Oral health status among Kenyans in a rural arid setting: dental caries experience and knowledge on its causes

Determinants of Dental Health Problems Among Adult Patients at Dental Clinic, Debre Berhan Comprehensive Specialized Hospital, Ethiopia: Unmatched Case-Control Study

Purpose

This study was aimed to assess the determinants of dental health problems among adult patients at the dental clinic of Debre Berhan Comprehensive Specialized Hospital, Ethiopia.

Methods

A case-control study was conducted to recruit a total of 267 adults (cases = 134, and controls = 133) who received oral health screening service in Debre Berhan Comprehensive Specialized Hospital, 2018. Data were collected by physical examination and pretested semi-structured questionnaire from March 1 to 31, 2018. Collected data were entered in EpiData 3.1 and analyzed by using SPSS version 20. Bivariable and multivariable logistic regressions were done via the forward stepwise method. Variables were declared statistically significant when p-value <0.05.

Results

Of the total study participants, 75 (55%) of cases and 62 (46.6%) of controls were males. The mean age (± SD) of cases was 36.2 (± 14.2) years and that of controls was 31.4 (± 10.3) years. The classification table revealed that the sensitivity of cases was 70.7%, and the specificity of controls was 74.8%. This study showed that 28 (20.89%) of cases and 6 (4.5%) of controls had confirmed gastritis (P < 0.05). Regarding dental health information, 78 (58.2%) of cases and 123 (92.5%) of controls perceived that they had received dental health information from different sources. Access to dental health information and tooth brushing practice reduced dental health problems (adjusted odds ratio (AOR) = 0.28; 95% CI: 0.12, 0.64; and AOR = 0.24; 95% CI: 0.13, 0.45), respectively, whereas study participants who had gastritis were at increased risk of developing dental health problems (AOR = 3.12; 95% CI: 1.14, 8.57).

Interpretation

Study participants who had adequate information on dental health had a reduced risk of developing dental health problems by 72% and participants who practiced tooth brushing were at reduced risk of developing dental health problems by 76%. However, individuals who had gastritis were 3 times more likely to develop dental health problems compared with their counterparts.

Conclusion

In summary, health information, tooth brushing practice, and gastritis infection were the determinants of dental health problems. Thus, health information dissemination on dental health particularly on how to prevent and control dental health problems is very critical. Moreover, strategies to combat gastritis integrated with life course principles should be strengthened to improve dental health.

Prevalence of Dental Caries and Associated Factors in East Africa, 2000-2020: Systematic Review and Meta-Analysis

Background: Dental caries affects mastication, growth and development, and school attendance and has a long-term psychological effect on affected individuals. In developing countries, the prevalence of dental caries is increasing due to the growing consumption of sugary foods, poor tooth brushing habits, and a low level of awareness about dental caries. Even if there was a high prevalence of dental caries in sub-Saharan Africa, there is a paucity of data on the prevalence of dental caries in East Africa. Hence, this study aimed to determine the prevalence of dental caries and associated factors in East Africa. Methods: A systematic search of articles was conducted in MEDLINE, Scopus, and Google Scholar using all the synonyms of dental caries in published literature (until December 2020) in East Africa. Important data were extracted using a standardized data extraction form prepared in Excel. Stata software (version 14.0) was used to calculate the pooled prevalence of dental caries. Besides, subgroup analysis was done based on country and dentition type. Moreover, associated factors of dental caries were assessed and the overall effect was presented in the form of odds ratios. The quality of the included studies was evaluated using the Joanna Briggs Institute reviewers' manual. Results: The overall pooled prevalence of dental caries was found to be 45.7% (95% CI = 38.0-53.4). The pooled prevalence was high in Eritrea (65.2%, 95% CI = 49.2-81.1), followed by Sudan (57.8%, 95% CI = 36.0-79.7), and a low prevalence was found in Tanzania (30.7%, 95% CI = 21.5-39.9). Moreover, the subgroup analysis revealed a prevalence of 50% (95% CI = 38.4-62.1) in permanent dentition and 41.3% (95% CI = 33.5-49.2) in mixed dentition. The overall mean decayed, missed, and filled permanent (DMFT) and primary (dmft) teeth were 1.941 (95% CI = 1.561-2.322) and 2.237 (95% CI = 1.293-3.181), respectively. High DMFT scores were reported in Sudan (3.146, 95% CI = 1.050-5.242) and Uganda (2.876, 95% CI = 2.186-3.565). Being female (OR = 1.34, 95% CI = 1.24-1.46) and having poor tooth brushing habit (OR = 1.967, 95% CI = 1.67-2.33) were independent risk factors of dental caries. Conclusion: The overall prevalence of dental caries was comparatively high. Being female and poor oral health practice were independent risk factors of dental caries. The Ministry of Health of the member countries, along with dental associations of each country, ought to offer due attention to strengthen the oral health program in schools and primary health care centers and the implementation of school water fluoridation.

