ABSTRACT
OBJECTIVES: The prevalence of illicit drug use and its associated oral health complications have been increasing in South Africa (SA). There has been a paucity of studies to determine the oral health status among illicit drug users in SA. This study aimed to determine the oral health knowledge, practices, and status of illicit drug users at rehabilitation centers in a district in SA. MATERIALS AND METHODS: This was a cross-sectional study conducted at four rehabilitation centers in Pretoria, SA. Data were collected using a validated self-administered questionnaire and an oral examination. The questionnaire consisted of three parts: demographics, oral health knowledge, and oral health practices. The oral examination was conducted by a calibrated researcher and included caries, periodontal status, dental erosion, trauma, and soft tissue lesions. STATISTICAL ANALYSIS: The data were analyzed using the Statistical Package for Social Sciences (SPSS) software. RESULTS: The mean age was 25.5 (±7.49) years with 91% being male. The majority (84%) of patients were Black, and almost all (87%) had never received oral health education; 55% were not aware that illicit drugs could have an impact on the oral health status and 40% had never had a prior dental consultation. The caries prevalence was 68% with a mean decayed, missing and filled teeth (DMFT) score of 5.3 (±6.18). More than half (58%) required periodontal treatment and there were minimal soft and hard tissue lesions diagnosed. Those who perceived their teeth to be in a poor condition had a significantly higher Decayed, Missing and Filled Teeth (DMFT) score compared with those who perceived their oral health to be good. Just under half (41.9%) of the participants did not need any periodontal intervention, with the other half presenting with plaque retention or calculus and thus needed oral hygiene intervention inclusive of scaling and polishing. There was minimal evidence of pathological oral lesions with only 1.5% presenting with necrotizing periodontal disease (NPD). Overall, there was generalized poor oral hygiene CONCLUSION: Many of the participants had poor oral hygiene knowledge and practices and a relatively high prevalence of caries. It is imperative that oral health promotion and education is incorporated into the medical interventions provided at rehabilitation centers.
ABSTRACT
The high oral disease burden among children in South Africa, specifically early childhood caries, has received scant attention despite the fact that it is a public health concern that negatively impacts the overall well-being and quality of life of the child. While South Africa has a number of well documented policies that focus on oral health in general and maternal and prenatal health, none specifically addresses the oral health of children under the age of six years. The integration of oral health in maternal and child health care in South Africa could lead to an improved oral health quality of life and better oral health outcomes for mothers and children to address the high prevalence of childhood caries and unmet treatment needs for this population. While the integration of oral health care into primary healthcare is recognised as crucial and affordable, it however continues to be neglected. In South Africa, oral health disparities are attributed to the unequal distribution of oral health services, and policies that govern oral, maternal and child health seem to work in parallel with one another. Integrating oral health into interventions for primary health care delivery is a cost-effective way to improve the health of disadvantaged groups. Considering that maternal oral health predicts children's oral health and primary health care teams regularly see under-6-year-olds, this primary care setting is ideal for integration of these services. Despite growing interest in an integrated oral health and primary care system, there is little literature on oral health integration models. Improving the oral health of vulnerable populations requires integrating oral health into primary care and implementing interdisciplinary public health programs. The development of an Integrated Maternal and Child Oral Health policy would play a critical role in advancing integration; however, such a policy should be designed with both implementation and translation in mind for it to be successfully followed through. Such a policy should be comprehensive and contextual, aimed at increasing access to oral health services for women and children and reduce the oral disease burden. This paper proposes and describes the possible content and objectives of such a policy that will enhance effective leadership and accountability and strengthen health system delivery platforms for quality maternal and child oral health services along the continuum of healthcare. Furthermore, it will illustrate the importance of a policy that aims to promote coordinated, relevant, trans-multi-disciplinary and inter-sectoral community engagement to improve pregnancy and oral health outcomes, and importantly, establish a sustainable and contextual surveillance system for maternal and child oral health.
