Traumatic dental injuries to permanent anterior teeth in 12 - 15 year old children in Nairobi

Objective: To determine the prevalence and pattern of occurrence of traumatic injuries to permanent anterior teeth.Design: A descriptive cross-sectional survey.Setting: Public primary schools in the City of Nairobi.Subjects: A sample of 1382 children (672 males and 710 females) were interviewed and examined.Results: Among the 1382 children examined, 222(16.1%) had experienced traumatic dental injuries (TDIs). Males had experienced a significantly higher prevalence of trauma 126(18.8%) than females 96(13.5%) p=0.008. Falls were the leading cause of TDIs as reported by 78(35.1%) children. Amongst the, male children, falls were the leading cause of traumatic injuries to the permanent anterior teeth 47(37.3%). Approximately half 43(44.8%) of the females did not remember the cause of injury while 31 (36.5%) had sustained TDIs due to falls. One hundred and seventy two (77.5%) children who had experienced TDIs had no symptoms associated with the traumatised teeth. Ninety six (43.2%) of the children were injured while in the home environment. The maxillary central incisors were the most commonly traumatised teeth accounting for 220(73.5%) out of 299 injured teeth. The most frequently observed type of dental trauma was enamel fracture 206(68.9%) followed by enamel-dentin fracture 71(23.8%). Two hundred (90%) children had not sought treatment for TDIs.Conclusion: Overall traumatised permanent incisors were found to occur fairly frequently with males having experienced significantly more TDIs than females. The prevalence of TDIs was 16.1%; enamel fractures were the most frequently observed injury and falls were the leading cause of trauma

Cigarette Smoking And Oral Health Among Healthcare Students

Background: The knowledge, attitudes and practices of cigarette smoking and health risks among health workers has been found to be predictive of their efficiency as agents for tobacco cessation campaigns.Objective: To describe the knowledge, attitudes and practices of cigarette smoking and oral health risks among healthcare professional students.Design: A cross sectional multi-level study.Setting: College of Health Sciences, University of Nairobi.Subjects: Two hundred and eighty one students.Results: Thirty four (12.1%) of the students were current smokers, 174 (61.95%) had never smoked, while 73 (26%) were former smokers. Seventy nine point four per cent of the current smokers were males and 20.6% were females. Pharmacy students had the highest smokingprevalence at 11 (32.4%), while dental and nursing students had the lowest percentages of current smokers. Differences observed in smoking status of students in the constituent schools of the College of Health Sciences were statistically significant (p = 0.008). Apart fromknowledge levels on the association between tobacco consumption and lung cancer (p = 0.142), there were statistically significant differences in the awareness of the severe oral and systemic effects of smoking amongst the four student groups.Conclusions: There is a need for harmonisation of teaching of oral and systemic effects of smoking so as to impact on the smoking habits and effectiveness of healthcare professional students as agents of smoking cessation programmes

Pattern And Clinical Characteristics Of Firearm Injuries

Objective: To determine the pattern and characteristics of patients admitted with firearm injuries (FAls) and establish the morbidity and mortality associated with these injuries. Design: Retrospective cross-sectional study. Setting: Kenyatta National Hospital (KNH), January 2004 to December 2005. Subjects: All patients admitted with physically evident firearm injury. Results: There were a total of 717 patients recorded with FAIs constituting 0.6% of the total number of patients seen in the casualty. Of these, 421 (58.7%) were admitted and treated as in- patients. A firearm was used in 6.7% of the 6300 assault cases recorded in 2004 and in 9.7% of the 3079 cases recorded in 2005. The increase from 6.7% in 2004 to 9.7% in 2005 was statistically significant (

Malocclusion and orthodontic treatment need among 12-15-year-old children in nairobi

