Esthetic perception of missing teeth among a group of Tanzanian adults.

PURPOSE: To assess esthetic perceptions among Tanzanian adults regarding missing teeth using a cross-sectional clinical study of a convenience sample of 5,532 subjects in the Northern coastal zone of Tanzania. MATERIALS AND METHODS: The dental status of urban and rural Tanzanian adults (5,532 subjects, ages between 20 and 80 years) was recorded. A structured interview was used to assess esthetic perception (yes/no complaint) considering the location and number of missing teeth. Logistic regression analysis was applied to determine the effects of the variables age (2 groups: < or = 45 years vs > 45 years), gender, socioeconomic status (high/middle vs low), and residence (urban vs rural) on the number of complaints. RESULTS: Of the subjects with 1 or more missing maxillary anterior teeth, 54% reported a complaint. Dissatisfaction was reported by significantly more subjects < or = 45 years of age and subjects with high/middle socioeconomic status. Gender and residence had no significant influence. Of the subjects with missing maxillary premolar(s) (no missing anterior teeth), 25% reported esthetic complaints (missing first premolar: 24%; missing second premolar: 11%; missing first and second premolar on the same side: 44%). Dissatisfaction was significantly greater in women, subjects < or = 45 years of age, and subjects with high/middle socioeconomic status. Residence had no significant influence. Fewer than 1% of the subjects were dissatisfied with missing maxillary molars. CONCLUSION: Among this group of Tanzanian adults, absence of teeth played a considerable role in the esthetic appreciation of their dentition. Complaints were associated with both number and location of missing teeth.

Decayed/missing/filled teeth and shortened dental arches in Tanzanian adults.

PURPOSE: This study assessed decayed/missing/filled teeth (DMFT), presence of occlusal units, and prevalence of shortened dental arches in a Tanzanian adult population. MATERIALS AND METHODS: The dental state of samples of the Tanzanian population was studied. Oral examinations were conducted on 5,532 adults from rural and urban cluster samples. DMFT was related to age, gender, and residence. The pattern of tooth loss within dental arches was mapped, and the prevalence of shortened dental arches was estimated. RESULTS: Mean DMFT scores increased gradually from 1.8 (20- to 29-year-olds) to 3.8 (50- to 59-year-olds). A steep increase was observed in the > or = 60-year-olds (DMFT 8.1). "Missing" was the dominant component of DMFT. The mean number of present teeth ranged from 27 in the youngest to 20 in the oldest age group. Under 60 years of age, DMFT was significantly higher for women than for men. No differences were found between residence categories. Molars were more frequently decayed, missing, and mobile than premolars. Of all subjects, 41% had complete dental arches, 44% had interruptions (of these, 73% were in posterior regions only), and 15% had shortened dental arches; 0.5% were edentulous. Of the subjects with shortened dental arches, about 65% had at minimum three pairs of occluding premolars. CONCLUSION: An initial low DMFT rate increased after the age of 60 years. Molars had the highest risk of dental decay and were most frequently absent. Shortened dental arches develop as a consequence of the pattern of tooth decay and tooth loss, although interruptions were frequently seen in the posterior regions.

Chewing ability of subjects with shortened dental arches.

OBJECTIVES: The objective was to study chewing ability in subjects with shortened dental arches in Tanzania. METHODS: A sample of 725 adults with shortened dental arches comprising intact anterior regions and 0-8 occluding pairs of posterior teeth and 125 adults with complete dental arches were recruited. Subjects were classified into nine categories according to arch length and symmetry. Chewing ability was investigated by interview on chewing complaints and on perceived difficulty of chewing 20 common Tanzanian foods, 12 soft, and 8 hard. RESULTS: Categories with extreme shortened arches (0-2 pairs of occluding premolars) reported most frequent (95-98%) and most severe complaints ('cannot chew all foods' or 'have to use special or specially prepared food'). Categories with intact premolar regions and at least one occluding pair of molars had nearly no complaints (95-97%). The other arch categories had an intermediate volume of complaints (33-54%). Perceived difficulty of chewing deteriorated with a decrease of occluding pairs of teeth. Subjects with 0-2 pairs of occluding premolars had major difficulties with chewing. Subjects with 3-4 pairs of occluding premolars or asymmetric arches comprising a short side with none or one pair of premolars and a long side including at least one occluding pair of molars had more difficulties with chewing compared to subjects with more complete dental arches. As a whole, they perceived for hard foods, 'minor problems, not adapted'. CONCLUSIONS: Shortened dental arches with intact premolar regions and at least one occluding pair of molars provide sufficient chewing ability. Shortened arches with 3-4 pairs of occluding premolars and asymmetric arches with a long side result in impairment of chewing ability, especially for hard foods. In extremely shortened arches comprising 0-2 occluding premolars, chewing ability is severely impaired.

