Testing a consensus conference method by discussing the management of traumatic dental injuries in Tanzania

Objectives: To test the recommended consensus conference methods in Tanzania by discussing the management of traumatic dental injuries, and to reach consensus on the feasibility of the treatment modalities of traumatic dental injuries recommended in western countries in theTanzanian situation.Study participants: Fifteen dentists as representatives of the profession and two lay people as representative of potential consumers.Interventions: Presentation of treatment modalities for traumatic dental injuries recommended in western countries.Main outcome measure: Consensus on the feasibility of the recommended treatment modalities of traumatic dental injuries in the Tanzanian situation.Results: For most types of injuries, consensus on the feasibility of the recommended treatment methods for Tanzania was reached immediately. More time was spent to discuss management of some injuries where the members felt that the recommended managementregimes for these injuries are not feasible in the current Tanzanian situation. Panel members made three recommendations. First, parents and teachers should be provided with guidelines or instructions about self-care following trauma. Second, teaching on the management oftraumatic dental injuries at training institutions should be emphasised and third, dental practitioners at dental clinics in the country should get continuing education about the management of traumatic dental injuries.Conclusion: The methods for achieving consensus were useful in the Tanzanian dental situation, therefore it is recommended that the methods be adopted to reach consensus on other oral health issues

Treatment delays in paediatric dento-alveolar trauma at a tertiary referral hospital

Background: Paediatric dento-alveolar trauma is a common event. Delays in treatment can have adverse effects on long term outcomes and the aim of this study was to quantify the treatment delays in paediatric dento-alveolar trauma in a tertiary referral hospital. Methods: All cases of paediatric dento-alveolar trauma over a two-year period from July 2000 to June 2002 were identified and the charts were reviewed retrospectively. All children presenting the emergency department with dento-alveolar trauma within 48 hours of injury during the time period were included. Results: Forty-three patients were identified. The average age was 5.51 years, though there was a bias towards one and two year olds. Males were injured 1.5 times more frequently than females. There was an average delay of 9.6 hours between injury and treatment for all patients. Transit time from outside practitioners to hospital and waiting times in hospital made up the greatest delays. Children injured an average of 2.37 teeth and only 14 per cent were uncomplicated crown fractures. Conclusions: Children who present to children's hospitals for treatment of dento-alveolar trauma have more severe injuries than those treated elsewhere. They have large but potentially reducible delays between injury and treatment

Editorial

This Issue has been earmarked to commemorate the 10th anniversary of the East and Southern Africa Division. The Tanzania Dental Journal Is the only one published by the Oral Health professionals In the whole of the East and Southern Africa region. As we gather for this important occasion, pemaps we should remind ourselves the 'importance of having a local good quality journal. In view of the ever Increasing number of scientists in the world contributing manuscripts to the relatively few scientific journals, our chances of publishing In the International journals are IncreaSingly slim. Furthermore, a local contributor's article could be rejected by a foreign journal just because the Information is of no Interest to that region. However, the same article could be very relevant to our community. A good quality local journal, unlike imported ones, would be affordable and easily be distributed In the region. This Is the forum for all levels of oral health professionals to exchange scientific information relevant to the region. Therefore constant production of a local high quality journal is one of the challenges facing the Oral Health professionals in the Eastern and Southern African region. We challenge the Oral Health professionals in the region to come up with high quality papers for publication in this journal

Prevalence and awareness of early childhood caries among attendees of a reproductive and child health clinic at Mnazi Mmoja dispensary, Dar es Salaam

The aim of this study was to determine the prevalence, and awareness of early childhood caries (ECC) among attendees of a Reproductive and Child Health clinic at Mnazi Mmoja dispensary in Dar es Salaam. The parents or guardians were aged 16-55 years old, while the children were aged 6-36 months. Caries was scored according to WHO criteria (1997). A structured questionnaire, translated in Kiswahili was used to inquire on awareness in etiology and prevention of early childhood caries. Caries prevalence was 26.4% among the children examined, 22% of the children had caries on maxillary central incisors and 8% had caries on maxillary lateral incisors. None of the children had caries on the upper molars. About 57% of the caries was on maxillary central incisors, and only 4% on mandibular central incisors. The participants indicated that the causes of ECC are; frequent consumption of sugary foods (59%), improper tooth brushing (10%) and frequent use of medicinal syrups (8%). Regarding prevention, 31% of the participants knew that restricting use of sucrose foods prevents early childhood caries, while none of the mothers knew that not practicing breastfeeding at will and restriction of frequent bottle feeding prevents ECC. Parents who attained secondary school education were more aware of ECC than those who attained primary school education only. From the results of this study it is concluded that the prevalence of ECC in this study group is high and within the range previously reported, ECC was not related to breast feeding at will. Furthermore, we conclude that a high percentage of parents studied knew what ECC is, a substantial proportion knew its cause but few knew its prevention. Tanzania Dental Journal Vol. 12(2) 2006: 35-4

Oral habits and open bite among children aged 8-12 years in Kinondoni, Dar es Salaam, Tanzania

