[Relationship between oral health status of parents and that of their children]

The aim of this study was to evaluate the oral health status of the parents and their children and the relationships between the parents' oral health status and their children one. Subjects comprised 200 parents (mothers and fathers) and 200 of their children selected at the pediatric dental clinic of the children's hospital Albert Royer and the pediatric dental clinic of the Department of Odontology. In both groups, we have evaluated the dental caries prevalence and dental examination was performed using DMFT or DMF teeth for children. To evaluate the oral hygiene habits we used the Silness and Löe index and a questionnaire. We have finally assessed the relationships between the parents' oral health status and their children' oral health. The dental caries prevalence was 63% for the parents with mean DMF teeth of 5.8 and 5.2 SD and for the children it was 94% and the DMF teeth was 5.85 and 4.00 SD. The parents' DMF teeth, their gingival health and their oral hygiene habits were significantly associated to their professional status (ANOVA: p = 0.00 < 0.05). The DMF teeth of the children was associated with those of their parents and to their parents' professional status. The children's oral hygiene habits and their parents' habits were also associated.

[Dental fluorosis and dental caries prevalence in Senegalese children living in a high-fluoride area and consuming a poor fluoridated drinking water]

INTRODUCTION

The role of fluoride in dental caries prevention when applied at optimal levels is well established. However, ingestion of excessive fluoride during tooth development can cause structural changes in tooth enamel named fluorosis. At Gandiaye a city situated in the Senegalese endemic fluorosis area, the main water supply provided by a unique drilling with highly fluoridated water has broken down in 1996. Since then, the drinking water comes from wells which have poor levels of fluorides. The aims of this study were to evaluate the prevalence and severity of dental fluorosis and tooth decays in children born and reared continuously at Gandiaye after the stoppage of the drills and who were drinking water well.

METHODS

Water samples were collected from two wells and analyzed using a spectrometer and a specific fluoride electrode. The prevalence and severity of dental fluorosis was evaluated according to Dean's method, and the caries experience was measured using the DMF teeth index in 150 children aged from 6 to 8 years.

RESULTS

The fluoride levels in the water well were comprised between 0.03 ppm and 0.09 ppm according to the method used. The prevalence of dental fluorosis was 39.33% with the predominance of the very low to low fluorosis forms. The tooth decay prevalence was 48.66% and the mean DMF tooth was 0.98. A significant relationship was found between the dental fluorosis and the low caries levels.

CONCLUSION

A low to moderate dental fluorosis associated with a significant decrease of caries prevalence was found in children living in a high-fluoride area and consuming poorly fluorided water.

[Study of oro-dental injuries during seizures in Senegalese children with epilepsy]

The objectives of this study were to study the prevalence of oral traumatisms and their relationship to epileptic seizures in Senegalese children. This study was undertaken in the Children's National Hospital of Dakar and deal with children with epilepsy. Sotf tissues and the teeth traumatisms that have occurred during epileptic seizures were recorded. We have also studied the relationship between the frequency of the seizures and the oral soft and hard tissues traumatisms. One hundred and eight children aged from 5 to 15 years with 67 boys and 41 girls with an average age of 8.16+/-2.86 years were enrolled. Several types of epileptic seizures were observed during which 44.5% of the children presented oral traumatisms of soft tissues (27.8%) and the teeth (16.7%). There is no significant relationship between the number of seizures and the frequency of the dental traumatisms (p = 0.352). The tooth fractures are the lesions most frequently noticed and are observed in 24.4% of the children. The traumatisms of the maxillary central incisors account for 38% of the traumatisms, followed by the canines (2.7%) and the molars (1.9%). The lower central incisors are the least affected. The traumatisms of soft tissues were observed in 27.8% of the children: the lips are more often affected (44%), followed by the tongue (30%), the association between lip and tongue (18%) and the cheeks (8%). There is no significant relationship between the number of seizures and the frequency of the traumatisms of soft tissues (p = 0.35).

