Prevalence of malocclusion and its associated factors among pre-schoolchildren in Kinondoni and Temeke Districts, Tanzania

Background: Malocclusion is any deviation in the arrangement of teeth exceeding the standards of normal occlusion characterized by anomalies within the dental arches. The objective of this study was to assess the prevalence of malocclusion and its associated factors among pre-school children in Kinondoni and Temeke Districts in Tanzania.Methods: This cross sectional survey of children aged 3-5 years was conducted in Kinondoni and Temeke Districts in Tanzania. T Parents of pre-schoolchildren were interviewed regarding their socio-demographic details and their child’s sucking habits. Clinical examination was performed to each child to assess malocclusions.Results: The overall prevalence of malocclusion was 32.5%. In bivariate analysis, sucking habit was the significant factor associated with malocclusions. After controlling for socio-demographic variables, current sucking habits and sex remained significant determinants for having an open bite with odds ratios of 13.5 and 2.2, respectively.Conclusion: The study showed that more than one third of pre-schoolchildren in the two districts had one or more forms of malocclusions. Open bite was the most common vertical malocclusion trait which was significantly related to sucking habits and child’s sex. Thus, 3-5 year-olds can benefit from preventive and interceptive oral health measures which may either totally prevent or lessen the development of severe forms of malocclusions later in their lives

Dental pain, oral impacts and perceived need for dental treatment in Tanzanian school students: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Dental caries, dental pain and reported oral problems influence people's oral quality of life and thus their perceived need for dental care. So far there is scant information as to the psychosocial impacts of dental diseases and the perceived treatment need in child populations of sub-Saharan Africa.</p> <p>Objectives</p> <p>Focusing on primary school students in Kilwa, Tanzania, a district deprived of dental services and with low fluoride concentration in drinking water, this study aimed to assess the prevalence of dental pain and oral impacts on daily performances (OIDP), and to describe the distribution of OIDP by socio-demographics, dental caries, dental pain and reported oral problems. The relationship of perceived need estimates with OIDP was also investigated.</p> <p>Methods</p> <p>A cross-sectional study was conducted in 2008. A total of 1745 students (mean age 13.8 yr, sd = 1.67) completed an extensive personal interview and under-went clinical examination. The impacts on daily performances were assessed using a Kiswahili version of the Child-OIDP instrument and caries experience was recorded using WHO (1997) criteria.</p> <p>Results</p> <p>A total of 36.2% (41.3% urban and 31.4% rural, p < 0.001) reported at least one OIDP. The prevalence of dental caries was 17.4%, dental pain 36.4%, oral problems 54.1% and perceived need for dental treatment 46.8% in urban students. Corresponding estimates in rural students were 20.8%, 24.4%, 43.3% and 43.8%. Adjusted OR for reporting oral impacts if having dental pain ranged from 2.5 (95% CI 1.8–3.6) (problem smiling) to 4.7 (95% CI 3.4–6.5) (problem sleeping),- if having oral problems, from 1.9 (95% CI 1.3–2.6) (problem sleeping) to 3.8 (95% CI 2.7–5.2) (problem eating) and if having dental caries from 1.5 (95% CI 1.1–2.0) (problem eating) to 2.2 (95% CI 1.5–2.9) (problem sleeping). Students who perceived need for dental care were less likely to be females (OR = 0.8, 95% CI 0.6–0.9) and more likely to have impacts on eating (OR = 1.9, 95% CI 1.4–2.7) and tooth cleaning (OR = 1.6, 95% CI 1.6–2.5).</p> <p>Conclusion</p> <p>Substantial proportions of students suffered from untreated dental caries, oral impacts on daily performances and perceived need for dental care. Dental pain and reported oral problems varied systematically with OIDP across the eight impacts considered. Eating and tooth cleaning problems discriminated between subjects who perceived need for dental treatment and those who did not.</p

Oral mucosal lesions in skin diseased patients attending a dermatologic clinic: a cross-sectional study in Sudan

