Assessing association of dental caries with child oral impact on daily performance; a cross-sectional study of adolescents in Copperbelt province, Zambia.

BACKGROUND: Dental caries and child oral impact on daily performance (C-OIDP) have been linked in several studies. However, the studies used caries indices, which limit the ability to examine how C-OIDP prevalence varies across various stages of the dental caries process. Furthermore, cross-cultural differences between Zambia and other African countries where the C-OIDP instrument has been widely used necessitate testing its pychometric properties. This study's primary aim was to evaluate the association between dental caries and C-OIDP. Secondarily, the study reports the psychometric properties of the C-OIDP index among Zambian adolescents. METHODS: A cross-sectional study was conducted between February and June 2021 among grade 8-9 adolescents in Copperbelt province, Zambia. A multistage cluster sampling method was used to select participants. Using a pretested self-administered questionnaire, socio-demographics, oral health behaviors, self-reported oral health, and C-OIDP were evaluated. The test-retest and internal consistency reliability of the C-OIDP were evaluated. The Caries Assessment and Treatment Spectrum (CAST) was used to evaluate dental caries. Adjusted odd ratios and 95% confidence intervals were used to evaluate the association between dental caries and C-OIDP after adjusting for confounders identified by a directed acyclic graph. RESULTS: Among 1,794 participants, 54.0% were females, while 56.0% were aged 11-14 years. About a quarter (24.6%) had one or more teeth at the pre-morbidity stage, 15.2% at the morbidity, 6.4% at the severe morbidity and 2.7 at the mortality stage. The internal consistency reliability of the C-OIDP Cohen's Kappa was 0.940, while the Kappa coefficients of the C-OIDP items ranged from 0.960 to 1.00. Participants with severe caries had a high prevalence of C-OIDP, with rates for morbidity, severe morbidity, and mortality stages being 49.3%, 65.3%, and 49.3%, respectively. Oral impacts were 2.6 times (AOR 2.6, 95% CI 2.1-3.4) more likely to be reported by participants with dental caries than those without caries. CONCLUSIONS: Dental caries was associated with high reporting of C-OIDP, and C-OIDP prevalence was high among participants in the severe stages of the caries process. The English version of the C-OIDP demonstrated adequate psychometric characteristics for assessing OHRQoL among Zambian adolescents.

Dental caries according to CAST among Zambian adolescents; pattern, socio-demographic and behavioral correlates.

BACKGROUND: Dental Caries affect more than half of children and adolescents globally and more so in Africa. Most caries studies in Africa are based on DMFT index which does not assess early carious lesions making early prevention and minimal invasive treatment impossible. This study therefore aimed at determining pattern, socio-demographic and behavioral correlates of dental caries according to Caries Assessment and Treatment Spectrum (CAST). METHODS: Cross-sectional study involving secondary school adolescents in Copperbelt province, Zambia. Socio-demographics and oral health related behaviors were assessed using a structured questionnaire while dental caries was assessed using CAST. Data were summarized as frequency distributions while cross-tabulation with Chi-squire test and adjusted multinomial logistic regression assessed strength and direction of relationship between socio-demographics, oral health behaviors and dental caries. Level of statistical significance was set at 5%. RESULTS: A total of 1,794 participants were enrolled 54% being females. Total frequency of adolescents with healthy teeth (CAST0-2) was 51.1%, pre-morbidity stages (CAST 3-4) was 24.7%, severe morbidity CAST (6-7) was 6.4% and mortality was 2.7%. The odds of being found with teeth at pre-morbidity stage decreased among male OR (95%CI) = 0.55 (0.44, 0.70) and younger participants OR (95%CI) = 0.77 (0.61, 0.98). Participants in high socio-economic status had lower odds of morbidity OR (95%CI) = 0.69 (0.52, 0.92) while those taking sugary foods five times or more per day had higher odds of morbidity OR (95%CI = 1.52 (1.01, 2.34). The odds of being found at mortality clinical stage of caries was lower among males OR (95% CI) = 0.53 (0.29, 0.96) and those who did not attend to a dentist in the previous year OR (95%CI) = 0.42 (0.23, 0.75), while higher odds OR (95%CI = 2.01 (1.02, 3.97) were among the high socio-economic status. CONCLUSIONS: The proportion of participants with teeth at pre-morbidity and morbidity were high. Socio-demographics and behavioral predictors of dental caries were sex, socio-economic status, frequency of sugary food intake per day and dental visit in the previous year.

Anthropometrics Analysis of Mental Foramen and Accessory Mental Foramen in Zambian Adult Human Mandibles.

The mental foramen (MF) and accessory mental foramen (AMF) are the strategically important landmarks during surgical interventions and anaesthetic nerve blocks procedures involving the mental nerve. The study aimed at evaluating anthropometrics of MF and AMF in Zambian adult human mandibles and it was cleared for ethics from TDRC Ethics Review Committee (Reg. No.: 00002911; FWA: 00003729). A total of 33 Zambian adult human mandibles were evaluated for shape, position, and direction of opening of foramen. All measurements were performed using a Digital Vernier Calliper and statistically analysed for per cent frequency and mean and standard deviations, and we performed the one sample t-test for comparative analysis. Data were considered significant at p<0.05. All mandibles that were examined had bilateral MF while unilateral AMF was found in two mandibles (6%). The foramens were mostly oval in shape and their most common position was between the second premolar and first molar and the most common orientation was posterior-superior. The comparative analysis of mandibular anthropometrics showed significant variations (p<0.05) with different ethnic groups. The findings emphasize the ethnic variations and edify that the foramen position is not always as stated in reference textbooks. The clinical creditability of the study is cautioning the surgeons on possible variations of the MF and AMF anthropometrics compared to existing literature in order to avoid any unforeseen injury related to anaesthesia or dental surgeries. Further studies with large sample sizes representing whole country are recommended to establish the standard MF and AMF anthropometrics of Zambian population.

Impact of Malocclusions on the Oral Health-Related Quality of Life of Early Adolescents in Ndola, Zambia.

The study aimed to assess the prevalence of malocclusions and its impact on oral health-related quality of life (OHRQoL) among early adolescents in Ndola, Zambia. It used a random sample of 384 primary school children aged 12-14 years. The Child Oral Health Impact Profile-Short Form 19 (COHIP-SF19) was used to assess OHRQoL, and the Dental Aesthetic Index (DAI) was used to examine dentofacial anomalies. The chi-square test was used to study whether there was a statistically significant association between variables and multivariate logistic regression for the influence of sociodemographic and malocclusions on OHRQoL. Statistical significance was set at p < 0.05. Participants' sociodemographics were 53.6% female, 41.7% aged 13 years, and 43.5% from grade six. The overall reported impact on OHRQoL was 11.7%, which was significant (p < 0.001) by age and sex, and higher in females than males. The overall prevalence of malocclusions was 27.9%, which was significant (p=0.005) by sex, and higher in males than females. Children with malocclusions reported significant (p < 0.001) negative oral health impact compared to the children without malocclusions. Spacing, diastema, and crowding were most prevalent malocclusions that showed clear inverse association with OHRQoL. The study findings provide indications that malocclusions are negatively associated with OHRQoL among Zambian early adolescents.