[Applicability of standard of Demirjian's method for dental maturation in Senegalese children]

INTRODUCTION

the dental age which can be deduced from the stages of dental maturation is accepted as being a reliable indicator in the estimate of civil age of children whose date of birth is unknown. It is also a good indicator of the biological maturity of growing children and the relevance of its use in paediatric dentistry and orthodontics was proven. Various methods of determination of maturation or dental development from radiographies were described. The mostly used method is that of Demirjian. Studies have shown that genetic factors could influence the maturation of certain organs. Thus, the generalisation of Demirjian standards to others population can be questioned. The aim of the present study was to test the applicability of Demirjian's standards for the determination of the civil age from dental maturation stages.

MATERIAL AND METHODS

The dental maturation stages of a randomised sample of 200 Senegalese children aged from 6 to 14 years (101 boys and 99 girls) was evaluated by Demirjian's method. Data collected were converted into Dental Age from the conversion charts proposed by Demirjian. The dental age obtained was compared with the civil age of the subjects.

RESULTS

The results of this study indicate that the civil age of the patients was overestimated when evaluated from Demirjian's standards (0.89 years for girls and 0.48 years for boys). A linear regression equation was then proposed for the correct estimate of the civil age from the dental maturation stages.

[Caries patterns and diet in early childhood caries]

INTRODUCTION

Early childhood caries (EEC) are multiple carious lesions affecting the primary teeth of infants and preschool children. They are related to a prolonged and night bottle-feeding rich in fermentable carbohydrates. The carious lesions characterised by their patterns and the rapidity of their process can lead to a widespread tooth destruction. The aim of this study was to evaluate the patterns of the carious lesions and their relationship to the diet.

MATERIAL AND METHOD

This prospective study was carried out in Dakar in public heath structures that have a dental office. It has included 68 children of both sex aged from two to 6 years consisted of 35 boys (51% of the sample) and 33 girls (49%) with the predominance of the 5-year-old children. These children were examined using a plan mouth mirror and probes and their mothers were interviewed.

RESULTS

The observed carious lesions were distributed on all tooth surfaces but the complete coronal destruction was the most common lesions observed and represented 25 of the lesions, followed by lesions in three faces of the tooth (17%). The most frequently affected tooth was the association maxillar incisors and molars and the mandibular molars (32.4%). The incisor alone represented 22.1% of the affected teeth. The children were breast-fed associated with either pap or with hard food (52.9%). The bottle was added to this association in 32.4% of the cases and 10% of the children were exclusively breast-fed. The carious lesions were more severe and more frequent in children fed with breast associated with pap and hard food and in those fed with breast associated with the bottle pap and food than to children exclusively breast-fed. These differences were not statistically significant (p = 0.73 > 0.05).

CONCLUSIONS

Early childhood caries are related to a diet rich in carbon hydrate. They lead to severe tooth destruction. The treatments cost are very high thus prevention by information on the bad effects of sugar on diet and the baby bottle are of great interest.

[Evaluation of oral health and access to care in senegalese children with Down syndrome: preliminary study]

Down syndrom is the most frequent genetic disease discribed for viable (live born) children and the commonest cause of mental deficiency in developed countries. It is an autosomal chromosomic anomaly resulting from trisomy of all or part of chromosome 21 and is characterizd by general and mental deficiencies and a typical facial phenotype. The aims of this study are:--to evaluate the general and oral health of a senegalese group of children with Down syndrome and their siblings the closest in age,--to assess their access to care. We used the OADS (Oral Assessment Down Syndrome) questionnaire in 25 senegalese children with Down syndrome living in Dakar and 17 od their siblings the closest in age. Their ages range from 4 to 20 years old in both groups. Our results revealed that senegalese children with Down syndrome have more general and oral health problems compared to their siblings the closest in age but they were more likely to have difficulty finding both medical and dental services. This study pointed out the need for special care services with trained people for a better management of these specific patients.

