Oral health status and hygiene practices among visually impaired adolescents from a school in Kenya.

BACKGROUND: Visual impairment affects a significant population globally. The aim of this study was to determine the oral health status and oral hygiene practices among visually impaired adolescents from a school in Kenya. METHODS: A descriptive cross-sectional study was carried out among 159 adolescents aged 10-19 years attending the largest public primary boarding school for the blind in Kenya. A questionnaire was used to record participants' socio-demographic variables and oral hygiene practices. Clinical examination was undertaken to assess oral health status which consisted of oral hygiene, gingival health, and dental caries. Bivariate analyses were conducted to compare dental health outcomes across socio-demographic characteristics. RESULTS: There were 69 (43.4%) and 90 (56.6%) participants in Category I and II visual impairment respectively, 85 (53.5%) were male and 74 (46.5%) were female. Study participants were divided into three age categories: 10-12 years 48 (30.2%), 13-15 years 67 (42.1%), and 16- 19 years 44 (27.7%), with an overall mean age of 13.9 ± 2.3. All participants brushed their teeth, majority 107 (67.3%) brushed two or more times daily. Only 66 (41.5%) of the participants replaced their toothbrushes at 3 months. Sex (p =< 0.001) and age (p = 0.04) influenced frequency of toothbrush replacement. The average plaque score and gingival score index was 0.95 ± 0.45 and 0.28 ± 0.25 respectively, with gingivitis prevalence of 88.1%. Overall dental caries prevalence was 44.7%, [42.1%)] permanent dentition and [8.2%] deciduous dentition. Mean DMFT and dmft were 0.44 ± 0.60 and 0.12 ± 0.32 respectively. DMFT had a statistically significant association with sex (t = 1.82, p = 0.03). Oral hygiene practices did not influence oral hygiene and dental caries status. However, a statistically significant association was reported between frequency of toothbrush replacement and gingival score index ("p" =< 0.001). CONCLUSIONS: The study reported general good oral hygiene, prevalent gingivitis 140 (88.1%), and almost half of the study population affected by dental caries 71 (44.7%). Most participants were unaware of using fluoridated toothpaste and of needing to change toothbrushes within 3 months. Frequency of toothbrush replacement was reported to influence gingival score index.

Comparison of measured and predicted mesiodistal tooth-widths of 13-17 years old Kenyans: a descriptive cross-sectional study to develop a new prediction equation for use in the mixed dentition in a Kenyan population.

BACKGROUND: The Tanaka and Johnson equation is commonly used in mixed dentition analysis. However, the analysis is based on  a Caucasian population making clinical decisions challenging when used in different ethnic groups. This study developed a prediction equation based on a Kenyan population. DESIGN: A descriptive cross-sectional study done in 68 13-17 years old Kenyans of African descent in two boarding secondary schools. Alginate impressions were taken, study models obtained, and mesiodistal tooth-widths measured on upper and lower study models from the first molar to the contralateral first molar. Descriptive statistics, paired t-tests and independent t-tests were conducted and Pearson product-moment correlation coefficients calculated (p < 0.05). RESULTS: The mean age was 13.78 years (SD ± 0.70), females were 59%. The mesiodistal tooth-widths of the permanent canines and premolars were different between males and females (p ˂ 0.1). The Tanaka and Johnston equation significantly under-estimated the mesiodistal tooth-widths of the permanent canines and premolars (p ˂ 0.05). The addition of lower first permanent molars to the permanent lower incisors provided higher correlation coefficients than the Tanaka Johnston equation. CONCLUSIONS: A new equation that includes the permanent lower incisors and first permanent molars as predictor teeth seems to be more suitable for mixed dentition analysis for this Kenyan population. A larger study is needed to validate these findings.

A Fatal Case of Infant Oral Mutilation Practice.

Infant oral mutilation (IOM) is a traditional dental practice where traditional healers enucleate primary canine tooth buds in children in the hope of preventing or curing childhood illness. The method applied is heinous, painful, and carried out in unsterile environment, and this increases the morbidity and mortality of children from the communities where IOM is rife. The case report described here arose from a village, where an infant with a medical issue ended up in the hands of a local traditional healer who enucleated her four primary canine tooth buds. The traditional treatment resulted in the fatality of the child in <24 h of the procedure, a testimony that some traditional therapeutic procedures have no place in managing common childhood illnesses.

Molar incisor hypomineralization, prevalence, pattern and distribution in Sudanese children.

BACKGROUND: Molar incisor hypomineralization (MIH) has serious impact on oral health-related quality of life for a child, due to its effects on tooth structure, aesthetics and behavior of the child. The current study was designed to determine the prevalence, pattern and distribution of MIH in school children in Sudan. METHODS: This was a descriptive cross-sectional study involving 568 children, aged 8-11 years from schools in Khartoum State. Following the collection of their socio-demographic data, the children were examined for hypomineralization on the 12 MIH-index teeth, the pattern and distribution of the MIH. The data collected was analyzed to obtain descriptive statistics. The results related to the socio-demography and other dental-related factors were tested using chi-square test and Spearman Rank Correlation, with the significant level set at p < 0.05. RESULTS: The prevalence of MIH in the study population was 20.1%. The majority of the participants had both permanent first molars (PFMs) and permanent incisors affected (12.5%). However, in 7.6% of the cases only molars were affected. Even though more maxillary teeth were affected when compared to the mandibular teeth, there was no statistical significant difference between the occurrence of hypomineralization on mandibular and maxillary molars (p = 0.22). Maxillary incisors were significantly more affected by MIH when related to the mandibular ones (p = 0.00). Demarcated opacities were the commonest pattern of MIH defects (69.9%) in the experimental group. CONCLUSION: The prevalence of MIH in Sudanese children was 20.1%. In both dental arches, the permanent molars and incisors were frequently affected, with the demarcated opacity type of MIH being the most common form of defect.

