Abstract:In 1973 and 1984 the caries status of 624 and 394 children, respectively, was recorded in an urban area of northern Tanzania where the water fluoride content was 2.0-3.5 ppm. Although slightly different scoring criteria were used, the data showed very' low levels of caries, and little evidence of increases in caries experience over the 10-yr period. Tbe distribution of caries lesions was markedly skewed, such that a minority of mdi\'iduals accounted for most of the caries. Tbe leveh of caries were low by inter… Show more
“…For many years, the Tanzanian population demonstrated a high prevalence of untreated dentine lesions, especially among children [Kerosuo et al, 1986;Manji et al, 1986;Mosha et al, 1988;Frencken et al, 1990;Mosha et al, 1994;Kikwilu and Mandari, 2001]. Most (95%) of the dentine lesions are situated in pits and fissures of occlusal, buccal and palatinal surfaces.…”
The present randomised clinical trial was aimed at comparing three minimally invasive restorative treatment approaches for managing dental caries in occlusal surfaces using a non-gamma-2 amalgam and a low-viscosity glass-ionomer as the restorative material. The treatment approaches tested in parallel groups were: conventional in a university setting, modified-conventional and ultraconservative (Atraumatic Restorative Treatment, ART) approaches in a field setting. A split-mouth design was used in which the two restorative materials were randomly placed in 430 matched contralateral pairs of permanent molar teeth. A total of 152 children from five primary schools were recruited and treated by a dental therapist. The restorations were evaluated after 6 years by 2 calibrated independent examiners. The 6-year successes for all occlusal amalgam and glass-ionomer restorations were 72.6 and 72.3%, respectively. There were no statistically significant differences observed between the successes for both amalgam and glass-ionomer restorations placed either by the ART (68.6%, with 95% CI = 61–76%) approach or by the conventional (74.5%, with 95% CI = 65–82%) and the modified-conventional (75.8%, with 95% CI = 67–83%) approaches after 6 years. There was also no statistically significant difference observed between the successes of occlusal ART restorations with glass-ionomer (67.1%, with 95% CI = 56–77%) and occlusal conventional restorations with amalgam (74%, with 95% CI = 61–85%) after 6 years. ‘Restoration fracture/marginal defects’ and ‘loss of material’ were the most common causes for failure. The former was more often recorded in amalgam restorations and the latter in glass-ionomer restorations. Secondary caries was observed for 2% of glass-ionomer and for 10% of amalgam restorations. This difference was statistically significant (p = 0.001). The ART approach using glass-ionomer performed equally well as conventional restorative approaches using electrically driven equipment and amalgam for treating dentinal lesions in occlusal surfaces after 6 years.
“…For many years, the Tanzanian population demonstrated a high prevalence of untreated dentine lesions, especially among children [Kerosuo et al, 1986;Manji et al, 1986;Mosha et al, 1988;Frencken et al, 1990;Mosha et al, 1994;Kikwilu and Mandari, 2001]. Most (95%) of the dentine lesions are situated in pits and fissures of occlusal, buccal and palatinal surfaces.…”
The present randomised clinical trial was aimed at comparing three minimally invasive restorative treatment approaches for managing dental caries in occlusal surfaces using a non-gamma-2 amalgam and a low-viscosity glass-ionomer as the restorative material. The treatment approaches tested in parallel groups were: conventional in a university setting, modified-conventional and ultraconservative (Atraumatic Restorative Treatment, ART) approaches in a field setting. A split-mouth design was used in which the two restorative materials were randomly placed in 430 matched contralateral pairs of permanent molar teeth. A total of 152 children from five primary schools were recruited and treated by a dental therapist. The restorations were evaluated after 6 years by 2 calibrated independent examiners. The 6-year successes for all occlusal amalgam and glass-ionomer restorations were 72.6 and 72.3%, respectively. There were no statistically significant differences observed between the successes for both amalgam and glass-ionomer restorations placed either by the ART (68.6%, with 95% CI = 61–76%) approach or by the conventional (74.5%, with 95% CI = 65–82%) and the modified-conventional (75.8%, with 95% CI = 67–83%) approaches after 6 years. There was also no statistically significant difference observed between the successes of occlusal ART restorations with glass-ionomer (67.1%, with 95% CI = 56–77%) and occlusal conventional restorations with amalgam (74%, with 95% CI = 61–85%) after 6 years. ‘Restoration fracture/marginal defects’ and ‘loss of material’ were the most common causes for failure. The former was more often recorded in amalgam restorations and the latter in glass-ionomer restorations. Secondary caries was observed for 2% of glass-ionomer and for 10% of amalgam restorations. This difference was statistically significant (p = 0.001). The ART approach using glass-ionomer performed equally well as conventional restorative approaches using electrically driven equipment and amalgam for treating dentinal lesions in occlusal surfaces after 6 years.
