2042??Indian Journal of Public Health Research & Development, February 2020, Vol. 11, No. 02
Selected Oral Variables in Children of Inbreeding Parents and
Children of Not Inbreeding Parents in
Babylon Government/Iraq
Zahra Muhamad Weiss1
, Nadia Aftan Al Rawi2
1
B.D.S., M.Sc. Student, Department of Pedodontics and Preventive Dentistry, College of Dentistry, University of
Babylon, 2 B.D.S., M.Sc., Ph.D. Assistant Professor, Department of Pedodontics and Preventive Dentistry,
College of Dentistry, University of Baghdad
Abstract
Consanguineous marriage is a relationship between biologically related individuals. Genetic factors have
role in gene environment interactions take the center stage. The evidence of oral disease (dental caries,
enamel anomalies and teeth wear) is based on the study of inherited diseases, genetic syndromes, familial
studies etc.Aim of study: This study was conducted to assess the impact of consanguineous marriage on the
occurrence and prevalence of dental caries, enamel anomalies and teeth wear in children of inbreeding parents
with children of not inbreeding parents among primary schools in Al-Qasem city/Babylon government, in
Iraq Three hundred ninety eight (398) student, 6-12 years old, from 4 primary school, 199 child that their
parents of inbreeding marriage (study group), and other 199 child their parents not inbreeding marriage
(control group), were included in this study. Dental caries and enamel anomalies were diagnosed and
recorded according to World Health Organization criteria (WHO, 1987)(1) (WHO, 1997)(2) respectively in
addition, teeth wear was assessed according to criteria of Smith and Knight Index, 1984.
A higher percentage
of caries experience and enamel defect were recorded in children of inbreeding parents than children of not
inbreeding parents.
Keywords: Consanguineous marriage, oral health.
Introduction
Consanguineous marriages have generally been
accepted as having important detrimental effects on
offspring. There is a lot of genetic research about
consanguineous marriage and its detrimental effects on
offspring.(4 & 5) Although consanguineous marriages are
common in the world, the relationship with oral health
status has been thoroughly still investigated. There
are many studies found that genetic basis of occlusal
trait and dental anomalies through analysis result of
inbreeding study in subdivided isolated community, also
see the role of heredity, exacerbated through inbreeding,
in the etiology of tooth wear(6 & 7).
Dental caries is a localized, progressive, irreversible,
microbial disease of mineralized tissues of the teeth,
characterized by demineralization of inorganic portions,
and destruction of organic substances of the tooth. It is a
multifactorial etiology related to the interactions overtime
between tooth substance, certain microorganisms, and
dietary carbohydrates producing dental plaque (8). Most
of the oral diseases are complex in nature, resulting from
infectious microbial agents coupled with hereditary and
environmental factors, with application of newer genetic
techniques, an increased understanding of genetic risk
factor relationships between dental caries and individual
phenotypic expression is coming into light(9). Dental
caries was affected by nutrition as seen in study by (10 & 11).
Tooth enamel is formed during only a certain
period of the tooth development and is irreplaceable.
Ameloblasts, which are secretory cells that produce
dentalenamel, are particularly sensitive to changes in
their environment during the long process of enamel
production. Dysfunction of ameloblasts may occur
resulting inchanges in the appearance of the enamel in
the dentition.(12).
Indian Journal of Public Health Research & Development, February 2020, Vol. 11, No. 02??2043
Materials and Method
Subjects: Three hundred ninety eight (398) students,
6-12 years old, were collected from 4 primary school,
they were divided into 199 child that their parents of
inbreeding marriage (study group), and other 199 child
their parents not inbreeding marriage (control group),in
Al-Qasem city/Babylon government, in Iraq
This study was done during the period from
December 2018 to February 2019. A pre-study ethical
approval was assigned, also the children’s parent consent
form which taken before start the study.
Inclusion Criteria: Students with
• No history of medication, (anti- inflammatory or
antimicrobial therapy) within previous 3 months.
• No history of orthodontic treatment.
• No history of any systemic disease.
Diagnostic criteria included the sex, age and history
of family if inbreeding parents or not.
Oral examinations was performed on chairs, under
good illumination by using dental mirror, probe and
dental tweezers Dental caries experience, were diagnosed
and recorded according to the criteria of WHO, (1987).(1)
Clinical examination was conducted using plane mouth
mirror and dental explorer. A systematic approach of
the dental caries was performed, starting from the upper
right second molar proceeding in an orderly manner
from tooth to the adjacent tooth reached upper left
second molar, then going to the lower left second molar
passing to the lower right molar (WHO, 1987).(1)
The developmental defects of enamel index was
used WHO, (1997)(2). Enamel abnormalities were
classified in to one of three types on the basis of their
appearance. They vary in their extent, position on the
tooth surface and distribution within the dentition. Ten
index teeth were examined on the buccal surface only,
if any index tooth is missing, the area was excluded.
