Enamel defects among Syrian schoolchildren in Damascus city: A cross-sectional epidemiological survey

Abstract

Background:Enamel defects EDs can affect the quality of life due to poor aesthetic appearance, post-eruptive caries and breakdown. Therefore, there is a need to provide further understanding about prevalence of EDs among Syrian children and etiological factors. Therefore, this study was undertaken to determine the prevalence and etiological factors of EDs among Syrian children aged 7 to 12 years in Damascus. Methods: a cross-sectional observational study was undertaken. A total of 2000 schoolchildren (934 boys and 1066 girls) were firstly examined to detect EDs. Using the Enamel Defect Index (EDI), a second clinical examination was performed to 240 children with EDs. All surfaces of affected teeth were examined individually. A following telephone interview with parents was performed to investigate the etiological factors of EDs. Results: The prevalence of EDs was 16.1%. Percentages of Localized enamel defects LEDs, Molar incisor hypomineralization MIH, amelogenesis imperfecta AI and EDs related to high fluoride intake were 51.7%, 42.7%, 5% and 0.6% respectively. The highest prevalence of EDs was observed in the upper incisors followed by the lower first molars, whilst EDs were least prevalent in upper lateral incisor. The etiological factors that significantly contribute to EDs type, were the place of residence and educational level of parents. Having higher educational level of parents was significantly associated with higher prevalence of MIH of children whilst LEDs were significantly associated with low educational level of parents. Other factors including gender, age, consanguineous marriage, economic status of family, medical problems and medications during pregnancy, nature of delivery, timing of birth, child's birth weight, type of feeding, genetic and systemic diseases and allergic problems, injuries, bruises and surgeries during childhood, were not associated with EDs. Conclusions: information about the prevalence of EDs and etiological factors have been provided. Educational level of family and place of residence can be predisposing factors for the presence of EDs among Syrian children. There is a need for raising awareness towards EDs among Syrian community to take preventive measures in order to preserve the rest of intact dental tissues and prevent post-eruptive breakdown of affected teeth.

Prevalence and clinical characteristics of molar-incisor hypomineralization in Syrian children: a cross-sectional study

“…The crisis has led to significant disruptions in the healthcare system and access to medical care in Syria, which could potentially affect the incidence and diagnosis of MIH. Additionally, the crisis has led to a displacement of a large number of Syrian people, which could lead to changes in children's and their mothers' living conditions, diet, and access to clean water, which are all potential risk factors for MIH [26][27][28] . Moreover, factors such as stress, malnutrition, and exposure to environmental toxins, which are all associated with the Syrian crisis, could also affect the development of children's teeth and lead to an increased incidence of MIH 29 .…”