Objective: To describe the pattern of occurrence of malocclusion and orthodontic treatment need.Design: A descriptive cross-sectional survey.Setting: Six public primary schools in Nairobi, Kenya.Subjects: A randomly selected sample of 1382 children aged 12 to 15 years. Clinical examination for malocclusion was conducted using the Dental Aesthetic Index (DAI). Orthodontic treatment need was derived using the regression equation stated in the DAI.Results: Among the 1382 (672 males and 710 females) children examined, 70 children (5.1%) had missing teeth. Crowding and spacing in the incisal segments occurred in 652 (47.2%) and 644 (46.6%) children respectively. Anterior irregularities were found in 533 (38.6%) of the subjects in the maxilla and 430 (31.1%) in the mandible. Anterior crossbite was found in 86 (6.2%) of the children. The anterior open-bite occurred in 194 (14%) of the children with significantly more open-bite in females than males (p=0007). The maxillary median diastema and antero-posterior molar relation discrepancies were found in 289 (20.2%) and 344 (24.9%) of the sample respectively. The sample mean DAI score was 26.6 (SD 7.8). Seven hundred and thirty two (53.0%) of the children examined had either no need or slight need for treatment whereas 650 (47%) were found with orthodontic treatment needs ranging from elective 318 (23%), highly desireable 176 (12.7%) to mandatory 156 (11.3%).Conclusion: There was an overall high prevalence of malocclusion with 11.3% of the sample exhibiting handicapping malocclusion. Notably, there were no significant gender differences for most of the traits except for anterior open-bite which was found to occur more in females than males

Oral hygiene practices and risk of oral leukoplakia

Objective: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. Design: Case control study. Setting: Githongo sublocation in Meru District. Subjects: Eighty five cases and 141 controls identified in a house-to-house screening.Results: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the “don't brush” group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1 .4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). Conclusion: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes. East African Medical Journal Vol. 83(4) 2006: 73-7

Nutritional and oral health status of an elderly population in Nairobi

Objective: To determine the nutrition and oral health status of elderly persons in Nairobi, Kenya. Design: A cross-sectional study. Setting: Households in Dagoretti Division of Nairobi. Subjects: Two hundred and eighty nine persons (29.8% males and 70.2% females) aged 45 years and above were assessed. Results: The level of malnutrition using the mid upper arm circumference was 18.8% while by body mass index was 11.4%. Of the population assessed, 46.4% had normal nutritional status while 40.9% were overweight, with more females (48.0%) than males (25.9%) being overweight. The study established that many of the elderly persons suffered from dental problems, especially periodontitis with 89.9% having dental plaque, calculus 85.6%, gingival recession 82.5% and bleeding gums 77.4%. The decayed index missing and filled teeth, was 7.173 with 19.7% caries free, 51.9% reported tooth mobility and edentulousness was common. Conclusions: Under-nutrition, obesity and dental problems are issues of concern among the elderly. There is need to develop policies that will look into the nutrition and dental health of the elderly in order to improve their welfare.East African Medical Journal Vol. 85 (8) 2008: pp. 378-38

The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leukoplakia and oral submucous fibrosis in southern Taiwan

In areas where the practise of betel quid chewing is widespread and the chewers also often smoke and drink alcohol, the relation between oral precancerous lesion and condition to the three habits is probably complex. To explore such association and their attributable effect on oral leukoplakia (OL) and oral submucous fibrosis (OSF), a gender–age-matched case–control study was conducted at Kaohsiung, southern Taiwan. This study included 219 patients with newly diagnosed and histologically confirmed OL or OSF, and 876 randomly selected community controls. All information was collected by a structured questionnaire through in-person interviews. A preponderance of younger patients had OSF, while a predominance of older patients had OL. Betel quid chewing was strongly associated with both these oral diseases, the attributable fraction of OL being 73.2% and of OSF 85.4%. While the heterogeneity in risk for areca nut chewing across the two diseases was not apparent, betel quid chewing patients with OSF experienced a higher risk at each exposure level of chewing duration, quantity and cumulative measure than those who had OL. Alcohol intake did not appear to be a risk factor. However, cigarette smoking had a significant contribution to the risk of OL, and modified the effect of chewing based on an additive interaction model. For the two oral premalignant diseases combined, 86.5% was attributable to chewing and smoking. Our results suggested that, although betel quid chewing was a major cause for both OL and OSF, its effect might be difference between the two diseases. Cigarette smoking has a modifying effect in the development of oral leukoplakia

