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This paper describes the prevalence and severity of gingival recession in Tanzanian adults covering the age range from 20 to 64 years. In addition, it attempts to assess the relationship between the degree of gingival recession and the presence and amount of calculus. In the 20-34 years age group recession occurred in > or = 32% of the buccal, > or = 25% of the lingual, and > or = 13% of the approximal surfaces. These %s increased to > or = 64%, > or = 52%, and > or = 48%, respectively, in the 45-64 years age group. In the 20-34 years age group, lingual surfaces of mandibular incisors and canines followed by buccal surfaces of these teeth were the sites most severely affected with gingival recession. With increasing age, all sites became gradually more severely affected, particularly the buccal and lingual surfaces of the maxillary first molar. The lingual surfaces of mandibular incisors exhibited on an average 1.3 mm, 2.4 mm and 3.2 mm recession in the 20-34 years, 35-44 years and 45-64 years age group, respectively. Most of the correlation coefficients between gingival recession and calculus at the individual tooth surface in three age groups were statistically significant. The highest correlation coefficients (0.50-0.67) were found in the youngest (20-34 years) age group at the lingual surfaces of the mandibular incisors, canine and first premolar and at the buccal surfaces of the mandibular incisors. Based on these findings, the working hypothesis is advanced that longstanding calculus is an important determinant in the onset of gingival recession at sites exhibiting pronounced recession at a young age in populations deprived of prophylactic dental care.

In 1984, 1986 and 1988 a mixed-longitudinal study was carried out to determine the prevalence of plaque, calculus, gingival bleeding and type of tooth cleaning device amongst school children in Morogoro, Tanzania. The background parameters considered were age, geographical location and sex. The reproducibility of the methods of diagnosis was assessed. In general, more children possessed a chewing stick than a toothbrush, except urban children. The prevalence of visible plaque decreased and the prevalence of calculus increased with increasing age. Gingival bleeding was not age-dependent. Urban children had significantly more surfaces covered with visible plaque, but had a significantly lower prevalence of calculus, than rural children. Boys showed a significantly higher prevalence of visible plaque and calculus than girls. In the majority of those with gingival bleeding, only 1 of the 6 examined papillae was involved, most often the mesio-lingual papilla of the 3.6. The children had not been subjected to organized oral health care and professional intervention. The findings of the study indicate the need for organized school-based oral hygiene programmes in the area in order to improve the periodontal health of these children.

The purpose of this study was to investigate the relationship between clinical parameters and periodontitis in a population receiving no regular prophylactic dental care. From a sample of 164 adult rural and urban Tanzanian subjects aged between 30 and 44 years, 16% were identified with periodontitis according to the criteria that at least three teeth had a probing depthor = 6 mm. Subjects with periodontitis in this sample exhibited a much higher bleeding tendency (at sites where periodontal pockets and did not exist) than subjects without periodontitis, but dental plaque scores were comparable. Sensitivity and specificity values and odds ratios indicated a strong association between bleeding on probing and the presence of periodontitis. This may indicate that people from a population deprived of regular dental care with a high tendency of bleeding on probing are more prone to develop periodontitis. Whether bleeding on probing could serve as a marker in this population to identify subjects who develop future periodontal destruction has to be explored through further longitudinal studies.

In 1984, a four-year mixed-longitudinal study of oral health was begun in Morogoro Town and Morogoro District, Tanzania. Its main goal was to detect a possible upward trend in prevalence of caries in child cohorts in this developing country. The sample consisted of 722 seven-to nine-year-olds in 1984, 833 seven- to 11-year-olds in 1986, and 989 seven- to 13-year-olds in 1988. Mixed-longitudinal studies provide the opportunity for application of the Age-Period-Cohort analysis. On the basis of external information, either age and/or cohort and/or period effects can thus be isolated. Apart from significant age and period effects, a cohort effect was found, indicating that the prevalence of caries has decreased in these child populations between 1984 and 1988.

A study to assess the prevalence and severity of periodontal conditions among 809 adults in Tanzania was carried out in 1982 in Morogoro District. The prevalence of plaque (99.6%), calculus (95, 7%) and gingivitis (93.8%) among them was high. The mean number of teeth per person with pockets between 3.5 and 5.5 mm was 3.5 for the urban and 4.2 for the rural population. Pockets of more than 5.5 mm were found on average in 0.1 (urban) and 0.2 (rural) teeth per person. In the 45+ age group on average 3.0 teeth per person were missing in urban areas and 6.9 teeth in rural areas. There were no statistically significant differences found in periodontal conditions between urban and rural adults, except for the 45+ age group. In this age group a higher mean number of teeth per person with recession, calculus, pockets, gingivitis and missing were found among the rural than the urban population. The study suggests that high prevalence of plaque, calculus and gingivitis at a young age. if untreated, does not lead for all persons to severe periodontal breakdown with ultimately tooth loss in old age in this population. Effects of the study in terms of planning primary health care teaching programs have been presented.