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.

Socio-demographic and behavioural correlates of oral health related quality of life among Tanzanian adults: A national pathfinder survey.

In response to the growing recognition of quality of life measurement in health care, indicators that address the social and psychological consequences of oral disorders have been developed to complement conventional clinical assessment. The objective of this study was to determine socio-demographic and behavioural correlates of oral health related quality of life (OHRQoL) among Tanzanian adults. The national pathfinder survey methodology described in the WHO Oral Health Surveys - Basic Methods was used to obtain a total of 1,759 Tanzanian adults aged 18 years and above. In line with the pathfinder methodology clusters were purposively selected to represent cities, towns and rural areas. In each cluster individuals were stratified by age and sex. The outcome variable was the OHRQoL in terms of oral impacts on daily performances (OIDP). Frequency distribution, bivariate analyses, and generalized linear models using log binomial regression models were performed by SPSS version 15. About half (49.1%) of the respondents reported at least one oral impact during a period of three months before the survey. Difficulty in chewing was the most prevalent impact affecting 3 9.9% of participants. A higher proportion of those who reported poor conditions of teeth had difficulties in chewing and sleeping was often interrupted. Multivariate analysis indicated that those who perceived their teeth conditions to be good (PR=0.38; CI: 0.32-0.44), were of younger age (PR=0.84; CI: 0.77-0.90), and had visited a dentist during the past five years or more (PR=0.84; CI: 0.77-0.90) and were less likely to have an oral impact. On the other hand those who restricted their sugar consumption (PR=1.12; CI: 1.03-0.1.22) were more likely to have an impact on at least one daily performance. It is concluded that the prevalence of OIDP was high while perceived teeth conditions and age varied with OHRQoL in terms of OIDP in the expected direction. Those who visited the dental clinic in the recent past had more impacts than those who did not. The findings of this study confirm the usefulness of subjective indicators in explaining peoples' suffering. In this regard it is recommended that in the next national pathfinder survey traditional clinical oral health indicators should be complemented with subjective indicators in order to obtain triangulated data for planning oral health services in Tanzania.

Oral health related behaviors among adult Tanzanians: a national pathfinder survey.

BACKGROUND: The oral health education programs which have been organised and delivered in Tanzania were not based on a thorough understanding of behaviours which influence oral health. Therefore, evaluation of these programs became difficult. This study aimed at investigating the oral health related behaviours and their determinants among Tanzanian adults. METHODS: A national pathfinder cross sectional survey was conducted in 2006 involving 1759 respondents from the six geographic zones of mainland Tanzania. Frequency distributions, Chi square and multiple logistic regression analyses were performed using SPSS version 13.0. RESULTS: The rates of abstinence from alcohol for the past 30 days and life time smoking were 61.6% and 16.7% respectively, with males being more likely to smoke (OR 9.2, CI 6.3 -12.9, p < 0.001) and drink alcohol (OR 1.5, CI 1.2 -1.8, p < 0.001). Multiple regression analysis revealed that; having dental pain (OR 0.7, CI 0.5-0.8; p < 0.001) and being minimally educated (OR 0.48, CI 0.4-0.6; p < 0.001) reduced the likelihood of having a high sugar score. Whereas being male (OR 1.5, CI 1.2- 1.8; p < 0.001), urban (OR 1.9, CI 1.5 -2.3; p < 0.001), and young (OR 1.5, CI 1.2 -1.8; p < 0.001) increased the likelihood of having a high sugar score. Urban residents were less likely to take alcohol (OR 0.7, CI 0.6-0.9; p < 0.01), or smoke cigarette (OR = 0.7, CI = 0.6-0.9); less likely to be those who do not use fruits (OR 0.3, CI 0.2-0.4; p < 0.001); dental clinic (OR 0.5, CI 0.4-0.7; p < 0.001); factory made tooth brushes (OR 0.1, CI 0.08-0.17; p < 0.001) and toothpaste (OR 0.1, CI 0.1-0.2; p < 0.001) than their rural counterparts. More rural (13.2%) than urban (4.6%) residents used charcoal. CONCLUSION: The findings of this study demonstrated social demographic disparities in relation to oral health related behaviors, while dental pain was associated with low consumption of sugar and high likelihood to take alcohol.

Satisfaction with urgent oral care among adult Tanzanians.

The aim of this study was to determine patient satisfaction with urgent oral care and to evaluate the association between patient satisfaction and different aspects of such care. A 5-point Likert scale questionnaire on patient satisfaction (score 1 = very dissatisfied; score 5 = very satisfied) was administered to 741 adults. Chi-squared test and logistic regression analysis were used to identify associations between dependent and independent variables. The mean patient satisfaction score was 3.79 (SEM = 0.02). Cleanliness of the clinic; hospitality of the dentist; and effectiveness of local anaesthesia; had the highest mean satisfaction scores of 4.0 to 4.15. Cost of treatment and explanation of treatment had the lowest mean scores (2.79 and 3.17 respectively). Sixty-eight percent of respondents were satisfied with urgent oral care. Rural residents were more satisfied with cost of treatment than urban residents (P < 0.0001). Urban residents were more satisfied with explanation of treatment than rural residents (P < 0.0001). Women were more satisfied with many aspects of oral care than men (P < 0.05). It is concluded that adult Tanzanians have moderate levels of satisfaction with urgent oral care. Cost of treatment and explanation of treatment are the two aspects of urgent oral care that are least satisfactory for patients.