Prevalence and distribution of oral health knowledge according to sociodemographic, behavioural and clinical characteristics in selected coastal districts of Tanzania

Background: Having knowledge about health issues is necessary for making informed decisions related to practicing lifestyles conducive to good health. The aim of this study was to identify socio-demographic, behavioural and clinical covariates of knowledge related to the cause and prevention of oral diseases among older adults in Tanzania.Methods: A cross sectional household survey was conducted in two regions of Tanzania; Pwani and Dar es Salaam city. A total 1031 older adults aged 55 and above were personally interviewed, before undergoing a full mouth examination.Results: the proportion of older adults with knowledge (total knowledge score≥ 1) on dental caries and gum disease was 14.9% and 2.3%, respectively. Having low education level, belonging to a lower wealth quartile and lack of perceived need to see a dentist, were strongly associated with having no knowledge on dental caries. None of the covariates were significantly associated with knowledge on gum disease.Conclusion: Knowledge on the two oral diseases is low among older adults interviewed. Factors associated with knowledge demonstrate substantial socio economic disparities. Development of policies and health education programs that target behavioural and socio economic determinants is recommended

Childhood negative dental experiences and tooth loss in later life:A 25-year longitudinal study in Sweden

OBJECTIVE: To explore the association between childhood NDEs and changes in tooth loss over 25 years among Swedish older adults, and the role of dental visits in explaining such an association.METHODS: We used data from 6154 adults, members of a cohort study that started in 1992 when participants were 50 years old. All data were self-reported through postal questionnaires (6 in total, one every 5 years). Information on childhood NDEs was collected at baseline only. Tooth loss was the repeated outcome measure. Mixed effects logistic regression models were used to test the association between childhood NDEs and tooth loss adjusting for confounders.RESULTS: Childhood NDEs was positively associated with greater odds of experiencing tooth loss and its rate of change over the 25-year period. Although having a dental visit within the past year was positively associated with childhood NDEs and inversely associated with incidence of tooth loss, it explained very little of the association between childhood NDEs and tooth loss in later life.CONCLUSION: The findings underscore the long-lasting damaging effects of early life NDEs on adult oral health.CLINICAL SIGNIFICANCE: A positive patient-dentist relationship starts early in life. Early visits to the dentist are essential to build an enduring relationship of trust between people and healthcare providers.</p

Applicability of an abbreviated version of the Child-OIDP inventory among primary schoolchildren in Tanzania

Background: There is a need for studies evaluating oral health related quality of life (OHRQoL) of children in developing countries. Aim: to assess the psychometric properties, prevalence and perceived causes of the child version of oral impact on daily performance inventory (Child- OIDP) among school children in two socio-demographically different districts of Tanzania. Socio-behavioral and clinical correlates of children's OHRQoL were also investigated.Method: One thousand six hundred and one children ( mean age 13 yr, 60.5% girls) attending 16 ( urban and rural) primary schools in Kinondoni and Temeke districts completed a survey instrument in face to face interviews and participated in a full mouth clinical examination. The survey instrument was designed to measure a Kiswahili translated and culturally adapted Child-OIDP frequency score, global oral health indicators and socio-demographic factors. Results: The Kiswahili version of the Child- OIDP inventory preserved the overall concept of the original English version and revealed good reliability in terms of Cronbach's alpha coefficient of 0.77 ( Kinondoni: 0.62, Temeke: 0.76). Weighted Kappa scores from a test-retest were 1.0 and 0.8 in Kinondoni and Temeke, respectively. Validity was supported in that the OIDP scores varied systematically and in the expected direction with self-reported oral health measures and socio-behavioral indicators. Confirmatory factor analyses, CFA, confirmed three dimensions identified initially by Principle Component Analysis within the OIDP item pool. A total of 28.6% of the participants had at least one oral impact. The area specific rates for Kinondoni and Temeke were 18.5% and 45.5%. The most frequently reported impacts were problems eating and cleaning teeth, and the most frequently reported cause of impacts were toothache, ulcer in mouth and position of teeth. Conclusion: This study showed that the Kiswahili version of the Child- OIDP was applicable for use among schoolchildren in Tanzania

Malocclusion, psycho-social impacts and treatment need: A cross-sectional study of Tanzanian primary school-children

<p>Abstract</p> <p>Background</p> <p>studies on the relationship between children's malocclusion and its psycho-social impacts are so far largely unexplored in low-income countries. This study aimed to assess the prevalence of malocclusion, reported dental problems and dissatisfaction with dental appearance among primary school children in Tanzania. The relationship of dissatisfaction with socio-demographic characteristics, clinically defined malocclusion and psychosocial impacts of dental anomalies was investigated. Orthodontic treatment need was estimated using an integrated socio-dental approach.</p> <p>Method</p> <p>One thousand six hundred and one children (mean age 13 yr) attending primary schools in the districts of Kinondoni and Temeke completed face to face interviews and a full mouth clinical examination. The survey instrument was designed to measure a Kiswahili translated and culturally adapted Child Oral Impact on Daily Performance (Child-OIDP) frequency score, reported dental problems, dissatisfaction with dental appearance/function and socio-demographic characteristics.</p> <p>Results</p> <p>The prevalence of malocclusion varied from 0.9% (deep bite) to 22.5% (midline shift) with a total of 63.8% having at least one type of anomaly. Moderate proportions of children admitted dental problems; ranging from 7% (space position) to 20% (pain). The odds ratio of having problems with teeth position, spaces, pain and swallowing if having any malocclusion were, respectively 6.7, 3.9, 1.4 and 6.8. A total of 23.3% children were dissatisfied with dental appearance/function. Children dissatisfied with their dental appearance were less likely to be Temeke residents (OR = 0.5) and having parents of higher education (OR = 0.6) and more likely to reporting problem with teeth position (OR = 4.3) and having oral impacts (OR = 2.7). The socio-dental treatment need of 12% was five times lower than the normative need assessment of 63.8%.</p> <p>Conclusion</p> <p>Compared to the high prevalence of malocclusion, psycho social impacts and dissatisfaction with appearance/function was not frequent among Tanzanian schoolchildren. Subjects with malocclusion reported problems most frequently and malocclusion together with other psycho-social impact scores determined children's satisfaction with teeth appearance- and function.</p