[Clinical study of cysts jawbones]

The objective of this study was to appreciate the clinical and paraclinical aspects of cysts jawbones. It was an exploratory study about 61 cases of jawbones cysts (24 men and 37 women). It took place in the Odontostomatology Department of the General Hospital of Grand Yoff at Dakar, during a period of 5 years (February 1996 to December 2000). The mean age of patients was 29.67 years with extremes of 14 and 55 years. The mean reason of consultating was an important perish-jawbone tumefaction which can be associated with dental displacements, mobilities or pains. The radiographic assessment was essential for the diagnosis. The radiological image was characterized by an osteolysis with regular contours. We have noted the invasive appearance of the osseous lysis which is developed in several teeth concerning 50 cases (81.97%). The anatomo-pathological exam which is essential to confirm the diagnosis has been possible only for 9 patients by lack of means. Thus, in our study the diagnosis of jawbones cyst was retained while being based primarily on clinical experience and the radiological assesment. The types of diagnosed cysts are: 53 perish-apical cysts (86.89%), 5 dentigerous cysts (08.20%), 2 globulo-jawbone cycts (03.28%), and only one case of paramount cyst. The jawbones cysts are often of aggressive development with various etiologies. They may be voluminous. Their diagnosis must be exact in order to allow an adapted surgical technics and to prevent the reccurence.

[Treating five cases of Class III skeletal brachygnatia maxilla with the Delaire mask]

Class III skeletal abnormalities are known as sagittal defects and they are recognized by a hollow profile, which is an unesthaetical morphological distorsion often ill--accepted by the patient, a severe disability. Due to the large number of clinical patterns, it is crucial to make an accurate diagnosis. Class Ill skeletal abnormalities involving a maxillary brachygnatia are caused by an insufficient development of the jawbone. Treatment will therefore consist in boosting growth of the lower back section of the jawbone. The external device known as Delaire mask which stimulates growth of the lower back section of the jaw is particularly recommended to achieve this. This piece of research set out to assess the effectiveness of this method based on five of our patients. Outstanding results were obtained, namely alveolar ridge slided forward on the jawbone, improved profile (a cutaneous Class I is obtained), and a disappearance of the occlusion, along with a correction of the inverted backward bite. When adequately prescribed, the use of the Delaire mask, as opposed to corrective surgery, leads to a slow and gradual improvement. Furthermore, results achieved among young children blend into their own natural growth. By resorting to early treatment with the mask, it is possible to avoid falling back on complex surgery, which would almost necessarily be of the orthognatic type among adults.

[Oro-dental treatments in the child under general anesthesia (apropos of an initial case)]

Oro-dental treatments under General Anesthesia (G.A.) depend on precise indications and the expected results in some cases in Pediatric Dentistry. In this report we have an indication case of oro-dental treatment under G.A. That clinical case has allowed us to record the difficulties that we face in Dakar in order to realize effectively that technics. That case has also allowed us to ascertain the necessity to integrate that practice in the training board in Pediatric Dentistry. Actually, the clinical indications of oro-dental treatments under G.A. are more and more numerous, and in some cases, the dentist intervention becomes a necessity. Moreover, the technics of intervention under G.A. for some patients is the more indicated technics to reach the expected objectives.

[The health of the child during eruption of the deciduous teeth]

Teething is a physiological process that may be marked by local regional or general physiopathologies. We have studied these disorders in a sample of 499 children whom we followed from the age of 5 until the age of 30 months. The study consisted in a clinical endobuccal examination. Each month we recorded the order and the eruption date of the tooth or teeth and the disturbances that arise during the process or after, if any. We expose the results of this study in this paper. We collected local and general disturbances during the primary teeth eruption period. We considered that in certain conditions these disturbances could be to the eruption process. Teething is certainly a natural process, however considering its traumatic impact on the young child, we should not reject the aetiology in the justification of the disturbances observed in this process and seek another one which might not be valid.