Aim: To determine the prevalence of oral habits and their relationship with the occurrence of open bite among 8 to 12 years old children in Kinondoni District, Dar es Salaam. Study design: A cross sectional study. Subjects and methods: All children aged 8-12 years from four government primary schools were eligible to participate. Using school registers, twenty children of each age were randomly selected giving a total of 100 children from each school. Face to face interviews were conducted using a structured questionnaire. The questionnaire inquired about oral habits of the children including thumb sucking, tongue thrusting, lip sucking, nail biting and/or mouth breathing. Children were also examined clinically for the presence of open bite. Results: A total of 394 primary school children participated. Females constituted 52.5% of the study sample. Nail biting was the most frequently practiced habit (53.3%), followed by lip sucking (13.7%), tongue thrusting (11.9%), thumb sucking (9.4%) and finger sucking (5.1%). Mouth breathing was the least practiced oral habit. Forty six children (11.7%) had an open bite. Tongue thrusting was significantly associated with age being seen more (14.8%, P = 0.026) in the younger age group 8-10 years. Open bite was significantly more prevalent among thumb (P=0.01) and finger (P=0.001) suckers than non suckers. Conclusion: The most common oral habits in this age group were nail biting, lip sucking and tongue thrusting. Open bite was more prevalent among thumb and finger suckers than non suckers. Key words: Oral habits, open bite, school children, Tanzani

Emergency visits at a paedodontic clinic in Tanzania

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Natal teeth - Two Case Reports

Natal teeth are the teeth present in the mouth at birth where as neonatal teeth erupt during the first month of life. Occurrence of these teeth is rare and when they occur, they cause apprehension to parents. For centuries, these teeth have been associated with diverse superstition and folklore or myths.The aim of this report is to describe two cases of natal teeth that were attended at the Paediactric dental clinic, School of Dentistry, Muhimbili University of Health and Allied Sciences (MUHAS) in the year 2013. Both children were satisfactorily managed. They were followed up regularly. At the most recent appointment one child was aged seven and the other eight months where both were growing normally.Key Words: Natal teeth, eruption, newbor

Factors associated with oral health status and normative treatment needs among primary school children in Kinondoni Municipality, Tanzania

Aim The aim was to determine oral health status, factors affecting caries, experiences, and dental treatment needs among primary school children in Kinondoni District, Dar Es Salaam Region. Materials and Methods A cross sectional survey was done in 2005 to involve 784 (females 56.2%) children aged 7 to 19 years, with average age of boys slightly higher than that of girls. The examinations were carried out according to WHO criteria (World Health Organisation, 1997) under artificial light using dental mirrors and the WHO CPI periodontal probe. Before the clinical examinations took place the children participated in an interview whereby information was gathered about oral health related knowledge, experience with toothache, extractions, restoration and tooth brushing practices. A structured questionnaire was used which was field tested to a group of 50 primary school children prior to the survey. Results Dental caries experience was 1.35 dft and 0.33 DMF-T, for 12 year olds (the WHO indicator age group) DMFT was 0.4. The proportion of caries free among 12 year olds was 77.6. The determinants of caries experience were age and sex, while oral health related knowledge, caries in deciduous dentition, geographical location that was taken to be a proxy indicator of social economic status, were not associated with caries experience in permanent dentition. Much of the dental caries went untreated and every 8th child needed one surface filling on at least one tooth. Few children required extractions and two surface fillings. One third of the children had calculus requiring oral hygiene instructions and scaling and on average one sextant had calculus per child. One third of the children experienced bleeding upon brushing, and 54.8% had experienced toothache. All children brushed their teeth at least once a day. Knowledge on gingival health did not account for variations in calculus accumulation. Conclusion Caries experience; predicted by age and sex, was very low but much of the disease went untreated, toothache was a common encounter, with every eighth child requiring one surface filling on at least one tooth. Every third child had calculus requiring oral hygiene instructions although all children reported to brush their teeth at least once a day. The findings are discussed in line with their usability in planning oral health services in the District. Tanzania Dental Journal Vol. 13(2) November 2006: 35-4

Caries status and opinions of people living with HIV/AIDS on oral health care providers' desired behaviour

Aim The aim of this study was to investigate the dental caries status and opinions of the People Living with HIV/AIDS (PLHA) on how they should be handled by oral health care providers. Design: A cross sectional study. Study subjects and Methods The study was carried out among PLHA in Dar es Salaam, Tanzania. Data was collected using a face to face interview utilizing a structured questionnaire which inquired on participants' views on how they should be handled by oral health care providers. An intra oral examination to assess dental caries status was done according to WHO recommendation. Results The response rate was 43.9%. Majority of the participants suggested that dental professionals should have empathy to PLHA (95%), should avoid stigmatization of PLHA (94%) and should observe sterile procedures to control cross infection. The mean decayed component was 2.45, mean missing 3.63, mean filled 0.25 and the mean decayed missing and filled teeth (DMFT) 6.34. Only 8.9% of the participants were caries free, 15.8% had one decayed tooth, 13.9% had one missing tooth, 5.9% had one filled tooth and 10.9% had one DMFT. The most affected teeth were third molars, observed on the upper right jaw of 42.5% of the participants and on the lower left jaw of 56.4%. Extensive destruction of the tooth structure was frequently observed. Conclusion We conclude that the study group of PLHA has a higher caries experience than the general Tanzanian population, requires dental professionals to observe social requirements and to offer them professional services. Keywords: HIV/AIDS, PLHA, Dental caries, Dental services Tanzania Dental Journal Vol. 13(2) November 2006: 56-6