Partial Edentulousness in a Rural Population Based on Kennedy's Classification: Epidemiological Study.

INTRODUCTION: Edentulousness falls in a special category among the various conditions of dental origin. A simple estimation of the partial edentulous condition is a rough indication of the prevalence of dental diseases and success or failure of dental care.
METHODOLOGY: In this study a cross sectional survey was carried out among 1000 patients of rural population in JKK Nataraja Dental College, Komarapalayam, Namakkal District, Tamilnadu, India. The aim of this study was to evaluate the epidemiological features of partial edentulous condition in the age group of 30-60 years in a rural Population based on the Kennedy classification. A pre tested questionnaire was Used in this study. RESULT: Chi-square test was conducted and results were obtained and P value <0.05 was considered stastically significant.
CONCLUSION: The study revealed Kennedy Class III partially edentulous condition was more common than other conditions. There is significant correlation between lack of awareness, education and socio-economic status in relation to loss of teeth among population.

INTRODUCTION

The presence of teeth and its associated structures has played a vital role in the maintenance of overall well-being of a person. When there is a loss of one or more teeth, the need to replace the missing teeth is to be met. Treating a population like in India where there is diversity in every aspect is very challenging.[1] In rural population, the beliefs based on tradition and habits increase the challenge and access to healthcare is limited. It is mandatory to classify the partially edentulous arches for better visualization of the underlying condition and for interoperator communication.[2] Therefore, a universally accepted method of classification is to be adopted. Owing to the large Indian population, a nationwide survey cannot be done. However, the epidemiological features of partial edentulousness of one community or one village can be evaluated on the basis of a cross-sectional study conducted in college.[3] A simple estimation of the prevalence of edentulous situation and the success or failure of dental care was evaluated in this study.

Aims and objectives

This study aims to study the epidemiological feature of partial edentulousness in the age group of 30–60 years[4] in a rural (Komarapalayam) population based on Kennedy's classification of partially edentulous arches and to evaluate the incidence of various Kennedy's classes of partial edentulousness and to assess the gender ratio, socioeconomic parameters, and the reason for tooth loss.

METHODOLOGY

A cross-sectional study was conducted among 1000 patients in the Department of Prosthodontics, JKK Nattaraja Dental College and Hospital, Komarapalayam. The patients included in the study were in the age group of 30–60 years and patients with permanent dentition alone were selected. A pretested questionnaire which includes particulars such as personal history, dental history, socioeconomic status, reason for edentulousness, and oral hygiene was used. The patients were spot examined and the data were recorded. After analyzing the recorded data, results were tabulated (Chi-square test was conducted and results were obtained and P < 0.05 was considered statistically significant).

RESULTS

Data were collected and analyzed. Chi-square test was conducted and results were obtained and P < 0.05 was considered statistically significant. The major criteria considered in this study, i.e., the results of categorization of the population based on Kennedy's classification of partially edentulous arches were found to be 10% of Kennedy's Class I, 16% of Kennedy's Class II, 54% of Kennedy's Class III, and 20% of Class IV. [Graphs 1 and 2].

Graph 1

Kennedy's classification of Partially edentulous: Class I: 10%, Class II: 16%, Class III: 54%, Class IV: 20%

Graph 2

Gender ratio: Female - 48% partially edentulous, male - 52% partially edentulousne

Among all the patients, 48% female and 52% male were partial edentulous [Graph 3]; the reason for tooth loss was 14% due to trauma, 32% due to caries, and 54% due to periodontal conditions [Graph 4]. The majority of the population of partial edentulism were found to be from a middle-class population, around 50%, and 46% were found to be from lower socioeconomic group, and 14% were from the upper class of socioeconomic group.

Graph 3

Reason for loss of teeth: Periodontal disease - 54%, caries - 32%, trauma - 14%

Graph 4

Socioeconomic status: upper class - 4% edentulousness, middle class - 50% edentulousness, lower class - 46% edentulousness

DISCUSSION

This epidemiological study was conducted in JKKN Dental College - Department of Prosthodontics among 1000 patients representing a cross section of Komarapalayam population. The pretested pro forma was used including the name, age, sex, socioeconomic status, and particulars such as personal history and dental history for the collection and analysis of data.

In the present study, more number of men (52%) were partially edentulous when compared to women (48%), this could be because of the poor brushing habits due to their work schedule, and the need to seek treatment among the group of men were more when compared to women.[56]

The most common type of partially edentulous arch among the four classes of Kennedy's classification was mainly accessed in this study. In correlation to Burt et al. in 1985, Kennedy's Class III was most frequently seen among the other classes.[7] Mandibular arch has higher incidence of partially edentulism as similar to the study conducted by Udani.[4] The age group of the patients surveyed has better awareness and knowledge; hence, this could have been the reason for the minimal tooth loss.[89] Furthermore, the molars are the first tooth to erupt in the oral cavity; hence, they pose a major risk for caries development and subsequently lead to the loss of molars; therefore, a Class III situation is more frequented.[10] The early eruption of the mandibular teeth in comparison of the maxillary arch could also be the reason for the early loss of mandibular teeth.[11]

With correlation to observations made by Ronald and Shah et al., in this study, people with lack of awareness, periodontal problems, and poor oral health have higher incidence of partial edentulousness.[6] The loss of teeth from the poor socioeconomic status shows the lack of proper education and awareness about oral health. This also shows the lack of affordability, and awareness of the patient to save their teeth during disease condition has forced to extract their teeth leading to partial edentulous condition.[12] Due to cost effective nature of proper hygiene accessories there is poor oral health among low socioeconomic group.[13]

This study has to be further elaborated with large samples for planning oral healthcare to the population and preventing partial edentulousness.

CONCLUSION

Kennedy's Class III (54%) is the most common class of partial edentulousness. Mandibular partial edentulism is more common than maxillary partial edentulism. More predominant in 52% males. Reason for this partial edentulous seems to be more of 54% periodontal cause. Reduction in partial edentulousness with higher income and higher education status is because they have awareness for replacement of missing teeth than the lower income status. Poor oral hygiene is associated with higher incidence of partial edentulousness. As low family income, lower literacy, and lack of motivation are associated with higher partial edentulism, dental professionals should try to educate these groups of people more intently. Awareness should be created for proper dental hygiene and timely replacement of missing teeth.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.