Objective: To determine the causes and pattern of missing permanent teeth among Kenyans. Design: A descriptive cross-sectional study. Setting: Five districts in Kenya. Subjects: Seven hundred and twenty two persons aged 6-85 years (346 males and 376 females). Methods: This study was undertaken in October 2001 during the National Dental Health Action Month organised by the Kenya Dental Association. Six centres in five districts were identified and subjects randomly selected. Intra-oral examination was done visually and results were recorded on specially designed clinical examination forms. Results: The mean number of missing teeth in the population was 1.60. Among those with missing teeth, the mean number of missing teeth was 3.35. The most commonly missing teeth were lower molars followed by upper molars. No record of complete edentulousness in both jaws was encountered. Dental caries was the commonest cause of tooth loss (52.6%), followed by periodontal disease (27.6%). Extractions, as a form of traditional practice, accounted for 12.3% of total tooth loss. Orthodontic treatment and trauma accounted for 2.2% and 2.0% respectively of total tooth loss. The upper and lower posteriors were the commonest teeth lost due to dental caries and periodontal disease. Teeth lost due to trauma were mostly upper anteriors, whereas those extracted due to traditional practices were exclusively lower anteriors. Conclusion:The findings of this study show that the commonly lost teeth are molars and the principal cause of tooth loss is dental caries followed by periodontal disease. Overall, very few extractions had been done for orthodontic reasons.

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Objective: To determine the internal root morphology of the maxillary first premolar in Kenyans of African descent. Design: In vitro descriptive cross-sectional study. Setting: School of Dental Sciences, University of Nairobi. Subjects: One hundred and fifty five extracted maxillary first premolars obtained from patients aged between 13-30 years attending dental clinics within Nairobi. Results: There were 77 premolars from males and 78 from females. Majority (87.1%) of the teeth had two canals. Males presented with three canals more commonly than females. This difference was statistically significant. According to Vertucci's classification, male specimens demonstrated five of the canals types while female specimens demonstrated all the eight canal types. These differences were not statistically significant. Conclusions: Kenyan maxillary first premolar was mostly found to have two canals. There were eight canal types, with type IV being the commonest.

Objective: To evaluate, radiographically, the root forms of maxillary incisors in a sample of patients seeking orthodontic treatment in Nairobi, Kenya. Design: A retrospective study of maxillary incisor root forms based on periapical radiographs. Setting: A private dental clinic in Nairobi, Kenya. Materials and Methods: The study comprised 393 maxillary incisors in 100 consecutive subjects(51 boys, 49 girls) aged 9-24 years. Intra-oral periapical radiographs of the incisors were evaluated. An index was used to categorise the roots as follows: 0=normal, 1=short, 2-blunt, 3=apical bend, 4=pippete apex. Results: Normal root form was recorded in 60%, short in 12.5%, blunt in 7%, apical bend in 13%, and pippete-apex in 7% of the roots. Sixty nine percent of the pippeteapex roots were in central incisors and 94% of the roots with apical bend were in lateral incisors. Seventy three percent of short roots were in females. Conclusion: Based on evidence from previous studies on risk of root resorption which indicates that pipette and blunt roots are the forms mostly involved in this phenomenon, the present data imply that about 14% of the roots may have been at risk of moderate to severe resorption during fixed orthodontic treatment.

Hereditary gingival hyperplasia (HGF) is a rare condition characterised by hyperplastic, dense fibrous connective tissue with acanthotic gingival epithelium. A family presented at the School of Dental Sciences, University of Nairobi with a complaint that some of the children developed swollen gums very early in life and that this got worse with eruption of the permanent teeth. The first born, a 23-year-old male, had had the swellings for over ten years. Other siblings aged 5,9 and 12 years were also affected. The swellings had affected the appearance, speech and the psychosocial wellbeing of the children. The parents were unaffected with apparently negative family histories. Following oral examination and appropriate investigations, conventional gingivectomy was performed of the maxillary and the mandibular gingivae for the siblings: the 23-12-and the nine-year olds. The fourth affected child, a five-year-old, was still in primary dentition and had just started showing mild signs of gingival hyperplasia. The histopathological examination of the specimens from the present cases confirmed features consistent with those of HGF. This article highlights a familial presentation of HGF.