Search

Background: There is hardly any information regarding oral health status of handicapped primary school pupils in Tanzania. Determination of their oral health status could help in planning sustainable intervention programmes for this disadvantaged group., Objectives: To determine caries and periodontal status and treatment needs of handicapped primary school pupils in Dar es Salaam, Tanzania., Design: A descriptive cross-sectional study., Setting: Uhuru Mchanganyiko and Buguruni special schools, Dar es Salaam., Results: The sample consisted of 179 (55.8%) males and 142 (44.2%) females aged between 7 and 22 years. Majority (71%) were deaf followed by blind (17.8%) and mentally retarded (8.7%). Six (1.9%) pupils were both deaf and blind, while one (0.3%) pupil was blind and mentally retarded. Forty one (12.8%) pupils had at least one decayed deciduous tooth, with the mean (dmfs) ranging from 0.25 to 3.24. The deaf had the highest mean decayed surfaces, followed by the mentally retarded and the blind. There was only one (0.3%) pupil who had a filled deciduous tooth. Thirty three (10.3%) pupils had decayed permanent teeth and 31 (9.7%) had missing permanent teeth. None of the decayed permanent teeth were restored. The blind had the lowest mean deciduous surfaces (DS) scores of between 0 and 1.0. In the mentally retarded group the mean DS ranged from 0.25 to 1.75. About 73.5% of the studied group had bleeding of the gums, with the blind having the highest mean bleeding index scores (p < 0.001) and about 82.8% of the pupils had calculus, with highest mean scores mainly among the blind (p = 0.008)., Conclusion: The caries prevalence among handicapped primary school pupils was quite low. However, there was relatively high level of gingival bleeding and calculus. Regarding treatment needs, 23% required dental fillings mainly of one and two surface restorations and 82% required scaling and polishing. Despite these treatment needs these pupils had not received any dental attention.

Objective: The aims of the cohort study were to study the association between permanent dentition caries and malnutrition and other risk factors or indicators in a group of children with little or no access to restorative and preventive dental care., Methods: The study was conducted at two primary schools in Dar es Salaam, Tanzania in the period 1997-2003. One school recruits its children from affluent families and the other school is attended by the children of poor families. The children attended grade 1 at the first examination and had a mean age of 7.6 years (SD = 0.4); when the study was completed, the mean age was 13.3 years. Two-hundred and eighteen children examined in 1997 were re-examined in 1999; 147 of the children were examined in 1997 as well as in 2003, and 122 children were examined in all three years. An age- and sex-based body mass index (BMI) was computed to determine the nutritional status of each child. Each year, the same standard methods were used to determine the count of lactobacilli and mutans streptococci, stimulated flow rate and buffering capacity of saliva, and caries. Risk ratios were computed with generalized linear models using the tooth as the unit of analysis., Results: Mean annual caries increment was 0.27 in the period 1997-1999 and 0.80 in the period 1999-2003 with most children developing no caries at all. Malnutrition at baseline in 1997 was insignificantly predictive for the development of caries, whereas a low stimulated flow rate of saliva (< or =0.7 ml/min) and a high count of lactobacilli (> or =100,000/ml) at baseline in 1997 were significantly associated. However, the generalized linear models for the two time periods 1997-1999 and 1999-2003 presented a confusing picture with different risk ratios and without consistency of the associations between the exposure variables and the development of caries. In accordance with this finding, the consistency of the exposure variables over time for the individuals was very low., Conclusions: The results were inconclusive and left us with more questions than answers. The findings do, however, support the view that our methods for predicting caries are inappropriate or nonexistent.

Background: Data on caries are usually collected with the tooth surface or the tooth as the unit, but subsequently analysed by aggregating the data at the level of the individual., Aims: To evaluate how different units of analysis may affect the result of the statistical analyses in a study of the association between deciduous dental caries and a set of risk factors., Method: 293 children (mean age: 7.5 yrs) from two primary schools in Dar es Salaam, Tanzania were examined. Thus the study design was cross-sectional. Logistic regression analysis was used to determine the association between caries experience and nutritional status, socioeconomic background, and microbiological and salivary characteristics using the subject, the tooth, and the tooth surface as unit of analysis, allowing for the fact that teeth and surfaces within the same individual must be considered non-independent., Results: When aggregated data were used, point estimates were larger in some instances. The precision of the estimates increased considerably when the tooth as compared to the individual was used as the unit of analysis. No or limited gain in precision was obtained when the tooth surface as compared to the tooth was used as unit of analysis., Conclusions: The choice of unit of analysis may strongly influence the result of the statistical analyses and thus the conclusion of an investigation.

