to be significant determinant factors. Health information dissemination on oral hygiene and dietary habits are obligatory to prevent dental caries among primary school children