<p>Abstract</p> <p>Background</p> <p>So far there have been no studies focusing on the prevalence of a wide spectrum of oral mucosal lesions (OML) in patients with dermatologic diseases. This is noteworthy as skin lesions are strongly associated with oral lesions and could easily be neglected by dentists. This study aimed to estimate the frequency and socio-behavioural correlates of OML in skin diseased patients attending outpatient's facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan.</p> <p>Methods</p> <p>A cross-sectional hospital-based study was conducted in Khartoum from October 2008 to January 2009. A total of 588 patients (mean age 37.2 ± 16 years, 50.3% females) completed an oral examination and a personal interview of which 544 patients (mean age 37.1 ± 15.9 years, 50% females) with confirmed skin disease diagnosis were included for further analyses. OML were recorded using the World Health Organization criteria (WHO). Biopsy and smear were used as adjuvant techniques for confirmation. Data were analysed using the Statistical Package for Social Science (Version 15.0.1). Cross tabulation and Chi-square with Fisher's exact test were used.</p> <p>Results</p> <p>A total of 438 OML were registered in 315 (57.9%, males: 54.6% versus females: 45.6%, p < 0.05) skin diseased patients. Thus, a certain number of patients had more than one type of OML. <it>Tongue lesions </it>were the most frequently diagnosed OML (23.3%), followed in descending order by <it>white lesions </it>(19.1%), <it>red and blue lesions </it>(11%) and <it>vesiculobullous diseases </it>(6%). OML in various skin diseases were; <it>vesiculobullous reaction pattern </it>(72.2%), <it>lichenoid reaction pattern </it>(60.5%), <it>infectious lesions </it>(56.5%), <it>psoriasiform reaction pattern </it>(56.7%), and <it>spongiotic reaction pattern </it>(46.8%). Presence of OML in skin diseased patients was most frequent in older age groups (62.4% older versus 52.7% younger, p < 0.05), in males (63.2% males versus 52.6% females, p < 0.05), patients with a systemic disease (65.2% with systemic versus 51.9% without systemic disease, p < 0.05) and among current users of smokeless tobacco (toombak) (77% current use versus 54.8% no use, p < 0.00).</p> <p>Conclusions</p> <p>OML were frequently diagnosed in skin diseased patients and varied systematically with age, gender, systemic condition and use of toombak. The high prevalence of OML emphasizes the importance of routine examination of oral mucosa in a dermatology clinic.</p

Applying the theory of planned behaviour to explain HIV testing in antenatal settings in Addis Ababa - a cohort study

<p>Abstract</p> <p>Background</p> <p>To facilitate access to the prevention of mother-to-child HIV transmission (PMTCT) services, HIV counselling and testing are offered routinely in antenatal care settings. Focusing a cohort of pregnant women attending public and private antenatal care facilities, this study applied an extended version of the Theory of Planned Behaviour (TPB) to explain intended- and actual HIV testing.</p> <p>Methods</p> <p>A sequential exploratory mixed methods study was conducted in Addis Ababa in 2009. The study involved first time antenatal attendees from public- and private health care facilities. Three Focus Group Discussions were conducted to inform the TPB questionnaire. A total of 3033 women completed the baseline TPB interviews, including attitudes, subjective norms, perceived behavioural control and intention with respect to HIV testing, whereas 2928 completed actual HIV testing at follow up. Data were analysed using descriptive statistics, Chi-square tests, Fisher's Exact tests, Internal consistency reliability, Pearson's correlation, Linear regression, Logistic regression and using Epidemiological indices. P-values < 0.05 was considered significant and 95% Confidence Interval (CI) was used for the odds ratio.</p> <p>Results</p> <p>The TPB explained 9.2% and 16.4% of the variance in intention among public- and private health facility attendees. Intention and perceived barriers explained 2.4% and external variables explained 7% of the total variance in HIV testing. Positive and negative predictive values of intention were 96% and 6% respectively. Across both groups, subjective norm explained a substantial amount of variance in intention, followed by attitudes. Women intended to test for HIV if they perceived social support and anticipated positive consequences following test performance. Type of counselling did not modify the link between intended and actual HIV testing.</p> <p>Conclusion</p> <p>The TPB explained substantial amount of variance in intention to test but was less sufficient in explaining actual HIV testing. This low explanatory power of TPB was mainly due to the large proportion of low intenders that ended up being tested contrary to their intention before entering the antenatal clinic. PMTCT programs should strengthen women's intention through social approval and information that testing will provide positive consequences for them. However, women's rights to opt-out should be emphasized in any attempt to improve the PMTCT programs.</p

Evaluation of oral health-related quality of life among Sudanese schoolchildren using Child-OIDP inventory

