10.59987/ads/2012.2.38-43
The aim of this study was to determine the caries prevalence in urban and suburban Albanian schools. A large sample (n= 2617) of subjects, aged 7-15, was examined by a clinical observation without radiograms. The sample comprised 1257 males and 1360 females. For each subject an anamnestic questionnaire about feeding, fluoride, dentist attendance and familiar informations was obtained. Gender and age differences were compared by Chi-square test. The total dmft index (decayed, missing and filled teeth in deciduous dentition) was 2.082; dmft in males was 2.137, in females was 2.032. The total DMFT index (Decayed, Missing and Filled Teeth in permanent dentition) was 2.327; DMFT in males was 2.253, in females was 2.396. Decayed teeth was principal component of both dmft and the DMFT index. Caries prevalence results higher in girls than boys in deciduous and in permanent teeth.
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Annali di stomatologia
Albanian schoolchildren
Caries prevalence in a 7- to 15-year-old Albanian schoolchildren population
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Caries prevalence in a 7- to 15-year-old Albanian schoolchildren population
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                                                                                                   Original article



Caries prevalence in a 7- to 15-year-old Albanian
schoolchildren population




                                                                                         li
Giuseppina Laganà, DDS, MS1                                Introduction
Francesco Fabi, DDS2




                                                                                      na
Ylka Abazi, DDS4                                           Dental caries is an infective transmittable bacterial dis-
Ada Kerçi, DDS4                                            ease characterised by a multifactorial pathology; it is a
Megi Jokici, DDS†                                          preventable disease and it can be stopped and even po-
Evisi Beshiri Nastasi, DDS4                                tentially reversed during its early stages. People remain




                                                                                   io
Françesca Vinjolli, DDS4                                   susceptible to the disease throughout their lives (12, 19).
Paola Cozza, MD, DDS, MS3                                  It is widely accepted that factors such as socioeconomic
                                                           status, educational level, and behavioural factors (e.g.




                                                                                az
                                                           usual reasons for dental attendance, frequency of tooth
1
  Department of Orthodontics, School of Dentistry, Fa-     cleaning and use of additional methods for tooth clean-
culty of Medicine, University of Rome Tor Vergata, Italy   ing like flossing) have an effect on oral health (5).
2
  Research Fellow CIBB Centre for Biostatistics and Bio-   In the developed countries, decline in dental caries




                                                                   n
informatics, University of Rome Tor Vergata, Italy         prevalence has been attributed to population-based
3
  Head Department of Orthodontics, School of Dentistry,    preventive programmes with use of fluoride, improved




                                                                er
Faculty of Medicine, University of Rome Tor Vergata,       partecipation in oral health programmes and changes in
Italy                                                      oral hygiene and sugar intake habits. On the other hand,
4
  Dentist in Tirana                                        in many developing countries an increase in dental car-


Corresponding author:
Giuseppina Laganà, DDS, MS
                                         nt                ies has resulted from unhealthy dietary habits, limited
                                                           use of fluoride and poor access to oral health services.
                                                           In many developing countries, most oral health services
                                                           provide symptomatic treatment with little priority given to
                                       iI
Department of Orthodontics, School of Dentistry, Faculty   restoration and prevention. The urbanisation and adop-
of Medicine, University of Rome Tor Vergata, Italy         tion of Western lifestyles into many developing countries
Via G. Baglivi, 5/E                                        in the absence of public prevention programmes have
                                     on

00161 Roma, Italy                                          also caused a sudden increase in dental caries. Dental
Phone: +39 06 44232321                                     caries affects 60-90% of schoolchildren in most devel-
e-mail: giuseppinalagana@ibero.it                          oped countries, and in several developing countries the
                                                           prevalence rates are increasing (2). Many epidemiologi-
                              i


                                                           cal studies on the prevalence of caries in different ethnic
                           iz


                                                           groups have been published in the last years. They re-
Summary                                                    ported a prevalence of caries that varied in the different
               Ed




