Relationship between habits and dental health among rural Tanzanian children.

The study was done in 1982/83 as an oral health baseline for a comprehensive health project involving primary school children in rural areas of Tanzania. A number of 399 standard two pupils with a mean age of 10.9 yr were dentally examined and interviewed using closed questions. Interexaminer reproducibility for caries was 99%, inter-interviewer reliabilities for population correspondence were between 81% and 100%. DMFS + defs was 1.1 for the 92% brushing their teeth daily and 1.9 for children brushing once a week or less. The amount of plaque, calculus, and gingivitis showed no relation to brushing, if it was performed more than once a week. The effect of using chewing sticks or plastic toothbrushes was identical. Children eating cakes, biscuits and/or sweets at least three times a day seemed to have more caries than the rest, DMFS + defs being 1.5 and 1.1, respectively. Consumption of sugar cane did not show any relation to the caries amount. In one of five districts traditional removal of primary tooth germs had caused a mean loss (or deformity) of 1.0 permanent tooth, thereby being the most injurious dental condition. The study confirms the need of educational interventions. It does not indicate any justification for prompting children in general to brush more than once a day or restricting sweet snacks to less than once a day.

Caries experience of the primary dentition among groups of Tanzanian urban preschoolchildren.

Five hundred and forty-six urban Tanzanian preschoolchildren aged 5-7 were examined for dental caries in the primary dentition. Caries was diagnosed according to the WHO criteria (1977). The mean dft was 1.06 (1.76) for the whole sample and 62% of the children were caries free. Only three fillings were observed in the primary teeth, indicating a very low rate of conservative treatment in this population group. The results of this study call for both preventive and restorative care for this group. However, for these activities to be cost effective they will have to be focused on the 38% of children who have the experience of dental caries. Planning an appropriate oral care program for this risk group needs careful consideration within the Tanzanian context.

Perceived need and use of oral health services among adolescents and adults in Tanzania.

The perceived need and use of oral health services among adolescents and adults in Tanzania were studied. One region from each of the country's five zones was chosen at random. Final sample selection (n = 1061) was done in the main towns of the selected regions. Participants were interviewed using a structured questionnaire which dealt with perceived need for dental treatment and use of oral health services and several demographic variables. Frequency tables were computed and analyzed. Odds ratios were calculated based on 2 x 2 tables and logistic regression models. The majority, 82% (95% CI: 79-85%) had sought treatment due to pain or for tooth extraction. Perceived need, dissatisfaction with own oral health status and use of oral health services were slightly more frequent among women. Bleeding gums had no explanatory value on the dependent variables. The strongest explanatory variable in a logistic regression model for perceived need and dissatisfaction with own oral health status was previous dental treatment with an estimated odds ratio of 6.4 (95% CI: 4.7-8.7) and 7.2 (95% CI: 5.3-9.9), respectively. People living nearest a treatment facility tended to use the services more [odds ratio 1.3 (95% CI: 0.8-2.1)]. A very strong relation between previous dental problems and use of oral health services was found, namely an odds ratio of 68.8 (95% CI: 39.0-121.4). The findings in the study may be useful in the attempts to implement Tanzania's National Plan for Oral Health.

Oral health status and treatment needs in different age groups in two regions of Tanzania.

The present study was conducted in two regions of Tanzania, where development of oral health services is supported by the Danish International Development Agency (Danida). The study comprised 6035 subjects in five age groups (5-6 yr, 12 yr, 18 yr, 35-44 yr, 55+ yr). Data were collected using WHO's survey methodology. Dental caries affected the primary dentition of one third to one fourth of the 5-6-yr-olds and mean dft was less than 1.0 in both regions. DMFT for 12-yr-olds was also low (< 1.5 DMFT), but was higher in older age groups, mainly due to more missing teeth. The F-component was negligible in all age groups. Treatment need was mainly simple fillings and extractions. Most periodontal sextants in all age groups were affected by bleeding or calculus. Periodontal pockets were rare and loss of teeth limited. It is concluded that the oral health situation in Tanzania is better than that foreseen in the goals for oral health in Tanzania in the year 2002. On the basis of these findings and the severe economic constraints prevailing within the health services in Tanzania, a revision of The National Plan for Oral Health seems urgent. A realistic estimate of the cost and the possible sources of funding of the plan is mandatory.

