CORRELATION OF ORAL HEALTH HOME-CARE PRACTICES, SNACKING HABITS AND DENTAL CARIES EXPERIENCE AMONG HIV-POSITIVE CHILDREN IN NAIROBI, KENYA.

OBJECTIVE: To determine the correlation of oral health home-care practices, snacking habits and dental caries experience among 3-15 year-old-HIV-positive children attending out-patient clinic at the Kenyatta National Hospital, Kenya. DESIGN: Cross-sectional descriptive study. SETTING: Kenyatta National Hospital comprehensive care centre out-patient clinic. SUBJECTS: Two hundred and twenty participants were selected by consecutive sampling. The children's socio-demographic characteristics and oral health home-care practices were obtained from parent or guardian interviews. Oral examination of the children was carried out to determine the presence of dental caries. RESULTS: Of the 220 children in the study, 126 (57.3%) brushed their teeth at least once a day. Forty one (18.6%) children regularly consumed sweetened snacks daily. Almost all children (75.5%) were taking medication in the form of tablets and capsules. One hundred and seventy nine (81.4%) children had never had a dental visit. The prevalence of dental caries was 65% while the mean dmft and DMFT scores were 1.75 and 1.08 respectively. Caries experience was significantly higher for those children who frequently consumed sweetened snacks and those who took their medication in the form of sweetened syrups while it was lowest in those who brushed their teeth at least twice a day. CONCLUSION: Dental caries experience was significantly higher among HIV-infected children who had increased frequency of consumption of sweetened snacks and those who used syrupy medication. There was poor attendance for dental treatment among the children.

Internal root morphology of the maxillary first premolars in Kenyans of African descent.

OBJECTIVE: To determine the internal root morphology of the maxillary first premolar in Kenyans of African descent. DESIGN: In vitro descriptive cross-sectional study. SETTING: School of Dental Sciences, University of Nairobi. SUBJECTS: One hundred and fifty five extracted maxillary first premolars obtained from patients aged between 13-30 years attending dental clinics within Nairobi. RESULTS: There were 77 premolars from males and 78 from females. Majority (87.1%) of the teeth had two canals. Males presented with three canals more commonly than females. This difference was statistically significant. According to Vertucci's classification, male specimens demonstrated five of the canals types while female specimens demonstrated all the eight canal types. These differences were not statistically significant. CONCLUSIONS: Kenyan maxillary first premolar was mostly found to have two canals. There were eight canal types, with type IV being the commonest.

Dental caries, gingivitis and the treatment needs among 12-year-olds.

BACKGROUND: One of the World Health Organisation (WHO) global health goals stated that the global average for dental caries should not have been more than 3 DMFT at 12 years of age by the year 2000. However, the prevalence of dental caries, gingivitis and dental treatment needs among 12-year-old children in many regions of the developing world had then hardly been investigated. OBJECTIVE: To determine the prevalence of dental caries and gingivitis and the dental treatment needs among 12-year-old children in Kitale Municipality in North- Western Kenya. DESIGN: Descriptive cross-sectional study. SETTING: Primary schools in Kitale Municipality. SUBJECTS: Two hundred and ninety two children aged 12 years were randomly selected from eight schools that were also randomly selected. Data were collected according to the WHO Oral Health Survey Methods. The children were examined for decayed (D), missing due to decay (M) and filled teeth and the caries experience using the DMFT index was computed. Gingivitis and treatment needs were assessed using the CPITN index. RESULTS: The overall prevalence of dental caries was 50.3% while its prevalence when only the permanent teeth were considered was 44.5% with a mean DMFT of 0.92 +/-50 1.36. Girls had a significantly higher caries experience (DMFT) than boys (p<0.05). The main treatment need indicated for decayed teeth was one surface restoration with 46.9% of all the children requiring this kind of treatment. Endodontics was indicated in 7.5% of the children while extractions were the least required treatment with 5.1% of the children examined requiring this treatment. The prevalence of gingivitis was 77.7%. Out of these 38.7% of the children required professional dental care entailing scaling and oral prophylaxis. CONCLUSION: The prevalence of dental caries and gingivitis was high hence there was greater need for one surface restoration and full mouth scaling for these children. School based oral health programme to improve oral hygiene of these children is recommended.

Dental injuries in 0-15 year olds at the Kenyatta National Hospital, Nairobi.

