Environmental Impact on Human Health: The Association between Drinking Water Quality and Teeth Decay in School Children in South Kalimantan Province, Indonesia

摘要

Background: In some areas in Indonesia, such as South Kalimantan province, water quality has been a problem due to natural environmental hazards and anthropogenic activities. Indonesian Basic Health Research Survey (2008), showed that the prevalence of dental decay was high (83,6 %) and much of the drinking water quality was poor (58,6 %). Aim : This environmental risk factor research investigates the association between drinking water quality and tooth decay in school children. Methods: Quantitative & Qualitative methods are used in a cross sectional study, with oral health examinations of 300 school children (5-7 years old) in 20 villages, 3 districts, in South Kalimantan Province. Interviews were to investigate social risk factors. Drinking water samples were collected from 20 villages and examined in the laboratory. Results: The prevalence of teeth decay is 99,7% On average there are 11 decayed, exfoliated or filled deciduous teeth per person. Laboratory findings showed that 30 % of drinking water is outside the normal pH range of 6.5-8.5. 95 % of Fluoride concentration is below the optimum level (0.7 ppm) to prevent dental caries. In certain areas, manganese concentration of 8.75 ppm exceed the safety level of 0.4 ppm. Bivariate analysis showed significant correlations (p＜0.05); the more acidic water, the lower the fluoride, the higher the dental caries. Manganese is positively correlated with dental caries. These findings support the people views that they have tooth decay due to poor quality water. The Governor once said "many teenagers failed the health examination of Army School entry test. Mostly due to teeth decay". Hence, tooth decay also reflects poor environmental conditions and has consequences for future socio-political life, education & employment. Conclusion: Tooth decay is highly prevalent related to poor drinking water quality in certain areas. This needs to be taken into account as a potential indicator of general environmental problems.