Impact of socio-economic status on malocclusions prevalence to school-children from Western Romania; ethnical disparities.

Introduction Malocclusions are considered deviations from the normal evolution of dento-maxilary apparatus, being conditioned by a plurality of general and specific factors, presenting a varied ethiopatogenetic mechanism (Schapira 1973). While considered nonlife threatening, malocclusion may cause altered functions (mastication, speech) and poor dento-facial esthetics that reduce the quality of life of affected subjects including social and functional limitations (Mtaya et al 2009). Widespread and representing significant obstacles in social life integration, the malocclusions have become considerable public health issues, conducting to the necessity of determining the expansion within the population as well as the prevalence (Kenealy et al 1989). Epidemiological studies have demonstrated that the prevalence and the severity of malocclusion have increased over the years as well as the fact that children of lower socioeconomic background had more severe malocclusions and poorer general dental health (Hebling et al 2004). There are few if any exhaustive studies on oral health comprising significant number of children from a specific area of Romania whilst such a study may be essential in order to evaluate the health status of population as well as the tendencies in evolution (Dorobat et al 2011). Nevertheless, the few studies conducted on various groups of children from Romania show an increasing tendency in prevalence of malocclusions, varying from 50 to 60%, and 73.6% 76.9%. Most of these studies Abstract. Background: Epidemiological studies have demonstrated that the prevalence and the severity of malocclusion have increased over the years as well as the fact that children of lower socioeconomic background had more severe malocclusions and poorer general dental health. With respect to Western Romania, particularly to rural and small urban areas, isolated if considering the availability of pediatric dentistry services, facing increased unemployment and very low living standards, the information on oro-dental status on children, therewith the malocclusions epidemiology are scarce or missing. The mining area of Roșia Montană, Western Romania, is presenting the features as described above. Objectives: The aim of this study is an exhaustive approach of children population from Roșia Montană mining area, as to establish the prevalence of malocclusion as well as to determine the extent of socio-demographics features, such as ethnicity and socio-economic status may influence the malocclusion distribution. Material and method: In this cross-sectional study we investigated, within the study area, all the children who met the inclusion criteria. The batch consisted of 960 children (518 boys and 442 girls), aging 7 to 14. This batch represented 57.54% of total age category. There were two dimensions of the study: firstly, to establish the distribution of the batch by demographic factors and to determine the prevalence of malocclusions within the batch by Angle classes’ distribution and secondly, the batch was investigated by the distribution of parental education level and family income level and we aimed to establish the correlations (if any) amongst the prevalence of malocclusions and education and income level, as to determine whether the socio-economic status could be considered as determinant in increasing prevalence of malocclusions. Results: Within the studied batch we determined a prevalence of malocclusions of 91.35%, wich is one of the highest prevalence in Europe. The malocclusion distribution varied significantly by parental level of education such as: the most affected category was „8 to 12 grades” category, standing for 93.1% malocclusion prevalence, as the least affected was paradoxically the „less than 4 grades” category, standing for 80.9% prevalence of malocclusion. The only possible explanation of this paradox could stand with the ethnical factor, as all the subjects who are part of „less than 4 grades” parental education category are Roma subjects. Likewise, weather the Romanian subjects followed a rule stating that the prevalence of malocclusion was inversely proportional to both level of education and level of income, in Roma subjects the distribution seemed not to follow such clear rules. Conclusions: The distribution of malocclusions depended on socioeconomic status and ethnic variances. The prevalence of malocclusions in Roma subjects was significantly smaller than in Romanian subjects, despite the fact that Roma subjects were social and economical disadvantaged.