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

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.

The Prevalence and Diagnostic Patterns of Oral and Maxillofacial Lesions: A Seven-Year, Retrospective, Single-Center Cone Beam Computed Tomography and Histopathology Study in Saudi Arabia

Objective: To determine the prevalence of oral and maxillofacial lesions among patients at King Abdulaziz University from January 2016 to December 2022. Methods: This cross-sectional observational study included patients diagnosed with oral and maxillofacial intra-bony lesions based on radiological findings and confirmed by histopathological examination. The lesions were classified according to the fourth edition of the World Health Organization Classification of Head and Neck Tumors. Results: This study included 237 patients with a mean age of 31.53 ± 14.97 years, of which 45.1% were female. Most patients (46.7%) had mandibular lesions, followed by maxillary lesions (35.9%). Only 2.95% of the tumors were malignant. Odontogenic cysts were the most prevalent (65.40%), with radicular cysts and keratocytes being the most common types. The most prevalent tumor types were odontoma and ameloblastoma. The most malignant lesion was multiple myeloma. Conclusions: Our findings reveal that mandibular cystic lesions predominated, and emphasize the low incidence of malignancy in the study population. They provide valuable insights into the oral and maxillofacial lesion landscape at a high-volume tertiary care center.

Effectiveness of a Comprehensive School-Based Oral Health Intervention Program on Periodontal Disease Outcomes: A Randomized Controlled Trial

Background

Periodontitis is a prevalent oral health issue in rural India, contributing to tooth loss and systemic health complications. School-based oral health education programs offer a promising prevention and early intervention strategy.

Objective

To assess the impact of a comprehensive school-based oral health program on periodontal disease prevalence and severity among school-aged children in rural Bhopal.

Materials and Methods

A randomized controlled trial was conducted among 5000 children (10-15 years) in rural Bhopal. The intervention group received a 6-month program comprising oral hygiene instruction, dietary counseling, information on periodontitis, and facilitated dental checkups. The control group received no additional oral health education. Pre- and post-test assessments included clinical examinations (Community Periodontal Index, Gingival Index, Plaque Index) and oral health knowledge and practices questionnaire.

Results

After six months, the intervention group showed significant reductions in periodontal indices (CPI: -0.45, P < 0.001; GI: -0.30, P < 0.001) and plaque levels (PI: -0.65, P < 0.001) compared to the control group. They also demonstrated significant improvements in oral health knowledge (P < 0.001) and reported oral hygiene practices (P < 0.001).

Conclusion

A comprehensive school-based oral health education program is efficacious in improving periodontal health, knowledge, and practices among rural Indian children. The program's success supports its potential for broader implementation as a sustainable and cost-effective public health intervention in similar settings.

Systematic review of oral health in slums and non-slum urban settings of Low and Middle-Income Countries (LMICs): Disease prevalence, determinants, perception, and practices

BACKGROUND

A comprehensive summary of evidence about oral health in slum settings that could inform policy directions is lacking.

OBJECTIVE

To summarise the latest evidence regarding oral disease burden and their determinants, perceptions, practices, and service utilization in the slums and non-slum urban settings of LMICs.

DESIGN

Systematic review.

DATA SOURCES

Embase and MEDLINE (Ovid); PubMed; Scopus, Web of Science, CRD DARE Database; ELDIS; Essential Health Links; HINARI; African Index Medicus (AIM); and Bioline International, all searched from January 2000 to June 2023 using slum-related terms.

ELIGIBILITY CRITERIA

Empirical studies of all designs were eligible. Studies published in English with full-text available and reporting disease burden, perceptions, behaviours and service utilisation related to oral health of residents of slums or broader settings including slums in low and middle-income countries were included.

DATA EXTRACTION, QUALITY ASSESSMENT, SYNTHESIS AND REPORTING

Studies were categorised and data were extracted and charted according to a preliminary conceptual framework refined by emerging findings. The Mixed Methods Assessment Tool (MMAT) was used to appraise the quality of empirical studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and (where applicable) the Synthesis Without Meta-analysis (SWiM) guideline were adopted for guiding synthesis and reporting. Results were tabulated and narratively summarised.

RESULTS

Full-text articles for 56 records were assessed for eligibility and 23 of the articles were included in this review. The majority (13 studies, 57%) were conducted in Asia, and nine studies (39%) in Africa. Six focused on slums (two examined slum and urban non-slum and four examined purely slum settings), two examined general urban settings, eight included both rural and urban areas in their settings, two examined disadvantaged/low socioeconomic, one assessed rural/urban/metropolis/municipal/district, three covered the national population or whole country, and one looked at high versus low socioeconomic regions. The commonest oral diseases reported were dental caries (prevalence: 13% - 76%), and periodontal diseases (prevalence: 23% - 99%). These were higher in slum settings and showed differences across age groups, gender, and socioeconomic classes. Most participants in the studies perceived their oral health status as satisfactory, a belief commoner among younger people, males, those in higher socio-economic classes, and employed. Mouth cleaning was mostly once daily, usually in the mornings. The use of toothpaste and brush was commonest. Other oral hygiene implements included toothpowder, chewing-stick, neem, charcoal, sand, snuff, salt, and the fingers. There was widespread engagement in home remedies for oral disease cure or prevention, while the use of professional dental care facilities was generally low and problem-driven.