These teeth include: 11, 12, 13, 14, 21, 22, 23, 24, 36,
46 for permanent teeth and 51, 52, 53, 54, 61, 62, 63, 64,
75, 85for primary teeth was examined according to The
Criteria of Enamel Anomalies
Results
Dental Caries: Table (1) illustrates the distribution
of caries free and with caries with among children of
inbreeding parents and children of not inbreeding
parents. For total sample found that a high percentage of
children with caries in study group than control group.
The same table illustrates that, children in study groups
has a low percentage of caries free compared with
children among control group.
Table (1): Distribution of dental caries and caries
free among children of study and control groups.
Groups Caries Free
No. (%)
Dental Caries
No. (%)
In breeding 3 (23.08) 196 (50.91)
Not breeding 10 (76.92) 189 (49.09)
Total 13 (3.3) 385 (96.7)
Table (2) illustrates that mean and standard deviation
of caries experience of the permanent dentition by age
among study and control groups.
Table (2): Caries experience of the permanent teeth among children of study and control groups.
Age (Y)
Groups
In breeding Not breeding P value
N Mean ±SE N Mean ±SE
<=10
DS 114 3.50 .28 136 1.43 .16 .000
MS 124 .40 .18 137 .20 .08 .325
FS 123 .06 .02 137 .00 .00 .019
DMFS 118 3.86 .33 137 1.63 .18 .000
10.1+
DS 65 5.89 .57 59 2.95 .47 .000
MS 68 .32 .21 59 .36 .17 .903
FS 68 .07 .04 59 .12 .05 .492
DMFS 66 6.21 .65 59 3.25 .49 .000
Total
DS 179 4.37 .28 195 1.89 .19 .000
MS 192 .38 .14 196 .25 .08 .431
FS 191 .06 .02 196 .04 .02 .308
DMFS 184 4.71 .32 196 2.12 .20 .000
2044??Indian Journal of Public Health Research & Development, February 2020, Vol. 11, No. 02
Caries experience was found higher mean value in
inbreeding group than not inbreeding. Difference was
statistically highly significant existed between groups.
Decayed surface was recorded a largest fraction
of DMFS value compared to MS and FS among both
groups with highly significant difference. Regarding MS
and FS fractions, statistically, no significant difference
was found between study and control groups.
Enamel Defect: Table (3) illustrates the percentage
of children with enamel defect in study and control
groups. The result showed that a slightly the same values
were recorded between both groups with no significant
difference. According to the gender, the result showed
that male had higher percentage of enamel defect than
female. Regarding to the age, among children of total
sample, the result showed that age (10-12) years old had
higher percentage of enamel defect than (6–10) years.
Table (3): Distribution of enamel defect among children of study and control groups.
Age (Y) Gender
Groups
In Breeding No Breeding P Value
N % N %
<=10
Male
Yes 41 58.57 29 41.43
.049
No 22 40.74 32 59.26
Female
Yes 33 44.59 41 55.41
.750
No 34 47.22 38 52.78
Total
Yes 74 51.39 70 48.61
.255
No 56 44.44 70 55.56
10.1+
Male
Yes 16 34.78 30 65.22
.000
No 19 79.17 5 20.83
Female
Yes 20 60.61 13 39.39
.724
No 14 56.00 11 44.00
Total
Yes 36 45.57 43 54.43
.016
No 33 67.35 16 32.65
Total
Male
Yes 57 49.14 59 50.86
0.640
No 41 52.56 37 47.44
Female
Yes 53 49.53 54 50.47
0.995
No 48 49.48 49 50.52
Total
Yes 110 49.33 113 50.67
0.762
No 89 50.86 86 49.14
Table (4) distribution of enamel defect scores
(number and percentage) among students by age, gender
among inbreeding and not inbreeding status. Score 1
and score 3 slightly higher in children of not inbreeding
parents than children of inbreeding parents. While score
2 is slightly higher in children of inbreeding parents
than children of not inbreeding parents. Statistically, no
significant difference was recorded between children of
both groups.
Indian Journal of Public Health Research & Development, February 2020, Vol. 11, No. 02??2045
Table (4): Distribution of enamel defect scores In study and control groups
Age Score
Inbreeding Not Breeding
Gender Gender
M F T M F T
N % N % N % N % N % N %
<=10
1 33 52.3 32 47.7 65 50.0 29 47.5 38 48.1 67 47.8
2 12 19.0 4 5.9 16 12.3 7 11.4 11 13.9 18 12.8
3 6 9.5 2 2.9 8 6.1 5 8.2 3 3.8 8 5.7
10.1
1** 15 42.8 16 47.0 31 44.9 30 85.7 12 50.0 42 71.1
2 5 14.2 10 29.4 15 21.7 6 17.1 5 20.8 11 18.6
3 0 .00 1 2.9 1 1.4 3 8.5 0 .00 3 5.0
Total
48 44.8 48 48.9 96 46.8 59 55.1 50 51.0 109 53.1
17 56.6 14 46.6 31 51.6 13 43.3 16 53.3 29 48.3
6 42.8 3 50.0 9 45.0 8 57.1 3 50.0 11 55.0
Teeth Wear: Table (5) illustrates the distribution
of the children (study and control groups) according to
the mean of teeth wear index by age groups. The results
revealed that mean of teeth wear higher in control group
than study group. According to the age, the result showed
the children in age 6–10 years old have higher teeth
wear mean value than children in age 10–12. Regarding
to gender, the results showed that tooth wear in general
was higher among females than males.
