Selection of impression materials and techniques employed by dentists in Kenya

Objectives: The aim of the study was to determine the preferred impression material and impression recording technique employed by the dentists in Kenya for specific clinical procedures.Design: A descriptive cross sectional study.Setting: Dental clinics/institutions within Kenya.Participants: Dentists registered by the Medical Practitioners and Dentists Board as at 2015.Methods: A sample n=322 was randomly selected among the 1000 dentists registered in 2015. Data was collected using a pre-tested self-administered questionnaire that was distributed via online web-based survey monkey softwareand off-line by data collection assistants. Data was analysed using SPSS version 20 and Microsoft Excel 2013. Results were presented in tables, pie and bar charts.Results: Ninety seven dentists (30.1%) returned the questionnaires, 57 (58.8%) completed the hard copy version while 40 (41.2%) responded via the on-line tool. Majority of the respondents were males 52 (53.6%), 44 (45.4%) females while one dentist (1%) did not respond. Nearly half of the dentists 44 (46.4%) had 0-5 years clinical experience and a sizeable number 72 (74.2%) were general practitioners. Majority 56 (57.7%) considered availability, cost, ease of use and degree of accuracy in selecting impression materials (IM’s). The most commonly used (IM) was alginate whereas the least applied were polysulphide and vinyl siloxanether. Alginate was used in primary and final impressions of all procedures except border moulding, mostly in study model 88 (90.7%) and least in complete denture final impression 4 (4.1%). Addition and condensation cured silicones were preferred for fixed restoration impressions with majority 40 (41.1%) using single mix impression technique. One dentist used digital impression recording technique.Conclusion: Selection of (IM’s) is influenced by availability, cost, ease of use and degree of accuracy. Alginate and silicone impression materials were most utilised. The single mix impression technique was more popular while digital impression technique is yet to be widely embraced by dentists in Kenya

Management of dental waste by practitioners in Nairobi, Kenya

Objective: Dental wastes are material that has been utilized in dental clinics, which are no longer wanted for use and therefore discarded. Improper disposal of these dental wastes can cause harm to the dentist, the people in immediate vicinity of the dentist, waste handlers and general public and the environment through production of toxins or as by products of the destruction process. This study aims to determine the knowledge, attitudes and practice on management of dental wastes among dental practitioners in Nairobi, Kenya. Methods: Descriptive cross-sectional study of 70 dental practitioners practicing in Nairobi, Kenya. Results: A total of 50 dental practitioners were included in the study. Majority had graduated between 1991-1995. 47.5% had only a bachelors degree, 25% had masters 7.5% had PhD and 12.5% had postgraduate diploma. Forty five percent of the respondents indicated they have attended training on management of dental waste while 89.5% had been attending continuous dental education. Forty-two percent of the respondents worked in public institution while the rest were in private practice. Only 48.7% of the practitioners were aware of the existence of waste management guidelines. Only 64% felt it was important to follow the set guidelines, 5% thought it was tedious, 2% said they were not practical and the rest were not interested in the guidelines. Eighty-two percent of the respondents said that amalgam was toxic if disposed improperly with only 10.7% indicating pollution to be a consequence of improper disposal of amalgam. Seventyseven percent of the respondents did not know the hazardous effects of improper disposal of amalgam. Only half of the respondents stored waste amalgam under water, 25% said they did not know how to dispose amalgam. All (100%) knew about occurrence of cross-infection with improper disposal of bloody waste but only 56.1% said they incinerated bloody body waste while 24.4% disposed off bloody waste with general waste 35.7% of the respondents indicated that sharps were hazardous if improperly disposed. Only 52.4% incinerated their pathological wasted.On expired drugs, 7.3% disposed them off as part of general wastes. Conclusion: There is need for continuous professional development on waste management among dentists in Kenya.Key words: Access, Oral health, HIV, Physician, Dental waste

Convergence angles of tooth preparations assessed on dies for full crowns and bridge retainers

Objective: The aim of the study was to assess the convergence angles of tooth preparations on dies for full crowns and bridge retainers done by oral health providers in Nairobi, Kenya. Study design: This was a descriptive cross sectional study.Setting: Selected dental laboratories in Nairobi, Kenya.Subject: Dies of full crown and bridge retainers.Results: A majority (59%) of the tooth preparations were for single crowns and 41% were for bridge retainers. The mean convergence angle for all the dies was 24.0○ with a mean buccal-lingual convergence angle of 26.7 ○ +11.93SD and a mean mesio-distal convergence angle of 22.1 ○ +10.89SD. Ideal tooth preparations were found in 18.1% of the dies. Majority of which were for single crowns (58.9%) followed by the abutment preparations for three unit bridges at 23.2%.Conclusion: Most of the tooth preparations did not have both ideal mesio-distal and buccal-lingual convergence angle measurements. There is therefore a need to provide Continuing Professional Education courses for dentists on tooth preparation for crown and bridge to enhance clinical application of tooth preparation guidelines

Selection of direct restorative and rooting filling materials by Kenyan dentists in 2014

Objectives: To establish the categories of direct restorative and root filling materials used by dentists in Kenya as well as the factors considered in their selection.Design: A descriptive cross-sectional study.Setting: Public and private dental practices in major towns in Kenya.Participants: Registered, practicing dentists in Kenya in 2014.Methods: Out of approximately 1000 dentists, a sample size of 384 was determined. Using stratified random sampling, respondents were selected from the former eight provincial administrative regions. Data was collected using a pre-tested selfadministered semi-structured questionnaire. Microsoft Excel 2013 was used for data analysis and presentation of results.Results: Eighty three filled questionnaires were returned. The preferred direct restorative materials were resin composites (RC)(33.2%), glass ionomer cements (GIC) (30.3%) and dental amalgam (DA) (29.9%);compomers had limited use (6.6%). In permanent dentition, the use of RC was 52.6%, mostly for anterior restorations (30.3%)while DA was 49%, mostly for posterior restorations (89.5%). In deciduous dentition, the use of GIC was 47.1% while that of compomerswas 21%. The most commonly used root filing material was Guttapercha(GP) (96.4%). Overall, site and type of cavity (22.5%) and material properties (19%) were considered during selection.Conclusion: Kenyan dentists have access to modem direct restorative and root filling materials. Although RC is used more frequently in permanent dentition, DA is still preferred for posterior restorations while GIC is used more frequently in deciduous dentition; further, majority use GP for root fillings