Prevalence and Socio-behavioral Influence of Early Childhood Caries, ECC, and Feeding Habits among 6-36 Months Old Children in Uganda and Tanzania.

Early childhood caries (ECC) is a serious problem that has remained unexplored in sub-Saharan Africa. This study aimed to identify possible socio-behavioral correlates of ECC focusing 6-36 months old children and their caretakers.\ud Cross sectional studies were conducted in a high fluoride rural area, Manyara, Tanzania and a low fluoride urban area, Kampala, Uganda. Totals of 1221 and 816 child - caretaker pairs attending health care facilities for growth monitoring were recruited in Manyara and Kampala, respectively. All caretakers completed face to face interviews at the health care facility. Children underwent oral clinical examination whereby ECC and Enamel hypoplasia were recorded using the dmft (WHO 1997) and the DDE index (FDI 1992). The prevalence of ECC was 3.7% in Manyara and 17.6% in Kampala. According to multiple logistic regression analyses, received oral health information from health worker was the strongest determinant of ECC in Manyara, adjusted OR 0.3, 95% CI 0.09 - 0.93. In Kampala, visible plaque, high sugar intake and presence of enamel hypoplasia associated with ECC, adjusted ORs 2.8 (95% CI 1.61- 4.95), 3.0 (95% CI 1.39 - 6.34) and 2.3 (95% CI 1.36 - 3.95). Oral health education aimed at caretakers of 6-36 months, including health care workers' information regarding the detrimental consequences for oral health of frequent sugar consumption and poor oral hygiene is important for prevention of ECC in Tanzania and Uganda

Perceived dental treatment need among older Tanzanian adults – a cross-sectional study

Need perceptions for dental care play a key role as to whether people in general will seek dental care. The aim was to assess the prevalence of perceived need of problem based dental care, dental check-ups and any type of dental care. Guided by the conceptual model of Wilson and Cleary, the relationship of perceived need for dental care with socio-demographic characteristics, clinically defined dental problems and self-reported oral health outcomes was investigated. Partial prosthetic treatment need was estimated using a socio-dental approach. A cross-sectional survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. Information from interviews and clinical examination became available for 511 urban and 520 rural adults (mean age 62.9 yr). 51.7% (95% CI 46.2, 57.0) urban and 62.5 % (95% CI 53.1, 70.9) rural inhabitants confirmed need for dental check-up, 42.9% (95% CI 36.9, 48.9) urban and 52.7% (95% CI 44.5, 60.6) rural subjects confirmed need for problem oriented care and 38.4% (95% CI 32.4, 44.6) urban versus 49.6% (95% CI 41.8, 57.4) rural residents reported need for any type of dental care. Binary and ordinal multiple logistic regression analyses revealed that adults who reported bad oral health and broken teeth were more likely to perceive need for dental care across the three outcome measures than their counterparts. Socio-demographic factors and clinically defined problems had less impact. Based on a normative and an integrated socio-dental approach respectively 39.5% and 4.7% were in need for partial dentures. About half of the participants confirmed need for problem oriented care, dental check-ups and any type of dental care. Need perceptions were influenced by perceived oral health, clinically assessed oral problems and socio-demographic characteristics. Need estimates for partial denture was higher when based on clinical examination alone compared to an integrative socio-dental approach

Socio-demographic disparity in oral health among the poor: a cross sectional study of early adolescents in Kilwa district, Tanzania

There is a lack of studies considering social disparity in oral health emanating from adolescents in low-income countries. This study aimed to assess socio-demographic disparities in clinical- and self reported oral health status and a number of oral health behaviors. The extent to which oral health related behaviors might account for socio-demographic disparities in oral health status was also examined. A cross-sectional study was conducted in Kilwa district in 2008. One thousand seven hundred and forty five schoolchildren completed an interview and a full mouth clinical examination. Caries experience was recorded using WHO criteria, whilst type of treatment need was categorized using the ART approach. The majority of students were caries free (79.8%) and presented with a low need for dental treatment (89.3%). Compared to their counterparts in opposite groups, rural residents and those from less poor households presented more frequently with caries experience (DMT>0), high need for dental treatment and poor oral hygiene behavior, but were less likely to report poor oral health status. Stepwise logistic regressions revealed that social and behavioral variables varied systematically with caries experience, high need for dental treatment and poor self reported oral health. Socio-demographic disparities in oral health outcomes persisted after adjusting for oral health behaviors. Socio-demographic disparities in oral health outcomes and oral health behaviors do exist. Socio-demographic disparities in oral health outcomes were marginally accounted for by oral health behaviors. Developing policies and programs targeting both social and individual determinants of oral health should be an urgent public health strategy in Tanzania