Dental caries and associated factors in Ethiopia: systematic review and meta-analysis

BACKGROUND

Globally, dental caries may be a major public health issue which may be preventable. Many studies have been conducted on dental caries in Ethiopia which present inconsistent results.

OBJECTIVE

This meta-analysis was expected to consolidate the findings conducted in various regions of the country and generate country representative information on the burden and its associated factors of dental caries in Ethiopia.

METHODS

Our systematic review and meta-analysis was carried out to estimate the pooled prevalence of dental caries and its associated factors in the Federal Democratic Republic of Ethiopia. Medical specialty databases like ScienceDirect, HINARI, Embase, PubMed, Google Scholar, and Cochrane Library were consistently and exhaustively searched. To determine the aggregate prevalence, studies delineating the prevalence of dental caries and associated factors were included. Important data were extracted employing a standardized data extraction tool ready in Microsoft Excel and imported to the STATA version-13 statistical software package for analyses. To assess non-uniformity, the Cochrane Q test statistics and I2 test were performed respectively. A random effects model meta-analysis was accustomed to estimate the pooled burden of dental caries.

RESULTS

The result of thirteen studies disclosed that the overall prevalence of dental caries in the Federal Democratic Republic of Ethiopia was found to be 40.98 (31.62, 50.34). Within the subgroup analysis, the uppermost prevalence was determined in Tigray region (46.59% (24.64, 68.54)) whereas the bottom prevalence was determined in Addis Ababa (34.20% (8.42, 59.97)). Dental caries prevalence was considerably high among study subjects who consumed sweet food (OR= 2.4 (95% CI (1.91, 3.01))). But the presence of dental plaque (OR = 5.14 (95% CI (0.67, 39.39))) and habit of tooth- cleaning (OR = 0.71 (95% CI (0.17, 2.96))) were not statistically significant with the outcome of interest.

CONCLUSION

Our meta-analysis found that the prevalence of dental caries was comparatively high, and sweet food consumption was the most risk issue for dental caries in Ethiopia. The Ethiopian Federal Ministry of Health ought to offer a lot of attention to strengthen the oral health care system and also the implementation of community-level interference programs.

Magnitude of Dental Caries and Its Associated Factors Among Governmental Primary School Children in Debre Berhan Town, North-East Ethiopia

Background

In Ethiopia, oral health prevention and treatment have gotten low attention in the government, and the existing dental services are privately owned and thus expensive. Hence, this study aimed to assess the prevalence of dental caries and its associated factors among governmental primary school children in Debre Berhan town, Ethiopia, 2019.

Methods

An institutional-based cross-sectional study was conducted from January 30 to February 14/2019. A total of 417 primary school children were selected using computer-generated simple random sampling and interviewed using structured and pretested questionnaires. Data were coded, entered, and cleaned using Epi-data version 3.1 and export to SPSS version 22 for analysis. Binary logistic regression analysis was employed to test the association between dependent and independent variables. P-value less than 0.05 was taken as significant association. Finally, the result of this study was present by text, tables, and graphs.

Results

Out of the 396 study participants, 135 (34.1%) had dental caries. Of these, more than half, 95 (59.37%) had the pre-molar decayed. Two hundred eighty-five (72.0%) of them were cleaned their teeth. The Independent predictors of dental caries were drinking sugared tea [AOR= 2.034, 95% CI: (1.223–3.385)] and food particle on their teeth [AOR= 6.709, 95% CI: (3.475–12.954)], which had shown a significant association with dental caries.

Conclusion

The over magnitude of dental caries was relatively high and found to be a public health problem. Drinking sugar tea, presence of food particles, or dental plaque were significantly associated with dental caries. In contrast, merchant occupation reduced the chance of dental caries. Giving health education to minimize drinking sugar tea and cleaning their teeth after consumption of sugar tea should be given attention.

Dental caries experience and treatment needs of an adult female population in Nigeria

Background

Experience and awareness of adult females concerning dental caries is important in its prevention particularly in children because of their natural role as care givers.

Objectives

To determine the prevalence of dental caries and treatment needs in an adult female Nigerian population.

Methods

In this cross-sectional study, adult females attending outreach programmes were examined for dental caries using the Decayed Missing and Filled Teeth caries index (DMFT). Socio-demographic variables were also recorded and statistical analysis done with SPSS software.

Results

A total of 430 females aged 16 to 59 years participated in the outreach programme out of which 109 (25.3%) had a DMFT score > 0. Mean DMFT was 0.7 ± 1.6. Fifty-five (12.8%) participants had decayed teeth, 78 (18.1 %) had missing teeth and 10(2.3%) had filled teeth. The treatment need was 34.3%, restorative index was 13.3% and significant caries index was 2.0. There were significant differences in caries experience based on age, marital status and educational qualifications of participants p < 0.05.

Conclusion

The prevalence of dental caries among the study group was low but the treatment need was high. Younger females, singles and those with lower educational qualifications had a higher dental caries experience.

