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The tongue flap is a suitable alternative to local mucoperiosteal flaps in closure of wide, persistent oronasal communications, surrounded by scarred and fibrotic tissue as a result of previously attempted palatoplasty. Herein, we report two cases with large recurrent oronasal communication closed using the anteriorly based dorsal tongue flap., Competing Interests: The authors declare that there is no conflict of interest., (© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Alveolar bone grafting is a complex procedure utilized in alveolar cleft repair; however, the ideal site of bone graft material remains highly debated. In this study, we describe the management of a 14-year-old girl with bilateral alveolar clefts using alternative intraoral donor sites for bone graft harvest., Competing Interests: The authors declare that there is no conflict of interest., (© 2021 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Background: Soil-transmitted helminths and schistosomiasis are mostly prevalent in developing countries due to poor sanitation and lack of adequate clean water. School-age children tend to be the target of chemotherapy-based control programmes because they carry the heaviest worm and egg burdens. The present study examines adverse events (AEs) experienced following co-administration of albendazole and praziquantel to school-age children in a rural area in Kwale County, Kenya., Methods: Children were treated with single doses of albendazole and praziquantel tablets and then interviewed using a questionnaire for post treatment AEs., Results: Overall, 752 children, 47.6% boys, participated in the study. Their median (interquartile range) age was 12.0 (10.0-14.0) years. A total of 190 (25.3%) children reportedly experienced at least one AE. In total, 239 cases of AEs were reported with the most frequent being abdominal pains (46.3%), dizziness (33.2%) and nausea (21.1%). Majority of the reported AEs (80.8%) resolved themselves while 12.1% and 6.3% were countered by, respectively, self-medication and visiting a nearby health facility. More girls (60.5%) than boys (39.5%) reported AEs (P = 0.027)., Conclusions: The AEs were mild and transient, and were no worse than those expected following monotherapy. The current study adds to the evidence base that dual administration of albendazole and praziquantel in school-based mass drug administration is safe with only mild adverse events noted.

The study aimed to describe the effect of an oral health education intervention on oral hygiene status and gingival inflammation among persons with HIV attending two comprehensive healthcare centres in Nairobi, Kenya. This was a quasi-experimental study of 195 participants (with 102 in the intervention group, and 93 serving as the control group) who were selected using stratified random sampling. The data were collected at baseline, at three months (review 1), and at six months (review 2) using an interviewer-administered World Health Organization clinical examination form. The prevalence of plaque among the participants in the intervention decreased from 70.6% to 18.6%, with a significant decrease in their mean plaque score, from 0.89 to 0.15. The prevalence of gingival inflammation in the intervention group decreased from 58.2% to 12.7%, with a significant decrease in the mean gingival score, from 0.66 to 0.11. No significant change in degree of oral hygiene and gingival inflammation was observed among the non-intervention group. There was a strong association between the change in the mean gingival score and the change in the mean plaque score between baseline and at six months for the intervention group. The regression analysis yielded a coefficient of determination (r2) of 0.76; therefore, 76% of the variation in change in gingival score was explained by the variables in the equation. Only the change in mean plaque score was a significant predictor of the change in gingival score.

Objective: To assess the effect of oral health education on knowledge and oral health seeking behaviour of persons living with HIV/AIDS (PLWHA)., Methods: Quasi-experimental study design conducted among 195 Persons living with HIV/AIDS attending two Comprehensive Care Centres (CCC) at the Kenyatta National Hospital (intervention group) and Mbagathi district hospital (non-intervention group) in Nairobi Kenya. The participants were selected using systematic random sampling method and data collected using a questionnaire. Data was collected at baseline, at three months (review 1) and at six months (review 2)., Results: There was a significant change in oral health knowledge for KNH participants. However, no significant change in oral knowledge was recorded for MDH participants. The proportion of participants who brushed their teeth at least twice a day increased significantly from 52% to 88% for KNH. The proportion of those who had brushed the previous evening increased from 47% to 83.2%. There was no significant change in the proportion brushing at least twice a day among the non-intervention group. There was a significant association between change in knowledge and change to brushing at least twice a day among the intervention group., Conclusion: Oral health education led to improved oral health knowledge and oral hygiene practices among PLWHA.

