Objective: To determine the pattern of occurrence of salivary gland tumours in Tanzania over a period of twenty years. Design: Cross-sectional retrospective study. Setting: Two referral centres; Muhimbili National Hospital (MNH) and Kilimanjaro Christian Medical Centre (KCMC). Methods: Medical records of patients who presented with tumours of the salivary glands in the two major referral centres over a period of twenty years from 1982 to 2001 were reviewed. Data regarding demographic, clinical and histologic information was analysed. Results: Salivary gland tumours constituted 6.3% of all oral-facial tumours and tumour like lesions. Among the salivary gland tumours, 54% were benign and 46% malignant, which occurred in 80 males and 53 females. Peak age was between 20 and 49 years, with a malefemale ratio of 1.5:1 (p< 0.05). Pleomorphic adenoma was the commonest occurring tumour (44.4%) followed by adenoid cystic carcinoma (24.8%), mucoepidermoid carcinoma (9.8%) and adenocarcinoma (6.5%). Among the benign tumours, pleomorphic adenoma dominated (83.9%), followed by adenoma (9.9%). Among malignant tumours adenoid cystic carcinoma occurred in 54.3% followed by mucoepidemoid carcinoma (22.9%) and adenocarcinoma (11.4%). The parotid gland was the commonest site of occurrence followed by the palate. At initial stages the only complaint from the patients was essentially a slowly growing painless swelling. Treatment modality was mainly surgical in both benign and malignant tumours, however, for malignant tumours radiotherapy alone or in combination with surgery was sometimes employed. Conclusion: On average salivary gland tumours occurred at a relatively younger age compared to that reported in Western countries. Contrary to reports from Europe and America, adenoid cystic carcinoma was the most frequently occurring malignant salivary gland tumour. Late presentation was seen as a problem that needs to be addressed in order to maximise the effectiveness of treatment.

Background: Neoplasms of the oral maxillofacial area are an interesting entity characterized by differences in nomenclature and classification at different centers.

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Oral health policies must be developed that emphasize the role of social determinants in health and oral diseases. The aim of this report is to review literature on determinants of oral diseases and apply the concepts to promoting oral health in the African countries in the African and Middle East region (AMER). Structural and proximal determinants of oral diseases are common to those affected by other noncommunicable diseases (NCDs). Oral diseases are also heavily affected by issues of politics, poor health behaviors, underdeveloped health systems, and low oral health literacy. Wide-scale poverty exists in populations in the AMER. Oral health promotion and preventive oral health programs should therefore be integrated with those for general health and use the common risk factor approach (CRFA). Attempts should be made to improve the daily living conditions and reduce the incline of the social gradient. Oral health practitioners should use the CRFA when dealing with determinants of oral diseases and in the design of preventive oral health programs. The detrimental effects of the social determinants of health may be ameliorated by involving both the individual and community. Interventions in health promotion programs in the AMER need more research on the epidemiology of oral diseases and the role played by the social determinants of oral diseases, especially with regard to poverty. The high levels of poverty and low gross domestic product in most countries in the African region make it difficult to fund high-quality, affordable, accessible oral health services.