Caries experience,oral hygiene and nutritional status among 5-15 year old children with hearing-disability in comparison to those without hearing-disability
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Background: The hearing disabled are a significant part of the society who are often trivialized or forgotten in comparison to most other disabilities. A high prevalence of dental caries, poor oral hygiene and poor nutritional status has been reported among children with hearing disability. However, there is paucity of this data in many parts of the developing world, including Kenya. Objectives: To compare the caries experience, oral hygiene and nutrition of children with hearing disability to those without hearing disability. Study design: This was a cross-sectional study over a period of three months. Subjects & methodology: A total of 162 children were recruited in the study. Of these, 81 included all the children with HD in the city council deaf units in Nairobi. Matching was done for age and gender with 81 children without HD from the same schools. Data on the frequency of taking confectionaries was collected using a confectionary frequency chart from the parenti guardian. Oral examination was carried out to assess caries experience using dftl DMFT index and oral hygiene status was assessed using Loe and Silness index (1964). Nutritional status was assessed using BMI for age index and HAl index, and recorded in a nutritional assessment form. Data analysis: Data on dental caries experience and oral hygiene status was analysed using SPSS - 12.0. (SPSS Inc, Chicago, Illinois, USA), while nutrition data was analysed using the Epi-Info statistical programme 3.5.1 Chi-square (l) test, Mann-Whitney U Test, Spearman's rank order correlation and One way ANOVA were used. The confidence level was set at 95% (psO.05). Results: The mean age of children with HD was 10.3 years, 36 (44.4%) were males and 45 (55.6%) were females. The Mean dft was lower among the children with HD (1.06 ±2.34) compared to' the children without HD (1.11 ±2.72). This was not statistically significant (p = 0.67). The mean DMFT was higher among the children with HD (0.56 ±1.42) compared to the children without HD (0.19 ±0.55). This was statistically significant (p = 0.05). Mean plaque score was significantly higher among the children with HD (1.18 ±0.5) compared to the children without HD (1.07 ±0.43). p = 0.04. Stunting (HAl < -2) was higher in 6 children (7.41%) with HD compared to 5 children (6.17%) without HD. This was not statistically significant (p = 0.76). Underweight (8MI for Age < 5%) was higher in 18 children (22.22%) with HD compared to 11 children (13.58%) without HD. This too was not statistically significant (p = 0.15). Overweight (8MI for Age 85%-95%) was higher in 6 children (7.41%) with HD compared to 3 children (3.70%) without HD. This was not statistically significant (p = 0.30). Four children (4.94%) without HD were obese (8MI for Age ~95%) while one child (1.23%) with HD was obese. This was not statistically significant (p = 0.17). Generally, there was a negative correlation between caries experience and nutritional status in both groups, though this was not statistically significant. Children with HO provided 544 responses as to their frequency of consuming confectionaries, with 205 responses (37.68%) being consumption more than twice a week. Children without HO provided 671 responses as to their frequency of consuming confectionaries, with 248 responses (36.96%) being consumption more than twice a week. This was not statistically significant (p=0.08). Frequency of taking 'kool' was found to have an association with the dft among the children with HO (p = 0.001), while milk! tea with sugar was found to have an association with dft of the children without HO (p = 0.02). Conclusion: Children with HO had a lower mean dft compared to children without HO. This was not statistically significant. However, children with HO had statistically significant higher mean OMFT compared to the children without HO. The higher mean OMFT among the disability group is supported by their significantly higher mean plaque score and higher frequency in taking confectionaries. With the exception of obesity, the nutritional parameters were poorer among the HO, compared to the non HO, though not statistically significant. As caries experience increased the nutritional status generally reduced in both groups, though not statistically significant. 'Kool' had a significant association with the caries experience of deciduous teeth among HO group, while milk! tea with sugar had a significant association with the caries experience of the deciduous teeth among the non HO group. Recommendations: There requires increased efforts towards oral health campaigns targeting unmet dental needs (dental caries) and improving snacking habits among children, with more emphasis on children with HD. The city council should be involved so as to eliminate 'kool' and other confectionaries from kiosks located within and near schools. A future study to assess toothbrushing , habits and the reason for higher plaque scores among children with HD would be beneficial.