Correlation between the salivary Streptococcus mutans levels and dental caries experience in adult population of Chandigarh, India

Objectives:

To determine the level of Streptococcus mutans (S. mutans) in adults of Chandigarh and to correlate the dental caries in these individuals with their S. mutans titers.

Materials and Methods:

Salivary levels of Streptococcus mutans, using Dentocult SM commercial kits were estimated in 200, 25-35 year old adults (males and females). Streptococcus mutans were detected in 87% of the study sample. Score 2, representing 10⁵-10⁶ CFU/ml (Colony Forming Unit) of saliva was found to be most prevalent, i.e. in 80 of 200 adults, followed by score 1, depicting S mutans with <10⁵ CFU/ml, in 56 of 200 adults and score 3, with bacterial titer >10⁶ CFU/ml in 38 of 200 adults.

Results:

Dental caries, recorded using Møller's index, was found to be maximum in individuals with score 3, followed by score 2,1 and 0, thereby showing a positive correlation of dental caries with increasing titers of S. mutans. This correlation was statistically highly significant in males with figures as 8.73 decayed surfaces at score 2 rising to 17.38 at score 3. The mean of DMFT was higher among females than in the males in the present study.

Conclusion:

The split up data in males and females, showed a positive association between caries experience and salivary S. mutans scores. The results of the study will serve as a baseline data for future planning of preventive programs in adults.

New curriculum in dentistry for Tanzania: competency-based education for patient and population health (2008-2011)

From 2008 to 2011, the School of Dentistry at Muhimbili University of Health and Allied Sciences in Tanzania revised and then initiated implementation of a curriculum to improve the educational process for, and competence of, its graduates. As an increasing body of research demonstrates the detrimental effects of oral diseases on health and the interrelationships between oral and systemic diseases (including HIV and diabetes), the importance of dentistry education grows. We describe the population oral health problems in Tanzania, the need to enhance the dental workforce, and the process of curricular reform to meet these needs. This reform included transition to a competency-based curriculum featuring teaching methods that will enhance the effectiveness of the education and performance of graduates in traditional and new roles. We conclude with lessons for Tanzania and for health professions educational institutions elsewhere, as well as for public health-care planners concerned about linking health professions education to improving population health in resource-poor countries.

Dental Caries, and Supragingival Plaque and Calculus among Students, Tanga, Tanzania

The prevalence of dental caries and supragingival plaque and calculus in 785 secondary schools students was assessed. More than half (53.6%) of the students were caries-free, and the majority of those with dental caries experience were aged 14-17 (68.1%) and females (53%). Mean DMFT was 1.26, with mean D-component of 1.05, and molars were most affected. Most students had supragingival plaque (74%) and calculus (56.9%) and more so in males than females (P > 0.05). Less than half of the students had experience of dental caries and those with caries were mostly females and of the younger age group. The low DMFT was contributed to the D-component, and molars were the tooth type most affected.The majority of students had supra-gingival plaque and calculus and more so in males than females.

The Akhonya Dental Project: a new charity aiming to provide oral health education and preventative care in Kenya

Kenya is a country plagued by HIV and lacking in adequate healthcare resources, and despite dental caries remaining the most common disease in the world, there is estimated to be only one dentist per 100,000 population in Kenya. Evidence suggests that many Kenyans are unaware of the causes of dental disease and half of the population are unaware of measures that can be taken to prevent dental disease. Oral health education is a clearly vital for improving the health of the Kenyan population. The Akhonya Dental Project is a new charity which aims to provide oral health education, prevention and treatment for AIDS orphans in rural Kenya. This article describes the ethos of the charity and long-term aim to increase oral health awareness in the region.

Assessment of factors associated with dental caries in rural communities in Rakai District, Uganda

To assess factors associated with dental caries in rural communities in Rakai District, Uganda. This was a cross-sectional survey in 18-62 year olds, randomly selected from three sub-counties: Kyalurangira (n = 121), Kabira (n = 133), and Kacheera (n = 67). The participants were clinically examined for caries using Decayed Missing Filled Teeth (DMFT) index and were administered to a structured questionnaire. In the whole material, caries prevalence (DMFT score > 0) was 57.3% and the mean DMFT score was 2.3. The M-component contributed 61% of the DMFT scores. Using bivariate analyses, age, consumption of sugared snacks and tobacco smoking were directly and significantly associated with development of dental caries. Tooth cleaning and previous dental visits were indirectly and significantly associated with dental caries. In binary logistic regression analyses, the participants who were older were four times and those who consumed sugared snacks were 11 times more likely to develop dental caries as compared to their counterparts. The participants who cleaned their teeth or who had visited the dentists were less likely to develop dental caries as compared to their counterparts. The odds ratios were 0.6 and 0.5, respectively. Based on stepwise multiple linear regression analyses, age, previous dental treatment, consumption of sugared snacks, tooth cleaning and tobacco smoking explained a total of 46% of the variations in DMFT scores. Caries prevalence and severity were relatively low in this population. Although a number of independent variables were significantly associated with caries they gave a modest overall multivariate model.