Clinical and socio-behavioral correlates of tooth loss: a study of older adults in Tanzania

BACKGROUND: Focusing 50 year olds and above, this study assessed the frequency, extent and correlates of tooth loss due to various reasons. Frequency and correlates of posterior occluding support was also investigated. METHOD: A cross-sectional household survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. One thousand and thirty-one subjects, mean age 62.9 years participated in a clinical examination and completed interviews. RESULTS: The prevalence of tooth loss due to any reason was 83.5 %, due to caries 63.4% and due to other reasons than caries, 32.5%. A total of 74.9% had reduced number of posterior occluding units. Compared to subjects having less than 5 teeth lost due to caries, those with 5 or more lost teeth were more likely to be females, having decayed teeth, confirming dental attendance and to be among the least poor residents. Compared to subjects who had lost less than 5 teeth due to reasons other than caries, those who had lost 5 or more teeth were more likely to be of higher age, having mobile teeth, being males, being very poor and to disconfirm dental attendance when having problems. Predictors of prevalence of tooth loss (1 or more lost tooth) due to various reasons and reduced number of occluding units followed similar patterns of relationships. CONCLUSION: The results are consistent with prevalence and extent of tooth loss due to caries and due to reasons other than caries being differently related to disease- and socio- behavioral risk indicators. Caries was the principle cause of tooth loss and molar teeth were the teeth most commonly lost

Causes of pattern of missing permanent teeth among Kenyans

Objective: To determine the causes and pattern of missing permanent teeth among Kenyans. Design: A descriptive cross-sectional study. Setting: Five districts in Kenya. Subjects: Seven hundred and twenty two persons aged 6-85 years (346 males and 376 females). Methods: This study was undertaken in October 2001 during the National Dental Health Action Month organised by the Kenya Dental Association. Six centres in five districts were identified and subjects randomly selected. Intra- oral examination was done visually and results were recorded on specially designed clinical examination forms. Results: The mean number of missing teeth in the population was 1.60. Among those with missing teeth, the mean number of missing teeth was 3.35. The most commonly missing teeth were lower molars followed by upper molars. No record of complete edentulousness in both jaws was encountered. Dental caries was the commonest cause of tooth loss (52.6%), followed by periodontal disease (27.6%). Extractions, as a form of traditional practice, accounted for 12.3% of total tooth loss. Orthodontic treatment and trauma accounted for 2.2% and 2.0% respectively of total tooth loss. The upper and lower posteriors were the commonest teeth lost due to dental caries and periodontal disease. Teeth lost due to trauma were mostly upper anteriors, whereas those extracted due to traditional practices were exclusively lower anteriors. Conclusion: The findings of this study show that the commonly lost teeth are molars and the principal cause of tooth loss is dental caries followed by periodontal disease. Overall, very few extractions had been done for orthodontic reasons. East African Medical Journal Vol.81(6) 2004: 322-32

Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context : a randomized controlled pilot study

Objective: To assess the feasibility of conducting a randomized controlled trial of an instructional and educational stroke DVD and determine the feasibility and preliminary efficacy of this intervention in a multinational context. Design: Non-funded, pilot randomized controlled trial of intervention versus usual care. Setting: International, multicentre, community-based. Participants: Community-living adults up to three years post stroke with moderate to severe disability and their nominated informal caregivers. Interventions: Intervention patients viewed and practised rehabilitation techniques demonstrated in the DVD over six weeks. Main measures: Trial feasibility by number of active recruitment sites, recruitment efficiency, randomization and follow-up. Intervention feasibility by patient and caregiver impressions. Preliminary efficacy by the quality of life – 5-level EuroQol-5D (EQ-5D) health status measure, General Health Questionnaire and Centre for Epidemiological Studies–Depression at two months. Results: In total, 14 recruitment sites were established across eight countries. Recruitment was achieved at nine (64%) sites. Over 16 months, 66 participants were recruited (mean (SD) age = 63.5 (12.47) years) and randomized to intervention (n = 34) and control (n = 32) groups. In total, 54 (82%) completed a follow-up assessment. Patient and/or caregiver comments about the benefits and barriers to accessing the intervention were mixed. There were no significant between-group differences in outcomes at two months (P > 0.05). Conclusion: Conducting a multinational trial of a stroke DVD requires full funding. The intervention was acceptable to some patients and their caregivers, yet a generalized education approach did not fully meet their needs and/or expectations. A more individualized method may be required to meet peoples’ changing needs during stroke recovery

SUPPLEMENTARY_MATERIAL – Supplemental material for Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context: a randomized controlled pilot study

<p>Supplemental material, SUPPLEMENTARY_MATERIAL for Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context: a randomized controlled pilot study by Kelly M Jones, Rohit Bhattacharjee, Rita Krishnamurthi, Sarah Blanton, Suzanne Barker-Collo, Alice Theadom, Amanda G Thrift, Steven L Wolf, Narayanaswamy Venketasubramanian, Priya Parmar, Annick Maujean, Annemarei Ranta, Dominique Cadilhac, Emmanuel O Sanya, Marilyn MacKay-Lyons9, Jeyaraj D Pandian, Deepti Arora, Reginald O Obiako, Gustavo Saposnik, Shivanthi Balalla, Natan M Bornstein, Peter Langhorne, Bo Norrving, Nita Brown, Michael Brainin, Denise Taylor and Valery L Feigin in Clinical Rehabilitation</p