Abstract
BackgroundThe predominant mode of treatment in government dental clinics in Tanzania has been tooth extraction because the economy could not support the conventional restorative care which depends on expensive equipment, electricity and piped water systems. Atraumatic Restorative Treatment (ART) was perceived as a suitable alternative. A 3.5-year study was designed to document the changes in the treatment profiles ascribed to the systematic introduction of ART in pilot government dental clinics.MethodsDental practitioners who were working in 13 government dental clinics underwent a 7-day ART training. Treatment record data on teeth extracted and teeth restored by the conventional and ART approaches were collected from these clinics for the three study periods. The mean percentage of ART restorations to total treatment, ART restorations to total restorations, and total restorations to total treatments rendered were computed. Differences between variables were determined by ANOVA, t-test and Chi-square.ResultsThe mean percentage of ART restorations to total treatment rendered was 0.4 (SE = 0.5) and 11.9 (SE = 1.1) during the baseline and second follow-up period respectively (ANOVA mixed model; P < 0.0001). The mean percentage of ART restorations to total restorations rendered at baseline and 2nd follow-up period was 8.4% and 88.9% respectively (ANOVA mixed model; P < 0.0001). The mean percentage of restorations to total treatment rendered at baseline and 2nd follow-up was 3.9% and 13.0%, respectively (ANOVA mixed model; P < 0.0001). Ninety-nine percent of patients were satisfied with ART restorations, 96.6% willing to receive ART restoration again in future, and 94.9% willing to recommend ART treatment to their close relatives.ConclusionART introduction in pilot government dental clinics raised the number of teeth saved by restorative care. Countrywide introduction of the ART approach in Tanzania is recommended.
Highlights
The predominant mode of treatment in government dental clinics in Tanzania has been tooth extraction because the economy could not support the conventional restorative care which depends on expensive equipment, electricity and piped water systems
Rural residents, who constituted 77% of the total population in Tanzania [9], had to travel long distances to urban centres to seek oral care. This unsatisfactory oral health care had existed since independence in year 1961, and a need to seek for alternative approach of managing dental caries in Tanzania became apparent
Selection of Dental Clinics The inclusion requirement for participation in the pilot study was willingness of the health authority to: (1) allocate finances for purchasing glass-ionomer and Atraumatic Restorative Treatment (ART) hand instruments for use in dental clinics and (2) allow the dental practitioners to participate in a fulltime 7-day ART training course
Summary
The predominant mode of treatment in government dental clinics in Tanzania has been tooth extraction because the economy could not support the conventional restorative care which depends on expensive equipment, electricity and piped water systems. Rural residents, who constituted 77% of the total population in Tanzania [9], had to travel long distances to urban centres to seek oral care. This unsatisfactory oral health care had existed since independence in year 1961, and a need to seek for alternative approach of managing dental caries in Tanzania became apparent. The available epidemiological data had shown that most of the carious lesions were single surface lesions located in pits and fissures of molars, which could be managed by simple restorative care [7]
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