Social Impact of Dental Caries on Adult Patients in Bungoma County, Kenya

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Abstract

Dental caries manifests itself through the existence of a hole in the hard tissue of teeth, and it has a brown or black colour. Untreated dental caries causes a lot of challenges such as toothache and eventually tooth loss resulting in swelling, inability to eat or swallow, inability to open jaw or talk, difficulty in breathing and low self-esteem as a result of the bad breath from cavity. The outcome of the social effect of dental caries is the inability to pronounce or talk, inability to chew, sleep disruption due to pain and difficulty in breathing especially for those who use the mouth to breathe. In Bungoma County, little is known about the social impact of dental caries among patients. Therefore, there was a need to investigate the social impact on adult patients in Bungoma County, Kenya. This study was conducted in Bungoma County. The study adopted a descriptive cross-sectional study design. Adults with dental challenges and the dental staff formed the study population. The sample size was 347 dental patients. The sampling strategy was proportionate probability sampling and simple random sampling. Data was collected using a pretested WHO-modified assessment questionnaire of 2013, WHO-modified observation checklist and key informant interviews. Data was analysed using descriptive and inferential statistics with the aid of the Statistical Package for Social Sciences tool (SPSS) v 25.0. Data was presented using tables, figures, narratives and verbatim. Association and strength between the variables were assessed using correlation, multiple regression and logistical regression at 0.05. Thematic analysis was used to analyse qualitative data. Results: The burden of dental caries according to sociodemographic was as follows: youth < 35 years was 60%, the female was 57.4%, rural dwellers had 56.8% and low-income earners had 65.6%. The study established that poor oral hygiene habits (OR: 1.2) frequent consumption of sugary food (OR: 1.0) and smoking contributed (OR: 0.8). Toothache due to cavity was 97.9% and tooth loss was 40.4% while bad breath was reported by 60.7%. There was a significant strong positive association between the level of teeth loss and the level of pain experienced by a patient with dental caries, (r (347) = 0.86, p < 0.001). the study concluded that dental caries was more prominent in those with poor oral hygiene practices, those who frequently consume sugary foods and those who smoke tobacco. Toothache, tooth loss and bad breath were the major social impacts of dental caries that affect the quality of the affected. The study recommended that community members should be informed to foster a habit of attending dental clinics occasionally at least once a year for a check-up.

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Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990–2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors

N.J. Kassebaum, A.G.C. Smith, E Bernabé … (2017)

The Global Burden of Disease 2015 study aims to use all available data of sufficient quality to generate reliable and valid prevalence, incidence, and disability-adjusted life year (DALY) estimates of oral conditions for the period of 1990 to 2015. Since death as a direct result of oral diseases is rare, DALY estimates were based on years lived with disability, which are estimated only on those persons with unmet need for dental care. We used our data to assess progress toward the Federation Dental International, World Health Organization, and International Association for Dental Research’s oral health goals of reducing the level of oral diseases and minimizing their impact by 2020. Oral health has not improved in the last 25 y, and oral conditions remained a major public health challenge all over the world in 2015. Due to demographic changes, including population growth and aging, the cumulative burden of oral conditions dramatically increased between 1990 and 2015. The number of people with untreated oral conditions rose from 2.5 billion in 1990 to 3.5 billion in 2015, with a 64% increase in DALYs due to oral conditions throughout the world. Clearly, oral diseases are highly prevalent in the globe, posing a very serious public health challenge to policy makers. Greater efforts and potentially different approaches are needed if the oral health goal of reducing the level of oral diseases and minimizing their impact is to be achieved by 2020. Despite some challenges with current measurement methodologies for oral diseases, measurable specific oral health goals should be developed to advance global public health.

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Ending the neglect of global oral health: time for radical action

Richard G. Watt, Blánaid Daly, Paul Allison … (2019)

Oral diseases are a major global public health problem affecting over 3·5 billion people. However, dentistry has so far been unable to tackle this problem. A fundamentally different approach is now needed. In this second of two papers in a Series on oral health, we present a critique of dentistry, highlighting its key limitations and the urgent need for system reform. In high-income countries, the current treatment-dominated, increasingly high-technology, interventionist, and specialised approach is not tackling the underlying causes of disease and is not addressing inequalities in oral health. In low-income and middle-income countries (LMICs), the limitations of so-called westernised dentistry are at their most acute; dentistry is often unavailable, unaffordable, and inappropriate for the majority of these populations, but particularly the rural poor. Rather than being isolated and separated from the mainstream health-care system, dentistry needs to be more integrated, in particular with primary care services. The global drive for universal health coverage provides an ideal opportunity for this integration. Dental care systems should focus more on promoting and maintaining oral health and achieving greater oral health equity. Sugar, alcohol, and tobacco consumption, and their underlying social and commercial determinants, are common risk factors shared with a range of other non-communicable diseases (NCDs). Coherent and comprehensive regulation and legislation are needed to tackle these shared risk factors. In this Series paper, we focus on the need to reduce sugar consumption and describe how this can be achieved through the adoption of a range of upstream policies designed to combat the corporate strategies used by the global sugar industry to promote sugar consumption and profits. At present, the sugar industry is influencing dental research, oral health policy, and professional organisations through its well developed corporate strategies. The development of clearer and more transparent conflict of interest policies and procedures to limit and clarify the influence of the sugar industry on research, policy, and practice is needed. Combating the commercial determinants of oral diseases and other NCDs should be a major policy priority.

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Oral Conditions and Health-Related Quality of Life: A Systematic Review.

D Brennan, D G Haag, K Peres … (2017)

The objective of this study was to verify whether oral conditions (tooth loss, periodontal disease, dental caries) are negatively associated with health-related quality of life (HRQoL) in adults. A search was carried out on PubMed, EMBASE, Web of Science, Scopus, SciELO, and LILACS databases until the end of July 2016 with no date restrictions. Quantitative observational studies written in English were included and data extraction was performed independently by 2 reviewers. HRQoL was investigated as the outcome, and tooth loss, periodontal diseases, and dental caries were exposures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used and the quality of the selected studies was assessed by using the Joanna Briggs Institute Meta-Analysis of Statistics assessment and review instrument (JBI-MAStARI). Twenty-one studies were included. The sample sizes ranged from 88 to 15,501 subjects; 20 studies were cross-sectional designs, while 1 was a case-control study. Case definitions of the exposures were different across the studies, mainly for tooth loss, which was defined according to 11 different criteria. Fifteen studies were of "high" and 6 of "medium" quality. Eight HRQoL instruments were identified, and the most frequent was the EuroQol ( n = 8). Ten of 16 studies reported a negative impact of tooth loss on HRQoL. Four of 7 studies reported that periodontal disease impairs HRQoL, and 1 study showed that periodontal disease is positively associated with HRQoL. All studies that assessed dental caries reported a negative association between this condition and HRQoL. Despite the different definitions and measures of tooth loss and dental caries, the majority of the available evidence reported a negative impact of these conditions on HRQoL. Mixed and inconclusive findings were observed for the association between periodontal disease and HRQoL. Longitudinal prospective studies are suggested to improve the strength of the findings.