Perceived general health in relation to oral health status in a rural Kenyan elderly population.

BACKGROUND: This study aimed to determine the present oral health status of the rural Kenyan elderly population and to investigate whether oral health status is associated with the perceived general health. METHODS: A total of 131 individuals aged 65 years and over in Mbita Constituency, Homa Bay County in Kenya were randomly selected and visited at home. The home visit study, which was conducted from 2014 to 2016, included oral examination by a dentist and administration of a self-reporting questionnaire. The number of teeth present and functional tooth unit (FTU) points were calculated using the dental chart. Perceived general health, subjective masticatory ability, and self-reported periodontal symptoms were collected using a questionnaire sheet. Fisher's exact test and nonparametric test were used to determine the difference in percentage and means. The odds ratio of good general health based on the participants' masticatory satisfaction was calculated by logistic analysis. RESULTS: Satisfactory mastication was dependent on the number of teeth present, FTU points, and self-reported "gum bleeding" and "tooth mobility". Furthermore, satisfactory mastication was associated with perceived general health status independent of sex and age. The adjusted odds ratio of good perceived general health was 2.29 (95% confidence interval 1.05-4.99) for participants who had the subjective masticatory ability. CONCLUSION: Among the Kenyan elderly population, satisfactory mastication was related to the number of teeth present, FTU points, and self-reported periodontal symptoms. Furthermore, satisfactory mastication was associated with perceived general health status independently.

Age assessment services in public dental health facilities in Kenya: burden and sources of referral (a cross-sectional study).

Introduction: the need for age assessment remains relevant due to unregistered births or lack of identification documents as a result of political and socioeconomic conflicts. Dentists play a significant role in age assessment. In order to establish the need for capacity building and collaboration, the study set out to determine the proportion of dental patients referred for age assessment and their sources of referral. Methods: a cross-sectional study, based on 5-year records (2014-2018) of dental patients and a selected sample of 316 patients who visited for age assessment in 2019-2020 in the same hospitals. The study centers were 8 county hospitals. Variables included gender, dental visits, health facility, and sources of referral. One-way Analysis of Variance (ANOVA) and Fisher´s Exact test were used to identify a significant association between variables. Results: from the records, 12,738 (5.7%) patients sought age assessment services. Females 6,410 (50.3%) and males 6,328 (49.7%) were nearly equal. There was a statistically significant difference in the average number of patients who required age assessment services from different facilities, p=0.000. The selected sample comprised of 186 (58.9%) and 130 (41.1%) males and females respectively. Sources of referral included; court of law (267, 84.5%), prior to acquiring identification documents (47, 14.9%), and others (2, 0.6%). Conclusion: an average of 5% of dental patients seek age assessment services signifying the need for sustained capacity building so as to ensure competent service delivery. The majority of the sampled patients were referrals from the court of law. Further research on how the dental fraternity can collaborate with the Judiciary to ensure justice in age disputes is recommended.

Associations of Interleukin-1 Polymorphisms with Chronic Periodontitis in Two Different Kenyan Ethnic Groups: A Case Control Study.

