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DENTAL CARIES AND GINGIVAL STATUS OF 3-14
YEAR OLD BETA THALASSEMIA MAJOR PATIENTS
ATTENDING PAEDIATRIC OPD OF VANI VILAS HOSPITAL,
BANGALORE
Navpreet Kaur * , S.S.Hiremath †
ABSTRACT:
Objective : To assess the dental caries experience and gingival status of 3-15 year old Beta thalessemia patients attending
paediatric OPD of Vani Vilas hospital.
Material and methods: A total of 70 thalassemia patients and 69 healthy controls (age =3-15 years) were examined for
plaque deposits, gingivitis and dental caries using Silness and Loe Plaque index, Loe and Silness Gingival index, dmft (for
decidous dentition) and DMFT(for permanent dentition) respectively.
Results: Mean DMFT was found to be 3.45 ± 4.20 among cases as compared to 1.82 ± 2.51 among controls. Mean dmft was
2.82 ±3.22 and 1.44 ± 1.79 among cases and controls respectively. Among cases mean plaque index was 1.70 ± 0.51 while
among controls mean plaque index was 1.60 ±0.52. While among cases mean gingival index was 1.64 ± 0.51 as compared to
mean gingival index of 1.54 ± 0.49 among controls.
Conclusion: Our findings suggest that in patients with Beta thalassemia dental caries was significantly higher than the normal
children. No significant increased levels of gingivitis or plaque accumulation were seen in Beta thalassemia patients than in
controls.
AOSR 2012;2(2):67-70.
Key Words: Dental caries, Gingival status, Thalassemia
* Department of Preventive & Community Dentistry, K D Dental College, Mathura, Uttar Pradesh, India.
† Former Prof. & Head, Department of Preventive & Community Dentistry and Former Dean & Director,
Government Dental College and Research Institute,Bangalore, Karnataka, India.
INTRODUCTION:
Thalassemia is an inherited autosomal recessive blood
disease in which the genetic defect results in reduced
rate of synthesis of one of globin chains that form
hemoglobin which in turn causes anemia. Thalassemia
major (Cooley’s anemia) occurs due to striking deficiency
in beta chain production of globin in hemoglobin. Beta
Thalassemia major exhibits the most severe clinical
symptoms while Thalassemia minor (alpha thalassemia)
is mild & is clinically asymptomatic. 1 It is a disease
which not only affects patients but also leaves a devastating
psychosocial effect on the family of the patient. 2
Beta Thalassemia is widely prevalent in South Asian
countries including India & accounts for 10,000 of 1,00,000
patients of Beta Thalassemia born world wide every year. 3
Not much information is available on the association of
dental caries & gingival status with Beta thalassemia which
affects both general & oral health related quality of life.
Therefore, there is a need to assess the oral health status of
the patients with Beta thalassemia, a disease which poses
a major health problem to the society. Thus, this study was
designed & carried out in the Paediatric OPD of Vani Vilas
hospital, Bangalore.
MATERIAL & METHODS:
In this study a total of 70 patients (cases) with Beta
Thalassemia major visiting Paediatric OPD in Vani Vilas
hospital were examined while 69 children (controls) were
examined in Bangalore Mahanagar Palike Shishu Vihar,
Valmiki Nagar & in Fort Government School, Bangalore
India.
Institutional ethical committee of hospital approved the
study & written informed consent was obtained from all the
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Navpreet Kaur et al.
study participants and parents of children participating in
the study before their examination. The study was carried
out from February 2007 to June 2007.
Inclusion criteria were:
1. Age group between 3 & 14 years.
2. Only those patients who were diagnosed previously
for Beta Thalassemia major were considered as
cases.
3. Matching of age, sex & socioeconomic status of
cases & controls.
4. The controls were free of thalassemia, both the
major and minor forms.
Exclusion criteria were:
1. Those seeking dental treatment.
2. Those suffering from other diseases known to
influence dental caries or severity of periodontal
disease such as diabetes.
The study consisted of an interview & intraoral
examination
In oral examination following indices were being used:
1. DMFT index for permanent teeth 4 & dmft index
for primary teeth 5 to record dental caries
experience.
2. Plaque index given by Silness & Loe. 6
3. Gingival index given by Loe & Silness. 7
Plaque index & Gingival index were modified according
to criteria wherein for primary dentition, teeth 54, 64, 74,
84, 71 and 81 were evaluated. In the case of permanent
dentition, teeth 16, 26, 36, 46, 31 and 41 were evaluated.
In mixed dentition cases, in the previous sector, teeth
were substituted by the successive permanent ones, and
in the posterior sector, the first permanent molars were
evaluated. 8
Plane mouth mirror & explorer were used to examine the
oral cavity. Autoclaved instruments were used for oral
examination of subjects. Single examiner & single recorder
were maintained throughout the study period.
