Sudeshni Naidoo

Traumatic dental injuries of permanent incisors in 11- to 13-year-old South African schoolchildren.

Traumatic dental injuries (TDI) are common in children. There are few data on prevalence of TDI in South African populations. We assessed the prevalence and causes of TDI to anterior teeth in 11- to 13-year-old South African schoolchildren through a cross-sectional study, using a random cluster sampling method. Oral examinations were performed by calibrated examiners following training for TDI to anterior permanent incisor teeth (eight teeth) using a modified version of Elliss classification. Of the study population of 2610 children aged 11-13 years old from 26 primary schools, 1665 children participated. The response rate was 64%. More than two-thirds (64.4%) were 12 years old. One hundred and six children had a TDI (6.4%). After adjusting for the effect of age and socio-economic status, boys had an almost 2.5 (95% CI: 1.59, 3.69) times higher probability of having a traumatic dental injury than girls. The highest prevalence was in 12 year olds and in the high socio-economic status group. Most of the children had trauma to one tooth. Enamel fracture was the main type of TDI (69.1%). The majority of the TDIs were untreated (85.4%). Homes and schools were the most common places where TDIs occurred, while only 5.7% occurred on a street, road or pavement. Falls were the main cause of TDIs. Sport was the second most common cause and the third most common cause was collision with objects. The present study indicates that the prevalence of TDIs in schoolchildren is not as high as has been reported in other countries. The prevalence of TDIs in this population was relatively low.

Do oral lesions associated with HIV affect quality of life

OBJECTIVE To assess the impact of oral lesions on quality of life (QOL) in HIV-positive (HIV+) individuals using the Oral Health Impact Profile (OHIP). STUDY DESIGN This was a cross-sectional analytic study that compared 2 groups of HIV+ patients. Group 1 (n = 71) consisted of patients who presented with oral manifestations of HIV infection. Patients in group 2 (n = 79) were also HIV positive but had no oral lesions. The QOL measures were assessed by either simple frequency counts or the use of item weights. RESULTS Oral candidiasis was the most common oral lesion diagnosed. Patients in group 1 reported significantly greater impacts (P < .05) for all 7 subscales in OHIP. CONCLUSIONS Oral lesions associated with HIV infection negatively affect the oral health-related QOL in infected patients.

Knowledge and practice of traditional healers in oral health in the Bui Division, Cameroon

BackgroundThe majority of Cameroonians depend on traditional medicines for their health care needs and about seven per cent of the average household health budget is spent on traditional medicines irrespective of their incomes. The aim of the present study was to determine the oral care knowledge and practices of Traditional Healers (TH) on oral health delivery in the urban and rural areas of Bui Division of Cameroon and the objectives to determine the cost of treatment and reasons why people visit TH.MethodsThe present study was cross sectional and utilized semi-structured questionnaires to collect data.ResultsThe sample consisted of 21 TH and 52 clients of TH. Sixty two percent of the THs were above 40 years and 90% male. The mean age was 46 years (range 20-77 years). Twenty four percent of the TH practiced as herbalists and the remainder both divination and herbalism. Sixty seven percent of people in the Bui Division, who patronize TH for their oral health needs, fall within the 20-40 year age group. There is little collaboration between the oral health workers and TH and only 6% of all patients seen by TH are referred to the dentist. Socio-cultural and economic factors affect the oral health care seeking behavior of patients in this area and only 6.5% of patients visit dental clinics. Reasons for not attending dental clinics included high cost, poor accessibility, superstition and fear. THs are not experienced in the treatment of pulpitis - the majority of patients who presented with toothache had temporary or no relief, but despite this 67% reported being satisfied with their treatment. Sixty nine percent of the patients visited TH because of low cost - the average cost of treatment with TH (approximately

Why dentists should take a greater interest in sex and gender

5) is very low, as compared to conventional treatment (

Results of a self-assessment tool to assess the operational characteristics of research ethics committees in low- and middle-income countries

50).ConclusionsTraditional healers are willing to co-operate with oral health workers in improving oral health. Since they have a vital role to play in health care seeking attitudes in this community and barriers affecting the oral health seeking behaviours should be removed. Mutual cooperation, collaboration and by integrating TH into primary oral health care services needs to be increased.

Prevalence of dental caries and toothbrushing habits among preschool children in Khartoum State, Sudan

This brief review highlights the lack of evidence relating to sex and gender differences in oral health as well as the widespread conceptual confusion and conflation that often underlies them. A broader biomedical understanding of these issues will offer a valuable framework within which differences in oral health between women and men can be further explored. This in turn would facilitate the development of the evidence base necessary to optimise the efficacy of dental practice in meeting the needs of both women and men patients.

Billions with oral disease: A global health crisis—a call to action

Purpose Many research ethics committees (RECs) have been established in low- and middle-income countries (LMICs) in response to increased research in these countries. How well these RECs are functioning remains largely unknown. Our objective was to assess the usefulness of a self-assessment tool in obtaining benchmarking data on the extent to which RECs are in compliance with recognised international standards. Methods REC chairs from several LMICs (Egypt, South Africa and India) were asked to complete an online self-assessment tool for RECs with a maximum score of 200. Individual responses were collected anonymously. Results The aggregate mean score was 137.4±35.8 (∼70% of maximum score); mean scores were significantly associated with the presence of a budget (p<0.001), but not with duration of existence, frequency of meetings, or the presence of national guidelines. As a group, RECs achieved more than 80% of the maximum score for the following domains: submission processes and documents received, recording of meeting minutes, criteria for ethical review and criteria for informed consent. RECs achieved less than 80% of the maximum score for the following domains: institutional commitment, policies and procedures of the REC, membership composition and training, policies and procedures for protocol review, elements of a decision letter and criteria for continuing review. Conclusions This study highlights areas where RECs from LMICs can improve to be in compliance with recommended international standards for RECs. The self-assessment tool provides valuable benchmarking data for RECs and can serve as a quality improvement method to help RECs enhance their operations.

