Comparison of the prevalence of dental caries in 12-15 year-old children with dental fluorosis and those without dental fluorosis from Juja in rural Kenya

Objective: To determine any association between varying degrees of dental fluorosis and dental caries in children aged 12-15 years in a rural community in Kenya.Design: Descriptive cross-sectional study.Setting: A rural school in the central province of Kenya.Subjects: Two hundred and twenty five primary school children aged 12-15 years consisting of 100 males and 125 females.Results: A total of 225 children were included in the study, of these 125 were males and 100 were females and the age range was 12-15 years with a mean of 13.28 + 1.11SD. The prevalence of caries was 39.1% and the mean DMFT of the sample population was 1.51 + 2.25SD. The mean decayed component was 1.48 and none of the children had any filled teeth. The mean DMFT of the children with fluorosis and those without fluorosis was 1.44 and 1.55 respectively.Conclusion: There was no association between dental fluorosis and dental caries. Though there was no association between dental fluorosis and caries experience

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

Two-year survival of glass ionomer sealants placed as part of proximal atraumatic restorative treatment restorations

Objective: To evaluate after two years, the survival rate of glass ionomer cement (GIC) sealants placed in primary molars of six to eight year-olds and as part of proximal atraumatic restorative treatment (ART) restoration.Design: A longitudinal clinical study.Setting: Matungulu/Kangundo rural divisions, Machakos district, Kenya.Subject: A total of 804 six to eight year-olds from rural Kenya received a sealant as part of a proximal restoration placed in a primary molar using the atraumatic restorative treatment (ART) approach.Results: The two-year cumulative survival of the sealants was 10.9%, and the survival of the sealants was not significantly affected by the GIC material brand and the toothisolation method used. However, slightly more sealants survived when Fuji IX and rubber dam tooth- isolation method were used.Conclusion: The two-year survival rate of the sealants was poor and was not significantly influenced by the GIC material or the tooth-isolation method used

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

Factors influencing behaviour patterns in 3-5-year-old children attending three public paediatric dental clinics in Nairobi, Kenya

Objective: To determine factors that influence behaviour patterns in 3-5year olds attending paediatric dental clinics.Design: A descriptive cross-sectional study.Setting: The School of Dental Sciences, University of Nairobi Dental Hospital,Kenyatta National Hospital, Dental Clinic, and the Lady Northey Children’s ClinicSubjects: Three hundred and thirty children aged 3-5 years who had been accompanied by their parents/guardians.Results: Among the 330 children (174males and 156 females) examined those with ‘Definitely negative’ behaviour observed were 33 (10%) of the children, while 94 (28.5%) had ‘negative’ behaviour, 108 (32.7%) had ‘positive’ behaviour and 95 (28.8%) had ‘definitely positive’ behaviour. There was no relationship between child behaviour and previous clinical experience of the parent/guardian (p=0.21). The older children were significantly better behaved than the younger children (p=0.04). There was a significant relationship between child behaviour exhibited and previous clinical experience of the child (p=0.004). Parents/guardians were accurately able to predict the behaviour of their children in the clinic (p=0.00).Conclusion: Positive behaviour was significantly related to the age of the child and parents were able to accurately predict the behaviour of their children. Behaviour was also significantly related to previous clinical experiences of the child. Hence the dentists management of the child may result in negative or positive behaviour

EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2013 . Scientific opinion on Dietary Reference Values for fluoride

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) derived Dietary Reference Values (DRVs) for fluoride, which are provided as Adequate Intake (AI) from all sources, including non-dietary sources. Fluoride is not an essential nutrient. Therefore, no Average Requirement for the performance of essential physiological functions can be defined. Nevertheless, the Panel considered that the setting of an AI is appropriate because of the beneficial effects of dietary fluoride on prevention of dental caries. The AI is based on epidemiological studies (performed before the 1970s) showing an inverse relationship between the fluoride concentration of water and caries prevalence. As the basis for defining the AI, estimates of mean fluoride intakes of children via diet and drinking water with fluoride concentrations at which the caries preventive effect approached its maximum whilst the risk of dental fluorosis approached its minimum were chosen. Except for one confirmatory longitudinal study in US children, more recent studies were not taken into account as they did not provide information on total dietary fluoride intake, were potentially confounded by the use of fluoride-containing dental hygiene products, and did not permit a conclusion to be drawn on a dose-response relationship between fluoride intake and caries risk. The AI of fluoride from all sources (including non-dietary sources) is 0.05 mg/kg body weight per day for both children and adults, including pregnant and lactating women. For pregnant and lactating women, the AI is based on the body weight before pregnancy and lactation. Reliable and representative data on the total fluoride intake of the European population are not available