OBJECTIVE: To determine the pattern of occurrence of dental injuries in the 0-15 year-olds. DESIGN: A retrospective study. SETTING: Kenyatta National Hospital, Nairobi. SUBJECTS: Five hundred and five patient records with dental injuries were retrieved and analysed. RESULTS: A total of 505 patient records with dental injuries were retrieved and analysed. Most of the injuries were recorded in the year 1999 (22.2%). Boys were more affected (63.0%) than girls (37.0%). The main presenting complaint recorded was pain (75.8%). The majority of the patients (69.5%) presented for treatment during the same day or the day after trauma. Falls were the leading cause of injuries (73.5%). Most injuries involved two teeth (47.1%) and the maxillary central incisors were the most affected teeth both in the primary (67.5%) and permanent (64.0%) dentitions. Luxation injuries were the most common type of dental trauma with 47.5% occurring in the permanent teeth and 77.3% in the primary teeth. The main radiographic investigation performed was intraoral periapical views (52.9%) following which dental extraction (34.4%) was the main treatment modality offered. CONCLUSION: Prospective cross-sectional studies to determine the prevalence of dental injuries are needed. Furthermore improving the knowledge of dental practitioners through continuing dental education programmes would help in updating them on current trends in managing these injuries.

Presenting chief complaints and clinical characteristics among patients attending the Department of Paediatric Dentistry Clinic at the University of Nairobi Dental Hospital.

OBJECTIVES: To evaluate the chief complaints and clinical presentation among patients attending the Department of Paediatric Dentistry clinic at the University of Nairobi Dental Hospital (UONDH). DESIGN: A retrospective survey of hospital records. SETTING: The University of Nairobi Dental Hospital. SUBJECTS: Patients who attended the Department of Paediatric Dentistry clinic during a three year period. MAIN OUTCOME MEASURES: Chief complaint, dental caries, gingivitis, traumatic injuries, treatment at first visit. RESULTS: The records of 800 patients were examined, including 391 male and 400 female. The average age of the patients was 9.0 years. The presenting complaint for most patients was dental pain (31.5%), orthodontic related complaints (25.4%) and dental decay (19.7%). Very few children attended for dental check-up (3.9%). Five hundred ninety (73.8%) children suffered from dental caries, while 275 (34.4%) children manifested gingivitis. The average number of teeth decay was 3.71 (SD+/-3.76). Only 51 (6.4%) children attended with traumatic injuries to the dentition. Treatment performed at the first visit mainly consisted of dental extractions (21.8%), oral prophylaxis and dental health education (20.5%) and restorative treatment (20.0%). CONCLUSIONS: The presenting complaint for most patients was pain. However, there was an almost equal demand for orthodontic treatment. Dental caries was the most prevalent dental disease. Oral prophylaxis and dental health education (DHE) constituted a significant component of treatment offered at first visit.

Socio-demographic characteristics and clinical features among patients attending a private paediatric dental clinic in Nairobi, Kenya.

OBJECTIVES: To evaluate the socio-demographic characteristics, chief complaints and clinical presentation of children attending a private dental clinic in Nairobi, Kenya. DESIGN: A retrospective survey of dental clinic records. SETTING: A private dental clinic in Nairobi, Kenya. SUBJECTS: All patients aged 0-18 years who were first-time attenders at the dental clinic during a three year period. RESULTS: The records of 800 patients were examined, comprising 395 males and 405 female children. The average age was 7.2 years (95%CI, 6.9-7.4). Referral to the clinic for treatment was mostly by self (81.4%). Most patients (57.9%) were self-sponsored for their dental treatment. Majority of the patients attending (86.8%) did not clinically have any underlying medical conditions. The major complaints for most patients were dental decay (27.4%) and dental pain (21.6%). Very few children (7.6%) attended for dental check-up. Five hundred and forty nine (68.6%) of the children suffered from dental decay while 294 (36.8%) suffered from gingivitis. The average number of teeth decayed was 4.02, SD +/- 2.4 (95% CI 3.8-4.2). Most carious lesions occurred in the younger children. There was a significant increase in the occurrence of decay over the three year period of the study. Significantly higher levels of gingivitis was observed in the prepubertal and pubertal age group. Attendance for traumatic injuries was relatively low with only 46 (5.8%) children reporting traumatic injuries to their dentitions. Most traumatic injuries involved the anterior teeth as a result of falls. Treatment given at the first visit was mainly restorative (28.6%) followed by dental extractions (25.4%). CONCLUSION: The average are of patients attending the clinic was 7.2 years. Interdisciplinary referral was low since most patients were self-referred and self sponsored for treatment. Dental caries was prevalent, necessitating a high demand for restorative treatment. Although gingivitis was less prevalent, it was significant among children in the prepubertal years.

The prevalence of dental caries and gingivitis and their relationship to social class amongst nursery-school children in Nairobi, Kenya.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.