Attitudes towards tooth fillings in Tanzanian adults and its association with previous filling experience.

BACKGROUND: Tooth filling treatment is utilized at low levels in many low and middle-income countries (LMICs), further, little is known about the prevailing attitudes towards such treatment. This study aimed to assess attitudes towards tooth filling among Tanzanian adults and how previous tooth filling experience is associated with these attitudes. METHODS: A pretested structured questionnaire was distributed among 1522 out-patients in four regional hospitals in Tanzania in 2015-16. The questionnaire had eight statements on a 6-point Likert scale measuring attitudes towards tooth filling. Responses were analyzed independently and through a constructed attitude sum score. Linear regression analysis was used to assess the association of previous tooth fillings on attitudes towards tooth filling treatment. RESULTS: The respondents were mostly female (57.3%), with a mean age of 33.1 years (SD 11.3). About one third of the respondents (36.4%) had primary level of education. Attitudes towards tooth filling treatment were generally negative. Low levels of education and income were associated with more negative attitudes. A small proportion (11.5%) had a previous tooth filling. Having a previous tooth filling was associated with a more positive attitude towards tooth fillings regardless of socioeconomic status. CONCLUSIONS: This study shows that even in areas with limited resources and availability of services, previous experience of tooth fillings is related to more positive attitudes towards restorative treatment, which should be taken into account when planning oral health care programs.

The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania.

BACKGROUND: Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. METHODS: A survey of all district and regional dental clinics in selected regions was conducted in 2014. A total of 28/30 facilities participated in the study. A structured interview was undertaken amongst practitioners and clinic managers within the facilities. Daily resources for consumption (DRC) were used for estimation of patients' relative cost. DRC are the quantified average financial resources required for an adult Tanzanian's overall consumption per day. RESULTS: Tooth extractions were found to cost four times the DRC whereas restorations were 9-10 times the DRC. Studied facilities provided tooth extractions (100%), scaling (86%), fillings (79%), root canal treatment (46%) and fabrication of removable partial dentures (32%). The ratio of tooth fillings to extractions in the facilities was 1:16. Less than 50% of the facilities had any of the investigated dental materials consistently available throughout the year, and just three facilities had all the investigated equipment functional and in use. CONCLUSIONS: Dental materials and equipment availability, skills of the practitioners and the cost of services all play major roles in provision and utilization of comprehensive oral care. These factors are likely to be interlinked and should be taken into consideration when studying any of the factors individually.