Oral health among children in the Barents region: study on determinants of child’s oral health, their oral related quality of life and quality of dental care

Abstract

In most industrialised countries, children’s and adolescents’ oral health has improved during the past 15 years. This is especially the case in the Nordic and Western European countries. The aim of the present series of studies was to assess the dental status, its determinants and oral health related quality of life in 12-year olds children from two regions in the Barents area, in Northern Norway and in North-West Russia. One study also analysed the oral health care provision systems and their performance in all countries in the Barents region. Four studies based on three data sets were undertaken. A pilot study comprising of questionnaires to 12-year olds children and their parents and a clinical examination of the children was undertaken in Severodvinsk (n=70) and in Tromsø (n=78) in 2009. A new clinical study, modified according to the findings of the pilot study, was conducted during 2010-2011 on 590 children in Arkhangelsk and 246 in Tromsø. Participants were selected using a stratified cluster sample procedure. Clinical examinations used methods recommended by the WHO. Both the children and their parents filled in questionnaires about determinants of dental caries and perceived oral health related quality of life of the children. The participation rate was 87% in Russia and 47% in Norway. Conventional statistical methods were used in the analyses. For the fourth study, the data were collected from national and local reports, supplemented by questions to local experts and chief dentists. Comparative case studies were provided. The results revealed that the mean DMFT and DMFS-scores were significantly higher in schoolchildren in Arkhangelsk (respectively 3.0 and 4.4) than in Tromsø (1.2 and 1.5, p<0.001). Half of the Norwegian (52%) but only 16% of the Russian children were caries free and the Norwegian children also had better oral hygiene than the Russian ones. Most parents in Russia (65%) and a third (31%) of the Norwegian parents were dissatisfied with the school dental service. The strongest predictor of bad oral health among the study subjects was being of Russian origin; both the questions put to the children (OR=3.8) and to the parents (OR=2.4) were consistent with this. Other strong predictors were (from questions to children) the child having had filling therapy during the latest dental visit (OR=5.0) and (from questions to parents) the parent having had problems with teeth during the last two years (OR=1.8) Most Russian 12-year-olds were found to be less satisfied with their oral health compared with the Norwegians and the oral health related quality of life (CPQ11-14) overall score was 9.9 for the Norwegian and 19.5 for the Russian children (p <0.001). In all countries, except Sweden, the mean 12-year-olds DMFT values were higher in the Barents region than in the more central parts of each country. Furthermore, fewer resources were available for dental care. The study revealed a great need for preventive efforts in dental care especially in the Russian parts of the Barents area.