CONCLUSION

The systematic review identified a sparse body of literature on oral health surveys in slums and other urban settings in LMICs. Available data suggest a high oral disease burden, worse in slums, use of inappropriate mouth cleaning tools, self-care practices for pain relief, and few visits to care facilities.

SYSTEMATIC REVIEW REGISTRATION

Systematic review registration with PROSPERO in February 2020, number CRD42020123613.

Exploring the association of self-rated oral health with self-rated general and mental health among older adults in a resource-poor context: Insights for advancing Sustainable Development Goal 3

INTRODUCTION

Older adults in Ghana have been disproportionately affected by oral health issues such as caries and periodontitis. This situation calls for comprehensive attention within health and healthcare policies, due to the established connections between oral health and other aspects of health and well-being in high-income countries, including physical and mental health. However, there is a significant gap in the literature when it comes to exploring the association of oral health with physical and mental health in resource-constrained settings like Ghana.

METHODS

To address this void, we collected a cross-sectional sample comprising older adults aged 60 and above (n = 1073) and analyzed self-rated health measures to investigate the relationship between oral health and general and mental health in Ghana.

RESULTS

The results of our logistic regression analysis revealed a significant association: older adults who reported poor oral health were more likely to rate their general (OR = 5.10; p < .001) and mental health (OR = 4.78, p < .001) as poor, compared to those with good oral health, even after accounting for demographic and socioeconomic variables.

CONCLUSIONS

Based on these findings, we discuss the policy implications of our findings, especially in the context of advancing Sustainable Development Goal 3 in Ghana and other resource-constrained settings.

Oral health knowledge, practice and associated factors among Junior High School students of Koforidua, Ghana: a cross-sectional study

BACKGROUND

Oral disease poses a significant public health burden for many countries and affects individuals throughout their lifetime, causing pain, disfigurement, impairment of function and reduced quality of life. Among children and adolescents globally, there is a recognized trend of poor oral hygiene, attributed to the accumulation of plaque and calculus deposits that increase with age. This study assessed the knowledge, practice and factors associated with the practice of oral hygiene among Junior High School students (JHS) in Koforidua, in the Eastern Region of Ghana.

METHODS

A school-based cross-sectional study design was conducted among 233 JHS students in Koforidua township using a multistage sampling technique. Descriptive and inferential statistics, including frequency, percentage, and Pearson's Chi-square test, were conducted. The results were interpreted using tables and graphs.

RESULTS

Findings from the study revealed that more than half 126 (54.1%) of the respondents had a good level of knowledge of oral hygiene. The majority 130 (55.8%) of them also had good oral hygiene practice. The findings further indicated that a significant relationship was found between the class or education level of students and good oral hygiene practice (χ2 = 17.36, p < 0.001).

CONCLUSION

Overall, the current study found that over half of the JHS students had good knowledge as well as practice of oral hygiene. This reinforces the significance of oral health education and awareness campaigns, especially in school settings, to improve knowledge, attitudes, and behaviours related to oral hygiene. The study however found only class or education level of students to be statistically associated with the practice of oral hygiene. While other variables did not reach statistical significance, our research serves as a starting point for further investigation and exploration of the various factors that may contribute to oral hygiene practices.

Overview of oral health status and associated risk factors in maritime settings: An updated systematic review

OBJECTIVES

The aim of this study is to provide an updated overview of the oral health status and associated risk factors in maritime settings.

METHODS

We systematically searched PubMed, Ovid Embase, Web of Science, CINAHL and SCOPUS from January 2010 to April 2023. Two independent reviewers extracted the data. The quality of included studies was assessed using relevant assessment tools.

RESULTS

A total of 260 records were found in the initial search; 24 articles met the inclusion criteria. Most studies had descriptive design, and only two randomized controlled trials were found. The main oral health issues noted are oral cancer, dental caries, periodontal diseases, oral mucosal lesions, and dental emergency. Male seafarers have higher risk of oral cancers in the tongue, lips, and oral cavity while oral mucosal lesions are more prevalent among fishermen.

CONCLUSIONS

Dental caries and periodontal diseases are prevalent in both seafarers and fishermen. The consumption of tobacco, alcohol, fermentable carbohydrate, and poor oral hygiene are risk factors that affect the oral health status at sea. The occurrence of oral diseases in maritime setting requires more attention of researchers and authorities to develop strategies to tackle these issues.

TRIAL REGISTRATION

Systematic review registration number in PROSPERO: CRD42020168692.

