BackgroundPromoting oral health of adolescents is important for improvement of oral health globally. This study used baseline-data from LASH-project targeting secondary students to; 1) assess frequency of poor oral hygiene status and oral impacts on daily performances, OIDP, by socio-demographic and behavioural characteristics, 2) examine whether socio-economic and behavioural correlates of oral hygiene status and OIDP differed by gender and 3) examine whether socio-demographic disparity in oral health was explained by oral health-related behaviours.MethodsCross-sectional study was conducted in 2009 using one-stage cluster sampling design. Total of 2412 students (mean age 15.2 yr) completed self-administered questionnaires, whereas 1077 (mean age 14.9 yr) underwent dental-examination. Bivariate analyses were conducted using cross-tabulations and chi-square statistics. Multiple variable analyses were conducted using stepwise standardized logistic regression (SLR) with odds ratios and 95% Confidence intervals (CI).Results44.8% presented with fair to poor OHIS and 48.2% reported any OIDP. Older students, those from low socio-economic status families, had parents who couldn't afford dental care and had low educational-level reported oral impacts, poor oral hygiene, irregular toothbrushing, less dental attendance and fewer intakes of sugar-sweetened drinks more frequently than their counterparts. Stepwise logistic regression revealed that reporting any OIDP was independently associated with; older age-groups, parents do not afford dental care, smoking experience, no dental visits and fewer intakes of sugar-sweetened soft drinks. Behavioural factors accounted partly for association between low family SES and OIDP. Low family SES, no dental attendance and smoking experience were most important in males. Low family SES and fewer intakes of sugar-sweetened soft drinks were the most important correlates in females.Socio-behavioural factors associated with higher odds ratios for poor OHIS were; older age, belonging to the poorest household category and having parents who did not afford dental care across both genders.ConclusionDisparities in oral hygiene status and OIDP existed in relation to age, affording dental care, smoking and intake of sugar sweetened soft drinks. Gender differences should be considered in intervention studies, and modifiable behaviours have some relevance in reducing social disparity in oral health.

BackgroundGeneric and condition-specific (CS) oral-health-related quality-of-life (OHRQoL) instruments assess the impacts of general oral conditions and specific oral diseases. Focusing schoolchildren from Arusha and Dar es Salaam, in Tanzania, this study compared the discriminative ability of the generic Child OIDP with respect to dental caries and periodontal problems across the study sites. Secondly, the discriminative ability of the generic-and the CS Child OIDP attributed to dental caries, periodontal problems and malocclusion was compared with respect to various oral conditions as part of a construct validation.MethodsIn Arusha, 1077 school children (mean age 14.9 years, range 12-17 years) and 1601 school children in Dar es Salaam (mean age 13.0 years, range 12-14 years) underwent oral clinical examinations and completed the Kiswahili version of the generic and CS Child-OIDP inventories. The discriminative ability was assessed as differences in overall mean and prevalence scores between groups, corresponding effect sizes and odd ratios, OR.ResultsThe differences in the prevalence scores and the overall mean generic Child-OIDP scores were significant between the groups with (DMFT > 0) and without (DMFT = 0) caries experience and with (simplified oral hygiene index [OHI-S] > 1) and without periodontal problems (OHI-S ≤ 1) in Arusha and Dar es Salaam. In Dar es Salaam, differences in the generic and CS Child-OIDP scores were observed between the groups with and without dental caries, differences in the generic Child-OIDP scores were observed between the groups with and without periodontal problems, and differences in the CS Child-OIDP scores were observed between malocclusion groups. The adjusted OR for the association between dental caries and the CS Child-OIDP score attributed to dental caries was 5.4. The adjusted OR for the association between malocclusion and CS Child-OIDP attributed to malocclusion varied from 8.8 to 2.5.ConclusionThe generic Child-OIDP discriminated equally well between children with and without dental caries and periodontal problems across socio-culturally different study sites. Compared with its generic form, the CS Child-OIDP discriminated most strongly between children with and without dental caries and malocclusion. The CS Child OIDP attributed to dental caries and malocclusion seems to be better suited to support clinical indicators when estimating oral health needs among school children in Tanzania.

The intervention activities did not show any effect with respect to dental caries, calculus and plaque status among the students investigated. Compared with the control group, more favorable changes in the intervention group occurred with respect to bleeding on probing, suggesting a weak but positive effect on students' oral hygiene status.

