Untreated dental caries - magnitude, treatment need and restorative care demand among patients aged 12 years and above attending public dental clinics in Dar es salaam, Tanzania

Abstract

Background Literature shows that patients attending dental clinics in Tanzania have long-standing untreated carious lesions. Dental caries has been a major reason for attendance in dental clinics. The accumulation and persistence of dental caries suggest that the disease has either not received proper attention or has been going on un-addressed for long time. Various factors have been implicated to the accumulation and persistence of dental caries, hence the load of the untreated disease. Dental caries experience levels in Tanzania is low with mean DMFT of 1.8 and 3.8 for age groups 20-29 years and 50-59 years, respectively; and below 1 for permanent dentition among 12 year olds. Despite the low experience levels, the reported high accumulation of untreated caries is a cause for concern. Aim The study aims to determine the magnitude of untreated dental caries, caries treatment needs and demand for restorative dental care among patients aged 12 years and above attending public dental clinics in Dar es Salaam, Tanzania. Methodology A cross-section study was conducted among patients aged 12 years and above who attended public dental clinics in Dar es Salaam between August and September 2012. A sample of 310 participants randomly selected was interviewed using a structured questionnaire. Clinical examination was performed by a calibrated examiner in which caries experience; severity, distribution and treatment needs were assessed and recorded using the WHO Basic Oral health Survey Methods criteria (WHO 1997). Informations obtained were recorded in a specially designed form. Data cleaning and analysis was done using Statistical Package for Social Sciences (SPSS) version 16 and statistical significance difference was assumed when p-value was less than 0.05.

Results A total of 310 dental patients aged 13-76 years (mean age of 31.9 years) participated in the study with females being more than half (64.2%) of all participants. Almost all participants (99.7%) reported to have experienced tooth decay with mean DMFT score of 6.6. The proportion of D component of DMFT (untreated dental caries) was found to be 62%. Dental caries were more in posterior teeth (88.8%) than other teeth. Dentinal caries were common in 62.7% of the carious teeth with majority of them (85.3%) being in posterior teeth. About 75% of the carious teeth needed restorative care (filling or endodontic care). Only 23.9% of participants demanded restorative dental care and demand varied significantly with education level (p<0.05). The most cited reasons for not demanding restorative care were high cost for the service (28.6%), fear that pain will persist (26.5%) and not being aware of the service (23.1%) Conclusion In this study the amount of untreated dental caries was high. Posterior teeth were the most affected teeth and majority of the lesions in all teeth were located in dentine which means they needed simple filling. Demand for restorative care was low. Recommendations 1. Community education on presence, importance, benefits and outcome of dental restorative care is required. 2. Atraumatic Restorative Treatment technique should be adopted in caries management and the focus should be to the strategic dentition. 3. Another large study that will include representative sample for Tanzania population is required for better estimate of the amount of untreated dental caries and treatment need in Tanzania at large.