Objective: To determine the prevalence, severity and pattern of early childhood caries (ECC) in Moshi Municipality, Tanzania., Design: Cross-sectional study., Setting: Moshi Municipality, Kilimanjaro region, Tanzania., Subjects: Three hundred and seventy two randomly selected children aged three to five years (157 males and 215 females) in 2008., Results: Overall caries prevalence was 30.1% with no significant gender difference (p>0.05). The severe form of ECC that attacks primary maxillary incisors occurred in 21.2% of the children. The mean dmft score was 0.95 (SD +/- 1.81). The decay component was 0.87 (SD +/- 1.71), whereas the missing component was 0.08 (SD +/- 0.41). There was no significant gender difference in the mean dmft scores (p>0.05). Among the posterior teeth, mandibular last molars had the highest caries prevalence (12.4%) and for the anterior teeth, the maxillary central incisors had the highest caries prevalence (21%). Majority of the affected children had three or less teeth affected. The sample mean plaque score was 0.57 (SD +/- 0.46) with no statistical gender difference (p>0.05). A total of 174 (46.8%) parents/guardians responded to the questionnaire. Caries risk and experience was significantly higher in children with guardians and in children with history of falling asleep with the breast in the mouth respectively (p<0.05)., Conclusion: Most of the affected children had ECC in the anterior and posterior segments. In the anterior segments, the maxillary teeth were affected more frequently than the mandibular teeth, while in the posterior segments the mandibular teeth were more frequently involved than the maxillary teeth. Significantly higher caries prevalence was found in children under the care of the guardians, children who had slept with breast in the mouth and those with higher sugar moments as the result of snacking.

Objective: To assess the morphological and functional traits of malocclusion., Design: Cross-sectional study., Setting: Moshi Municipality, Kilimanjaro region, Tanzania., Subjects: Examination for occlusal traits was done on 372 randomly selected 3-5-year olds (157 males and 215 females)., Results: The overall prevalence of malocclusion was 26.9%. Females had significantly more occlusal anomalies than males. The flush terminal plane (93.8%) was the commonest anteroposterior relation. Excessive maxillary overjet and deep-bite occurred in 5.1% and 21.5% of the children respectively. Reverse overbite (1.9%), frontal open-bite (1.6%), lateral open-bite (0.8%) and posterior cross-bite (0.3%) were relatively rare. Harmful oral habits were uncommon in this population. The sample mean for inter canine width in the maxilla was 31.1 mm (SD +/- 2.72) and for the mandible 25.3 mm (SD +/- 2.46). Lack of natural spacing in the anterior segment of the maxilla occurred in 34.4% of the children and 33.6% in the mandible., Conclusion: Generally, females had significantly more occlusal anomalies than males. The flush terminal plane was the commonest anteroposterior finding. Lack of natural spacing in the anterior segments and deep bite were common.

Introduction: Our objectives were to determine whether observer and patient sex and race or ethnicity determine esthetic preferences for lip positions., Methods: Four independent panels each consisting of 30 lay judges viewed pretreatment silhouette profiles of 10 European American, 10 Japanese, and 10 African American Angle Class I and Class II orthodontic patients. The panels included European Americans, Hispanic Americans, Japanese, and Africans. Profiles were traced from lateral cephalograms and manipulated so that the lip profile lay on the Ricketts' E-line or at various distances from the E-line from -8 to +4 mm in 2-mm increments. The judges selected the profile that they considered the most attractive and then classified the remaining 6 profiles as either acceptable or unacceptable., Results: The mean preferred lip positions (mean +/- SD) were -2.58 +/- 1.92 mm for European American, -3.28 +/- 2.26 mm for Hispanic American, -3.45 +/- 1.92 mm for Japanese, and -2.13 +/- 1.95 mm for African judges. The African judges preferred more protrusive profiles compared with the Hispanic American (P <0.01) and Japanese (P <0.001) judges. Patient race or ethnicity and sex also contributed significantly to the judgments of profile esthetics (P <0.001)., Conclusions: Judge race or ethnicity and patient race or ethnicity and sex significantly influence laypersons' standards for lip profile esthetics.