Eighty-eight per cent and 83% of the children knew the cause of tooth decay and bleeding gums respectively and 17-68% were aware of preventive measures. At the institutions visited, 92% of the children said they brush their teeth but 74% brushed when living on the streets, this difference was significant (chi2=4.40, P=0.05). About half did not use toothpaste during street life, whilst 8% do not use toothpaste at institutions, the difference was significant (chi2=5.081, P=0.025). Almost 22% use sweets and biscuits at institutions, about 44% used the snacks when living on the streets, the differences were significant (chi2=3.798, P=0.04, and chi2=3.893, P=0.04). Only 6% use sodas and sweetened juices at institutions, while 32-36% used the drinks during street life, the differences were significant (chi2=4.38 P=0.05 and chi(2)-12.87, P=0.01). The findings of this study show that most former street children are aware of the causes of dental caries and bleeding gums but have poor knowledge on prevention of the two diseases. Furthermore, children living on the streets are more likely to eat cariogenic foods and have poor oral hygiene practices.

Background:Educating parents on supervision of tooth brushing ensures effective plaque removal, healthy gums and attainment of tooth brushing skills. Objective:To evaluate the effect of educating parents about children's tooth brushing supervision on their own knowledge and act of supervision, their children's tooth brushing skills, plaque score and gingival health. Methods:Two arms cluster randomized controlled field trial among 8-9 years primary school pupils and their parents. The intervention trial was an educational leaflet on step by step supervision of children during tooth brushing. The outcomes were; improved tooth brushing skills, oral hygiene status and gingival health, parental awareness and supervision of children's tooth brushing. Data processing and statistical analysis was done using SPSS version 20.0. Frequency distribution for proportions, cross tabulations with Chi-square and adjusted binary logistic regression were performed. Results:A total of 237 pupils were followed to completion of the study. The odds of parents being aware and supervising children during tooth brushing were higher in the intervention group at follow-up 4.5 (1.5, 13.4) and 2.4 (1.3, 4.5) respectively. The unadjusted odds for good oral hygiene following intervention was 3.1 (1.4, 6.9) and that of tooth brushing skills 61.8 (7.7, 498.6). On adjusting with parental awareness and supervision of children during tooth brushing, odds of having tooth brushing skills increased to 88.2 (9.2, 847.4). Conclusion:Providing education to parents on children tooth brushing supervision effectively improved children's tooth brushing skills, plaque score and gingival health emanating from awareness and act of supervision improvements revealed on their part.

This study aimed to assess the longitudinal validity of the oral impacts on daily performance (OIDP) and to identify psychosocial determinants, in terms of self-efficacy and depressive symptoms, of the OIDP across time. Following conceptual frameworks of oral health, it was hypothesized that sociodemographic, clinical, and psychosocial factors predict oral impacts across time at both population- averaged and person-specific levels. Whether the effects of sociodemographic and clinical factors were accounted for, totally or in part, by psychosocial factors were also investigated. Self administered questionnaires and oral clinical examinations at baseline (2009) and follow-up (2011) were completed by 1,714 and 727 secondary school students, respectively. Generalized equalized equations and a random intercept model were used to account for the dependency in repeated observations. Mean OIDP change scores were negative (worsened) among those who reported worsened self-reported oral health. Psychosocial, clinical, and sociodemographic factors were independently associated with oral impacts at the population-averaged and person-specific levels. Mediation of sociodemographic and clinical variables according to psychosocial variables was not observed. Satisfactory longitudinal evaluative properties of the OIDP, and independent effects of psychosocial factors on oral impacts across time, were confirmed among secondary school students in Tanzania.

The two factors suggest that behaviors within each might be approached jointly in health promoting programs. A positive relationship with school and access to hygiene facilities might play a role in health promotion. Provision of healthy snacks and improved perceived behavioral control regarding sugar avoidance might restrict snacking during school hours.

Background:Management of children’s behavior is an integral component of pediatric dental practice.Objective:To investigate the oral health care providers’ awareness, use and factors for choice of behavior management techniques when attending paediatric dental patients.Methods:A cross-sectional study among dental practitioners in Dar es Salaam, Tanzania. Data collection was done through interview using a structured questionnaire. The recorded information included: awareness and application of behavior management techniques (BMT) when attending a child dental patient, factors influencing choice of a particular technique, socio-demographics, level of professional training, working experience and facility profile. Using SPSS program version 18, frequency distributions and cross tabulations analyses were performed.Results:74 dental practitioners participated in the study, of whom 49 (66.2%) were males and 44 (59.5%) were graduates. Most participants were aware of the behavior management techniques, ranging from 100% for Tell-Show-Do to 86% for distraction. A small proportion (9.5%) reported to have adequate skills, all of them were graduates. The use of universally accepted BMTs was reported by 65% of experienced practitioners, 61% of graduates, 59% of those reporting to have received formal training and all of those reporting to have fair/inadequate skills to apply BMTs (p= 0.01).Conclusion:Most participants were aware of BMTs, although few acknowledged having adequate skills to apply the techniques. They use BMTs during treatment of paediatric dental patients and their choice of the technique is mainly influenced by children’s factors.