An Assessment Of The Correlation Of Dietary Habits Of 10
Original Article
Tribal Populations Of The Paderu Revenue Division Of
Visakhapatnam District With Their Malocclusion Status
To cite: Uday Kumar
Digumarthi, R.Prakash, K
And Orthodontic Treatments Needs
Rajasigamani
1Uday Kumar Digumarthi, 2R.Prakash, 3K Rajasigamani, 4S N Reddy
1,4,5
Professor, 2Professor & Head, 3Professor and Dean
An Assessment Of The
Correlation Of Dietary Habits
1,2Anil Neerukonda Institute of Dental Sciences, Visakhapatnam.
Of 10 Tribal Populations Of
The Paderu Revenue
3 Rajah Muthiah Dental College & Hospital, Annamalai University, Annamalai Nagar
Division Of Visakhapatnam
District With Their
ABSTRACT
Malocclusion Status And
The purpose of this study was to evaluate the orthodontic status and perceived orthodontic
Orthodontic Treatments
Needs
treatment needs of
2016 tribal adolescents screened in the Paderu Revenue Division of
Visakhapatnam District. The sample chosen for this epidemiological survey comprised of a total
J Contemp Orthod 2020;4(4):
29-33.
of
2016 higher secondary schools students aged 13 to 19 years (1157 boys and 859 girls)
Received on:
none of whom had undergone any prior orthodontic treatment. The occlusion of the students was
13-10-2020
Accepted on:
assessed and classified into the categories of ideal occlusion and Angle’s Class I, II & III
24-11-2020
malocclusions. Other parameters noted were overjet, overbite, crowding, spacing and midline
Source of Support: Nil
diastema. Results revealed that 32% had normal occlusion. Of the 68% with malocclusion 71%
Conflict of Interest: None
had Angle’s Class I malocclusions, 27% had Angle’s Class II malocclusions & 2% had Angle’s
Class III malocclusions. Questions were posed during the examination process to assess
orthodontic awareness, self -perceived dental esthetics and perceived treatment needs. While
81% were aware of orthodontic treatment only 16% had a perceived need for treatment. The
most prevalent malocclusion amongst the tribal adolescents was Angles’s Class I malocclusion
with bimaxillary proclination. A chi-square test of independence showed that there was no
significant association between gender and the prevalence of malocclusion, X2 (2, N = 2016) =
5.5, p =.13.
Table 1: Tribes of Paderu revenue division,
INTRODUCTION
Visakhapatnam district, Andhra Pradesh, India
Tribal populations are usually considered to be a window to
the immediate past when compared to their urbanized
TRIBES OF PADERU REVENUE DIVISION
counterparts. The tribal populations in India are often referred
BHAGATHA
KAMMARA
KONDADORA
GADABA
to as Adivasis.1 Of the four revenue divisions
,Paderu
KHOND
KOTIAS
Division of Visakhapatnam District
( Fig
1.) has
10
KHONDAKAPU
PORJA
subcategories of Adivasis as listed in Table 1.2,3 A point of
VALMIKI
NOOKADORA
significance to be noted is that individuals belonging to a
subcategory only marry within that particular subcategory. In
The purpose of the screening was to assess the prevalence of
spite of this there were no instances of developmental
malocclusion and the perceived need for orthodontic treatment,
anomalies or abnormalities in the students screened . The
if any, amongst the tribal population. For this it was deemed
tribals lead a very simple agricultural lifestyle with a diet that
necessary to first determine what was the most prevalent
is predominantly a coarse diet and display good overall bodily
malocclusion amongst the tribals as this form and shape would
muscuolo-skeletal growth.4 Researchers have shown a
be considered normal influencing the perception of esthetics
correlation between the coarseness of diet and development of
amongst the population with therefore no perceived need for
the jaws.5-8
alteration.9-14 The presence of normal attrition as influenced by
Journal of Contemporary Orthodontics, Oct-Dec 2020; 4(4):29-33
29
Uday Kumar Digumarthi et al
their diet, coupled with normal musculosketelal growth due to
Exclusion Criteria:
the active chewing seemed to positively influence the
1.