<p>Abstract</p> <p>Background</p> <p>Information on oral health-related quality of life, in addition to clinical measures, is essential for healthcare policy makers to promote oral health resources and address oral health needs.</p> <p>Objectives</p> <p>This paper aimed at evaluating the psychometric properties of the Arabic version of Child-OIDP, estimating the prevalence, severity and causes of oral impacts on daily performances in 12-year-old public and private school attendees in Khartoum State and to identify socio-demographic and clinical correlates of oral impacts as assessed by the Child-OIDP inventory.</p> <p>Methods</p> <p>The Child-OIDP questionnaire was translated into Arabic was administered to a representative sample of 1109 schoolchildren in Khartoum state. Clinical measures employed in this study included DMFT index, Gingival index, Plaque index and Dean's index. A food frequency questionnaire was used to study the sugar-sweetened snack consumption.</p> <p>Results</p> <p>The instrument showed acceptable psychometric properties and is considered as a valid, reliable (Cronbach's alpha 0.73) and practical inventory for use in this population. An impact was reported by 54.6% of the schoolchildren. The highest impact was reported on eating (35.5%) followed by cleaning (28.3%) and the lowest impacts were on speaking (8.6%) and social contact (8.7%). Problems which contributed to all eight impacts were toothache, sensitive teeth, exfoliating teeth, swollen gums and bad breath. Toothache was the most frequently associated cause of almost all impacts in both private and public school attendees. After adjusting for confounders in the 3 multiple variable regression models (whole sample, public and private school attendees), active caries maintained a significant association with the whole sample (OR 2.0 95% CI 1.4-2.6) and public school attendees (OR 3.5 95% CI 2.1-5.6), and higher SES was associated with only public school attendees' Child-OIDP (OR 1.9 95% 1.1-3.1).</p> <p>Conclusion</p> <p>This study showed that the Arabic version of the Child-OIDP was applicable for use among schoolchildren in Khartoum. Despite the low prevalence of the dental caries pathology (24%), a significant relationship, with an average moderate intensity was found with OHRQoL. Focus in this population should be on oral health education, improving knowledge of the prospective treatment opportunities and provision of such services.</p

Eating disorders - knowledge, attitudes, management and clinical experience of Norwegian dentists

Background The purpose of this study was to investigate knowledge, attitudes and clinical experience with regard to patients with eating disorders (ED) among Norwegian dentists. Methods In 2010, a questionnaire was sent to all dentists in Norway (N = 4282) comprising 33 questions related to demographics of the participating dentists, their knowledge of ED (general and oral health aspects), clinical experience, attitudes and perceived management preferences. Results The participation rate was 40 % (47 % women and 53 % men). Their knowledge about ED was often retrieved from common media sources and the greater part of the participants reported they had seen very few patients with ED during their professional career. Female dentists reported superior knowledge about ED compared to males, but the former experienced greater difficulties to inform about the condition. Referrals of the patient to other health facilities were significantly more common among female compared to male dentists. The majority of dentists (76 %) reported a need of more education related to ED management. Conclusions The Norwegian dentists in this study reported limited clinical experience and insufficient knowledge regarding ED. There is therefore a need to increase both undergraduate and continuing education in this field, which can improve preventive and management measures that a dentist can provide for ED patients.publishedVersio

Norwegian Orthodontists’ Experience and Challenges With Treatment of Patients With Cleft Lip and Palate

Background: Patients born with cleft lip and/or palate (CL/P) have orthodontic treatment challenges due to maxilla deficiency, malocclusions, and dental abnormalities. In Norway, orthodontic treatment is done by centralized CL/P teams. Due to traveling restrictions, this treatment might be done locally in the future. The experience of Norwegian community orthodontists in managing such patients has not been investigated previously. Objective: To assess Norwegian orthodontists’ management of patients with CL/P and need for further education. Material and Methods: All orthodontists in Norway were sent a questionnaire about their experience, challenges, and knowledge and asked about their need of further theoretical education and clinical training in the management of patients with CL/P. Results: Norwegian orthodontists’ standard of knowledge of CL/P treatment is adequate. However, few respondents have treated a high number of cleft patients. Eighty-six percent of the participants believed that treating CL/P patients involves challenges, such as time-consuming treatment and technical difficulties. Increased perceived need for more education was revealed among participants stated unpreparedness during education (4 folds), encountered challenges, and lack of knowledge (almost 3 folds). Conclusions: The study revealed that community orthodontists in Norway lack experience and acknowledged the challenges in treating patients with CL/P. Most of the respondents perceived a need for additional education and clinical training to treat CL/P patients competently. The findings suggested more focus on patients with CL/P management in the curricula and more collaboration between centralized CL/P teams and community orthodontists.publishedVersio

Utvikling av forekomsten av oral helserelatert livskvalitet blant voksne i Norge i tidsrommet 2004-2018