The effects of an educational intervention on the early management of oral lesions in the uMgungundlovu District in KwaZulu-Natal

BACKGROUND Dental caries in preschool children remains a major dental public health problem and affects significant numbers of children in developed and developing countries. The incidence is increasing in developing countries, such as Sudan, because of lifestyle changes, absence of oral health-preventive services and inadequate access to oral health care. OBJECTIVES This study assessed the prevalence of dental caries and toothbrushing habits among 3- to 5-year-old preschool children in Khartoum State, Sudan, and described the correlation between the mean decayed, missing and filled tooth (dmft) score for primary teeth with toothbrushing and sugar consumption. MATERIALS AND METHODS The subjects were 553 preschool children with their mothers/guardians, selected by random sampling from the kindergartens of the seven localities of Khartoum State, Sudan. Data were obtained through clinical examination using a modified World Health Organization (WHO) examination data-capture sheet and through structured administered interviews with mothers/guardians. RESULTS The prevalence of dental caries was 52.4%, with a mean dmft score of 2.3. There was an increase in the dmft scores with increasing age. The frequency of children who brushed their teeth regularly at least once a day was high (83.4%), lower dmft scores were associated with starting toothbrushing earlier in life and with increased frequency of brushing per day. Eating sugar-containing food was significantly associated with dmft score. CONCLUSIONS The prevalence of dental caries was found to be high among 3- to 5-year-old preschool children, and caries experience increased with age. This was mostly associated with sugar consumption and therefore calls for educational interventions to control sugar intake. The toothbrushing habit is well established in Khartoum State, Sudan, as a large number of children were found to be brushing their teeth regularly. No significant association was found between feeding habits and dmft score.

Stigma and disclosure as barriers to regular dental care for people living with HIV/AIDS in Kwazulu-Natal and Western Cape, South Africa

Aubrey Sheiham, BDS, PhD, DHC; David M. Williams, BDS, MSc, PhD, FRCPath, FDSRCS; Robert J. Weyant, MS, DMD, DrPH; Michael Glick, DMD; Sudeshni Naidoo, BDS, LDS RCS, PhD, DSc, MDPH, DDPH RCS, MChD; Jean-Luc Eiselé, PhD; Harry-Sam Selikowitz, DDS, MSc, PhD A pproaches to improve oral health are relatively ineffective, yet costly. Despite some improvements in oral health outcomes, high-income countries are facing a dental crisis. The situation is worse in low-income nations where more than 90% of caries is untreated. In the United States, “the oral health of older Americans is in a state of decay,” one-fourth of US adults 65 years or older have lost all their teeth, and 1 in 5 people of any age has untreated dental caries. In lowand middleincome countries, dental diseases constitute a neglected epidemic, and rates are increasing. In quantitative terms, oral and dental diseases affect 3.9 billion people worldwide and leave a legacy of substantial morbidity and functional deficits among older adults. The global unweighted mean number of permanent decayed, missing, and filled teeth per 12-year-old in 2004 was 2.3, and untreated caries of the permanent dentition ranked first among all health conditions surveyed. Severe periodontal disease was the sixth most prevalent disease in the world; edentulousness, an effective marker of population oral health, affected 158 million people worldwide; and oral cancer was the sixth most common cancer in the world, accounting for an estimated 400,000 to 700,000 new cases and 127,700 deaths annually. In this editorial, we focus attention on the global burden of oral diseases, their negative social and economic effects, and the shared determinants of oral health with other noncommunicable diseases (NCDs). NCDs are defined broadly as cardiovascular disease, diabetes, respiratory disease, and cancer. We also highlight the need to reorient oral health policy as stated in FDI Vision 2020: Shaping the Future of Oral Health. Such a reoriented policy should be an integrated Oral Health in All Policies (OHiAP) embedded in Health in All Policies (HiAP).

The cadmium telluride photon counting sensor in panoramic radiology: gray value separation and its potential application for bone density evaluation.

Oral lesions that are associated with human immunodeficiency virus (HIV) infection are often the first clinical signs of an underlying infection. This study aimed to test primary healthcare (PHC) nurses’ knowledge and practices before and after an educational intervention on the detection and management of oral diseases, and in particular, those associated with HIV infection. A crosssectional study was conducted among PHC nurses who were employed in a range of clinical settings within the public sector (hospitals, clinics and nurse training colleges) in urban and rural areas in the uMgungundlovu Health District of KwaZulu-Natal. The convenience sample comprised 121 nurses who completed a self-administered questionnaire, undertook pre-education testing, were provided with educational material and underwent post-education testing. The obtained results showed that most nurses (90%) had received little or no undergraduate or postgraduate training in the examination, diagnosis or treatment of oral lesions. Analysis of the pre-education test results that pertained to the identification of a number of oral lesions revealed a mean correct response rate of 38.5%. Post-education results revealed a statistically significant (p-value < .0001) (24%) improvement to 62.4%. The provision of a basic education intervention can have significant effects on knowledge, treatment and referral patterns, and can lead to early diagnosis, treatment and improved quality of life for persons who are infected with HIV.