Mashoto Kijakazi O, Astrøm Anne N, David Jamil, Masalu Joyce R
Department of Clinical Odontology, University of Bergen, Bergen, Norway.
Health Qual Life Outcomes. 2009 Jul 30;7:73. doi: 10.1186/1477-7525-7-73.
Dental caries, dental pain and reported oral problems influence people's oral quality of life and thus their perceived need for dental care. So far there is scant information as to the psychosocial impacts of dental diseases and the perceived treatment need in child populations of sub-Saharan Africa.
Focusing on primary school students in Kilwa, Tanzania, a district deprived of dental services and with low fluoride concentration in drinking water, this study aimed to assess the prevalence of dental pain and oral impacts on daily performances (OIDP), and to describe the distribution of OIDP by socio-demographics, dental caries, dental pain and reported oral problems. The relationship of perceived need estimates with OIDP was also investigated.
A cross-sectional study was conducted in 2008. A total of 1745 students (mean age 13.8 yr, sd = 1.67) completed an extensive personal interview and under-went clinical examination. The impacts on daily performances were assessed using a Kiswahili version of the Child-OIDP instrument and caries experience was recorded using WHO (1997) criteria.
A total of 36.2% (41.3% urban and 31.4% rural, p < 0.001) reported at least one OIDP. The prevalence of dental caries was 17.4%, dental pain 36.4%, oral problems 54.1% and perceived need for dental treatment 46.8% in urban students. Corresponding estimates in rural students were 20.8%, 24.4%, 43.3% and 43.8%. Adjusted OR for reporting oral impacts if having dental pain ranged from 2.5 (95% CI 1.8-3.6) (problem smiling) to 4.7 (95% CI 3.4-6.5) (problem sleeping),--if having oral problems, from 1.9 (95% CI 1.3-2.6) (problem sleeping) to 3.8 (95% CI 2.7-5.2) (problem eating) and if having dental caries from 1.5 (95% CI 1.1-2.0) (problem eating) to 2.2 (95% CI 1.5-2.9) (problem sleeping). Students who perceived need for dental care were less likely to be females (OR = 0.8, 95% CI 0.6-0.9) and more likely to have impacts on eating (OR = 1.9, 95% CI 1.4-2.7) and tooth cleaning (OR = 1.6, 95% CI 1.6-2.5).
Substantial proportions of students suffered from untreated dental caries, oral impacts on daily performances and perceived need for dental care. Dental pain and reported oral problems varied systematically with OIDP across the eight impacts considered. Eating and tooth cleaning problems discriminated between subjects who perceived need for dental treatment and those who did not.
龋齿、牙痛及所报告的口腔问题会影响人们的口腔生活质量，进而影响他们对牙科护理的需求认知。迄今为止，关于撒哈拉以南非洲儿童群体中牙科疾病的社会心理影响以及所感知到的治疗需求，几乎没有相关信息。
本研究聚焦于坦桑尼亚基尔瓦地区的小学生，该地区缺乏牙科服务且饮用水中氟化物浓度较低。本研究旨在评估牙痛患病率及口腔问题对日常表现的影响（OIDP），并按社会人口统计学、龋齿、牙痛及所报告的口腔问题描述OIDP的分布情况。同时还研究了需求认知估计值与OIDP之间的关系。
于2008年开展了一项横断面研究。共有1745名学生（平均年龄13.8岁，标准差 = 1.67）完成了一次广泛的个人访谈并接受了临床检查。使用斯瓦希里语版的儿童OIDP工具评估对日常表现的影响，并根据世界卫生组织（1997年）的标准记录龋齿经历。
共有36.2%（城市地区为41.3%，农村地区为31.4%，p < 0.001）报告至少存在一项OIDP。城市学生中龋齿患病率为17.4%，牙痛患病率为36.4%，口腔问题患病率为54.1%，对牙科治疗的需求认知率为46.8%。农村学生的相应估计值分别为20.8%、24.4%、43.3%和43.8%。如果有牙痛，报告口腔影响的校正比值比范围为2.5（95%置信区间1.8 - 3.6）（微笑困难）至4.7（95%置信区间3.4 - 6.5）（睡眠困难）；如果有口腔问题，范围为1.9（95%置信区间1.3 - 2.6）（睡眠困难）至3.8（95%置信区间2.7 - 5.2）（进食困难）；如果有龋齿，范围为1.5（95%置信区间1.1 - 2.0）（进食困难）至2.2（95%置信区间1.5 - 2.9）（睡眠困难）。认为需要牙科护理的学生更不可能是女性（比值比 = 0.8，95%置信区间0.6 - 0.9），且更有可能在进食（比值比 = 1.9，95%置信区间1.4 - 2.7）和刷牙（比值比 = 1.6，95%置信区间1.6 - 2.5）方面受到影响。
相当比例的学生患有未经治疗的龋齿、口腔问题对日常表现有影响且有牙科护理需求认知。在所考虑的八项影响中，牙痛和所报告的口腔问题与OIDP存在系统性差异。进食和刷牙问题区分了认为需要牙科治疗的学生和不认为需要的学生。
