It is commonly believed that the prevalence of dental caries in developing countries is increasing, though in Kenya and Tanzania there is insufficient information to confirm such trends. In order to test the hypothesis, therefore, 762 children in Dar es Salaam and 802 children in Nairobi aged 12 yr in 1984 were examined for dental caries as part of a baseline study to monitor changes of prevalence with time. Dental caries was recorded by surfaces using the criteria recommended by the WHO and examinations were performed by standardized examiners. The mean DMFT in Dar es Salaam of 0.67 (SD 1.20) was significantly higher than that for Nairobi, 0.51 (SD 1.23). No differences were found in the mean DMFS index. Nairobi children had a greater number of filled teeth and surfaces. Although a greater proportion of children were caries-free in Nairobi than in Dar es Salaam, amongst those with caries, Nairobi children had significantly higher DMFS scores, and a greater proportion with DMFS greater than 4. The possible reasons for such findings are discussed. The mean DMFT and DMFS reported here are amongst the lowest reported in the recent literature from both countries.

Child↗

PubMed1986

Tooth and surface patterns of dental caries in 12-year-old urban children in East Africa.

In this report on the findings of a baseline study designed to monitor changes in the prevalence of dental caries in 12-yr-old children in Dar es Salaam and Nairobi, the details relating to the pattern of carious attack on particular tooth and surface types are described. In both populations molars accounted for over 90% of all affected teeth and in both groups first molars were more affected than second molars. Very few anterior teeth were affected in either population, though caries of the incisors and canines accounted for a greater proportion of affected teeth in Nairobi (3.4%) than in Dar es Salaam (0.6%). Significantly more mandibular first and second molars were affected in Dar es Salaam than in Nairobi, though in Nairobi the maxillary first molars were more affected than in Dar es Salaam. Occlusal surfaces were the most common site for caries in both populations. With the exception of buccal surfaces, smooth surface caries tended to be higher in Nairobi than in Dar es Salaam. Dar es Salaam children had, however, a significantly higher mean DFS score for occlusal surfaces. The preponderance of occlusal caries indicates that relatively simple restorative care is required to meet the needs of the two populations, and it is suggested that such care could be largely provided by auxiliary dental personnel.

Bicuspid↗

PubMed1986

Posteruptive tooth age and severity of dental fluorosis in Kenya.

The purpose of the present study was to assess whether the degree of severity of enamel changes in a population exhibiting rather severe dental fluorosis may be related to posteruptive tooth age and to describe the clinical manifestations of the enamel destructions. All permanent teeth in 102 children aged 10-15 yr who were born and reared in a 2 ppm fluoride area of Kenya were examined for dental fluorosis using the TF-Index. Clinically, at time of eruption all teeth appeared chalky white, but already prior to coming into occlusion discrete pits had formed. A variety of more extensive damages to the surface enamel was found in teeth already in occlusion. In particular, the maxillary incisors exhibited extensive artificial attrition for cosmetic reasons, which make these teeth unreliable for accurate scoring of severity in the present population. An analysis of the proportion of teeth exhibiting TFI-scores 4+, 5+ and 6+ showed that children aged 13-15 yr had a significantly greater proportion of teeth with TFI-scores greater than or equal to 6 compared to children aged 10-12 yr (Wilcoxon, P less than 0.0001). This finding is unlikely to be a result of different fluoride exposures in the two age groups and indicates that even several years after eruption there is a trend towards an increasing severity of enamel surface destructions in children exhibiting pronounced degrees of subsurface enamel hypomineralization at time of eruption.

Adolescent↗

PubMed1986

Enamel changes in two low-fluoride areas of Kenya.

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Adolescent↗

PubMed1986

Fluoride, altitude and dental fluorosis.

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Adolescent↗

PubMed1986

Dental fluorosis in an area of Kenya with 2 ppm fluoride in the drinking water.

We examined 102 children born and reared in an area of rural Kenya with 2 ppm fluoride in the drinking water for dental fluorosis, using the index developed by Thylstrup and Fejerskov (1978). The prevalence of dental fluorosis was 100%, 92% of all teeth exhibited a TFI score of 4 or higher, and 50% of the children had pitting or more severe enamel damage in at least half the teeth present. The fluorotic changes showed a high degree of bilateral symmetry. The intra-oral distribution of the changes corresponded to the pattern of fluoride-induced enamel changes reported by other investigators in high-fluoride areas. The high prevalence and severity of dental fluorosis in a 2-ppm-fluoride area is in accordance with recent observations on dental fluorosis being very prevalent in Kenya, even in low-fluoride areas (less than 1 ppm F). We are presently investigating the possible variables which may explain this unexpected susceptibility of large populations in Eastern Africa to fluorosis from exposure to low levels of fluoride.

Adolescent↗

PubMed1986