Oral Health Status and Treatment Needs in Spiti, Himachal Pradesh, India

Objectives: To examine the oral health status and treatment needs of people living in remote Himalayan Spiti valley of the state of Himachal Pradesh, India.
Methods: Approval from the University of Utah Institutional Review Board (IRB) was obtained prior to the implementation of this project. 121 participants were recruited through collaboration with a local non-profit organization and community leaders. Consenting participants completed a survey including demographic characteristics, oral health behaviors, oral health service utilization, and self-reported oral health status. The participants’ oral health status and treatment needs were evaluated using Decayed, Missing, Filled Teeth (DMFT) and Community Periodontal Index of Treatment Needs (CPITN) indices. The data were analyzed using STATA version 14.2 (Stata Corporation, College Station, Texas).
Results: Approximately 81% of participants reported oral pain within the last year. 90% had at least 1 site of untreated decay in the oral cavity. The average number of teeth present was 17, with a mean DMFT score of 21.3. According to the CPITN scale, loss of attachment was found in 45% of participants. Approximately 36% required prompt treatment, while 38% were evaluated to require urgent treatment due to pain or infection. Over half had not seen an oral health care provider within the last year, with 30% reporting never receiving oral health care.
Conclusions: The survey and clinical exam data identified important issues related to the oral health of this population in the Spiti region including limited access to care, deficits in home oral hygiene, and a lack of oral health education. While self-reporting of oral health status reflected findings of the clinical examination, an understanding of the oral disease causation and progression process was limited at both the individual and community level. This population has an urgent unmet need for dental treatment and would also benefit from oral health promotion and education interventions.