OBJECTIVE: The aim of this study was to investigate the association between IL-1ß and IL-1α isoforms with chronic periodontitis in two Kenyan ethnic groups, Taitas and Swahilis. METHODS: A case-control study in which participants were assessed for dental plaque, gingival inflammation, pocket depth and gingival recession after informed consent. Buccal swab samples were obtained and deoxyribonucleic acid was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction amplification using specific primers to IL-1 α rs1800587 (-889) and rs17561 (+4845) and IL-1ß (rs16944 (-511) and rs11443624 (+3954). Restriction fragment length polymorphisms were recorded and association with clinical data was assessed. RESULTS: Three hundred and ninety participants were recruited; four loci (-511, -889, +3953 and +4845) were analyzed per subject, equivalent to 1560 analysis events. No deviation from Hardy Weinberg equilibrium 1df was observed. Frequency of allele 2 at IL-1ß +3954 was associated with chronic periodontitis in Taitas (OR = 1.94, 95% CI = 1.01 - 3.70, p = 0.045), whereas frequency of allele 1 at IL-1α -889 was associated with chronic periodontitis in Swahilis (OR = 3.16, 95% CI = 1.644 - 6.083, p less than 0.001). Allele 1 at locus IL-1α -889 was also associated with mild, (OR = 5.2, 95% CI = 1.445 - 18.71, p = 0.005), moderate (OR = 4.51, 95% CI = 2.08 - 9.79, p less than 0.001) and severe disease (OR = 2.19, 95% CI = 1.013 - 4.738, p = 0.042) in Swahilis. Haplotype 3 (allele 1 at all four loci) was significantly associated with chronic periodontitis in Taitas (OR = 2.4, 95% CI = 1.1 - 5.14, p = 0.022) and Swahilis (OR = 4.2, 95%CI = 1.35 - 13.3, p = 0.008). CONCLUSIONS: This study has shown that in the African population of Bantu origin, the two polymorphisms associated with chronic periodontitis are IL-1ß +3954 in Taitas and IL-1α-889 in Swahilis. Additionally, haplotype 3 was associated with chronic periodontitis in both ethnic groups.

Arterial blood supply variation in the anterior midline mandible: Significance to dental implantology.

BACKGROUND: Inter-foraminal implant placement poses a risk to the sublingual artery as it enters the mandibular midline lingual foramen. Lack of consensus on the source of this artery poses a dilemma to surgeons during management of haemorrhagic episodes. Determination of the exact source of this artery is therefore pivotal. METHODS: This was a cross-sectional descriptive study involving 34 adult human cadavers. The facial and lingual arteries were followed from the external carotid artery to determine whether they terminated as the sublingual artery. Statistical significance tests were done using the Mann-Whitney U test and Pearson product-moment correlation. RESULTS: There were 30 (88.2 %) males and 4 (11.8 %) females (male/female = 15:2) aged between 25 and 40 years. The origin of the sublingual artery was mainly from the lingual artery (73.5 %), the submental artery (17.6 %), or an anastomotic branch from the two arteries (8.9 %). The mean distance between the mandibular midline lingual foramen (MMLF) and the inferior border of the mandible was 15.58 mm (range 11.03-19.62 mm). The mean thickness of the mandible at the level of the MMLF was 10.89 mm (range 8.00-12.91 mm). No statistically significant difference was found between the two genders with regard to the morphometric measurements. CONCLUSIONS: The sublingual artery that enters the MMLF was found to be the sublingual artery as either a branch of the lingual artery (73.5 %), the submental artery (17.6 %) or an anastomosis of the lingual and submental arteries (8.9 %).

Keratocystic odontogenic tumours of the jaws and associated pathologies: a 10-year clinicopathologic audit in a referral teaching hospital in Kenya.

AIM: To establish the pattern of occurrence and the clinicopathological features of keratocystic odontogenic tumour (KCOT) over a 10-year period. MATERIALS AND METHOD: Patients from the University of Nairobi Dental Hospital treated for KCOT were included in the study over a 10-year period. The study highlights the demographic, clinico-radiological and histological features of these tumours. RESULTS: A total of 22 confirmed cases of KCOTs were recorded with equal gender prevalence; (M:F = 1.44:1). The age range of the patients was from 10 to 69 years with a peak in the second decade of life (mean = 27.5 yrs). Of the 22 cases, 15 (68.2%) occurred in the mandible of which eight (53.3%) involved the body, five (33.4%) the angle and ramus. Six (27.3%) occurred in the maxilla, and one (4.5%) was in both jaws and was associated with Gorlin-Goltz Syndrome. The most common presenting complaint in most patients was swelling 54.6%, and in 18.2% was incidental finding. Eight (36.4%) cases showed satellite cysts upon pathologic evaluation. Thirteen (59.1%) cases were managed by surgical excision, while nine (40.9%) were managed by enucleation. CONCLUSION: Based on the outcome of this study, KCOT present mostly in body, angle and ramus of the mandible and its peak is in the second decade of life.