The role of traditional healers in the treatment of toothache in Tanga Region, Tanzania.

The study was conducted in five villages in each of two districts in the Tanga Region of Tanzania. Seventy-three traditional healers and 408 villagers of 14 years and above (selected through systematic random sampling) were interviewed. Most of the traditional healers had practised for more than ten years and the majority had been trained by their father or grandfather. Sixty per cent of the traditional healers claimed, that they treated dental patients with an average of three patients per month. A large variety of local herbs was used and about 40 per cent of the traditional healers claimed that they would refer the client to a modern health facility, if their treatment did not work. Half of the villagers interviewed had experienced toothache and 60 per cent of those who had experienced toothache within the last two years had sought treatment from traditional healers, where they had all been treated with local herbs. Relief was obtained for more than six months for 40 per cent of the patients, who sought this service. The establishment of modern emergency oral care in rural health centres and dispensaries did not influence the villagers' use of the traditional healers.

Tanzania oral health workers' views on the relevance of their training to their duties.

Oral health care in Tanzania is provided by three types of dental personnel, namely dental therapist, assistant dental officers and dental officers assisted by dental surgery assistants and dental technicians. The training of dental therapists under the Ministry of Health dates back to 1955 and takes three years after completion of secondary school education. Assistant dental officers are usually dental therapists who have at least five years of professional experience. They can seek admission to the school of Assistant Dental Officers in Muhimbili Medical Centre, Dar es Salaam and their training is of two years duration. The main objective of the dental school in Dar-es-Salaam is to train students in their local environment and create dentists who are better suited for working in Tanzania. The purpose of the study was to study Tanzanian oral health workers opinions of their undergraduate training programme in relation to their professional duties. A structure questionnaire was completed by 85 oral health care workers. Most of the subjects, especially the specific dental disciplines, taught during the training were considered very important. Only minor differences were found among the three categories of dental personnel. In general the participants' reported their level of theoretical knowledge and level of competence to be rather high.

Reasons for tooth extraction among Tanzanians.

In 1988 a study was carried out among Tanzanians of different age groups to determine the reasons for tooth extraction. The major reason was found to be dental caries or its associated complications (81%) while periodontal diseases was the runner-up (13%). The molars teeth were the most commonly extracted. The results of this study are important in planning resources for and provision of emergency oral health care especially for the rural population.

Prevalence of maxillo-mandibular fractures in mainland Tanzania.

In order to evaluate the current trends in maxillo-mandibular fractures, hospital records of all patients who had sustained maxillo-mandibular fractures (in Tanzania Mainland) from 1990-1992 were examined. A specially designed questionnaire was dispatched to Regional Dental Officers to be filled after examining the hospital files of patients. Factors considered were age, sex, date fracture and anatomical site of the fracture. Records of 179 patients who had sustained 187 maxillo-mandibular fractures were identified and analysed. Results showed that the greatest number of maxillo-mandibular fractures occurred in patients between the age group 21-30 years, with a male to female ratio of 3:1. Assault was found to have been the leading aetiological factor (29.9%) followed by motor vehicle and motor cycle accidents (27.3%), falls (18.2%), bar fights (9.1%), sports (8.6%), spouse abuse (3.7%) and work injuries constituted 3.2%. Mandibular fractures out-numbered maxillary fractures in a ratio of 4:1. Of the mandibular fractures, fracture of the body of the mandible occurred most followed by fracture at the angle of the mandible, symphysis, condyle, alveolar and ramus.

Periodontal status of pregnant and postpartum mothers aged 18-45 years attending MCH clinics in Tanga Municipality, Tanzania.

One hundred pregnant women and another hundred women post-partum aged 18-45 years were examined at Maternal and Child Health (MCH) clinics in Tanga Municipality, to determine their periodontal health status. The sample was selected by using convenient sampling method. Plaque was assessed as absent, score 0 and present, score 1, while calculus, gingivitis, shallow pockets and deep pockets were assessed according to the Community Periodontal Index for Treatment Needs (CPITN), for each of the six sextant examined. Findings were recorded on a special prepared oral health assessment form. Data analysis was done using SPSS Pc+. Results revealed that the majority of women examined had gingival bleeding and plaque on about 50% of the sextants during pregnancy as well as after delivery. Postpartum women in the age group 18-34 years had a higher number of sextants with plaque, calculus and gingivitis than pregnant women in the same age group both in the second and third trimester of pregnancy (p < 0.05). During the third trimester of pregnancy, women in the age group 18-34 had more sextants with plaque, calculus and gingival bleeding than women in the second trimester of pregnancy (p < 0.05). However, in the age group 35-45 women in the second trimester of pregnancy had more sextants with plaque, calculus and gingival bleeding than women in the third trimester of pregnancy (p < 0.05). Women postpartum in all age groups had shallow pockets, while in pregnant women they were found in the age group 25-45 in the second trimester and only in the age group 35-45 in the third trimester.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in dental caries experience of 12-year olds in low fluoride urban and rural areas of Tanzania.