Rampant caries
alignment of all teeth with relatively no incidence of
Table 2: List of Schools surveyed
School
Location
Date of Screening
Government Tribal Welfare Ashrama
THALARSING
14/12/2019
High School (GTWAHS)
Government Tribal Welfare Ashrama
SRIKRISHNAPURAM
15/12/2019
High School (GTWAHS)
Government AP Residential Girls School KANDAMAMIDI
16/12/2019
Government Tribal Welfare Ashrama
KANDAMAMIDI
07/02/2020
High School (GTWAHS)
Government Tribal Welfare Ashrama
LOCHALPUTTU
08/02/2020
High School (GTWAHS)
Government Tribal Welfare Ashrama
PEDDALABUDU
09/02/2020
High School (GTWAHS)
crowding or spacing. There was only an incidence of
2.
Missing teeth
bimaxillary protusion.
3.
Mutilated malocclusion
4.
Craniofacial anomalies
MATERIALS & METHODS
The school going children of standards 8th to
12th in the
600
average age range of 13 to 19 years were selected from the
500
schools listed in Table 2 after obtaining necessary consent and
permissions from the tribal authorities and school authorities
400
and the institutional ethical clearance committee. As the
300
screening was conducted during school hours the screening
M…
200
F…
process was possible utilizing natural daylight and was
performed with all due considerations towards hygiene and
100
infection prevention and control protocol.
0
Ideal
Angle's
Angle's
Angle's
Class I
Class II
Class III
Fig 2. Incidence of malocclusion / The Gender Based
Incidence of
Malocclusion
The findings were tabulated in Microsoft Excel
2010 and
subjected to a gender based percentage distribution (Table 3,4,
Fig 2) and a Chi Square statistical analysis . The responses to the
questions asked were subjected to a simple percentage
calculation(Table 5). The overall prevalence was converted to a
piechart. (Fig 3)
Incidence Of Malocclusion
Figure 1: The Revenue Divisions of Visakhapatnam District
Ideal
Class I
Inclusion Criteria:
Class II
1.
Students by default comprising a random sample of
Class III
tribal individuals in the region
2.
Students in the age group of 13 to 19 years with no
history of prior orthodontic treatment
Figure 3: Overall Prevalence of Malocclusion
30
Table 3: Gender based distribution of malocclusion
PADERU REVENUE DIVISION n=2016
Gender
MALES
% Male
FEMALES (859 )
% Female
(1157 )
Ideal occlusion
348
53.95%
297
46.04%
(31.99%) 645
Malocclusion
809
59.00%
562
40.99%
(68.00%) 1371
Distribution of Malocclusion (1371)
Malocclusion
Male &
% Prevalence
Female & % Female
% Prevalence
% Male
Total Male
Total Female
Angle’s Class I
571
571/809
402 (41.31%)
402/562
(70.97%) 973
(58.68%)
70.58%
71.53%
Class II
219
219/809
151 (40.81%)
151/562
(26.98% ) 370
(59.18%)
27.07%
26.86%
Class III
19
19/809
9 (32.14%)
9/562
(2.04%)
28
(67.85)
2.34%
1.60%
no incidence of crowding or spacing and only a slight prevalence
Results. A chi-square test of independence showed that there
of bimaxillary protusion.
was no significant association between gender and the
prevalence of malocclusion, X2 (2, N = 2016) = 5.5, p = .13.
On further interaction and enquiry with the tribals it was
Questions posed during the examination process to assess
revealed that as part of the traditional culture children solely rely
orthodontic awareness, self - perceived dental esthetics and
upon their mother’s milk until weaned naturally and there was
perceived treatment need revealed that while
81% were
almost no use of feeding bottles nor any subsequent development
aware of orthodontic treatment only 16% had a perceived
of detrimental habits. The active lifestyle allows for enough
need for treatment.
mental and physical exertion to ensure that both young and old
alike adopt a pattern of waking early in the morning and of
The following conclusions were drawn from the results:
retiring early to bed at night to a sound sleep. The absence of
detrimental habits coupled with coarse diet allows for adequate
The tribal adolescents revealed a predominant class I
normal functioning of the jaws and musculature to facilitate a
type of malocclusion with no gender bias
normal sequence of exfoliation of deciduous dentition and
The overall prevalence of malocclusion was 68% with
normal sequence of eruption of the permanent dentition along
the subgroup percentages as follows: Class I
with a sufficient stimulus for growth.5-8 A diet relatively free of
malocclusion as the most prevalent
(71%), followed by
processed food promotes good oral health on one hand but does
class II malocclusion (27%), and class III malocclusion
cause a certain degree of visible attrition on the other.