A study on occlusal stability in shortened dental arches.

PURPOSE: The aim of this study was to verify the hypothesis that shortened dental arches constitute a risk to occlusal stability. MATERIALS AND METHODS: Using cluster samples, 725 subjects with shortened dental arches comprising intact anterior regions and zero to eight occluding pairs of posterior teeth and 125 subjects with complete dental arches were selected. Subjects with shortened dental arches were classified into eight categories according to arch length and symmetry. Parameters for occlusal stability were interdental spacing, occlusal tooth wear, occlusal contact of incisors in intercuspal position, and vertical and horizontal overlap. Additionally, tooth mobility and overeruption of unopposed teeth were assessed. Influence of independent variables (dental arch category, age, gender, and residence) on the parameters for occlusal stability was assessed by one-way ANOVA and Tukey's multiple range tests. RESULTS: Extreme shortened dental arches (zero to two pairs of occluding premolars) had significantly more interdental spacing, occlusal contact of incisors, and vertical overlap compared to complete dental arches. Occlusal wear and prevalence of mobile teeth were highest in these categories. The category with three to four occluding premolars had significantly more interdental spacing and, for the older age group, more anterior teeth in occlusal contact compared to complete dental arches. Age was consistently associated with increased changes in occlusal integrity. CONCLUSION: Signs of increased risk to occlusal stability seemed to occur in extreme shortened dental arches, whereas no such evidence was found for intermediate categories of shortened dental arches.

Signs and symptoms associated with TMD in adults with shortened dental arches.

PURPOSE: This study investigated the prevalence of signs and symptoms associated with temporomandibular disorders (TMD) in adults with shortened dental arches in Tanzania. MATERIALS AND METHODS: The shortened dental arch group comprised 725 subjects with an intact anterior region and zero to eight occluding pairs of teeth posteriorly. They were categorized into five groups according to length and symmetry of the dental arches. A control group of 125 subjects with complete dental arches was included. The subjects were interviewed with questions related to pain and sounds within the temporomandibular joints and restricted mobility of the mandible. Clinical examination consisted of registration of clicking or crepitation of the joints, measuring maximum mouth opening, and assessing occlusal tooth wear. RESULTS: Joint sounds were reported significantly more frequently by subjects with posterior support only unilaterally (17%) and by subjects with no posterior support (10%) compared to other categories of dental arches (3% to 5%). No significant differences were found between categories of dental arches with respect to pain (2% to 9%), restricted mobility of the mandible (0% to 1%), maximum mouth opening < 40 mm (0% to 3%), or clicking or crepitation of the joints (12% to 23%). For the younger age group (> or = 20 and < 40 years), tooth wear occurred significantly more often in subjects with no posterior support. For the older age group (> or = 40 years), tooth wear increased significantly with decrease of posterior support. CONCLUSION: No evidence was found that shortened dental arches provoke signs and symptoms associated with TMD. However, when all posterior support is unilaterally or bilaterally absent, the risk for pain and joint sounds seems to increase.

The shortened dental arch concept--attitudes of dentists in Tanzania.

OBJECTIVES: The shortened dental arch concept is a problem-oriented strategy to reduce complex restorative treatment in the posterior regions. The aim of this study was to determine the attitude of Tanzanian dentists about this concept. METHODS: A questionnaire was sent to all 77 dentists treating patients in Tanzania. The questionnaire contained items to assess the dentist's opinions such as dentist's judgement about the oral function of subjects with shortened dental arches, the type of treatment (or no treatment) of subjects with shortened dental arches and the reactions of patients to the proposal to shorten the dental arch. A short description about the problem-oriented approach and the shortened dental arch concept was included. RESULTS: Most of the responding dentists judged that shortened dental arches can provide satisfactory or acceptable chewing function (71%) and dental appearance (79%). Most dentists (89%) indicated that the shortened dental arch concept, as an example of a problem-oriented approach, has a useful place in clinical practice. However, most dentists (89%) inserted free-end acrylic partial dentures in these cases. Dentists with experience to apply the concept indicated that most of the patients have no objections after explanation of the proposal to shorten the dental arch. CONCLUSIONS: From this study it is concluded that the shortened dental arch concept is an acceptable strategy for dentists in Tanzania. However, many dentists doubt its implementation in clinical practice.