Prevalence of oral conditions and associated factors among schoolchildren in Accra, Ghana: a cross-sectional study

Dental Caries Status of Children and Adolescents in West Africa-A Literature Review

Objectives: Dental caries is one of the most prevalent oral diseases worldwide, including in Africa. The aim of this article was to provide a comprehensive review of dental caries status of children and adolescents living in the West African region. Methods: Articles that fulfilled the study selection criteria were identified through systematic search in electronic databases (EMBASE and MEDLINE). Titles and abstracts were examined manually to screen for articles that study the caries prevalence and experience of children under the age of 18, and only English publications published from the years 2015 to 2024 were included. Publications that include participants with special healthcare needs were excluded. Relevant data related to caries prevalence and severity of participants below 18 were extracted with a standardized spreadsheet. Results: Out of 1288 studies, a total of 18 studies were included. Among the 16 countries in West Africa, only 3 countries (19%) including Ghana, Nigeria, and Senegal met the inclusion criteria, with a majority (15/18, 78.9%) focusing on Nigerian children and adolescents. The dmft scores of the included studies ranged from 0.06 to 3.04, and the DMFT scores ranged from 0.02 to 2.65. It is worth noting that dmft/DMFT scores across different countries were collected with a high heterogeneity in study design, and were thereby not directly comparable. Conclusions: The majority of the included studies were conducted in Nigeria. There are significant variations in caries prevalence and caries experience among children and adolescent in West Africa. Further research on oral health surveillance in West Africa is needed.

Prevalence and associated factors of self-reported oral health problems among adults in the Fanteakwa districts in Ghana

BACKGROUND

There is a paucity of data on oral health problems among the residents of Fanteakwa districts (South and North) in the Eastern region of Ghana. Therefore, this study assessed the prevalence and factors associated with self-reported oral health problems in the Fanteakwa districts of Ghana.

METHODS

This community-based cross-sectional study targeted residents of the towns of the Fanteakwa districts, who have not had any dental care visit in the past six months preceding the study. The participants were enrolled from July - October, 2023. Socio-demographic study variables collected were sex, age, educational level, income level, ethnicity, area of residence, household size and frequency of brushing teeth in a day. Whereas the self-reported oral health problems were tooth ache, swollen gum, bleeding gum, sensitive tooth/teeth, hole in tooth/teeth, discoloured tooth/teeth and mouth odour. The chi-square statistical test was used to test the association between the presence of oral health problem(s) and other independent variables. Whereas, Modified Poisson regression was used to test the relationships among the variables.

RESULTS

In total, 400 community members were interviewed. The mean age of respondents was 31 years (SD ± 12.4, Min = 19, Max = 81). The majority were females (55.2%) and more than 96% had some form of formal education. The Akan ethnic group accounted for as much as 47% of the respondents. The overall prevalence of self-reported oral health problems was 58.5% (95% CI 53.5% - 63.4%). The commonly reported oral health problems were toothache (51.7%), swollen gum (38.5%), difficulty in chewing (33.3%), bleeding gum (32.1%), and mobile teeth (17.1%). About 98% (229/234) of the study participants who self-reported oral health problems, reported up to four different problems. Self-reported oral health problems associated with participants' age (χ2 = 7.2, p = 0.027), income level (χ2 = 19.3, p < 0.001), ethnicity (χ2 = 21.2, p < 0.001), area of residence (χ2 = 26.9, p < 0.001), religious affiliation (χ2 = 15.7, p < 0.001) and frequency of brushing teeth in a day (χ2 = 6.85, p < 0.032). Despite the observed relationships, Modified Poisson regression identified that compared to the rural dwellers, the urban dwellers had lower odds of self-reporting oral health problems (aOR = 0.718, p = 0.032, CI: 0.531-0.971), after controlling for age and frequency of teeth brushing in a day.

CONCLUSION

High rate of self-reported oral health problems was observed in the study site. Participants from rural residence were disproportionately affected. Therefore, local health authorities are encouraged to leverage on the identified risk groups for enhanced oral health education towards reduction in the reported oral health problems.

Audit of oral neoplasms in children and young adults in Nigeria

BACKGROUND

Orofacial neoplasms in children and young adults may differ significantly from those observed in adults. Our aim was to describe the epidemiological characteristics of histologically diagnosed orofacial neoplasms among children and young adults in Nigeria.