“…Many of the studies from Africa have been carried out in Tanzania dealing with 5-19-yearolds, mainly urban residents [4,6,7,8,9,13,18,19,21,23,24,25,26,27,28,32]. The findings pertaining to 9-14-year-old Tanzanians are summarised in Table 1.…”
The aim of this investigation was to assess the role of predictors of caries experience among children in urban and rural areas of northern Tanzania. Children of the different communities had varying dietary habits and consumed water with varying fluoride (F) concentration. Subjects (n=256) aged 9-14 years were examined in high-F areas (3.6 mg F/l, Arusha and Arusha Meru, n=101) and low-F areas (<0.4 mg F/l, Moshi and Kibosho, n=155). Dental caries was assessed under field conditions using the decayed, missing, filled teeth (DMFT) index and the WHO criteria. The prevalence of caries was 14%. The mean DMFT score was 0.22 (n=256), the range between areas 0.07-0.66. Carious lesions were mainly observed in mandibular first molars. Logistic regression analyses indicated that subjects in the high-F and urban Arusha municipality were at a significantly higher risk of dental caries than children in the low-F areas (odds ratio [OR] 2.6). Controlling for ethnicity, children in urban areas were at higher risk for caries (OR 5.4) than children living in low-F rural Kibosho.
“…In tropical Africa, only a few studies have been con ducted to investigate the caries situation in populations consuming water with different fluoride levels. Results of these studies differ regarding the effect of fluoride in re ducing the rate of caries progression [Olsson, 1978;Mosha and Langebaek, 1983;Mosha et al, 1988].…”
mentioning
confidence: 99%
“…water fluori dation, have been suggested. In 1984In ,1986In and 1988, a mixed-longitudinal study amongst schoolchildren was carried out in a rural and urban area of Tanzania.In the rural area, shallow wells had been constructed at different periods in time in eight villages since the late 1970s. The drinking water in three of the vil lages contained fluoride in the range of 0.5-0.8 ppm (fluoridated) and con tained less than 0.4 ppm fluoride in the remaining five villages (non-fluoridated).…”
In general, the prevalence of caries in African children may be classified as low to very low. In order to reduce this level even further, methods including the practice of good oral hygiene and administration of fluoride, e.g. water fluoridation, have been suggested. In 1984,1986 and 1988, a mixed-longitudinal study amongst schoolchildren was carried out in a rural and urban area of Tanzania. In the rural area, shallow wells had been constructed at different periods in time in eight villages since the late 1970s. The drinking water in three of the villages contained fluoride in the range of 0.5–0.8 ppm (fluoridated) and contained less than 0.4 ppm fluoride in the remaining five villages (non-fluoridated). These fluoride levels were disclosed to the authors only during the course of the study. Thus the data were reanalysed to investigate the effects of fluoride and length of fluoride exposure on caries experience in the deciduous dentition. The study was carried out amongst 522 7- and 8-year-olds. Fluoride tablets were not used and toothpaste was virtually unavailable. Three periods of fluoride exposure were identified, i.e. 3,5 and 7 years. The outcome variable was the mean dmft score in deciduous molars whereas the explanatory variables were age, length of fluoride exposure and year of investigation. Nutrition was considered a co-variate. Analysis of co-variance revealed a fluoride effect (p = 0.0004). Regression analysis did not show significant relationships between the mean dmft score and the three periods of fluoride exposure. The findings indicated that 3 years’ exposure to low fluoride levels in drinking water can reduce further low caries severity levels in deciduous molars.
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