Objective: To assess malocclusion and orthodontic treatment needs among 12-15-year-olds in Moshi municipality, Tanzania., Design: A cross-sectional study., Setting: Moshi municipality, Tanzania., Subjects: Two hundred and eighty nine randomly selected primary school children in Moshi municipality in the year 2003., Results: Maxillary median diastema occurred in 20.1% of the children. Crowding and spacing in the incisor segments occurred in 41.2% and 28.4% respectively with significantly more crowding in males than in females (p = 0.009). Anterior irregularities occurred in 46% of the sample in the maxilla and 51.6% in the mandible. These irregularities were significantly more common in the females than in males in the maxilla and mandible (p = 0.014, p = 0.037 respectively). Reverse overjet was extremely rare (0.3%). Anterior openbite and antero-posterior molar relation discrepancies occurred in 6.2% and 32.5% of the sample, respectively. Crowding, irregularities in the incisor segments and antero-posterior molar relation discrepancies were dominant malocclusion traits in this population. The sample mean DAI score was 24.6 points (CI 95% 23.86-25.36). There was no statistically significant gender difference of DAI scores (p = 0.473). About 65% of the subjects had either no need or had slight need for treatment whereas 35.3% were found with orthodontic treatment needs ranging from elective (21.5%), highly desirable (6.9%) to mandatory (6.9%). There was no significant gender difference in the categories of treatment need (p = 0.942). Unmet orthodontic treatment needs were present in this population with a very small proportion of subjects exhibiting handicapping malocclusion., Conclusion: The information from this study forms part of the basis not only for further research, but also for planning orthodontic care in this community where unmet orthodontic treatment needs are present.

Objective: To assess awareness and concern about malocclusion in 12-15 year-olds in Moshi, Tanzania., Design: A cross-sectional study., Setting: Moshi Municipality in Kilimanjaro region, Tanzania., Subjects: Two hundred and ninety eight randomly selected Public primary school children aged 12-15 years (158 males and 140 females)., Results: About 56% of the respondents thought their teeth were properly aligned. However only 29.1% of the respondents reported being dissatisfied with the way their teeth appeared in their mouth. About 25% of the respondents found their teeth to have been worse than most of their age-mates. Children who reported to have been teased due to their malocclusion comprised 25.8%. Those who thought it was unpleasant to stay with malaligned teeth constituted 55.7% of the respondents. Subjective orthodontic treatment need was reported by 69.1% of the sample. Majority of the children (75%) were ready to accept orthodontic treatment. There were significant correlations between factors of awareness and those of concern about malocclusion among the subjects., Conclusions: In spite of very little orthodontic treatment exposure in this population, awareness and concern about malocclusion was reported by a significant proportion of the children. These findings form a baseline line for future studies on the trends of awareness and concern towards malocclusion in this population. They will also be useful in the planning of orthodontic services in Tanzania.

Objective: To determine the dietary patterns and nutritional status of pre-school children in Nairobi, Kenya., Design: A cross-sectional study., Setting: Pre-schools in Nairobi, Kenya., Subjects: Three hundred and four pre-school children (149 males and 155 females) aged three to five years were assessed., Results: About 96% of the children had been breastfed 46.7% of them for 12-24 months (46.7%), and the mean breastfeeding duration was 20.17 months. The most commonly consumed foods on a daily basis were fruits, vegetables bread, ugali, porridge and milk. The level of malnutrition was low with underweight at 16% stunting 4.3% and wasting 1.0%. The factors that positively correlated with child nutritional status were the age of the mother and father., Conclusions: The children were consuming a variety of foods both at home and in school, and this together with the high literacy levels the parents/guardians could have contributed towards the good nutritional status.

Objective: To determine the causes and pattern of missing permanent teeth among Kenyans., Design: A descriptive cross-sectional study., Setting: Five districts in Kenya., Subjects: Seven hundred and twenty two persons aged 6-85 years (346 males and 376 females)., Methods: This study was undertaken in October 2001 during the National Dental Health Action Month organised by the Kenya Dental Association. Six centres in five districts were identified and subjects randomly selected. Intra- oral examination was done visually and results were recorded on specially designed clinical examination forms., Results: The mean number of missing teeth in the population was 1.60. Among those with missing teeth, the mean number of missing teeth was 3.35. The most commonly missing teeth were lower molars followed by upper molars. No record of complete edentulousness in both jaws was encountered. Dental caries was the commonest cause of tooth loss (52.6%), followed by periodontal disease (27.6%). Extractions, as a form of traditional practice, accounted for 12.3% of total tooth loss. Orthodontic treatment and trauma accounted for 2.2% and 2.0% respectively of total tooth loss. The upper and lower posteriors were the commonest teeth lost due to dental caries and periodontal disease. Teeth lost due to trauma were mostly upper anteriors, whereas those extracted due to traditional practices were exclusively lower anteriors., Conclusion: The findings of this study show that the commonly lost teeth are molars and the principal cause of tooth loss is dental caries followed by periodontal disease. Overall, very few extractions had been done for orthodontic reasons.