                                                           populations (4, 6, 7, 11, 14).
The aim of this study was to determine the caries          Epidemiological surveys to monitor the changes in oral
prevalence in urban and suburban Albanian schools.         health status have not been conducted in Albania on
A large sample (n= 2617) of subjects, aged 7-15, was       a regular basis or by specialised institutions. Sporadic
examined by a clinical observation without radio-          studies by the dental school or by people who are con-
grams. The sample comprised 1257 males and 1360            ducting research for higher degrees have been under-
 IC




females. For each subject an anamnestic question-          taken. The data from the last epidemiological study con-
naire about feeding, fluoride, dentist attendance and      ducted in 2000 (using WHO indicators and age-groups)
familiar informations was obtained. Gender and age         are: 6 years old (caries free 83.7%), 12 years old (DMFT
differences were compared by Chi-square test. The          3.02), 18 years old (DMFT 4.7). Other national studies
C




total dmft index (decayed, missing and filled teeth in     of dental caries experience for 12-year-olds indicated
deciduous dentition) was 2.082; dmft in males was          that in 2005 the national mean Decayed, Missing, or
2.137, in females was 2.032. The total DMFT index          Filled Teeth (DMFT) index was 3.1. A more recent study
(Decayed, Missing and Filled Teeth in permanent            shows DMFT 3.8 in a 12 years old schoolchildren pop-
©




dentition) was 2.327; DMFT in males was 2.253, in          ulation (9). The data show worse oral health status in
females was 2.396. Decayed teeth was principal             children compared with the situation before 1990. Rea-
component of both dmft and the DMFT index. Car-            sons for higher oral disease prevalence are: increases
ies prevalence results higher in girls than boys in        in consumption of refined foods and fizzy drinks and of a
deciduous and in permanent teeth.                          wide variety of sweets, under utilisation of fluoride sup-
                                                           plements or sealants, the lack of widespread and regular
Key words: prevalence of caries, oral hygiene hab-         use of toothbrushes and fluoride toothpaste, the lack of
its, Albanian schoolchildren.                              dental health education and promotion, the privatisa-


38                                                                               Annali di Stomatologia 2012; III (2): 38-43
Caries prevalence in a 7- to 15-year-old Albanian schoolchildren population



tion of the dental services and the resultant high prices            lasted 20 minutes per child, following the WHO guide-
and largely ineffective public dental services (3,9). Other          lines. To assess dental caries DMFT (Decayed, Missing
reasons for this situation are the following: low fluoride           and Filled Teeth) index was used. The systematic ex-
level in drinking water (below 0.3 ppm), lack of financial           amination includes the crown and exposed root of every
resources for applying a caries prevention strategy all              primary and permanent tooth, each crown and root are




                                                                                                   li
over the country and absence of national caries and oral             assigned a number based on the result of that exam.
health preventive programme.                                         The numbers are recorded in boxes corresponding to




                                                                                                na
Aim of this study was to determine the caries prevalence             each tooth to provide a DMFT chart. Data were collected
in a schoolchildren population of Tirana.                            in an individual clinical chart that comprised anamnestic
                                                                     questionnaire and clinical examination measurements.




                                                                                             io
Subjects and methods                                                 Statistical methods
                                                                     Data were registered in Microsoft Excel 2007 and elabo-
Study population                                                     rated by Statistical Package for the Social Sciences Win-




                                                                                          az
A cross-sectional study was carried out and the study                dows, version 15.0 (SPSS, Chicago, Illinois, USA). De-
target population consisted of subjects, between 7 years             scriptive statistics were calculated for every measured
and 15 years of age, attending the public schools in                 variable, in order to evaluate the studied sample. Cat-
Tirana (Albania). The fifteen examined schools, ten in               egorical variables were analysed using the chi-square




                                                                                 n
the town and five in the province of Tirana, were cho-               test of Pearson to determine differences. The P value for
sen by the Statistical Department of Teaching Direction              statistical significance was set at 0.05, so any value less




                                                                              er
of Tirana, using a stratified selection technique, in order          than P<0.05 was interpreted as statistically significant.
to represent the distribution of socio-economical condi-             The relationship between caries prevalence and oral hy-
tions during the school year 2009-2010. Classes within               giene was assessed by Chi-square test.
schools were sampled systematically and all students

                                                  nt
attending the sampled classes were examined. Written
consent was obtained from the schoolchildren and their
parents, before starting examination. A questionnaire
                                                                     Results
                                                iI
was structured containing questions on socio-demo-                   A total of 2617 subjects, 1257 males (48.40%) and 1360
graphic factors, perceived oral and general health, oral             females (51.60%), 7 to 15 years old, were examined.
hygiene, fluoride assumption and oral diet.                          Table 1 describes the composition of the sample by age
                                              on

