Dental Morbidity Among School-Going Adolescents in a Fluoride-Endemic Belt of Rural Andhra Pradesh

Oral health problems are one of the major public health concerns that predominantly affect children, thereby affecting their general health, self-esteem, and quality of life. This study aimed to estimate the burden of dental caries, gingivitis, malocclusion, and fluorosis and understand healthcare utilization patterns and oral hygiene practices among school-going adolescents in a fluoride-endemic belt in the rural areas of Chittoor district, Andhra Pradesh, India.

Cross-sectional survey was conducted among 10-15 years aged school children in Gudipala Mandal of Chittoor district. Data on dental morbidity, oral health practices, and health utilization were collected. Categorical variables were presented as frequencies, and factors associated with dental caries were assessed using the chi-square test and adjusted for confounders using multiple logistic regression.

Among the 808 study participants, the proportion of dental caries was 36%, gingivitis 12%, fluorosis 29%, and malocclusion 6.3%. Good oral hygiene was observed in 68% of the study participants. Health-seeking behavior was reported by only 2.2% of the participants. Older children aged 13-15years [OR: 0.72 (95% CI: 0.53-0.98)], good oral hygiene [OR: 0.57 (95% CI: 0.42-0.78)], and mild fluorosis [OR: 0.72 (95% CI: 0.52-1)] were independently protective against dental caries.

The overall burden of dental caries and gingivitis was less, but health utilization was poor, indicating the need to bring awareness about healthcare facilities and the importance of seeking treatment in the local community. Health systems should support capacity building of primary care facilities to make dental treatment accessible, available, and affordable and aid in establishing proper referral pathways for seeking secondary care if necessary.