Table (5): Distribution of teeth wear among children of study and control groups.
Age (Y) Gender
In Breeding No Breeding
P Value
Mean ±SE Mean ±SE
<=10
Male 1.64 .27 3.81 .44 .000
Female .75 .16 4.51 .45 .000
Total 1.14 .15 4.17 .32 .000
10.1+
Male .83 .22 2.03 .37 .008
Female 1.58 .45 4.03 .94 .044
Total 1.14 .23 3.01 .51 .002
Total 1.14 .127 3.77 .275 .000
Table (6) showed distribution of teeth wear for
primary and permanent teeth according to age, gender in
children of study and control groups.
According to the age, the result showed that children
in age 6–10 years old have higher teeth wear mean value
than children in age 10–12, with statistically highly
significant. Concerning gender, the results showed that
tooth wear in general was higher among females than
males.
2046??Indian Journal of Public Health Research & Development, February 2020, Vol. 11, No. 02
Table (6): Distribution of teeth wear for primary and permanent teeth among children of study and control
groups.
Age (Y) Gender TW
Groups
In Breeding No Breeding P value
Mean ±SE Mean ±SE
<=10
Male
Perm. .90 .21 3.56 . 42 .000
Pri. .85 .25 .60 .31 .531
Female
Perm. . 67 .16 3.10 .36 .000
Pri. .11 .06 1.75 . 52 .003
Total
Perm. .77 .13 3.32 .27 .000
Pri. .44 .12 1.17 .31 .026
10.1+
Male
Perm. .79 .23 2.03 .37 .007
Pri. .08 .08 .00 .00 .365
Female
Perm. 1.33 .42 4.03 .94 .025
Pri. .30 .30 .00 .00 .489
Total
Perm. 1.02 .22 3.01 .51 .001
Pri. .18 .14 .00 .00 .209
Total
Perm. .84 .11 3.21 .25 .000
Pri. .37 .10 .94 .25 .033
Dental Caries: Generally, there were controversy
between studies who searched about caries experience as
it was well known that the caries is multifactorial disease
and can change from a population to another one, from
an individual to another one and even from a group of
teeth to another one (14).
In the present study, the percentage of caries
experience in the siblings of the consanguineous group
is (50.91) which higher than non-consanguineous
group’s (49.09) in Al_Qasem city. The results of the
present study of permanent teeth revealed that the
siblings of the consanguineous group had mean of
DMFs was (4.71), and the Decay surface fraction was
(4.37) which represent the highest proportion of this
fraction in the DMFs, followed by MS (.38) and then
FS fraction (.06) which represents the lowest one, the
siblings of the non-consanguineous group had mean of
DMFs was (2.12), and the Decay surface fraction was
(1.89) which represent the highest proportion in the
DMFS, followed by MS (.25) and then FS fraction (.04)
which represents the lowest one. This higher caries in
study group than control group could be due to genetic
factor in inbreeding marriage (16). The current study was
agree with a study done by Elfaki (2015) that was carried
out among 120 school age students and their families in
Najran – Saudi Arabia (Consanguineous marriage is very
common among the inhabitants of Najran), Elfaki found
significant association between hereditary factor and
the occurrence of dental caries among school children.
The study concluded that dental caries experience of
children is strongly influenced by hereditary factor and
consanguineous marriage could be the source of the
genetic factor that behind the high prevalence rate of
dental caries (17).
Enamel Anomalies: Percentage of enamel
anomalies was 49.33% in the siblings of the inbreeding
group and 50.67% in the siblings of the not inbreeding
group so that there is no significant difference between
two groups. The percentage of enamel defect was found
to be higher among 6–10 years children than 10–12
years children in both study and control groups. The
percentage of enamel defect was found in the present
study to be higher among boys than girls for both age
groups. This finding is in agreement with Slayton et al
(2001)(20). Mestrinho et al (2007) (21), Murad (2007)
(22), Masumo et al (2013) (23) and Robles et al (2013)
Indian Journal of Public Health Research & Development, February 2020, Vol. 11, No. 02??2047
(24), while it was disagree with Gatta (2005) (25) and
Jabber (2008) (26). Definitive reason for this finding is
not documented but suggested to be because of greater
intra uterine nutritional demands in boys than in girls,
since boy?s weight more, have more muscle mass, and
are developmentally delayed both in the uterus and at
birth.(27 & 28)
Conclusion
The impact of consanguineous marriage was
recorded on dental caries and enamel anomalies in
children of inbreeding parents than children of not
inbreeding parents.
Financial Disclosure: There is no financial
disclosure.
Conflict of Interest: None to declare.
Ethical Clearance: All experimental protocols
were approved under the Department of Pedodontics and
Preventive Dentistry, College of Dentistry, University
of Babylonand all experiments were carried out in
accordance with approved guidelines.
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