Sample size was calculated assuming a 50 per cent                    and gender.
prevalence ratio for any characteristics with a 95 per cent          Table 2 shows dmft results: the total dmft index (de-
confidence interval. This assumption leads to the highest            cayed, missing and filled teeth in deciduous dentition)
sample size with precision 1.9%. Two thousand six hun-               was 2.082: dmft in males was 2.137, in females 2.032.
                                      i


dred and seventeen students, 1257 males and 1360 fe-                 The subjects presenting caries in deciduous dentition
                                   iz


males, were randomly selected according to multistage                were 1115 (42.60% of the total sample), 561 females
stratified cluster sampling design. This is in according to          (41.25%) and 554 males (44.07%). The subjects pre-
WHO guidelines for national pathfinder surveys which                 senting missing teeth in deciduous dentition were 242
                   Ed




ensure the partecipation of a satisfactory number of peo-            (9.24% of the total sample), 114 females (8.38%), 128
ple that may present different disease prevalence in the             males (10.18%). The subjects presenting filled teeth in
conditions being examined (14, 17).                                  deciduous dentition were 132 (5.04% of the total sam-
Selection criteria for examination were: presence of de-             ple), 71 females (5.22%) and 61 males (4.85%). The
ciduous cuspid and deciduous second molar in primary                 highest number of subjects (n=193) presented only one
dentition and mixed dentition, presence of permanent                 decayed deciduous teeth and they were 7.4% of the
 IC




cuspid and first molar in permanent dentition. The exclu-            sample, 104 females (7.6% of the sample) and 86 males
sion criteria for this study were: subjects with craniofa-           (6.8% of the sample). One missing teeth in deciduous
cial anomalies (clefts and syndromes) and no Albanese                dentition was registered in the majority of the subjects
C




students.                                                            (n=133, 5.1% of the sample), 63 were females (4.6%)
                                                                     and 70 were males (5.6%). One filled teeth in deciduous
Clinical examination                                                 dentition was observed in 60 schoolchildren (2.3% of the
The examination was carried out by five examiners. Be-               total sample), 32 subjects (2.4%) were females and 28
©




fore clinical registration, they took part in a course on            were males (2.2%).
methods of clinical research and orthodontic diagnosis.              The total DMFT index (Decayed, Missing and Filled
A pilot study on 50 children was conducted before begin-             teeth in permanent dentition) was 2.327; DMFT in males
ning the present investigation to ensure the accuracy of             was 2.253, in females was 2.396 (Tab. 3). The subjects
diagnosis and to standardize the procedures; no statis-              presenting caries in permanent dentition were 1235
tically significant differences were found (P>0.05). The             (47.19% of the total sample), 647 females (47.57%) and
schoolchildren were examined in the medical room of                  588 males (46.77%). The subjects presenting missing
the schools. The oral conditions were assessed by us-                teeth in permanent dentition were 391 (17.56% of the to-
ing latex gloves and mouth mirrors. The examination                  tal sample), 196 females (14.41%), 195 males (18.36%).

Annali di Stomatologia 2012; III (2): 38-43                                                                                  39
 Table 1 - Composition sample (n = 2617) by age and gender
G. Laganà et al.
                                       Composition    Composition sample
Table 1 - Composition  sample (nsample
              Total Sample       = 2617)   by age and
                                       by age          gender
                                                   by gender
      Age
                M        F     M+F        M+F
                                       Composition     Males    Females
                                                      Composition sample
                n Total Sample
                         n       n    sample%by age     %by gender%          Table 1. Composition sample (n = 2617) by
     Age7      132     137      269      10.3%        49.10%    50.90%       age and gender.
               M        F      M+F       M+F           Males    Females
          8    101
               n       140
                        n       241
                                n         9.2%
                                           %          41.90%
                                                         %      58.10%
                                                                   %




                                                                                         li
      7       132     137      269       10.3%        49.10%    50.90%
          9    143     145      288      11.0%        49.70%    50.30%




                                                                                      na
      8       101     140     241        9.2%         41.90%    58.10%
       10      127     145     272       10.4%        46.70%    53.30%
      9       143     145     288        11.0%        49.70%    50.30%
       11      136     151     287       11.0%        47.40%    52.60%
      10      127     145     272        10.4%        46.70%    53.30%