[Dental cellulitis in children. Realities and perspectives in Senegal]

Cellulitises originated from teeth are frequent in developing countries. Theyare noted as well as in child as in adult. In child, causal tooth may be primary or permanent. In a prospective trial carried at Hôpital d'Enfants Albert Royer CHU-Fann, where we studied the frequency of cellulitises among the children, the main patterns of dental affections and the causal teeth involved and, in the same way, the management and prevention of these diseases in child. We noted that: 56.52% of the cases of cellulitises recorded interest the child of pediatric dentistry age and that 87.5% of the cellulitises cases are due to a primary tooth (primary molar overall) and first permanent molar necrosis. Management and prevention of cellulitises are based on: the respect of the therapeutic protocol, dental hygiene education and systematization of setting of dental caries preventive clinical procedures like SEALANTS and stainless steel crowns as well as in primaryand permanent dentition with as main target the primary molars and the first permanent molar or 6 years age tooth.

[Prevalence of dental agenesis: a radiologic and clinical study in Dakar]

A total of 1007 files were studied with regard to the prevalence of congenitally missing teeth. All patients were radiographed. 4.56% were found to have at least one congenitally missing tooth. The lower second premolar was the most commonly missing tooth in this study (41.66%), followed by the upper lateral incisor (22.2%). The prevalence and the distribution of dental agenesis between male and female was similar.

[Dental caries in the public primary schools dependent on the Nabil Choucair Health Center in Dakar, Senegal]

It is a holy study of observation and prevalence concerning a population of 268 pupils in first degree of the primary schools depending on the health center Nabil Choucair. 82% of these pupils have dental decay with DMFT egals 3.94. Our results suggest needs of preventive intervention on the intention to reach the objectives health for all by 2000 relatively to dental health in Senegal.

Oro-dental and craniofacial anomalies in LEOPARD syndrome

'LEOPARD syndrome' is a syndrome affecting many systems or organs. The main anomalies are summarized in the acronym LEOPARD in which each letter corresponds to the damage of a given organ. In the presented case, there are oro-dental and craniofacial anomalies. The relationship between the LEOPARD syndrome and the given anomalies and the possibilities of the management and the follow-up of the diseased are studied. The clinical case presented is a 4-year-old boy with LEOPARD syndrome showing retardation of dental development, delayed development and possible agenesis of permanent teeth, and craniofacial anomalies (osseous hypodevelopment). The bibliographical study shows that LEOPARD syndrome is due to damage of the neural crest cells. Thus, the dental and craniofacial anomalies arise since neural crest cells participate in the formation of the teeth and some craniofacial bones. Therefore, dental and craniofacial anomalies might be expected in some cases of the disease. The therapeutic management of the lesions, and the follow-up of the patient would be done by a multidisciplinary team.

[Chronology and date of eruption of primary teeth in Senegal]

Chronology and eruption dates of primary teeth are parameters of importance in different medical scientific fields. We carried a longitudinal clinical study to determine these parameters in a local Senegalese population. The study interests a sample of 573 Senegalese Negro children of the two sexes and its aims are to situate these parameters formally and in space in on hand, and to be able to justify; in comparison to these parameters, the disturbances which accompany often the phenomenon of dental eruption in the other hand. We have results relating to chronology and eruption date of the 20 primary teeth of each of the children. Our study strengthens data already known but it reveals also other data as well as important. Other studies are however necessary to set a good board of chronology and eruption date of primary teeth in the Senegalese population.

[Complications of injuries to the deciduous teeth. Clinical and radiographic evaluation. Perspectives on management and prevention. Apropos of 4 cases]

The traumatisms of primary teeth have often sequels thereabouts grave on the germs of their successional permanent teeth. They have many causes but they are above all frequent during the child's walking trial. We have carried out a clinical and radiographic study of some cases. The study has ascertained the fact that the diversity of the sequels and their gravity depend on the age of the occurring of the traumatism, the intensity and the direction of the shock. The therapeutic and preventive management of these traumatisms and their possible sequels use a pluridisciplinary protocol based on the strict application of indicated treatments, the clinical and radiographic regular follow up and the adoption of a rigorous preventive attitude by the parents during the target period of walking trial.

