Traditionally removed mandibular central incisors and oral health-related quality of life: a cross-sectional study among adolescents in Maasai populated areas, Northern Tanzania

Abstract

Background The traditional removal of mandibular anterior teeth has been existing for many years in the Sub-Saharan African countries. This study aimed to assess the prevalence and sociodemographic distribution of traditional removal of mandibular central incisors (TMRCI) and its association with oral impact on daily performance (OIDP) among adolescents in Maasai populated areas in the Northern part of Tanzania.Methods Using one-stage cluster sample design, with schools as the primary sampling unit, 23 out of 66 eligible rural schools were randomly selected. From each selected school, one class, expected to contain adolescents aged 12–14 years, was identified. The students from these selected classes were invited to participate in the study. A total of 989 adolescents were invited and 906 (91.6%) accepted to participate and completed both interview and a clinical oral examination.Results Mean age was 13.4 years (12–17 years, SD 1.2) and 43.9% were males (n = 398). The participants were from Longido district (47.1%) and Monduli district (52.9%). The Maasai group constituted 79.6% and the non-Maasai group 20.4%. The frequency of the participants missing both mandibular central incisors were 18.5%. Multivariable logistic regression revealed that adolescents from Longido district were more likely to report at least one TMRCI (OR = 2.5, CI 1.4–3.3) and less likely to report at least one impact on OIDP compared to those from Monduli district (OR 0.2, 95% CI 0.2–0.4). Adolescents with at least one TRMCI were more likely to report impacts on OIDP (OR = 3.28, 95% CI 1.9–5.7) than those without TRMCI. Independent of the TRMCI status, adolescents from Longido and non- Masaai adolescents were respectively, less and more likely than their counterparts to report impacts on OIDP. The corresponding ORs were 0.4 (95% CI 0.2–0.6) and 2.2 (95% CI 1.4–3.5).Conclusion TMRCI is common among adolescents in the Maasai populated areas in the Northern part of Tanzania and strongly associated with the district of residence and Maasai ethnicity and has a negative impact on oral health related quality of life. There is a need for oral health education in the rural Maasai communities in Tanzania to increase awareness of the negative consequences of this practice.