Statistical analysis was done using statistical software * . Chi
square test & student t test was used for the comparison of
study and control groups. The level of significance was set
at p

Dental caries & Gingival Status of ß Thalassemia Major Patients
dmft (p value < 0.05) (Table 3).
Mean total DMFT among males was 2.58 ± 3.61 as
compared to mean total DMFT of 2.79 ± 3.47 among
females. There was no significant difference between
males and females for mean gingival index (Fig 2).
DISCUSSION:
The present study was conducted in an attempt to assess
dental caries and gingival status among individuals
suffering from beta thalassemia.
Distribution according to mean DMFT:
When mean DMFT was compared between the cases
and controls it was found to be 3.45±4.20 among cases
as compared to 1.82±2.51 among controls.
Mean DMFT score was significantly higher in case
group compared to control group which is similar to
study conducted by Al- Wahadni A M, Taani D Q,
Al- Omari M O 1 and in another study conducted by
Sunil Gomber and Pooja Dewan. 9
Distribution according to mean dmft:
When mean dmft was compared between the cases
and controls it was found to be 2.82±3.22 among cases
as compared to 1.44±1.79 among controls.
females. The difference regarding mean total DMFT
among males and females was insignificant (Fig 1).
Mean total dmft among males was 2.11 ± 2.60
compared to mean total dmft of 2.21 ± 2.91 among
females.There was no significant difference between
males and females for mean total dmft (Fig 2)
Among cases mean plaque index was 1.70 ± 0.51 while
among controls mean plaque index was 1.60±0.52.
There was no significant difference between cases and
controls regarding mean plaque index (Table 4).
While among cases mean gingival index was 1.64±
0.51 as compared to mean gingival index of 1.54±0.49
among controls.No significant difference for mean
gingival index was found between cases and controls
(Table 4).
Mean plaque index among males was 1.66±0.52
when compared to females where it was 1.63±0.51.
There was no significant difference between males and
females regarding mean plaque index (Fig 2).
While when mean gingival index was compared it was
found to be 1.61± 0.50 among males and 1.54 ± 0.49 among
Mean dmft score was significantly higher in case group
compared to control group which is similar to study
conducted by Al- Wahadni A M, Taani D Q, Al- Omari
MO 1 and in another study conducted by Sunil Gomber
and Pooja Dewan. 9 However, study by Scutellori et
al 10 found similar dental caries experience among
beta thalassemia subjects and controls.
The patients with Beta thalassemia had higher caries
experience than the normal children. Level of dental
caries may be explained on the basis of chronic nature
of thalassemia. Patients preoccupied with their main, life
threatening problem, neglect basic preventive dental care.
Lack of oral health knowledge, poor motivation of these
subjects are also the attributable causes. Most of their
needs for restoration go unmet due to financial status &
other limitations including time. The DMFT scores reveal
that active dental disease is present among cases.
Genderwise distribution of DMFT and dmft:
Mean total DMFT among males was 2.58± 3.61 as compared
to mean total DMFT of 2.79±3.47 among females.
Mean total dmft among males was 2.11±2.60 as compared
to mean total dmft of 2.21±2.91 among females.
Gingival status of the sample population as measured
by Plaque index and Gingival index:
Mean plaque index was 1.70±0.51 while among controls
mean plaque index was 1.60±0.52. While among cases
mean gingival index was 1.64±0.51 as compared to mean
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Navpreet Kaur et al.
gingival index of 1.54±0.49 among controls.
The results were similar to study conducted by Al-
Wahadni A M, Taani D Q, Al- Omari M O1 in which beta
thalassemia was not associated with significant increased
levels of gingivitis.
Gender wise distribution of Plaque index and Gingival
index:
Mean plaque index among males was 1.66±0.52 when
compared to females where it was 1.63±0.51.While when
mean gingival index was compared it was found to be
1.61±0.50 among males and 1.54±0.49 among females.
CONCLUSION:
The patients with Beta thalassemia had higher caries
experience prevalence than the healthy controls. No
significant increased levels of gingivitis or plaque
accumulation were seen in Beta thalassemia patients than
in controls. However, oral health education to improve
oral hygiene is important to be given to beta thalassemia
patients to prevent dental diseases. Also, such patients
should receive regular follow up care and timely dental
treatment.
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1. Al-Wahadni AM, Taani DQ, Al Omari MO. Dental
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9. Gomber S, Dewan P. Physical growth & dental caries
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10. Scutellori PN, Orzincolo C, Andraghetti D, Gamberirni
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CORRESPONDENCE:
Dr. Navpreet Kaur
Senior Lecturer, Department of Preventive & Community Dentistry,
K D Dental College, Mathura, Uttar Pradesh, India
E mail: navpreet13879@yahoo.co.in
Ph: 09997870789, 09013434340
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