[Caries and gingivitis study among preschool children (2-5 years) of the region of Ziguinchor in Senegal. Strategies of prevention]

We studied the preschool (2-5 years) group of child's oral health status in Ziguinchor, the southern regions of Senegal. Our objective was to make the inventory of fixtures dealing with dental caries, gingivitis and tartar among the children of this age group. It's a transversal study based on a clinical examination of a sample size of 168 children collected by stratified random sampling in 12 neursey schools in the region. We used carious (dmf/t), gingival and plaque indices to estimate, orodental status of the population constituting the sample. In the lump, 60.71% of the children have a natural history of dental caries with a mean dmf/t of 2.47 and gingivitis and or tartar are observed in 42.86% of the children. Even children less than 3 years are affected. None age may no longer be free from these diseases. That lead us to suggest to set up in this regional area a preventive program involving mainling the parents and the educators and based on the oral health education and the optimal use of dental products with fluoride since the drinking water in the region is poor in fluoride. The aim of this program would be to reduce the prevalence of the diseases in the proportions indicated by the world health organization and even eradicate these diseases among the prescolar children during the coming years as it's going on actually in the developed countries.

Traditional tea drinking in Senegal. A real source of fluoride intake for the population

Tea drinking after meals is a traditional practice in Senegal where more than 80% of the population from 15 to 60 years old drink tea. According to the tradition, in one session, each tea consumer has to drink 3 cups of decocted tea. The content of a cup is about 30 ml of liquid. Some people drink tea three times daily, that is to say after each meal. Tea plant is rich in fluoride. To determine the effective intake of the Senegalese population from this source, we measured the fluoride concentration not only for each component of the prepared tea but also for each cup of prepared tea. For this study, we used the two main kinds of tea existing locally. The analyses have been done at Rochester, NY Eastman Dental Center, Oral Biology Dept Fluoride Laboratory using the Taves Microdiffusion Method and the fluoride Ion Specific Electrode. The results so that the mean total fluoride concentration of each cup, from the first to the third one, is: 4.0 mg F-/L, 7.436 mg F-/L and 1.230 mg F-/L. It means that on an average in one session, a Senegalese tea consumer has a daily fluoride intake of 1.139 mg F-/L when taking in count the total fluoride and drinking only 90 ml of tea. If we consider the ionic fluoride the amount of daily ingested fluoride for someone who takes only 3 tea-pots of 30 ml each, is 0.830 mg. To conclude, we state that this traditional practice may have a caries preventive effect. Further studies will be grateful for that practice when setting up a caries preventive program in our country. We will also be careful in extending that practice to children less than 8 years old because it might cause dental fluorosis as in Senegal the optimal dose of fluoride is 0.8 mg F-/L.

[Application of phytotherapy in odontology: the case of Euphorbia balsamifera. Endodontic clinical trial]

Phytotherapy is a medicinal and ancestral practice in Africa. It deals with all the fields of human pathology. We wanted to ascertain the efficacy of some plants used in odontology as Euphorbia balsamifera traditionally used as antalgic treatment of acute dental pulpitis. The latex of the plant was caught and treated as to get enough stable paste. We used that paste in the same conditions we use arsenical nerve caustics, a pulpal devitalizer widely used in dental offices. The study carried out on 37 teeth has shown that latex of Euphorbia balsamifera is an effective pulpal devitalizing in contact with the pulp. Its lifetime action was comparable to that of the pulpal nerve caustics. The active principles are not known, however the product seems attractive as a pulpal devitalizing agent.

[Asepsis and vigorous antisepsis against infectious disease transmission in the dental office]

Therapeutic acts often surgically practised in the dental office can lead to the transmission of infectious diseases such as A.I.D.S. To prevent this, the authors propose guideline base acts for antisepsis and asepsis. In conclusion, the authors exhort for an integration of these antiseptic acts in the efficient working of the dental office for an effective prevention of these infectious diseases in the area.