Bilateral Second Premolars Agenesia Together with a Unilateral Canine Radiculomegaly.

Congenitally missing teeth is a common feature for the third molars. However, missing teeth, macrodontia and radiculomegaly occurring in a single patient is very rare. This article describes a case of agenesis of mandibular second premolars, radiculomegaly with dilacerations of a canine tooth together with elongated roots of other canines. All these features had been discerned through diagnostic radiographs taken during a routine treatment planning.

Applying Bayesian Model to Predict Socio-demographic and Occlusal Determinants of Early Childhood Caries (ECC)

Objective: To use the Bayesian statistical Model approach to predict the most important socio-demographic and occlusal factors pertinent to high prevalence of ECC. Material and Methods: A questionnaire and an oral examination was conducted on children who attended a pediatric dental clinic in Nairobi during the period of study. The parents provided information on socio-demographic and oral habits of the children. The oral examination for presence of dental caries was recorded for each child. Descriptive statistics were obtained for dental caries, oral hygiene, using plaque score, and malocclusion. The results of the questionnaire and presence of dental caries were analyzed and the results subjected to Bayesian statistical analysis to determine any predictive factors for ECC. Results: 55% of the children had plaque accumulating on more than one third but less than two thirds of tooth surfaces. The highest plaque scores were reported among children whose fathers (48.2%) and mothers (42.0%) had completed secondary, and whose fathers were in non-formal employment 73.2%. The overall prevalence of dental caries in the study group was 95.5% with a mean dmft of 8.53 (+ 5.52 SD), with the male children having higher dmft 8.65 (SD+5.54) than the female children 8.37 (SD+ 5.50). The prevalence of malocclusion among children in the study was 55%. The majority had mesial step, 51.5% (n=140) and flush terminal plane 28.3% (n=77). Conclusion: The Bayesian Model, with a correct assumption, can be used to determine the important factors involved in high prevalence of ECC.

Renaissance or dimming hope - The dilemma of managing multi-surface dental carious lesions in primary dentition using an Atraumatic Restorative Treatment (ART)

Introduction: Atraumatic restorative treatment (ART) has been in use for the last couple of years. The survival rate of multi-surface restorations using this method has generally been very low for any given follow-up period. Most commonly quoted as the causes for the low survival rate included early restoration loss, poor choice of the cavity to be restored, operator factors, material factors and patient related factors, among other factors. Speculation has been that the premature loss may not actually denote failure to preserve the carious dental element, and that probably, the fluoride leach from the glass ionomer cement used with the technique, might be helping elongate the survival of the restored tooth. The question is whether, therefore, it is important to only look at the survival of the ART restoration or to also consider the survival of the tooth with premature restoration loss. Objective: To determine the current general survival rates of multi-surface ART restorations in the primary dentition, while simultaneously considering any consequences of the premature loss of these restorations in the primary dentition. The data for the study was obtained through Pubmed/Medline search for publications on multi-surface ART restorations from 2000 to 2011. Only publications on ART in the primary dentition were included and analyzed for survival rate, premature loss of restoration and effect of such loss. Conclusion: While the survival rates of multi-surface ART restorations in the review studies were low, the restorations appeared to provide some beneficial effects to the retention-longevity of the restored tooth even after the premature loss of restorations...

Two-year survival rates of proximal atraumatic restorative treatment restorations in relation to glass ionomer cements and Postrestoration meals consumed.

PURPOSE: The purpose of this study was to investigate the influence of 3 glass ionomer cement (GIC) brands and the postrestoration meal consumed on the survival rate of proximal atraumatic restorative treatment (ART) restorations. METHODS: A total of 804 proximal restorations were placed in primary molars by trained operators and assistants using 3 GIC brands. The materials' mixing/placement times, the room temperature and the postrestoration meal consumed by the subjects were documented. The restorations were evaluated soon after placement and after 2 years by trained and calibrated evaluators. RESULTS: After 2 years, approximately 31% of the restorations had survived. There were no statistically significant differences in the survival rate of the restorations in relation to the GIC brands. The postrestoration meal consumed, which was of "hard consistency," was associated with significantly lower survival rate of the restorations. CONCLUSIONS: The survival rate of the proximal restorations was not significantly affected by the glass ionomer cement brands used, but was significantly influenced by the consistency of the next meal consumed by each child.

Influence of the cavity-size on the survival rate of proximal ART restorations in primary molars.

AIM: To evaluate the influence of the size of proximal cavities on the survival rate of the atraumatic restorative treatment (ART) restorations. DESIGN: A total of 804 children, aged 6-8 years, from a low socio-economic community, with an ART restorable proximal carious lesion in their primary molars, participated. Over a 3-week period, three 'experienced' and four 'inexperienced' operators randomly paired with four 'experienced' and four 'inexperienced' assistants, made the restorations at site using hand instruments. They randomly used Fuji IX, Ketac Molar Easymix and Ketac Molar Aplicap glass ionomer cements to restore the cavities, under randomly selected rubber dam and cotton roll isolation methods. The fillings were independently evaluated by nine trained and calibrated evaluators. RESULTS: After 1 year, the survival rate of the fillings evaluated in the study was 44.8%. Irrespective of the other factors involved, restorations with the highest survival rate were of size between 2 and 3 mm (mesio-distal, bucco-lingual, and depth) or volumes 10.0-19.9 mm(3) (Chi-square, P = 0.002, KM mean survival of 345 days). CONCLUSIONS: While the survival rates for class II ART restorations were still low, the choice of medium-sized proximal cavities gave better survival rates for this technique.