THE PREVALENCE OF DENTAL CARIES AND ENAMEL FLUOROSIS AMONG SCHOOL CHILDREN IN THE WHITE NILE STATE

Abstract

Sudan is the largest country in Africa, forming 8.3% of the continent with a surface area of about one million square miles and a total population of around 30 millions. 69% of the Sudanese are farmers and nomads while the rest are engaged in other different economic activities. The country is divided into 26 states, ten of which are in the southern part of the country, while the remaining sixteen are in the north, east and western parts. Sudan lies in the eastern part of Africa, extending from latitude 4 South of the Egyptian borders to Latitude 23 degree. It has bounderies with 9 countries.(Fig I) The Nile is the longest river in the world and is formed by the White Nile flowing from lake Victoria in Uganda with many tributaries feeding it such as Sobat, IX and the Blue Nile flowing from Lake Tana in Ethiopia and is fed by many tributaries including Dinder, Rahd and river Atbara from the Ethiopian heighlands. The White Nile state (Fig II & III) is one of the 26 states of the Sudan, located 40 km south of the capital Khartoum. The White Nile state lies in the middle of Sudan from latitude 13 No - 15 No and from 31.3 Eo to 33 Eo. (1) It’s total area is about 41.000 sqkm divided into two parts from south to north by the White Nile. On the Eastern bank of the Nile we find the two provinces of Jeblein and Getina, while Dueim and Kosti provinces lie on the western bank of the White Nile. Dental caries is a major dental disease affecting the lives of large populations of the world. It impairs the quality of life for many people by causing pain and sepsis. Lack of treatment of dental caries can aggravate other systemic diseases. It is believed that bacteria plays a major role in the production of caries. The organisms most commonly associated with dental caries are the lactobacilli and many strains of streptococci (S.Mutans) as well as other forms of bacteria. The well established inverse relationship between fluoride concentrations in the drinking water and the prevalence of dental caries has stimulated extensive research aimed at determining the optium level of fluoride ingestion required to obtain the maximum protection against dental caries with the least risk of producing dental fluorosis. Fluoride represents about 0.06 - 0.09 of the earth crust, in rock and soil, and it is found combined in a wide vairety of minerals. Water contains varying concentrations of fluoride. The fluoride obtained from lakes and rivers or artesian wells is for the most parts below 0.5 mg/l. Even though high concentrations as high as 95mg/kg have been recorded in Tanzania. (WHO, 1986)(2) Humans ingest various amounts of fluoride and there are great individual variations in the daily intake of fluoride from solid foods depending on the composition of the diet and fluoride contents of the water by which the food has been prepared. The fluoride content of drinking water is commonly the largest contributor to the daily fluoride intake of humans which in turn depends on the fluoride concentration in water, age of the person, climatic conditions and dietary habits.(3) Dental fluorosis is a specific disturbance of tooth formation caused by excessive fluoride intake during the formative periods of the dentition.