1.1 Introduction
Dental caries is a multifactorial, chronic disease characterized by the progressive destruction of tooth structure due to the acidic by products of bacterial fermentation of dietary carbohydrates, especially sugars, which results in demineralization of enamel and dentine (Fejerskov 2004). It is one of the most common non communicable diseases affecting children worldwide, influencing not only oral health but also general health, nutrition, growth, and quality of life (Petersen 2003). Dental caries is particularly significant in school aged children because of their increased exposure to cariogenic diets, evolving oral hygiene behaviours, and developing dentition that is more susceptible to decay (Selwitz, Ismail & Pitts 2007).
Globally, dental caries continues to pose a substantial public health challenge, with a high prevalence and incidence reported in both developed and developing countries. According to the World Health Organization, nearly 60–90 % of school aged children experience dental caries, with untreated decay remaining a major burden in many regions (World Health Organization 2013).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Dental caries is widely recognised as one of the most prevalent chronic diseases of childhood, affecting millions of children globally and representing a major public health challenge in both developed and developing countries. According to the World Health Organization (WHO), dental caries is a bacterial mediated disease that results from the interaction of dietary sugars with plaque bacteria, leading to demineralisation of tooth surfaces and progressive destruction of enamel and dentine (World Health Organization 2013). The disease often begins early in life and may persist into adolescence and adulthood if appropriate preventive measures are not implemented. In many low and middle income countries, including Nigeria, dental caries remains under reported and under treated, worsened by limited access to oral health services, low levels of oral health awareness, and competing public health priorities.
Multiple authors have examined the burden of dental caries among children in sub Saharan Africa, asserting that the burden is not insignificant and requires urgent attention. According to Adebola et al (2018), dental caries is a major oral health problem among school aged children in many Nigerian states, with prevalence varying widely due to differences in socioeconomic factors, dietary habits, and oral hygiene practices. Similarly, Ekanayake and van der Hoeven (2003) reported that urbanised populations often show higher caries experience compared to rural populations, likely due to increased consumption of refined carbohydrates and sugary foods that accompany urban lifestyle changes.
According to Arowojolu, Taiwo, and Esan (2015), the prevalence of dental caries among school children in Ibadan was substantial, with a significant proportion of affected children having untreated decay. The authors reported that inadequate oral hygiene practices, frequent consumption of sugary snacks, and limited parental supervision of oral care were significant contributors to caries experience in the studied population. In a similar study, Okeigbemen and Ighogboja (2008) stated that Nigerian children exhibited a considerable burden of caries, with peak occurrences in the mixed dentition period corresponding to primary school ages.
In the context of Lagos State, the most populous and economically vibrant state in Nigeria, the oral health status of children reflects the broader challenges of rapid urbanisation and lifestyle transitions. Lagos State has experienced significant changes in dietary patterns over recent decades, with increasing availability and consumption of processed foods and beverages high in sugars. According to Olusile and Oginni (2010), dietary sugar intake is strongly associated with dental caries activity, particularly when combined with poor oral hygiene. The authors affirmed that children from urban environments may be at greater risk due to increased access to sugary snacks and inadequate reinforcement of oral hygiene routines in school and home settings.
Uti et al. (2014) affirmed that, school health programmes frequently overlook oral health, focusing instead on general health concerns such as immunisation, nutrition, and communicable disease prevention. The authors reported that when oral health education does occur, it is often irregular and lacking in practical components such as supervised tooth brushing or parental engagement. It is within this context that the prevalence and determinants of dental caries among primary school children in Lagos State warrant systematic investigation. This study is set against the backdrop of these identified gaps in knowledge and the pressing need to improve oral health outcomes among primary school children in Lagos State.
1.3 Statement of Problems
Investigation revealed that dental caries is recognized globally as one of the most common chronic diseases in childhood, with substantial impacts on children's ability to eat, speak, learn, and socialize without pain or discomfort (Petersen 2003). Despite being largely preventable, dental caries is widespread among school aged children, particularly in low and middle income settings, where access to oral health care and preventive services is limited (World Health Organization 2013).