METHODS

This was a multicenter cross-sectional study across geopolitical zones in Nigeria. Annual reports of clinical information and surgical biopsies submitted at the Oral Pathology Laboratory, clinic day registries, surgical day case registries and operative theatre registries were retrieved from January 2008 to March 2024. The relevant demographic data were obtained for each patient. The study subjects were categorized by age into children, adolescents and young adults. Tissue involvement was classified as soft tissue involvement, bony involvement or both soft tissue and bony involvement. The site and behaviour of the lesions were subdivided according to the ICD-10 codes. Statistical analysis was performed via the R programming language.

RESULTS

A total of 1889 cases were observed during the period under review, with a mean age of 15 years. Cases were more common in females (52%) and in young adults (47%). Most cases were benign neoplasms (85%), and bony affectation (54%) was slightly predominant. Odontogenic tumours (38%) and fibro-osseous lesions (20%) were the most common category of lesions observed, whereas salivary gland tumours (2.2%) and neoplasms of epithelial origin (2.5%) were the least common. Neoplasms in children involved mostly soft tissues, whereas those in adolescents and young adults had a preference for bone (p < 0.001). In all age groups, benign lesions were mostly observed in the mouth and pharynx. For malignant lesions, in children, the bones of the skull and face were mostly involved, whereas in adolescents, the mandible was the predominant site (p < 0.001). In children, mesenchymal neoplasms were the most prevalent category of lesions, whereas in both adolescents and young adults, odontogenic tumours were more common. The proportion of malignant neoplasms in males was significantly greater than that in females (p < 0.001).

CONCLUSION

This study revealed that although most biopsied orofacial lesions were more often benign, the proportion of malignant neoplasms in this population was greater than that previously reported.

Prevalence of dental caries and associated factors among primary school children in Ethiopia: systematic review and meta-analysis

BACKGROUND

Dental caries (decay or cavities) is the breakdown of teeth as a result of bacteria. Dental caries is one of the most preventable oral health problems and the most common chronic disease in primary school children. Poor dental and oral health affects the quality of children's lives.

OBJECTIVES

The study aimed to synthesize the existing literature on the prevalence and associated factors of dental caries among primary school children in Ethiopia in 2024.

METHODOLOGY

Studies were searched through the search engines of Google Scholar, PubMed, Scopus, MEDLINE, and the Cochrane Library. Searching was made using keywords and MeSH terms for dental caries, dental plaque, primary school children, and Ethiopia. Heterogeneity was assessed using the Cochran Q test and I2 statistics. A random-effects model with a 95% confidence interval was used for prevalence and odds ratio estimations.

RESULT

The result of seven studies disclosed that the overall prevalence of dental caries in primary school children in Ethiopia was 35% (26-45%). high intake of sweets (OR = 2.71,95%CI:1.968-3.451), a poor habit of tooth cleaning (OR = 2.46; 95% CI: 2.761-5.045), Grade level 1-4(OR = 2.46; 95% CI: 1.523-3.397), having a history of toothache(OR = 2.99; 95% CI: 2.679-3.314), absence of toothpaste use(OR = 1.42; 95% CI: -1.278-4.109), reduction of the previous year's academic score(OR = 5.51; 95% CI: 1.952-9.066), had a significant microbial load(OR = 3.82, CI: 3.439-4.192) and have acid bacillary pH on their teeth(OR = 2.42, CI: 1.494-3.335) were independent variables associated with dental carries among primary school children.

CONCLUSION

The overall prevalence of dental caries among primary school children in Ethiopia is 35%, ranging from 26 to 45%. However, variations in prevalence rates are observed based on sampling techniques. Studies using simple random sampling report a higher prevalence rate of 42%, while those employing multi-stage random sampling and systematic random sampling show lower rates of 30% and 35%, respectively. This indicates that the choice of sampling technique can impact reported prevalence rates, with simple random sampling yielding higher estimates compared to other methods.

Oral health of adolescents in West Africa: prioritizing its social determinants

Oral health is a major public health issue in West Africa, yet it has gotten little attention. Individual and group disparities in health status are influenced by social determinants of health (SDH), which also affect oral health. Adolescence is a significant transition into adulthood, a time when the SDH can contribute to lifelong health status. This article explored the SDH associated with oral health behaviour, perception, and oral health development amongst adolescents in West Africa. This article engaged articles published in peer-reviewed journals relating to adolescents' oral health and West Africa. The authors undertook this desk review to determine the social determinants of adolescents' oral health in West Africa. The literacy levels and oral health awareness of adolescents, family and social circle influences, socioeconomic status, nutritional levels, and cultural and environmental factors have been identified as important social determinants. Adequate policy implementation with the integration of oral health in schools' curriculum, health systems reorientation with the adoption of oral health delivery in primary health care and expansion in oral health research with the assessment of cultural influences on oral health development have been recommended as interventions to reduce oral health inequalities in West Africa.

