| dc.description.abstract | Aims and objectives
In Kenyan children aged five currently have a decayed, missing and filled -
teeth (dmft) index of 1.5 while the twelve year old have a DMFT of 0.2.
The objective of this study was to look at the disease pattern in preprimary
school children from different social economic backgrounds and
also to look at difference in presentation of disease between urban and
rural communities.
Materials and methods
This study was a descriptive cross sectional study involving three
hundred and seventy two (372) five year-old pre primary school children.
Children were sampled from four Municipality schools, which consisted
of the urban group, and four Ministry of Education schools distant from
the municipality using multistage sampling method.
Results
Children from the urban group were 191 (46.1% female, 53.9% male) and
181 (47.5% female, 52.5% male) from the rural population.
Health seeking behaviour: When companng the health seeking
behaviour it was found that most children (81.6% (n=146) rural and
83.8% (n=160) urban) had never visited an oral health facility.
Diet: With regard to the dietary preferences it was found that there were
statistical differences between both groups in the categories of commonly
enjoyed food, beverage and snacks with all having p values of 0.000.
Oral Hygiene: The oral hygiene habits of these children showed that 78%
(n=149) of the urban group and 35.9% (n=66) of rural children reported
use of toothbrushes showing a statistically significant difference between
the two groups (p = 0.000). Most of the urban children who brushed used
modern toothbrushes (91.5% (n=136) while only 51.5% (n=34) rural
children used modern brushes and 48.5% (n=32) used the traditional
mswaki. Amongst those children who brushed 87.9% (n=131) of the
urban children used toothpaste, however it was found that only half of
the rural children who brushed their teeth reported using t othpaste
(48.5% (n=32), with a p value of 0.000. Most of the children w 0 report
having toothbrushes brushed only once (49% (n=73), 33.6% (n=:50) twice
and 12.1% (n=18) three times. Fewer rural children who have
toothbrushes; 65.2% (n=43) brush only once, 15.2% (n=10) twice and
4.5% (n=3) three times (p=0.002), showing a statistically significant
difference.
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Dental Diseases: Dental caries contributed to most of the oral disease
burden found in the two study samples, with the dmft for rural children
comprising 1.97 (n=75). Forty six point four per cent (46.4% (n=84) werefound
to be caries free, whilst the urban children had dmft values of 3.30
(n=127) and 31.9% (n=61) were caries free). Using Mann Whitney
Analysis, p value of 0.001 was reported for both the decayed teeth and
dmft. This was indicative of a statistically significant difference between
the two groups. The greatest amount of oral disease seen in these two
groups is mainly dental caries. The number of decayed teeth (urban n=84
(44.5%) and rural n=61(33.7%) contributed to the majority of the dmft
with very few missing and filled teeth. This represents a high number of
unmet treatment needs (UTN). Estimation was made that the UTN for
rural children is 95% while that for the urban children is approximately
91%
Source of Drinking Water: A greater proportion of the urban children
reported use of chlorine treated tap water (71.2% (n=136)) where as most
rural children reported use of water from boreholes (84.5% (n= l53). A
statistically significant difference was shown between the samples
(p=0.000). Most children using treated tap water reported little incidence
of dental fluorosis (93.8% (n=136) while there were more children
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reporting use of water from boreholes 29.4% (n=60) having fluorosis than
those using river/streams water (30.4% (n=7).
Conclusion: It was concluded that health seeking behaviour, oral hygiene .
practices, diet and dietary habits, disease patterns and source of water all
affect oral health status of both urban and rural pre-primary school
children.
There was an association found between dmft and the following; dental
visits, plaque index, tooth brushing, source of water (p=0.000),
commonly enjoyed drink, commonly enjoyed snack (p=0.001)
respectively. However no association was found between dmft with
commonly enjoyed food (p=0.708), and tooth brushing frequency
(p=0.063).
The presence of dental fluorosis gingivitis, oral and peri oral pathology
did not feature significantly in both the urban and the rural samples.
Recommendation: It is recommended that comprehensive reporting of
dental caries should be advocated in order to provide a holistic verview.
This report should include; dmft values, the total number of children with
caries, the caries free individuals and total amount of unmet treatment
needs. In this way planning, policy development and strategic
implementation maybe made more focused for the population with most
need. | |
| dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
