Dental health by age, gender, and residence place in 6- to 12-year-old children living in Shahroud, Iran

Document Type : Original Article


1 Associate Professor, Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran

2 Researcher, Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran

3 Researcher, Vice-chancellery of Health, Shahroud University of Medical Sciences, Shahroud, Iran

4 Professor, Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran

5 Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran


BACKGROUND AND AIM: This study aims to determine dental health indices and their associated factors in 6-12-year-old Iranian school children.
METHODS: In this cross-sectional study, a total of 5620 students, living in Shahroud, northeast of Iran, participated as the participants of Shahroud School Children Eye Cohort Study (SSCECS). Children were selected through cluster sampling in urban areas and by census in rural areas. The children were examined by two trained dentists, using disposable dental mirrors and dental explorers on a dental unit. The indices of decayed, missing, and filled teeth (DMFT), decayed filled teeth (dft), and Significant Caries Index (SiC Index) as well as decay percentage were estimated by age, gender, and place of residence, with 95% confidence intervals (CIs). The differences in mean value were investigated by independent t-test or analysis of variance (ANOVA).
RESULTS: Dental examinations were performed for 5577 students, 3005 (53.9%) of whom were boys and 4434 (79.5%) were urban residents. The mean age of the participants was 9.7 ± 1.7 years. The overall DMFT, dft, and SiC indices were 0.97, 2.84, and 2.48, respectively. At the age of 12, DMFT and SiC indices were 1.80 and 4.07, respectively. Moreover, the mean DMFT was higher in girls and in rural areas, increasing with age. Overall, 36.2% and 38.9% of the male and female students had at least one decayed permanent tooth, respectively.
CONCLUSION: Dental health status in 6-12-year-old Iranian children was not favorable in Shahroud, especially in girls and in rural areas. Therefore, preventive and therapeutic programs and access to health care services need to be expanded.


