# Dental caries prevalence in all school children in one of the grassroots areas in Southern China: a retrospective study

## TL;DR

This study examines high dental caries rates in school children from a rural area in southern China and suggests policy measures to improve oral health.

## Contribution

The study provides a detailed analysis of dental caries prevalence in a grassroots area and proposes actionable policy recommendations.

## Key findings

- 79% of kindergarten children had deciduous teeth caries with a mean dmft score of 6.69.
- 88.5% of primary school children had combined deciduous and permanent teeth caries with a mean DMFT/dmft score of 5.63.
- 75.9% of middle school children had permanent teeth caries with a mean DMFT score of 3.86.

## Abstract

The prevalence of dental caries among minors has always been a major issue globally, especially in economically underdeveloped regions. To investigate the prevalence of dental caries among all school children in Feng'an Town, which is one of the typical grassroots areas in southern China, providing reference basis for the development of oral health care for children in grassroots areas.

Data of a total of 2,834 children from all kindergartens, primary schools, and middle schools in Feng'an Town, one of the grassroots area in southern China was surveyed in this retrospective study. The prevalence of dental caries and the mean Decayed, Missing, and Filled Teeth (DMFT/dmft) scores (an index used to measure the severity of dental caries) for deciduous and permanent teeth were statistically analyzed and reported. A Chi-square test was used to assess the differences between the caries-free and have-caries group. The Mann–Whitney U-test or Kruskal–Wallis H-test was used to evaluate mean DMFT/dmft score. The Benjamini-Hochberg procedure was used to correct the P values for False Discovery Rate (FDR). The Spearman's rank correlation coefficient (rs) was used to assess the trend relationship between ordinal variables (age, grade) and caries severity (DMFT/dmft score).

In kindergartens, 79% of the 481 children had deciduous teeth caries, with a mean dmft score of 6.69 ± 5.31, and age was a significant factor influencing caries prevalence and mean dmft score (P < 0.05). Primary schools showed a high combined prevalence of deciduous and permanent teeth caries at 88.5% among 1,504 children, with a combined mean DMFT/dmft score of 5.63 ± 4.15. Additionally, 42.6% of these children had permanent teeth caries, with a mean DMFT score of 1.04 ± 1.19. School, part of sex, and grade were significant factors affecting the mean DMFT/dmft and DMFT scores (P < 0.05). In middle schools, 75.9% of the 849 children had permanent teeth caries, with a mean DMFT score of 3.86 ± 3.85, and sex was a significant factor influencing caries prevalence and mean DMFT score (P < 0.05).

The prevalence of dental caries among school children in grassroots areas in southern China is severe, necessitating attention and collaborative efforts from multiple sectors. Based on our findings, several policy measures could be considered to improve the oral health of children in grassroots areas. Firstly, monthly structured parental workshops in kindergartens led by certified dental hygienists. Secondly, implement school—based fluoride programs and atraumatic restorative treatments (ART). Thirdly, town government subsidize dental kits for low—income families. Fourthly, schools integrate daily supervised toothbrushing into schedules. Collaboratively, Guangdong Provincial Education Department allocate funds for annual dental check—ups and sealant programs. Finally, schools and health centers design flexible schedules with "dental slots" for emergency and preventive care.