Prevalence and impact of infant oral mutilation on dental occlusion and oral health-related quality of life among Kenyan adolescents from Maasai Mara

Abstract

BackgroundInfant Oral Mutilation (IOM) includes germectomy and early extraction of primary and permanent incisors and canines, primarily in the lower jaw.The aim of the present study was to examine the prevalence and impact of IOM, involving the removal of mandibular permanent incisors and/or canines, on dental occlusion and Oral Health-Related Quality of Life (OHRQoL) among Kenyan adolescents from Maasai Mara.MethodsIn a cross-sectional study, 284 adolescents (14–18 yrs. of age) participated in an oral examination and an interview, using a structured questionnaire on age, gender, medical history, and IOM practice. For the analysis of the dental occlusion, participants with IOM, in terms of absence of two or more permanent teeth in the mandibular incisor and/or canine tooth segments (IOM group), were compared to participants who had all six incisors and canines present in the oral cavity (control group). OHRQoL was assessed using child perception questionnaire (CPQ11–14).ResultsThe majority of the participants (61%) had been exposed to IOM, among whom 164 (95%) had absence of two mandibular central incisors. More individuals in the IOM group had maxillary overjet exceeding 5 mm than in the control group (50.9% vs. 20%, p < 0.001). Nineteen (11%) subjects in the IOM group had mesial occlusion in contrast to none in the control group (p < 0.001). The mean and median total CPQ scores and the mean and median CPQ domain scores were low in both groups with no significant differences between the groups.ConclusionsApproximately two-thirds of the study population presented with IOM, with the majority of them missing two mandibular permanent central incisors. Although some participants with IOM had substantial maxillary overjet and mesial occlusion, only few of them showed substantial effect on their OHRQoL.

Prevalence of JP2 and Non-JP2 Genotypes of Aggregatibacter actinomycetemcomitans and Oral Hygiene Practice of Kenyan Adolescents in Maasai Mara

“…The study was conducted in Maasai Mara, more specifically in Mara North Conservancy, Kenya. The study population consisted of 284 Kenyan teenagers (mean age: 15.0; SD 1.1; range 14–18 years) recruited from the four primary and one mixed secondary schools in the Mara North Conservancy, Maasai Mara, Narok County of Kenya, as previously reported by Kemoli and coworkers [ 39 ]. The study population was representative of the Mara North Conservatory of Maasai Mara and consisted of healthy adolescents present at school on the day of the examination.…”

“…Structured questionnaires were used to collect data on age, gender, medical history, and the use of oral hygiene tools according to procedures previously described [ 39 ].…”

“…The recording of the teeth present in the oral cavity was performed, and teeth were recorded as present when either partly or fully erupted. Oral examinations, including inter-rater reliability testing, were conducted as previously reported [ 39 ]. A procedure including the recall of the subjects for traditional intra-reliability evaluation was not possible due to the limited working time at the research site.…”

Conflict between Science and Superstition in Medical and Dental Practices

“…Premature extraction of these teeth by traditional healers is believed to cure this condition. However, this practice can cause serious permanent damage to the child resulting in missing teeth and destruction of some of the surrounding permanent teeth [53][54][55][56][57]. A 1989 study conducted in Southern Sudan on the prevalence of Ibyinyo among the hospitalized infants found that one deciduous tooth had been removed from all the studied infants (n=90), and most were suffering from dehydration caused by various other abdominal complications [58].…”

A fatal case of infant oral mutilation practice

“…[ 21 ] In 2018, a study of teenagers from another area of Maasai land showed that 61.1% had had removal of primary canines mandibular central incisors in the form of dental enucleation/mutilation. [ 22 ]…”