Oral Health Survey in Burundi; Evaluation of the Caries Experience in Schoolchildren Using the DMFT Index

Background and objectives: There are no data on oral health in the population of Burundi. This study aimed to describe the oral health status of schoolchildren in Burundi using the dmft/DMFT index for the first time. Materials and methods: The study was designed as a cross-sectional population-based epidemiological survey. The survey was designed according to the WHO methodology for oral health surveys. Oral examinations were conducted in school rooms using a dental mirror, probe, and headlight. The following characteristics of primary dentition status were recorded: decayed (d/D), missing (m/M), and filled (f/F) teeth, and the dmft/DMFT (d + m + f t/D + M + F T) index was calculated for each subject. Quantitative and qualitative variables were represented by measures of position and variability. One-way ANOVA was used to assess differences between parametric variables. Logistic regression was performed for total caries experience and gender, age groups, living area, and geographical provinces. Results: A total of 1902 children were examined, 1007 (52.94%) six-year-olds and 895 (47.06%) in the older group. The dmft/DMFT and subgroups were statistically significantly different in terms of age groups, living areas, and geographical regions (dmft/DMFT d-subgroup and D-subgroup p < 0.01), but only for DMFT for sex. The ORs estimated by logistic regression by total caries experience showed a protective effect for 12 year old subjects and those living in southern provinces, an OR of 0.52 (95%CI 0.43-0.64) and an OR of 0.26 (95%CI 0.21-0.32), respectively. Conclusions: Dental caries in African countries, including Burundi, remains a major problem affecting the general health and wellbeing of the population. Tackling untreated caries requires a multifaceted approach, including strengthening oral health infrastructure, promoting oral health education, providing affordable dental services, and encouraging healthier eating habits.

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.

Understanding the association between unmet dental care needs and household food security status among older people in Ghana

The literature recognizes food insecurity as a barrier to access to health care services. However, we know very little about the association between food insecurity and unmet dental care needs among older people in Ghana. To address this void in the literature, this study uses a representative survey of adults aged 60 or older from three regions in Ghana to examine whether older people who experienced household food insecurity differently report unmet dental care needs in comparison to their counterparts without any food insecurity. We find that 40% of older adults reported unmet dental care needs. Results from logistic regression analysis show that older people who experienced severe household food insecurity were more likely to report unmet dental care needs, compared to those who did not experience any type of food insecurity, even after accounting for theoretically relevant variables (OR = 1.94, p < 0.05). Based on these findings, we discuss several implications for policymakers and directions for future research.

Oral Health and Pathologies in Migrants and Vulnerable Population and Their Social Impact: The Good Practices of the Intervention Model of a University Dental Clinic

Numerous studies have shown the high incidence of diseases affecting oral health in vulnerable populations. The Canary Islands is a region particularly affected by the low income of its inhabitants and a high migration rate. Poor oral health habits and limited access to health care have turned these groups into risk groups. The role of the Fernando Pessoa Canarias University (CDUFPC) dental clinic in the health care of these groups has been an example of good professional practice and a fundamental resource in their health care. The present study aims to identify the profile of pathologies as well as the impact on the oral health of vulnerable population groups served by the CDUFPC. This study was developed between September 2019 and July 2022 with a sample of 878 patients, of whom 267 (30.4%) belonged to vulnerable groups referred by institutions and social organizations. The results identified the prevalence of dental caries as the main pathology and the lack of good oral habits and commitment to oral health and care.

Understanding the Link between Household Food Insecurity and Self-Rated Oral Health in Ghana

There is increasing scholarly attention on the role of food insecurity on the health of older adults in sub-Saharan Africa, including Ghana. Yet, we know very little about the association between food insecurity and self-rated oral health. To address this void in the literature, this study uses a representative survey of adults aged 60 or older from three regions in Ghana to examine whether respondents who experienced household food insecurity rated their oral health as poor compared to their counterparts who did not. We found that 34% of respondents rated their oral health as poor, while 7%, 21%, and 36% experienced mild, moderate, and severe food insecurity, respectively. Moreover, the results from the logistic regression analysis showed that older adults who experienced mild (OR = 1.66, p < 0.05), moderate (OR = 2.06, p < 0.01), and severe (OR = 2.71, p < 0.01) food insecurity were more likely to self-rate their oral health as poor, compared to those who did not experience any type of food insecurity. Based on these findings, we discuss several implications for policymakers and directions for future research.

Dental Caries among Adult Population of a Municipality: A Descriptive Cross-sectional Study

Introduction

Oral disease as a public health problem poses a serious burden globally. The most common oral disease affecting adults is dental caries followed by periodontal disease leading to tooth loss. Early detection of dental caries can help reduce the severity and prevent further complications. This study aimed to ind out the prevalence of dental caries among adult population of a municipality.

Methods

This descriptive cross-sectional study was conducted among adults attending ive different dental camps in a municipality from 1 April 2022 to 2 June 2022. Ethical approval was obtained from Institutional Review Committee (Reference number: 060-078/079). Convenience sampling method was used. The prevalence of dental caries was determined by dentition status adopted from basic oral health surveys recommended by World Health Organization. Point estimate and 95% Conidence Interval were calculated.

Results

Among 239 adults, 138 (57.74%) (51.48-64, 95% Conidence Interval) had dental caries.

Conclusions

The prevalence of dental caries among adults in the municipality was lower than in similar studies done in similar settings.

Keywords

cross-sectional study; dental decay; prevalence.