Objective: To evaluate, radiographically, the root forms of maxillary incisors in a sample of patients seeking orthodontic treatment in Nairobi, Kenya., Design: A retrospective study of maxillary incisor root forms based on periapical radiographs., Setting: A private dental clinic in Nairobi, Kenya., Materials and Methods: The study comprised 393 maxillary incisors in 100 consecutive subjects (51 boys, 49 girls) aged 9-24 years. Intra-oral periapical radiographs of the incisors were evaluated. An index was used to categorise the roots as follows: 0=normal, 1=short, 2=blunt, 3=apical bend, 4=pipette apex., Results: Normal root form was recorded in 60%, short in 12.5%, blunt in 7%, apical bend in 13%, and pippete-apex in 7% of the roots. Sixty nine percent of the pippete-apex roots were in central incisors and 94% of the roots with apical bend were in lateral incisors. Seventy three percent of short roots were in females., Conclusion: Based on evidence from previous studies on risk of root resorption which indicates that pipette and blunt roots are the forms mostly involved in this phenomenon, the present data imply that about 14% of the roots may have been at risk of moderate to severe resorption during fixed orthodontic treatment.

Although multiple supernumerary teeth without any associated syndromes are rare, their occurrence can create a variety of clinical problems such as derangement of the occlusion, prevention of eruption of permanent teeth, damage to adjacent teeth, cystic degeneration and root resorption. Hence, clinical and radiographic evaluation of patients should always be thorough in order to detect their presence. Furthermore, because the clinical management of multiple supernumerary teeth poses a great challenge to clinicians, timely, appropriate consultation and interdisciplinary approach to treatment is extremely important. We report two cases, a 14 year-old boy with eight and a 13-year-old girl with seven supernumerary teeth not associated with syndromes. In the boy, the teeth were bilaterally distributed in all quadrants in the premolar regions, and in the girl they were distributed bilaterally in the premolar regions in the mandible and bilaterally distal to the upper third molars. The clinical implications and management are discussed.

Objective: To assess the occurrence of hypodontia (except 3rd molars) in a population of orthodontic patients., Design: A retrospective case study., Setting: Private orthodontic practice in Nairobi, Patients: Six hundred and fifteen orthodontic patients aged eight to fifteen years., Results: Hypodontia occurred in 39 children (6.3%). The missing teeth were observed in 24 males (7.2%) and 15 females (5.3%). Of the children with hypodontia, about 80% lacked one or two teeth, 54% had hypodontia involving anterior teeth, 18% lacked single posterior teeth and 8% had two or more teeth missing in the same quadrant. The highest recorded number of missing teeth in any one individual was seven. The most frequently missing teeth were mandibular 2nd premolars (30%), maxillary 2nd premolars (24%) and maxillary lateral incisors (22%) in that order., Conclusions: Our data for hypodontia were within the wide range reported in the literature. The finding of patients with hypodontia involving the anterior teeth and others missing more than two teeth in the same quadrant was an indication of a great need for orthodontic treatment. The present findings reiterate the neeed for a thorough radiographic evaluation of patients prior to removal of permanent teeth for orthodontic reasons.

The need for orthodontic treatment in Kenya was previously not been investigated. This study was undertaken to assess the need for orthodontic treatment in 13- to 15-year-old children in Nairobi. The objective need was assessed in 919 children by using the Norwegian treatment need index, and the subjective need was assessed in 739 children by using a structured questionnaire. Objective treatment need was recorded in 29% and subjective need in 33% of the children. Less than 1% were allocated the 'very great need' category. Relatively more girls than boys were dissatisfied with the appearance of their teeth, and a significantly higher number of girls (P < 0.001) said they would like to have their teeth straightened. The children's perceived need for treatment correlated significantly with the treatment need index. Fixed appliances were found necessary for correcting malocclusion in 23% of the children and removable appliances in 6%. Future studies in Kenya should be directed at determining the societal perception of malocclusion, upon which treatment standards may be based.