  1. Petersen PE. The World Oral Health Report 2003: Continuous improvement of oral health in the 21st century--the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2003; 31(Suppl 1): 3-23.
  2. World Health Organization. Oral health [Online]. [cited 2018 Jan 6]; Available from: URL:
  3. Nordstrom M. Global burden of caries disease [Online]. [cited 2018 Jan 6]; Available from: URL:
  4. Hobdell M, Petersen PE, Clarkson J, Johnson N. Global goals for oral health 2020. Int Dent J 2003; 53(5): 285-8.
  5. Kassebaum NJ, Smith AGC, Bernabe E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990-2015: A systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res 2017; 96(4): 380-7.
  6. Seyedein SM. Oral health survey in 12-year old children in the Islamic Republic of Iran, 1993-1994. East Mediterr Health J 1998; 4(2): 338-42.
  7. Dehghani M, Omrani R, Zamanian Z, Hashemi H. Determination of DMFT index among 7-11 year-old students and its relation with fluoride in Shiraz drinking water in Iran. Pak J Med Sci 2013; 29(1 Suppl): 373-7.
  8. Babaei Hatkehlouei, M., Tari, H., Goudarzian, A., Hali, H. Decayed, missing, and filled teeth (DMFT) index among first-grade elementary students in Mazandaran Province, Northern Iran. Int J Pediatr 2017; 5(6): 5069-77.
  9. Emamian MH, Hashemi H, Khabazkhoob M, Malihi S, Fotouhi A. Cohort profile: Shahroud Schoolchildren Eye Cohort Study (SSCECS). Int J Epidemiol 2019; 48(1): 27-27f.
  10. Momeni A, Mardi M, Pieper K. Caries prevalence and treatment needs of 12-year-old children in the Islamic Republic of Iran. Med Princ Pract 2006; 15(1): 24-8.
  11. Meyer-Lueckel H, Paris S, Shirkhani B, Hopfenmuller W, Kielbassa AM. Caries and fluorosis in 6- and 9-year-old children residing in three communities in Iran. Community Dent Oral Epidemiol 2006; 34(1): 63-70.
  12. Hamissi J, Hamissi H. Prevalence of dental caries among elementary school attendees in Iran. East Afr J Public Health 2010; 7(4): 338-41.
  13. Hamissi J. Prevalence of dental caries among preschool children in Qazvin, Iran: School screening programs. J Int Oral Health 2015; 7(12): 5-9.
  14. Ajami B, Ebrahimi M. Evaluation of oral health status amongst 6 - 7 - year - old children in Mashhad in 2001. Journal of Mashhad Dental School 2005 29 (3-4): 235-42. [In Persian].
  15. Ramezani GH, Valaei N, Eikani H. Prevalence of DMFT and fluorosis in the students of Dayer city (Iran). J Indian Soc Pedod Prev Dent 2004; 22(2): 49-53.
  16. Rezaei Z, Mansouri B, Pashaei T, Alihossaeni M, Habibi Y, Gharibi F, et al. Survey of DMFT status in elementary school students in Sanandaj City in 2014. Zanko Journal of Medical Sciences 2015; 15(47): 30-7. [In Persian].
  17. Sajadi FS, Mosharafian S, Torabi M, Hajmohamadi S. Evaluation of DMFT index and significant caries index in 12-year-old students in Sirjan, Kerman. J Isfahan Med Sch 2014; 10(4): 290-8. [In Persian].
  18. Faezi M, Farhadi S, Nikkerdar H. Correlation between DMFT, diet and social factors in primary school children of Tehran-Iran in 2009-2010. J Mashad Dent Sch 2012; 36(2): 141-8. [In Persian].
  19. Sadeghi M, Bagherian A. DMFT index and bilateral dental caries occurance among 12-year-old students in Rafsanjan-2007. J Rafsanjan Univ Med Sci 2008; 7(4): 267-74. [In Persian].
  20. Hiremath A, Murugaboopathy V, Ankola AV, Hebbal M, Mohandoss S, Pastay P. Prevalence of dental caries among primary school children of India - a cross-sectional study. J Clin Diagn Res 2016; 10(10): ZC47-ZC50.
  21. Al-Haddad KA, Al-Hebshi NN, Al-Ak'hali MS. Oral health status and treatment needs among school children in Sana'a City, Yemen. Int J Dent Hyg 2010; 8(2): 80-5.
  22. Srisilapanan P, Nirunsittirat A, Roseman J. Trends over time in dental caries status in urban and rural Thai children. J Clin Exp Dent 2017; 9(10): e1201-e1206.
  23. Kim HN, Han DH, Jun EJ, Kim SY, Jeong SH, Kim JB. The decline in dental caries among Korean children aged 8 and 12 years from 2000 to 2012 focusing SiC Index and DMFT. BMC Oral Health 2016; 16: 38.
  24. Patel RN, Eaton KA, Pitts NB, Schulte A, Pieper K, White S. Variation in methods used to determine national mean DMFT scores for 12-year-old children in European countries. Community Dent Health 2016; 33(4): 286-91.
  25. Nazemi S, Raei M. Fluoride concentration in drinking water in Shahroud (Northern Iran) and determination of DMF index in 7 year old children. Journal of Occupational Health and Epidemiology 2012; 1(1): 50-4.
  26. Cochrane N, Poureslami H. Necessity of water fluoridation in Iran: A review on water fluoridation and prevention of dental caries. J Oral Health Oral Epidemiol 2014; 3(1): 1-7.
  27. Kim AH, Shim YS, Kim JB, An SY. Caries prevalence in Korean children and adolescents from 2000 to 2012. J Clin Pediatr Dent 2017; 41(1): 32-7.
  28. Al-Bluwi GS. Epidemiology of dental caries in children in the United Arab Emirates. Int Dent J 2014; 64(4): 219-28.
  29. Lagerweij MD, van LC. Declining caries trends: Are we satisfied? Curr Oral Health Rep 2015; 2(4): 212-7.