In Lagos State, anecdotal reports from dental clinics and findings from small community based surveys suggest that many children experience untreated dental decay, which is linked with missed school days, reduced academic performance, impaired concentration, and poor nutritional status due to difficulties in eating (Adewumi et al 2016; Okeigbemen & Ighogboja 2008).
Furthermore, factors contributing to the high prevalence of dental caries include inadequate oral hygiene practices, high consumption of sugary foods and beverages, limited parental awareness of preventive dental care, and insufficient integration of oral health education in school health programs in Lagos State. Studies from other parts of Nigeria highlight that children from low income families are particularly vulnerable, as they have lower rates of regular dental visits and preventive care, increasing the risk of caries progression and complications (Onibokun et al 2011). It is against this backdrop that this study seeks to investigate the prevalence of dental caries among primary school children in Lagos State, identify associated risk factors, and provide evidence to inform oral health policies, preventive strategies, and community based interventions aimed at improving oral health outcomes in this population.
1.4 Aim and Objectives of Study
The aim of this study is to determine the prevalence of dental caries among primary school children in Lagos State and to identify associated risk factors.
The specific objectives of the study are:
- To assess the current prevalence of dental caries among primary school children in Lagos State.
- To examine the relationship between dietary habits and the occurrence of dental caries in the study population.
- To evaluate the role of oral hygiene practices in preventing dental caries among primary school children.
- To identify the accessibility and utilisation of dental care services among children in Lagos State.
- To provide recommendations for improving oral health outcomes and preventive strategies in primary schools.
1.5 Research Questions
Based on the stated objectives, the study seeks to answer the following questions:
- What is the current prevalence of dental caries among primary school children in Lagos State?
- How do dietary habits influence the occurrence of dental caries in primary school children?
- What is the relationship between oral hygiene practices and the incidence of dental caries?
- How accessible and utilised are dental care services for primary school children in Lagos State?
- What measures can be recommended to improve oral health outcomes among primary school children?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
- H0: There is no significant relationship between dietary habits, oral hygiene practices, access to dental care, and the prevalence of dental caries among primary school children in Lagos State.
- H1: There is a significant relationship between dietary habits, oral hygiene practices, access to dental care, and the prevalence of dental caries among primary school children in Lagos State.
1.7 Significance of Study
It is believed that at the completion of the study, the findings will enhance awareness among parents, teachers, and healthcare providers regarding the importance of preventive oral care. Also, healthcare providers will be able to identify high-risk populations and plan effective interventions.
Furthermore, the study will assist policymakers in designing targeted oral health policies for primary school children. In addition, teachers and school administrators will be better informed to integrate oral health education into school programs.
Lastly, the research will contribute to academic knowledge, supporting future studies and comparative analysis in other Nigerian states.
1.8 Scope of Study
The study focuses on primary school children within Lagos State, Nigeria, covering both public and private schools across selected local government areas. The research examines the prevalence of dental caries, oral hygiene practices, dietary habits, and access to dental care services.
The scope is limited to children aged 6–12 years, representing the typical primary school population in Lagos State. The study excludes secondary school children and children outside Lagos State.
1.9 Limitations of the Study
The study was constrained by several factors. In some schools, administrative delays affected timely data collection. Some children were absent on the day of dental examination, which was unavoidable.
Resource constraints such as limited funds and research materials affected the breadth of coverage. Additionally, the lack of comprehensive historical data on oral health in Lagos State was a challenge in comparing trends over time.
1.10 Definition of Terms
Dental Caries: A chronic, multifactorial disease characterised by the destruction of tooth enamel and dentine caused by bacterial activity on fermentable carbohydrates (Fejerskov 2004).
Primary School Children: Children enrolled in the first six years of formal education, typically aged 6–12 years (Arowojolu, Taiwo & Esan 2015).
Prevalence: The proportion of individuals in a population who have a specific disease at a given time (Petersen 2003).
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