Data on occlusal features and the need for orthodontic treatment in Kenya is scanty. This study was carried out to determine the prevalence of malocclusion in children in Nairobi, Kenya. Nine hundred and nineteen children aged 13-15 years (468 male, 451 female) were examined. The registration method used was that described by Björk et al. The prevalence of malocclusion was 72%. The predominant anteroposterior relationship of the dental arches was neutral occlusion (93%). Specific malocclusion traits were highest for crowding (19%), rotations (19%), posterior crossbite (10%), maxillary overjet (10%), and frontal open bite (8%). There was no statistically significant difference in the overall prevalence of malocclusion between males and females, but some occlusal traits were significantly higher in males. Although the findings indicate that the present population is not characterized by a substantial difference in the overall prevalence of malocclusion compared with other communities, some traits differed in prevalence from those reported elsewhere.

The prevalence of malocclusion in the deciduous dentition of 221 children aged 3-6 years in Nairobi, Kenya is reported. The children were drawn from six randomly selected preprimary schools (kindergarten, nurseries, and pre-units) from different areas of the city. Overall, 51% of the children were found to have some form of malocclusion. Maxillary overjet accounted for 13%, deep bite 13%, dental midline displacement 6%, frontal openbite 12% and anterior crossbite 5%. Anthropoid spaces were observed in 85% of the children, while over 60% had spacing in the incisor region. Straight terminal plane of the deciduous second molars was diagnosed in 53% of the children, mesial step in 43% and distal step occlusion in one percent of the children. The results suggest a need for interceptive orthodontic treatment in some of the children.

The report revisits the role of alcohol in the treatment of paroxysmal trigeminal neuralgia (PTN). The study included 6 patients, 3 male and 3 female, average age 50 years. In 3 cases PTN involved both the infraorbital and mental nerves; in 2 cases the infraorbital alone while one case had buccal branch involvement. In each case 2mls standard Lignocaine was infiltrated at each site followed by 2mls 60% sterile alcohol. All patients reported swelling postoperatively. One case with mental and infraorbital nerve involvement complained of oral dysaesthesia. Another patient with similar involvement failed to respond and developed trismus. Responders remained pain-free for 9 months on average. While paroxysmal trigeminal neuralgia (PTN) has been recognised for centuries, the aetiology and definitive treatment remain obscure. Since this is a debilitating condition, management should aim at improving the quality of life. Alcohol is available, affordable and offers useful results where medical resources provide limited PTN treatment modalities.

A light-curing, fluoride-releasing adhesive (VP 862, Vivadent, Liechtenstein) for bonding of brackets has been produced for inhibition of white spot lesions during orthodontic treatment. The tensile bond strength after 24 hours and 6 months was investigated and compared with two other light-curing adhesives (Transbond, 3M Corp., Monrovia, Calif., and Heliosit-Orthodontic, Vivadent, Liechtenstein) and two chemical-curing adhesives (Concise, 3M, Monrovia Calif., and Saga Bond, Saga Orthodontics, Kongsvinger, Norway). All adhesives produced adequate strength to be recommended for clinical use. The light-curing adhesives produced slightly lower bond strengths after 24 hours and 6 months, except Transbond, which showed an increase in bond strength in this period approaching the two chemical adhesives.

The prevalence of dental caries, malocclusion and fractured incisors was investigated in 245 children from a pastoral community in Kenya. Forty-eight per cent of them were found to be caries-free. The overall mean DMFT was 1.9 (s.d. 2.7). Among those with caries, the mean DMFT was 3.0 (s.d. 2.0). Fifty-eight per cent of the children had malocclusion. Overall, 84% of the sample had Angle's Class I, 11% Class II and 5% Class III molar relation. The prevalence of fractured incisors was 15%. Most of the fractures were in the maxilla and involved enamel only. Minimal treatment had been carried out on the children.

This paper reviews the cariological aspects of fixed orthodontic treatment and discusses the role played by topical fluorides. During fixed orthodontic treatment, carious lesions may occur in the form of white spots. These may constitute an aesthetic problem. The clinical management of white spot lesions remains unresolved. In order to prevent development of these lesions, the use of topical fluorides is advocated. The need for patient co-operation in the use of self-administered topical fluorides is critical. To reduce this critical need, the use of fluoride-releasing orthodontic cements is recommended. The literature suggests that calcium fluoride, which is the major reaction product on enamel during topical fluoride application, plays an important role in the cariostatic mechanism.

