Abstract:
BACKGROUND: The predominant mode of treatment in government dental clinics in
Tanzania has been tooth extraction because the economy could not support the
conventional restorative care which depends on expensive equipment, electricity
and piped water systems. Atraumatic Restorative Treatment (ART) was perceived as
a suitable alternative. A 3.5-year study was designed to document the changes in
the treatment profiles ascribed to the systematic introduction of ART in pilot
government dental clinics.
METHODS: Dental practitioners who were working in 13 government dental clinics
underwent a 7-day ART training. Treatment record data on teeth extracted and
teeth restored by the conventional and ART approaches were collected from these
clinics for the three study periods. The mean percentage of ART restorations to
total treatment, ART restorations to total restorations, and total restorations
to total treatments rendered were computed. Differences between variables were
determined by ANOVA, t-test and Chi-square.
RESULTS: The mean percentage of ART restorations to total treatment rendered was
0.4 (SE = 0.5) and 11.9 (SE = 1.1) during the baseline and second follow-up
period respectively (ANOVA mixed model; P < 0.0001). The mean percentage of ART
restorations to total restorations rendered at baseline and 2nd follow-up period
was 8.4% and 88.9% respectively (ANOVA mixed model; P < 0.0001). The mean
percentage of restorations to total treatment rendered at baseline and 2nd
follow-up was 3.9% and 13.0%, respectively (ANOVA mixed model; P < 0.0001).
Ninety-nine percent of patients were satisfied with ART restorations, 96.6%
willing to receive ART restoration again in future, and 94.9% willing to
recommend ART treatment to their close relatives.
CONCLUSION: ART introduction in pilot government dental clinics raised the number
of teeth saved by restorative care. Countrywide introduction of the ART approach
in Tanzania is recommended.