Prevalence of dental caries in the permanent dentition amongst 12-year-olds in Africa: a systematic review and meta-analysis

BACKGROUND

Dental caries (DC) is highly prevalent condition affecting mostly young children. There has been no systematic review done on the prevalence of DC amongst 12-year -olds in Africa. Although some African countries have reported a decrease in DC prevalence, others have shown an increase and it is essential to measure current trends in order to identify strategies and programmes that could assist in reducing DC in Africa. The aim of this systematic review was to determine the prevalence of DC (condition) amongst the permanent dentition of 12-year-old children (population) in Africa (context).

METHODS

A systematic review and meta-analysis was performed. Peer reviewed cross-sectional articles from January 2000 until December 2021 was searched and this included the following databases: Pubmed (Medline); SCOPUS; CINAHL (via EBSCOhost); Academic Search Complete (via EBSCOhost); Dentistry and Oral Sciences Sources (via EBSCOhost); and Science Direct. The search was last updated on the 10th January 2022. Joanna Briggs Institute critical appraisal tools were used to assess risk of bias. Prevalence figures were stratified by Urban/Rural status, country and time using a random-effects model. All studies performed on children 12-year-olds on the African continent were included. The prevalence of DC and the DMFT scores were the primary and secondary outcome measures, respectively. Only articles consisting of 12-year-old children who reside in Africa were included in this study. The systematic review was registered with Prospero CRD42021293666.

RESULTS

18,080 participants were included in this review. A total of thirty studies were included in the review. The pooled effect size of dental caries severity was 1.09 (CI 0.91-1.27) and the overall prevalence was 36% (CI 29.4-41.7%). Eritrea (78%) had the highest prevalence of DC while Zambia had the lowest (11%); Eritrea also had the highest DMFT score (2.5) with Sudan having the lowest score (0.49). Urban cities had the highest DMFT score (1.32, CI 0.97-1.68), compared to rural cities (1.13, CI 0.86-1.4) and there was an increasing trend in DC prevalence over time from 28% (CI 23-34%) in 2000 to 2005 to 57% (CI 43-72%) in studies conducted after 2015. The risk of bias was very low where majority of the studies scored more than 50% in the JBI critical appraisal tool.

CONCLUSIONS

There was a wide discrepancy in the DC prevalence and scores across the different countries, settings (rural versus urban) and there was an increase in the prevalence over time. This review was self-funded.

Assessment of oral health status in a Ghanaian population: rationale, methods, and population characteristics

Background

Oral health surveys aid in estimating the oral health of a population and provide a projection for future oral health care needs. We report the procedures and rationale of a survey carried out to assess the oral health status and risk factors for oral disease among adults in the Greater Accra Region (GAR) of Ghana. The objective was to provide prevalence estimates on dental diseases, oral health behaviour and risk factors, and to establish baseline epidemiological data on the population’s oral health for further research.

Methods

This was a population-based cross-sectional study of adults aged 25 years and above. A random, stratified two-stage sampling method was used to select participants from rural and urban communities in three types of districts (Metropolitan, Municipal, Ordinary). A semi- structured questionnaire was used to collect data on socio-demographic characteristics, oral health behaviours and risk factors for oral disease. Anthropometric data and a full-mouth clinical examination was carried out including: soft tissue assessment, tooth count, prosthodontic status, dental caries assessment and periodontal assessment.

Results

A total of 729 participants were included in the study with a mean age of 43.9 years (SD 14.6). Majority 425 (61.0%) were females. Though the metropolitan districts had more dental clinics and personnel, along with better health insurance coverage, they had a higher prevalence of missing teeth, retained roots, severe periodontitis and poorer oral health coverage. The findings also show some significant differences in disease prevalence, within the different localities and districts.

Conclusions

Availability and access to oral health services is not the most important determinant of good oral health outcomes in this region. We recommend exploring socio-behavioral and cultural factors as well. This study provides district level data to inform policy and guide further research.