                                                                                   io
       12      140     153     293       11.2%        47.80%    52.20%
      11
       13     136
               164    151
                       142    287
                               306       11.0%
                                         11.7%        47.40%
                                                      53.60%    52.60%
                                                                46.40%




                                                                                az
      1214    140
               167    153
                       179    293
                               346       11.2%
                                         13.2%        47.80%
                                                      48.30%    52.20%
                                                                51.70%
      1315    164
               147    142
                       168    306
                               315       11.7%
                                         12.0%        53.60%
                                                      46.70%    46.40%
                                                                53.30%
     14       167     179     346        13.2%        48.30%    51.70%




                                                                    n
     Total    1257    1360    2617       100.0%       48.40%    51.60%
      15      147     168     315        12.0%        46.70%     53.30%




                                                                 er
  Total       1257   1360    2617        100.0%       48.40%    51.60%

 Table 2 – dmft (deciduous teeth)

                 Males Females            nt Total
                                                            years, in the permanent dentition the highest value of
                                                            DMFT (3.609) was registered at the age of fifteen years.
                                        iI
Table 2 – dmft (deciduous teeth)                            Table 5 shows dmft and DMFT according to age and
     dmft        2.137    2.032              2.082          gender with inferior and superior confidence interval
                     Males Females           Total          (Sup CI, Inf CI): in 7-9 years group median of total DMFT
                                      on

     decayed                                                was 5.84, in 10-12 years group median of total DMFT
   subjects                                                 was 4.25 and in 13-15 years group median of total DMFT
      dmft (n) 2.137    554       561
                                 2.032       1.115
                                             2.082
                                                            was 3.36. DMFT in males was 2.253 and in females was
   subjects (%)        44.07     41.25       42.60
                                                            2.396; the difference between gender was not significant
     missing
                                i


   decayed                                                  (P>0.005).
   subjects(n)(n)       128       114         242
                             iz


 subjects              554        561        1.115          Caries prevalence results higher in girls than boys in de-
   subjects
 subjects (%) (%)      10.18
                      44.07       8.38
                                 41.25        9.24
                                             42.60          ciduous and in permanent teeth, but this difference is not
       filled                                               statistically significant.
    missing
                   Ed




   subjects (n)          61        71        132            Frequencies and percentages of first dental visit by age
  subjects (n)         128        114        242            groups are described in Table 6.
   subjects (%)         4.85      5.22       5.04
 subjects (%)         10.18      8.38        9.24           Significant correlation obtained by Chi square index at
     filled                                                 any age was found between low oral hygiene and DMFT
Table 2. dmft (deciduous teeth).                            (P=0.000), described in Figure 1.
  subjects (n)          61        71         132
                                                            Level of oral hygiene in the total sample is reported in
 IC




 subjects (%)          4.85      5.22        5.04
The subjects presenting filled teeth in deciduous denti-    Table 7. Oral hygiene was classified in three grades of
tion were 863 (32.97% of the total sample), 467 females     evaluation (good, not sufficient, absent): the subjects
(34.33%) and 396 males (31.50%). The highest number         presenting a good level of oral hygiene were only 1117
                                                            (42.6% of the total sample), the majority of examined
C




(n=421) of subjects presented one decayed permanent
teeth and they were 16.1% of the sample, 210 females        subjects ( n= 1203, 45.9% of the sample) presented a
(15.4% of the sample) and 211 males (16.8% of the           not sufficient condition of oral hygiene. Oral hygiene by
sample). One missing permanent teeth was registered         age and gender is reported in Tables 8 and 9.
©




in most of the subjects (n=209, 8.0% of the sample), 104    No significant correlation was observed between the dif-
were females (7.6%) and 105 were males (8.4%). One          ferent socio-economical level, oral use of fluoride and
filled permanent teeth was observed in 276 schoolchi-       natural/artificial feeding.
dren (10.5% of the total sample), 140 (10.3%) were fe-
males and 136 were males (10.8%). Decayed teeth was         Discussion
the principal component of both the dmft index and the
DMFT index (Tab. 2 and 3).                                  The results showed that 47.19% of the examined school-
Table 4 reports dmft and DMFT according to the age:         children, 1235 subjects, presented decayed permanent
the highest value of dmft (5.178) was observed at eight     teeth, while 391 (17.56%) subjects presented missing


