Atraumatic restorative treatment (ART): the Tanzanian experience

Abstract

Atraumatic Restorative Treatment (ART), which involves the use of hand instruments, is a relatively inexpensive, non-sophisticated, tooth conservative technique that offers the opportunity for restorative work in remote areas without electricity. The objectives of this survey were to evaluate the experience of dental practitioners with ART and the impact of the technique on oral health care in Tanzania, where ART was pioneered. Dental officers (DOs), assistant dental officers (ADOs) and dental therapists (DTs) from different parts of the Tanzania mainland participated in a cross-sectional study that gathered information using a self-administered structured questionnaire. Only 41 (35%) of the 117 respondents were practising ART with only 6.5% of them doing so either "most of the time" or "always". Practising ART was significantly associated with the cadre of the dental practitioner, being higher among ADOs (50%) than DOs (37%) and DTs (20%), and with ART training, but was not related to either working experience or material availability. To date, ART has made little impact on oral health care delivery in Tanzania, where dental extractions still account for over 90% of all forms of dental treatment, and restorative work for less than 5%. Several problems in providing ART were noted, such as limited practical training and practice in ART, scarce resources, and lack of advocacy. An increased involvement and support for ART from the Ministry of Health and professional organisations, and public education of ART is called for.