Oral health knowledge, hygiene practices and treatment seeking behaviour among 12-year-old children from Kitale Municipality in Kenya

Background: Several behavioural studies have shown a direct correlation between oral health awareness and practices. Awareness of individuals regarding their periodontal health status when accompanied with knowledge about the periodontal disease process can help improve self oral healthcare and prevent periodontal diseases.Objective: To describe the knowledge on aetiology, prevention of periodontal disease and the oral health practices among 12 year-old children.Design: Descriptive cross-sectional study.Setting: Eight out of 16 primary schools in Kitale municipality.Results: Majority of the children 197(67.5%) brushed their teeth among whom 109(55.3%) brushed their teeth three times a day, 43(21.8%) brushed twice a day and 45(22.8%) brushed once a day. Out of the children who brushed their teeth, 104(52.8%) started brushing their teeth before joining primary school while 53(26.9%) started brushing their teeth in primary school. A small number of children 29(14.7%) did not remember when they started brushing their teeth. Out of those children who brushed their teeth, 127(64.5%) used a toothbrush, 33(16.8%) used ‘miswaki’ and 32(16.2%) used both toothbrushes and ‘miswaki’. Among those who brushed their teeth, 173(87.8%) used toothpaste while 24(12.2%) did not use any. Less than half of all the children interviewed (36.3%) had visited a dentist before. Most of the children (18.2%) whovisited a dentist went for tooth extraction, 6.8% for tooth cleaning and 4.1 % for filling. A very small number of children (5.1 %) went for check-up. Majority of all the children interviewed (69.9%) had moderate oral health knowledge while only a few children (8.9%) had poor information.Conclusion: A large number of children carried out oral hygiene practices. Majority of those children who brushed their teeth started cleaning their oral tissues before joining primary school, possibly a result of parental influence. The utilisation of dental healthcare services was low among the children in the study

Pattern of bone loss in dry Mandibles of individuals who died before 1957

Objective: To map out the pattern of periodontal disease in individuals who died before 1957 and were not exposed to formal dental services.Design: Descriptive cross-sectional study.Setting: National Museums of Kenya. Subjects: The skeletons of people who died before independence are preserved at the National Museums of Kenya in Nairobi. Sixty four out of the 170 dry mandibles stored at the Museum were assessed for periodontal bone loss using a calibrated ruler.Results: All the 64 mandibles assessed were of individuals who died before 1957. Two thousand two hundred and seventy four sites were examined. Most of the subjects were adults aged 30-45 years and the age range was 18-80 years. Majority of the mandibles examined were of the ethnic group from Central Kenya. Of the teeth examined, premolars and molars were the teeth most frequently preserved intact in the sockets. The total mean bone loss for all teeth was 2.51 (SD 1.15) with a range of 0.85-5.80. When the different sites were examined, values for bone loss were 2.59 for mesial surfaces; 2.55 buccal surfaces; 2.38 for distal surfaces. Three categories were identified as follows:- 70% of the individuals had minimal or no bone loss, 26.5% had 3-4mm or moderate bone loss and 3.5% had >5mm bone loss or advanced bone loss. Further analysis showed that when bone loss of >3mm was examined, only 28.12% of the individuals were in this group, 10.93% had >4mm bone loss and 3.12% had 5mm or more bone loss. The first molars were the teeth most commonly affected by bone loss of 3mm or more followed by second molars then the premolars. Conclusions: In this group of individuals mainly from Central Kenya, the bone loss pattern showed that only a small number had experienced periodontal destruction as recorded by bone loss levels. Three groups were identified; those who had no or minimal destruction, those who had experienced moderate destruction and those where obvious bone destruction was evident. Thus susceptibility to periodontal disease is evident in a small proportion of individuals even in populations not exposed to modern diet and formal dental services. Periodontal destruction seems to affect a fraction of the population even when older populations are examined, thus it would save on resources both human and physical if these susceptible individuals could be identified early and treatment provided.East African Medical Journal Vol 82(10) 2005: 510-51