Kunnskap om oral helserelatert livskvalitet har betydning for planlegging av tannhelsetjenester. Denne studien hadde til hensikt å undersøke om forekomst av redusert oral helserelatert livskvalitet blant voksne i Norge øker eller minker fra 2004 til 2018. Ved hjelp av ‘Oral Impacts on Daily Performance’ (OIDP)-skalaen beregnes sammenhengen mellom oral helserelatert livskvalitet og populasjonskarakteristika på begge tidspunktene. Det undersøkes om sosiale og demografiske forskjeller i redusert oral helserelatert livskvalitet øker eller minker i observasjonsperioden. Spørreskjemaundersøkelser ble gjennomført i 2004 og 2018 i representative utvalg av befolkningen i aldersgruppen 16–79 år. Totalt deltok 1 390 og 1 557 individer i henholdsvis 2004 og 2018. Resultatene viste en betydelig økning i andelen som oppga redusert oral helserelatert livskvalitet fra 18 % i 2004 til 3,3 % i 2018. Andelen som oppga redusert oral livskvalitet økte med alderen og var høyere på Vestlandet og i Nord Norge sammenlignet med Østlandet og Oslo ved begge undersøkelsestidspunkt. Resultatene viser videre at aldersforskjellen økte og at de regionale forskjellene minket fra 2004 til 2018. Oral helserelatert livskvalitet minket med økende alder i 2004 og 2018. Dette viser at oral helserelatert livskvalitet reflekterer noe mere enn tennenes tilstand i den voksne norske befolkningen.publishedVersio

Male partner antenatal attendance and HIV testing in eastern Uganda: a randomized facility-based intervention trial

<p>Abstract</p> <p>Background</p> <p>The objective of the study was to evaluate the effect of a written invitation letter to the spouses of new antenatal clinic attendees on attendance by couples and on male partner acceptance of HIV testing at subsequent antenatal clinic visits.</p> <p>Methods</p> <p>The trial was conducted with 1060 new attendees from October 2009 to February 2010 in an antenatal clinic at Mbale Regional Referral Hospital, Mbale District, eastern Uganda. The intervention comprised an invitation letter delivered to the spouses of new antenatal attendees, while the control group received an information letter, a leaflet, concerning antenatal care. The primary outcome measure was the proportion of pregnant women who attended antenatal care with their male partners during a follow-up period of four weeks. Eligible pregnant women were randomly assigned to the intervention or non-intervention groups using a randomization sequence, which was computer generated utilizing a random sequence generator (RANDOM ORG) that employed a simple randomization procedure. Respondents, health workers and research assistants were masked to group assignments.</p> <p>Results</p> <p>The trial was completed with 530 women enrolled in each group. Participants were analyzed as originally assigned (intention to treat). For the primary outcome, the percentage of trial participants who attended the antenatal clinic with their partners were 16.2% (86/530) and 14.2% (75/530) in the intervention and non-intervention groups, respectively (OR = 1.2; 95% CI: 0.8, 1.6). For the secondary outcome, most of the 161 male partners attended the antenatal clinic; 82 of 86 (95%) in the intervention group and 68 of 75 (91%) in the non-intervention group were tested for HIV (OR = 2.1; 95% CI: 0.6 to 7.5).</p> <p>Conclusions</p> <p>The effect of the intervention and the control on couple antenatal attendance was similar. In addition, the trial demonstrated that a simple intervention, such as a letter to the spouse, could increase couple antenatal clinic attendance by 10%. Significantly, the majority of male partners who attended the antenatal clinic accepted HIV testing. Therefore, to further evaluate this simple and cost-effective intervention method, adequately powered studies are required to assess its effectiveness in increasing partner participation in antenatal clinics and the programme for prevention of mother to child transmission of HIV.</p> <p>Trial Registration</p> <p><b>ClinicalTrials.gov Identifier</b>: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01144234">NCT01144234</a>.</p

Caries experience by socio-behavioural characteristics in HIV-1-infected and uninfected Ugandan mothers – a multilevel analysis

Objectives To assess caries experience in Ugandan mothers according to HIV status, socio-behavioural-characteristics, gingival bleeding status and to examine whether HIV status impacts the association of socio-behavioural characteristics with caries experience. Third, using multilevel analysis, this study assessed to what extent surface-specific caries experience varied between and within individuals. Materials and methods Caries experience was recorded using the World Health Organization’s Decayed, Missed and Filled Teeth/Surfaces indices from a cohort of 164 HIV-1-infected Ugandan mothers and a cross sectional comparison group of 181 negative controls. Mixed-effects logistic regression was conducted with surface-specific caries experience as the outcome variable. Results The prevalence of caries in HIV-1-infected and uninfected mothers was 81% and 71%, respectively. Significant associations occurred between caries experience at surface level and women’s increasing age (odds ratio [OR] = 1.8, 95% confidence interval [CI]: 1.1–2.8) and presence of gingival bleeding (OR = 2.0, 95% CI: 1.2–3.2). Intra-class correlation (ICC) coefficient amounted to 0.54 (95% CI 0.48‒0.59). Conclusions Caries prevalence was higher in HIV-1 infected than in uninfected mothers and increased with age and gingival bleeding. ICC indicated that 54% of the variance was attributable to variation between individuals. Socio-demographic differences in dental caries did not vary by HIV-1 status.publishedVersio