40                                                                                Annali di Stomatologia 2012; III (2): 38-43
     DMFT              2.253          2.396          2.327
    Decayed
  subjects (n)           588           647           1235
Caries prevalence
 subjects    (%) in a 7-46.77
                         to 15-year-old Albanian schoolchildren
                                      47.57          47.19 population
    Missing
 Table    3 – DMFT (permanent teeth)
  subjects (n)           195           196            391
 subjects (%)          18.36
                       Males Females  14.41          17.56
                                                    Total       teeth and 863 (32.97%) subjects presented filled teeth.
      Filled                                                    DMFT index was 2.327 and this is according to other
                                                                studies of same population for age (WHO, 2004); this
  subjects
       DMFT(n)           396
                        2.253          467
                                     2.396            863
                                                    2.327       DFMT index can be classified as high dental caries ex-
 subjects
     Decayed (%)       31.50          34.33          32.97      perience.




                                                                                                         li
   subjects (n)          588          647           1235        The overall DMFT results of the studied sample was
   subjects (%)         46.77        47.57          47.19       lower than results of another study on a smaller (n=




                                                                                                      na
     Missing                                                    372) population, completed in Tirana in 2010 that shows
                                                                DMFT 3.8 in a 12 years old schoolchildren group(9).
   subjects (n)          195          196            391
                                                                These DMFT data are lower than the last epidemiologi-
   subjects (%)         18.36        14.41          17.56       cal study, conducted in 2000, that indicated DMFT 3.02




                                                                                                   io
       Filled                                                   in a 12 years-old group and DMFT 4.7 on a 18 years-old
   subjects (n)          396          467            863        group (3). Other national studies of dental caries experi-
   subjects (%)         31.50        34.33          32.97       ence for 12-year-olds indicated that in 2005 the national




                                                                                                az
                                                                          mean Decayed, Missing, or Filled Teeth (DMFT) index
 Table
Table    4 – dmft
      3. DMFT      and DMFT
              (permanent teeth). by age                                   was 3.1 (8).
                                                                          These results are similar to other examined groups, as
       Age           dmft            DMFT                                 Norwest Russian (6), Romanian (10) and Greek popula-




                                                                                  n
           7         5.052            0.844                               tion (14).
           8         5.178            1.220                               DMFT in Albanian sample is lower than Hungarian adult




                                                                               er
           9         3.924            1.413                               population (5), Iranian (2) and Indian population (15).
          10         3.217            2.033                               In Western European countries the situation is complete-
                                                                          ly different: DMFT in Albanian schoolchildren was higher
          11         1.683            2.425
                                                                          than other European population as Spain (1), Nether-
  Table 4 – dmft and DMFT by age2.614
          12
          13
          14
         Age
                     0.853
                     0.209
                     0.110
                     dmft
                                      2.990
                                      3.168
                                     DMFT
                                                  nt                      lands, United Kingdom, Germany and Italy (18).
                                                                          Decayed teeth was the principal component of both the
                                                                          dmft index and the DMFT index and this is another im-
                                                iI
          157        0.009
                     5.052            3.609
                                     0.844                                portant indicator of lacking dental prevention.
            8        5.178
Table 4. dmft and DMFT by age.       1.220
 Table 5 9– dmft and     DMFT by gender
                     3.924               and age
                                     1.413
                                              on

          10         3.217           2.033
   Total 11          7-9 years
                     1.683           2.425 10 -12 years                               13 -15 years
   DMTF       Inf CI  Sup CI Median Inf CI
          12         0.853           2.614 Sup CI Median                     Inf CI     Sup CI Median
   Males      5.36    6.32     5.84 4.00     4.96      4.48                  2.94       3.38      3.16
          13         0.209           2.990
                                      i


 Females14 5.44      0.110           3.168 4.41
                                   iz


                      6.24     5.84 3.66               4.04                  3.27      3.83     3.55
          15         0.009           3.609
   M+F         5.53      6.15       5.84      3.95      4.55     4.25        3.18      3.54     3.36
                   Ed




    dmft                 7-9 years               10 -12 years                         13 -15 years
                Inf CI   Sup CI    Median Inf CI   Sup CI Median             Inf CI     Sup CI Median
   Males         4.37      5.05     4.71   1.86     2.45      2.16            0.03       0.13      .08
 IC