This report is a 2-year follow-up of a baseline study conducted in Tanzania in 1984. 377 and 448 twelve-year old primary school children were examined in Dar es Salaam (urban) and rural areas respectively. The same criteria and examiners were employed to replicate conditions in 1984 as closely as possible. The mean DMFT score has remained stable over the 2-year period in both the urban (1984: 0.67 (s.d. 1.20); 1986: 0.64 (s.d. 1.32) and rural (1984: 0.51 (s.d. 1.07); 1986: 0.40 (s.d 0.93) areas. However, a significant decrease in the mean DMFS score in Dar es Salaam from 1.19 (s.d. 2.71) in 1984 to 0.81 (s.d. 1.96) in 1986, and in rural areas from 0.78 (s.d. 1.98) in 1984 to 0.48 (s.d. 1.44) in 1986 was observed. In 1986 significantly fewer children with caries had more than 5 involved surfaces in both urban and rural areas than in 1984. In the two areas the difference in caries prevalence observed between 1984 and 1986 affected different surfaces types to varying extents. The results do not support the finding that caries is increasing in all developing countries.

Primary oral health care. The Tanzanian experience.

Four years have elapsed since the introduction of the preventive oral health care approach by the Ministry of Health (1982-1985). A review of the new policy after four years of its implementation indicate that progress has been made in the utilization of non dental personnel in preventive oral health care. Current strategies are sound and some areas have been identified for more intensive activity in the future. The important area is the role of dental personnel in pursuing the concept of primary health care in the regions and districts. This assessment is of importance because total eradication of oral diseases by prevention is so far impossible and would need the whole national budget of Tanzania.

Distribution of dental therapists and assistant dental officers trained under the Tanzania-Danida Dental Health Programme 1981-1993.

The purpose of the present study was to describe the production of Dental Therapists and Assistant Dental Officers trained in Ministry of Health institutions in Tanzania during more that ten years of support from the Danish International Development Agency (Danida) through the Tanzania-Danida Dental Health Programme and to investigate their distribution and location. A total of 169 Dental Therapists and 38 Assistant Dental Officers have been trained from 1981 to 1993, representing more than 70% of the training capacity of the schools for training of oral health personnel under Ministry of Health. The distribution of both Dental Therapists and Assistant Dental Officers according to working station was, however very similar to that found before the Danida support began. Two out of every three Dental Therapists in government service were stationed in district clinics or non-government clinics at the district level. The same was true for one out of every three Assistant Dental Officers. It is concluded, that the intentions laid down in Tanzania's National Plan for Oral Health 1988-2002 of first staffing the district hospitals and, later on, the health centres with Dental Therapists have not yet been fulfilled.

Dental caries status of 5-7 year old children in three districts in Tanzania, Uganda and Mozambique.

This paper presents the baseline data of a longitudinal study assessing the dental caries status of 5-7 year old children in Tanzania, Uganda and Mozambique. Approximately one hundred 5-7 year-old-children from randomly selected schools in each of three locations (formal urban, informal urban and rural) were examined using the 1997 WHO Oral Health Survey Criteria. Thirty nine percent of the entire sample were found to bc caries-free, however this differed from location to location and from country to country. The overall mean dmft was 2.4 (SD 2.8), with the decayed component being 2.0 and the missing component 0.4. Of the children examined, only three had filled teeth. The mean dmft was significantly higher (p-value < 0.05) in Tanzania and Uganda than in Mozambique. There were also significant differences in the mean dmft between the various locations in Uganda and Mozambique. The prevalence of dental caries was not consistent across the formal urban, informal urban and rural locations in the three countries studied. It is thus essential to desegregate oral health status data to the most local level possible.