Study of Risk Factors for Dental Caries in Rural Madagascar

Objectives: Each summer, dental students and faculty from Stony Brook University's School of Dental Medicine (SBU-SDM), under the auspices of the Madagascar Ankizy Fund, travel to northwestern Madagascar to deliver dental care and oral hygiene instruction (the Dental Intervention Program or DIP) to the villages of Berivotra (V1) and Antanambao (V2). The objective is to determine the influence of DIP on oral hygiene and dental caries in V1 and V2.

Methods: V1 had been receiving DIP for 3 years, while V2 received no formal dental care prior to 2006. History of cariogenic foods, oral hygiene methods and social history were determined by a dental caries risk questionnaire, adapted from SBU-SDM, translated to French, followed by translation to the local dialect of Malagasy, and administered orally by translators. Oral examinations were performed by one dentist. Results of restored surfaces, plaque index (PI) and gingival index (GI) were recorded on standard dental charts. Means +/- SE in the two villages were analyzed by one-way ANOVA. (SPSS, version. 15.) Significance was assessed at p<.05.

Results: The results indicate that there is no significant difference between (self-reported) frequency of brushingin V1 and V2. However, the GI, PI, and frequency of cariogenic foods per day are significantly higher in V2 (p<0.05), which had not previously received DIP. The mean number of restored surfaces for V1 and V2 were 3.7 +/- 2.2 and 1.5 +/- .5, respectively. This was significant (p<0.05) and was indicative of the previous implementation of DIP in V1. However, there was no difference between the number of teeth extracted in V1 versus V2.

Conclusion: These results suggest that the DIP program has had a beneficial effect on oral hygiene and oral health in Madagascar and warrant a return in summer of 2008, to refine the study according to WHO methodology and to include a new village that has never received formal dental care to participate in the study using dmft/DMFT values. This follow-up study represents a unique opportunity to compare caries risk assessment in the Pediatric Dental Clinic at SBU-SDM with that collected in Madagascar.