  Females        4.34       4.96       4.65    1.40       1.87     1.63       0.03      0.22      .13

    M+F          4.45       4.91       4.68    1.70       2.07     1.88       0.05      0.16      .10
C




   DMTF                  7-9 years                     10 -12 years                   13 -15 years
               Inf CI    Sup CI Median        Inf CI     Sup CI Median       Inf CI     Sup CI Median
   Males        0.85       1.40    1.12        2.03        2.60     2.32      2.86        3.29     3.07
©




  Females       0.99       1.39       1.19     2.16      2.64     2.40        3.16      3.68     3.42

   M+F          0.99       1.33       1.16     2.17      2.55     2.36        3.08      3.42     3.25


Table 5. dmft and DMFT by gender and age.




Annali di Stomatologia 2012; III (2): 38-43                                                                                    41
  G. Laganà et al.

 Table 6 – First dental visit and age

    First dental visit                      No           Yes          Total      It is possible to observe a low improvement of oral hy-
    7-9 years       Frequencies             112       502              614       giene status in older subjects (good hygiene 7-9 years
                    Percentage             18.2%     81.8%            100.0%     = 349, 13-15 years = 424), and females appear gener-
    10-12 years     Frequencies             82        528              610       ally better than males. A significant correlation is evident
                    Percentage             13.4%     86.6%            100.0%     between grade of oral hygiene and DMFT, as shown in




                                                                                                               li
    13-15 years     Frequencies             68        627              695       other studies (9, 12, 20).
                    Percentage             9.8%      90.2%            100.0%     The results of the study show that just 1919 subjects




                                                                                                            na
    Total           Frequencies             262      1657              1919
                                                                                 (73.3% of the total sample) were visited by a dentist: it
                    Percentage             13.7%     86.3%            100.0%
                                                                                 is possible to note that the number of visited subjects is
  Table76. First dental visitin
                              and age.                                           higher in the 13-15 age group. These data demonstrate
Table   – Oral   hygiene        the total sample
                                                                                 that oral prevention is not frequent and the age of first




                                                                                                         io
                                                                                 dental visit has to be earlier in order to plan preventive
    Oral
Figure 1 –Hygiene             Frequencies
          Correlation between oral hygiene andPercentage
                                               DMFT
                                                                                 programmes. The current dental situation in Albania is
    Absent                                 297                       11.3
                                                                                 not valid to reach WHO global goals for oral health 2020:
    Not sufficient                         1203                      45.9




                                                                                                      az
                                                                                 - to minimise the impact of diseases of oral and craniofa-
    Good                                   1117                      42.6
                                                                                 cial origin on health and psychosocial development, giv-
    Total                                  2617                      100
                                                                                 ing emphasis to promoting oral health and reducing oral
    Table    Oral6   – First
  Table 8 – Oral hygiene by age
  Table                           dental visit           and age
  Table 87.– Oral  hygiene
                  hygiene by in
                             agethe total sample.                                disease amongst populations with the greatest burden of




                                                                                         n
    Oral hygiene level            Absent       Not         Good         Total    such conditions and diseases;
                                            sufficient
    Oral hygiene level
    7-9 years      Frequencies
                                  Absent
                                    80
                                               Not
                                               369
                                                           Good
                                                               349
                                                                        Total
                                                                         798
                                                                                  - to minimise the impact of oral and craniofacial manifes-
          First dental visit                                                No      Yes of systemic
                                                                                                 Total




                                                                                      er
                                            sufficient                           tations               diseases on individuals and society,
                   Percentage      10.0%     46.2%    43.7%             100.0%
    7-9 years      Frequencies       80       369      349               798
          7-9 years
    10-12 years    Frequencies
                   Percentage         Frequencies
                                    100
                                   10.0%
                                              407
                                             46.2%
                                                       342
                                                      43.7%               112
                                                                         849
                                                                        100.0%   and502to use these manifestations for early diagnosis, pre-
                                                                                                   614
                   Percentage      11.8%     47.9%    40.3%             100.0%
    10-12 years    Frequencies      100       407      342               849     vention and effective management of systemic diseases.
    13-15 years    Frequencies
                   Percentage         Percentage
                                    116
                                   11.8%
                                              426
                                             47.9%
                                                       424
                                                      40.3%             18.2%
                                                                         966
                                                                        100.0%    81.8%          100.0%
                                                                                 The process of formulating a regional, national or local
    13-15 years
    Total
    Total
                   Percentage
                   Frequencies
          10-12 years 12.0%
                   Frequencies
                   Percentage
                   Percentage
                   Frequencies
                    Percentage
                                   12.0%
                                    116