Objective: To describe the occurrence of dental caries in Danish children and adolescents from 1988 to 1997., Design: Cross-sectional data collected by the Danish National Board of Health., Results: The earlier trend of a marked annual decline in caries now appears to have halted, especially in respect of the permanent dentition of 7-year-old children. The distributions show marked positive skewness for all age groups, which may give rise to considerations of implementing high risk strategies in order to obtain further reductions in DMFS in the population., Conclusion: Calculations indicate, that the effect of a hypothetical high risk strategy on the occurrence of caries at the population level will be limited.

The present study was conducted in two regions of Tanzania, where development of oral health services is supported by the Danish International Development Agency (Danida). The study comprised 6035 subjects in five age groups (5-6 yr, 12 yr, 18 yr, 35-44 yr, 55+ yr). Data were collected using WHO's survey methodology. Dental caries affected the primary dentition of one third to one fourth of the 5-6-yr-olds and mean dft was less than 1.0 in both regions. DMFT for 12-yr-olds was also low (< 1.5 DMFT), but was higher in older age groups, mainly due to more missing teeth. The F-component was negligible in all age groups. Treatment need was mainly simple fillings and extractions. Most periodontal sextants in all age groups were affected by bleeding or calculus. Periodontal pockets were rare and loss of teeth limited. It is concluded that the oral health situation in Tanzania is better than that foreseen in the goals for oral health in Tanzania in the year 2002. On the basis of these findings and the severe economic constraints prevailing within the health services in Tanzania, a revision of The National Plan for Oral Health seems urgent. A realistic estimate of the cost and the possible sources of funding of the plan is mandatory.

The present study describes the experiences and results of the first 5-year period of a municipal dental clinic offering free dental care to drug addicts. One of the many problems was the instability of this socially deprived group whose erratic life style made it impossible to maintain regular dental care. The DMFS level of the drug addicts was 50.2 and mean caries increment per yr was 2.5 (1.3 new surfaces and 1.2 surfaces with recurrent decay). The caries increments among the present drug abusers and the individuals on methadone maintenance were higher than among the previous drug addicts, 3.1 and 1.3 surfaces per yr respectively, but this difference was not statistically significant. Only slight improvement in oral hygiene (VPI) could be demonstrated whereas gingivitis (BI) remained unaltered. Traumatic injuries of the orofacial region were frequent. The mean time expenditure concerning dental treatment was 5 hr per individual in the initial treatment phase but decreased to 1-2 h per individual per yr. Broken appointments and last minute cancellations were as a rule related to drug/alcohol abuse. The mean number of fillings was 8.2 per individual in the initial treatment phase and 1.7 per yr for individuals in a maintenance phase. The poor dental health of the drug addicts seems closely related to their life style habits and the clue to an improvement would probably follow the cure of the drug abuse and a concurrent resocialization. [ABSTRACT FROM AUTHOR]

The present study was undertaken to investigate the dental health of a group of parenteral drug addicts. The study population comprised 134 persons with a mean age of 25 yr (mm. 18, max. 37) examined in 1977-81. Mean DMFT was 18.3 and mean DMFS was 50.2, approximately twice as much as found in comparable age groups in Denmark. Even free smooth surfaces were often involved. The oral hygiene was measured by the use of the Visible Plaque Index (VPI) and the Bleeding Index (BI). Both indices were high, mean VPI = 77.4 and mean BI = 71.3. 12-40% of the teeth selected had a loss of periodontal attachment of more than 4mm. It is suggested that not only drug abuse, but also factors like low social status, low education and different barriers towards receiving dental treatment should be considered in a multifactorial cause-effect relationship. The effect of offering a free dental care system for this high-risk group will be dealt with in another paper. [ABSTRACT FROM AUTHOR]