Dental Fluorosis, Caries Experience And Snack Intake Of 13-15 Year Olds In Kenya

Objectives: To determine the dental caries experience in relation to the severity ofdental fluorosis and; to evaluate the dietary snacking habits of adolescents.Design: A descriptive cross-sectional study.Setting: A peri-urban primary school in Nairobi, Kenya.Subjects: Two hundred and seventy five adolescents aged 13-15 years among whom128 were males and 149 were females.Results: Two hundred and seventy five adolescents were examined for varying degreesof dental fluorosis according to the Thylystrup Fejerskov Index (TFI) scores and thedental caries was determined in the four first permanent molars. One hundred and fiveindividuals were found to have had a TFI score of zero with a corresponding decayedmissing and filled teeth (DMFT) for dental caries of 1.30±1.03 and 88(52%) individualshad mild to moderate severity of dental fluorosis (TF scores 1-4) and had a correspondingmean DMFT of 1.53±1.005 for dental caries. Furthermore, 82(48.2%) adolescents hadsevere degrees of dental fluorosis of TFI scores 5-9 and had a corresponding DMTFvalue of 1.85+1.24 for dental caries. When the prevalence of dental caries was comparedamong individuals with TFI scores zero (non-fIuorosed teeth) with those who hadfluorosed first permanent molars the Chi square test showed that there was a highstatistical significance with a p-value of 0.001 (P=0.005). Amongst the 175 adolescentswith varying degrees of severity of dental fluorosis it was noted that 44(26%) did notlike taking snacks and had a DMFT of 1.54+1:1.17whi1e 126(74%) adolescents whoenjoyed taking snacks had a DMFT of 1.64+1.08. However, there was no statisticalsignificance.Conclusion: While there was a statistically significant association between the severityof dental fluorosis and caries experience among the participants in the present study,there was no co-relation between the caries experience and snacking habits amongthose who had varying degrees of dental fluorosis

The significance of fluoride in Kenyan Water and tea leaves in relation to fluoresis and its effect on the enamel structure and restorative dentistry in general