The uptake of alkali soluble and alkali insoluble fluoride on and in fluorotic enamel was investigated in vitro. Teeth from Kenya, assigned score 3 in accordance with Thylstrup-Fejerskov's fluorosis index, were used. The enamel was treated with either a neutral 2% NaF solution, a 0.2% NaF solution (pH 5.5), or the supernatant from a 0.1% NaF-containing toothpaste (pH 7). The treatment time was 1 h. The reaction product formed on the enamel was analyzed by KOH extraction and acid etching. Significantly higher amounts of alkali soluble fluoride were formed on the enamel from the 2% and 0.2% NaF solutions, as compared with the control. There was also a significant increase in the firmly bound fluoride after treatment with the neutral 2% NaF solution.

The purpose of this study was to assess the prevalence and severity of dental fluorosis in 513 primary school children in Nairobi. The clinical examination was performed in a room with natural daylight using Thylstrup & Fejerskov's index (TFI). Overall, 18% of 6-8-yr-olds had dental fluorosis in the primary dentition and 76% of 13-15-yr-olds in the permanent dentition. There was no significant sex difference (P > 0.05) in either the prevalence or the severity of fluorosis. In children with mixed dentition, the prevalence and severity of fluorosis was higher in the permanent teeth. In the permanent dentition, no clear difference was demonstrable in the severity between the anterior and the posterior teeth. The degree of fluorosis in most of the children in the area served with river water (0.2-0.4 ppm F-) was of a very mild form. However, in the area served with borehole waters, 48% of the children and 40% of the teeth were found to have TFI scores > or = 5. Measures to reduce dental fluorosis are necessary in the latter area.

The purpose of this study was to record the caries status in children attending public primary schools in Nairobi. The sample comprised 513 children, 262 aged 6-8 years and 251 aged 13-15 years. The children were drawn from six randomly selected schools in the city. Clinical examination was carried out in a room with natural daylight, using the WHO (1977) criteria. Fifty-four per cent of the 6- to 8-year-olds and 50% of the 13- to 15-year-olds were caries-free. The mean dmft in the 6- to 8-year-olds was 1.7, and the mean dmfs was 3.5. The mean DMFT in the 13- to 15-year-olds was 1.8, and the mean DMFS was 2.9. The d- and D-components dominated and were mainly located in the occlusal surfaces. The f-component of the dmft and the F-component of the DMFT comprised 1% and 10%, respectively. There was no statistically significant difference (p > 0.05) in the prevalence of caries between males and females in the younger age group. In the older age group, however, females had a higher (p < 0.05) prevalence than males. In general, the study showed a low caries prevalence in Nairobi children.

Information related to bonding of orthodontic brackets to fluorotic teeth is scanty. The purpose of this study was to compare, in vitro, the tensile bond strength and the bond failure site of brackets bonded directly to fluorotic and nonfluorotic teeth. The etching patterns were also evaluated. The study involved 26 teeth classified as score 3 and 4, and 26 as score 0 with the Thylstrup and Fejerskov's (TF) fluorosis index. In addition to the clinical classification, difference in the concentration of fluoride in the teeth was verified by acid etching. Brackets were bonded with a composite resin after etching the enamel surface with 40% phosphoric acid for 60 seconds. Tensile bond strength was determined with an Instron testing machine. The bond failure site was assessed by the percentage of residue cement on the tooth surface after debonding and the etching pattern by SEM. The mean concentration of fluoride was 2888.5 ppm (SD 1081.7) in the fluorotic teeth and 1227.1 ppm (SD 526.3) in the nonfluorotic teeth. The mean bond strength was 7.8 N/mm2 (SD 1.47) for the fluorotic teeth and 8.6 N/mm2 (SD 2.19) for the nonfluorotic teeth. The difference between the means for bond strength was not statistically significant (p greater than 0.05). Bond failure site was primarily at the bracket-adhesive interface. The mean percentage of adhesive on the enamel surface after debonding was 70% (SD 25.90) for the fluorotic teeth and 75% (SD 24.66) for nonfluorotic teeth. The difference in the means was not statistically significant (p greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