(2%).
Most epidemiological studies on tribal populations have
The prevalence of excessive overjet and overbite was
focussed on the incidence of malocclusion and the index of
15% and 14% respectively
treatment needs and the oral health status.15-22 This study aimed
at analysing the incidence of malocclusion and evaluating the
The prevalence of midline diastema was 8%.
orthodontic awareness and self-perceived standards of dental
The prevalence of Bimaxillary Protrusion was 67%
esthetics as correlated with a self-perceived need for orthodontic
treatment as an indication that esthetic perception is a learned
The prevalence of crowding was 18%
process deeply influenced by cultural variations and the
9-14
community.
Fig 2. Incidence of malocclusion / The Gender Based Incidence of
Table 4: Other Findings
Malocclusion.
Condition
Present %
Absent %
DISCUSSION
Midline
8
92
Diastema
The tribal population of Paderu Revenue Division,
Crowding
18
82
Visakhapatnam District in the state of Andhra Pradesh
Excessive
15
85
displayed very good growth patterns of their jaws. The
Overjet
average individual displayed an athletic built and an overall
Excessive
14
86
well-being. Intra oral examination revealed that most
Overbite
Bimaxillary
67
33
individuals had an Angle’s Class I type of malocclusion with
Protrusion
little need for any form of orthodontic correction. There was
Journal of Contemporary Orthodontics, Oct-Dec 2020;4(4):29-33
31
Uday Kumar Digumarthi et al
7) Singh Navneet, Tripathi Tulika, Rai Priyank, Gupta
Table 5: Responses to questions posed to analyse self-
Prateek.
(2017).
Nutrition
and
orthodontics:
perceived need for orthodontic treatment.
Interdependence and interrelationship.. Research &
Reviews: Journal of Dental Sciences.
S.No Brief Verbal Questions
Y % N%
Y/N
8) TSOLAKIS, I.A. VERIKOKOS, C Perrea, Despina
1.
Are you aware of braces to
81
19
BITSANIS, E. TSOLAKIS, A.I.. (2019). Effects of diet
make teeth regular
consistency on mandibular growth. A review. Journal of the
2.
Do you feel your smile is
83
17
Hellenic Veterinary Medical Society.
70.
1603.
attractive
10.12681/jhvms.21782.
3.
Would you like to wear
16
84
clips to make your teeth
9) Van der Geld P, Oosterveld P, Van Heck G, Kuijpers-
more regular and attractive
Jagtman AM. Smile attractiveness: self-perception and
influence on personality. Angle Orthod. 2007; 77: 759-765.
CONCLUSION
10) Delcides Ferreria Paula, Erica ,Tatiane Silva, Ana Cristina
On the path to progress Man often experiments with options
Viana
,Campos, Margaret Olivera Nunez and Claudio
that are different from the ones already existing be it a
Rodrigues Leles. Effects of anterior teeth display during
lifestyle or food habits and even just for convenience. Nature
smiling on the self-perceived impacts of malocclusion in
on the other hand tries allowing the survival of certain genetic
adolescents. Angle Orthodontist 2011: Vol 81; No.3,540-
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and straightforward lifestyle of the tribes as in contrast to that
11) Broder HL, Slade G, Caine R, Reisine S. Perceived impact
of a city dweller one must pause to wonder if the multitude of
of oral health conditions among minority adolescents. J
dental problems ranging from decay to malocclusion are a sad
Public Health Dent. 2000; 60:189-192.
consequence of the progress made. As true progress is made
12) Enquist M, Arak A. Symmetry, beauty and evolution.
by introspection and retrospection it is always possible to
Nature 1994;372:169-172.
retain the best practices and to pass these on to future
13) Flores-Mir C, Silva E, Barriga M, Lagravère M, Major P.
generations.
Lay person’s perception of smile aesthetics in dental and
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