Includes photographs.Thesis (M.Sc.D.)--Boston University, Henry M. Goldman School of Graduate Dentistry, 1984 (Pedodontics)Bibliography : leaves 215-237.SECTION A In this study, 21 water samples obtained from springs, wells and boreholes were analyzed for fluoride using the fluoride electrode. Each water sample had a volume of 250ml. Spring water was found to have a fluoride concentration range of 0.2 - 1.2 ppm. Well water had a fluoride concentration range of 0.2 - 0.3 ppm. Borehole water was obtained from Nakuru and Naivasha in the Rift Valley and had a fluoride concentration range of 1.0 to 9.3 ppm. Concentrations above 1 ppm are considered high. Endemic dental fluorosis is of public concern in Kenya and has been associated with the high fluoride levels in domestic water. An analysis of tea infusions brewed from loose Kenyan tea having a mean weight of 3.9 grams in 195 ml of deionized water (equivalent to a regular cup of tea) showed 5 ppm fluoride. The tea infusions had been prepared in a manner similar to the way most Kenyan families brew tea, by boiling for a short period after placing the tea leaves in boiling water. In this study, the tea was boiled for 10 seconds. The tea was then steeped for 4 minutes prior to sieving the tea leaves. This indicates that an individual ingesting a cup of tea (195 ml) will have a fluoride intake of 980 [mu]g. The Kenyan tea bags with an average weight of 1.8 grams, yielded an average fluoride concentration of l.9 ppm fluoride. A cup of tea (195 ml) brewed from Kenyan tea bags yielded a mean fluoride concentration of 380 [mu]g. Extended boiling resulted in high concentrations in the tea being brewed. The fluoride concentration increased after boiling for 30 seconds then boiling for 5 minutes without steeping from 4.2 ppm to 16 ppm fluoride. The American Salada tea had a mean fluoride concentration of 520 [mu]g in 195 ml. Water and tea are sources of fluoride in Kenya that contribute to the development of unaesthetic fluorosed teeth observed in part of the population. In particular, it may be noted that many Kenyan children drink tea. Magnesium oxide and bone meal were used as chemical defluoridating agents to reduce excessive amounts of fluororide from artificial water samples which had been prepared to simulate Kenyan water samples with a fluoride concentration range of 1 – 9.3 ppm. These defluoridation procedures if utilized in rural areas will reduce the excess fluoride in borehole water to beneficial nontoxic levels. SECTION B The acid etch technique was employed on 8 "normal" American teeth, 8 "normal" Kenyan teeth, 8 moderately and 8 severely fluorosed teeth also from Kenya. The etching period ranged from 0 - 360 seconds. The enamel surface was observed in the scanning electron microscope. The ideal etching time for American normal teeth was found to be 60 seconds. The Kenyan normal teeth had an ideal etching period of 120 seconds. The fluorosed teeth had an ideal etch pattern at 180 seconds prior to grinding and 120 seconds after grinding. The predominant etch patterns were Class I and II even at etching times of 30 seconds. The enamel surface of normal American teeth appeared excessively etched at 120 seconds, normal Kenyan teeth had an apparent excessive etching of the enamel surface after 240 seconds. The fluorosed Kenyan teeth prior to grinding appeared excessively etched after 360 seconds. After grinding, there was no apparent extensive damage to the enamel surface after an etch period of 360 seconds. The brown staining of fluorosed enamel was macroscopically noted to reduce in intensity after grinding and polishing the enamel surface with a green stone and pumice. Acid etching for 150 seconds further produced a reduction in the intensity of the brown staining and improved the aesthetics. In the scanning electron microscope, the dark areas (areas of lower electron emission) macroscopically corresponded to the brown discoIored enamel in unground and unetched enamel surfaces. After grinding and without etching the dark area was reduced in size. The etched enamel had a similar changed appearance. Thus it appears that the changes in the enamel extend deeply into the enamel. “Craters" where enamel was lost were noted in a number of fluorosed teeth. The crater areas were generally poorly etched. This may be due to the inaccessibility of the area bordering the non-cratered enamel and the cratered enamel. The etch pattern in the cratered enamel had a moth-eaten appearance. The base of the crater had an ideal etch pattern class II after 360 seconds etching period. Removal of the surface enamel by grinding resulted in a surface exhibiting less discoloration and fewer craters. The etch pattern was evenly distributed after an etching period of 360 seconds. The enamel defects create a clinical problem of a possibly inadequate enamel etch which may cause clinical failure of the composite restorations. The brown staining is apparently deeply ingrained in the structure making gross grinding a destructive and inadequate way of improving the aesthetics of these teeth. Further more grinding may result in sensitivity. A combination of slight grinding approximately 1/10 mm of enamel polishing with the green stone, then applying the acid etch technique in conjunction with composite resins may greatly enhance the aesthetics. The experimental tensile bond strength tests were performed using the Instron machine and involved 120 specimens of an equal number of American, Kenyan normal and Kenyan fluorosed teeth. The mean experimental tensile bond strength for American teeth was 59. 08 [plus or minus] 15.81 Kg/cm2, Kenyan normal teeth 41.52 [plus or minus] 14. 64 Kg/cm2, and Kenyan fluorosed teeth prior to grinding 49.20 [plus or minus] 17.67 Kg/cm2. The coefficients of variation were 27 percent for normal American teeth, 35 percent for normal Kenyan teeth, 36 percent for Kenyan fluorosed teeth prior to grinding and 35 percent after grinding. There was an increase in the adhesive bond strength for fluorosed teeth after grinding and polishing with green stone and then pumice to a gloss (58.84 [plus or minus] 20. 65 Kg/cm2). The respective etching times were 60 seconds, 60 seconds, 150 seconds and 150 seconds, for American normal teeth, Kenyan normal teeth and for fluorosed teeth prior to and after grinding. The Kenyan normal teeth had a lower tensile bond strength than the American or Kenyan fluorosed teeth probably due to inadequate etching. Currently, composite materials may be employed with the acid etch technique to restore the unaesthetic teeth and the tooth morphology of fluorotic teeth. In this study, the use of the acid etch technique and composite restoration materials improved the tooth morphologγ and enhanced the aesthetics of these severely fluorosed teeth

Phytochemistry of Homalium zeylanicum (Flacourtiaceae) and Serjania salzmanniana (Sapindaceae).

Phytochemistry of Homalium zeylanicum (Flacourtiaceae) and Serjania salzmanniana (Sapindaceae)