The purpose of this study was to determine the oral health habits and periodontal health among a group of university students in Kenya. The study comprised 243 randomly selected first year students, mean age 23 years, at the University of Nairobi. Questionnaire response showed that 39% of the participants had visited a dentist before, mainly for extraction. Sixteen per cent said they visited a dentist at least once a year and 96% said they brushed daily. Clinical examination was done in a room with natural daylight using the WHO criteria. Plaque was visible on 35% of the surfaces. 11% of gingival sites examined bled on probing. Only one participant had pocket depth greater than or equal to 4 mm. Supra- and sub-gingival calculus was recorded at 18% of index tooth surfaces. The study will be considered as a baseline for later studies on oral health trends in similar populations.

Two hundred and fifty one African children aged 13-15 years were examined for specific intra- and inter-arch malocclusions and tooth loss. The children were from 6 schools randomly selected from 154 primary schools in Nairobi. Overall, 47% of the children were found to have malocclusion, the most frequently encountered anomaly being crowding. Some of the anomalies showed prevalences which differed markedly from those previously reported for American and British Caucasians of comparable age-groups. Nineteen per cent of the children had missing teeth due to caries, 5.6% due to extractions as part of orthodontic treatment and 13% due to other reasons. The mean number of permanent teeth missing due to caries was 0.2, orthodontic treatment 0.1 and due to other reasons 0.2. Almost all the teeth lost as a result of caries were molars and those due to orthodontic indications were premolars. No teeth were recorded as missing due to periodontal disease or trauma. The study indicated a need to exercise caution in trying to relate the numerical values for prevalence of malocclusions in current textbooks to the present population. The results also showed that the proportion of permanent teeth lost was small.

The purpose of this study was to obtain data on the oral hygiene practices, oral hygiene status, and periodontal health among primary school children in Nairobi. The study group consisted of 513 children, 262 aged 6-8 years and 251 aged 13-15 years. The children were from 6 schools randomly selected among the 154 public primary schools in the city. The clinical examination was performed in a room with natural daylight, using the WHO (1980) criteria. Although most of the children reported brushing habits, 75% of the index tooth surfaces in the younger and 55% in the older age group had visible plaque. In both age groups about 25% of the index sites had gingivitis. Moderate amounts of calculus were recorded among the older children. Only two children had periodontal pockets greater than or equal to 4 mm. There was no statistically significant difference (p greater than 0.05) between males and females recorded with plaque and gingivitis in the younger age group. In the older group, however, a significantly higher proportion of males (p less than 0.05) were recorded with plaque and gingivitis. The oral hygiene practices and oral hygiene status were poorer among children from low than from high socioeconomic status. Provision of dental health education for children in Nairobi is recommended.

This study was carried out to evaluate the practice and depth of knowledge of root canal treatment and pulpotomy by dentists in Kenya. Questionnaires were prepared and mailed to 114 dentists whose addresses were available. Sixty seven (58.8%) dentists responded. Of these, 67.2% carried out root canal treatment (RCT) and 43.3% carried out pulpotomy. The main reasons given by most dentists in the public hospitals for not carrying out these procedures routinely were lack of facilities and materials. Furthermore, it was found that amongst those who carried out these procedures, some used outdated techniques and materials. In order to reduce the large number of teeth lost through extraction, materials and equipment should be made available to enable dentists carry out root canal treatment and pulpotomies routinely. It is also necessary to have continuing dental education amongst dentists to update their knowledge of these procedures.

The present longitudinal study was conducted on ten children from age 5-6 years to determine the post-eruptive enamel changes of fluorosed permanent incisors. The children were born and reared in an area of Kenya with a water fluoride level of 14-45 parts per million. The incisors were examined and photographed periodically from the time of eruption over a period of 2 1/2 years. It was noted that the fluorosed incisor was intact as it erupted and then it underwent a variety of changes. In some there was mechanical breakdown (pitting) of the chalky white enamel which occurred rapidly initially and then the breakdown slowed down by 2 years. In others, there was smoothening of the pitted enamel resulting in a translucent appearance. Alternatively there was some degree of patchy staining of the enamel without surface breakdown. Much of the cervical 1/3 of the enamel remained intact even in teeth with severe breakdown. In most cases, these changes were bilaterally symmetrical. The possible reasons for these changes are discussed.