                                   11.3%
                                             44.1%
                                              426
                                      Frequencies
                                    296       1202
                                             44.1%
                                             46.0%
                                      Percentage
                                    296
                                   11.3%
                                              1202
                                             46.0%
                                                        nt
                                                      43.9%
                                                       424
                                                      1115
                                                      43.9%
                                                      42.7%
                                                      1115
                                                      42.7%
                                                                        100.0%
                                                                         966
                                                                           82
                                                                         2613
                                                                        100.0%
                                                                        100.0%
                                                                        13.4%
                                                                         2613
                                                                        100.0%
                                                                                    528
                                                                                 oral
                                                                                 tive
                                                                                  86.6%strategy
                                                                                                   610necessitates many stages. A preven-
                                                                                       health strategy
                                                                                                must be programmed for the Albanese fam-
                                                                                                 100.0%
                                                                                 ilies including dental knowledge, routine care visits, the
                                                      iI
          13-15       years                                                68       627            695
  Table 8.  Oral hygiene     by age. Frequencies                                 infectious nature of dental caries, awareness of dental
  Table 9 – Oral hygiene by gender
                                      Percentage                        9.8%      90.2% and 100.0%
                                                                                 benefits        access through Medicaid and awareness
  Table 9 – Oral hygiene by gender
                                                                          262    of1657
                                                                                     dentists and1919
                                                                                                   dental clinics in the community. Further-
          Total                       Frequencies
                                                    on

   Oral hygiene   level           Absent      Not     Good              Total
                                           sufficient                            more, appropriate interventions could be developed to
   Oral7hygiene
 Table
   Females– Oral  level
                   hygiene   in
                    Frequencies the   Percentage
                                  Absent
                                    total
                                    123
                                              Not
                                          sample
                                              557
                                                      Good
                                                       678              13.7%
                                                                        Total
                                                                         1358     86.3%
                                                                                 view            100.0%
                                                                                        and manage   caries as a chronic disease (13, 16).
                                           sufficient
                  Percentage      9.1%      41.0%          49.9%        100.0%
    Females       Frequencies      123       557            678          1358
    Males         Frequencies      173       645
                                            437    1255
     Oral Hygiene Percentage       Frequencies
                                  9.1%  Percentage
                                            41.0%
                                           49.9%  100.0%
                  Percentage      13.8%     51.4%
                                           34.8%  100.0%
     Absent                        173 297 645
                                            11.3
                                            i


    Males         Frequencies               437    1255
    Total         Frequencies
     Not sufficientPercentage
                                   296
                                  13.8%
                                            1202
                                           1115
                                            51.4%
                                           34.8%
                                                   2613
                                                  100.0%  Conclusions
                                  11.3% 120346.0%
                                            45.9
                                         iz


                  Percentage               42.7%  100.0%
    Total         Frequencies      296      1202
                                           1115    2613
     Good         Percentage      11.3% 111746.0%
                                            42.6 100.0%
                                           42.7%
  Figure
    Total
  Table     1 hygiene
        9. Oral – Correlation      between100
                      by gender. 2617         oral hygieneThe
                                                           andoral health status of children living in Tirana can
                                                                DMFT
                                                                                 be classified as quite poor: this situation indicates the
                         Ed




                                                                                 need for preventive and restorative strategies. Adequate
 IC
C
©




   Figure 1. Correlation between oral hygiene and DMFT.


  42                                                                                                    Annali di Stomatologia 2012; III (2): 38-43
Caries prevalence in a 7- to 15-year-old Albanian schoolchildren population



public dental health programmes including school-based                    in Northwest Russia. Community Dent Health 2012;
oral health education and primary oral care, increasing                   29(1):20-4.
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                                                                                                      li
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©




Annali di Stomatologia 2012; III (2): 38-43                                                                                           43
