Abstract
ObjectivesWe describe the prevalence, and individual and familial risk indicators for dental caries and gingivitis among 10–19-year-old adolescents in Ile-Ife, South-West Nigeria.MethodsThis cross-sectional study collected data through household surveys conducted between December 2018 and January 2019. Adolescents were recruited through multistage sampling. Oral health outcomes were caries, measured by the ‘Decayed, Missing due to caries, and Filled Teeth’ (DMFT) index, and gingivitis, measured by the Loe and Silness gingival index. Explanatory variables were individual (sex, age, oral health perception) and familial (socioeconomic status, birth rank, family size and parental living status) factors. Oral health behaviors (daily tooth-brushing, use of fluoridated toothpaste, consuming refined carbohydrates in-between meals, use of dental floss, dental service utilization in past 12 months, and smoking habits) were treated as confounders. Poisson regression models with robust estimation were constructed to determine associations between explanatory factors and oral health outcomes.ResultsA total of 1472 adolescents were surveyed. Caries prevalence was 3.4%, with mean (standard deviation) DMFT of 0.06 (0.36) and plaque index of 0.84 (0.56). Only 128 (8.7%) adolescents brushed their teeth twice daily, 192 (16.1%) used dental floss daily, 14 (1.1%) utilized dental services in the last 12 months, and 508 (36.1%) consumed refined carbohydrates in-between meals less than once daily. The proportion of respondents who currently smoked cigarettes was 1.6%, and 91.7% of respondents used fluoridated toothpaste daily. The adjusted prevalence ratio of having caries increased by 18% for every additional age-year (APR: 1.18; 95% CI 1.004, 1.34). Additionally, participants with high socioeconomic status had significantly lower prevalence of caries compared to those with lower status (APR: 0.40; 95% CI 0.17, 0.91). Moderate/severe gingivitis was significantly associated with higher frequency of consuming refined carbohydrates in-between meals (APR: 2.33; 95% CI 1.36, 3.99) and higher plaque index scores (APR: 16.24; 95% CI 9.83, 26.82).ConclusionCaries prevalence increased with increasing age and was higher among Nigerian adolescents with low socioeconomic status, while moderate/severe gingivitis was associated with frequent consumption of refined carbohydrates and higher plaque index score. While behavioral interventions may reduce the risk of gingivitis, structural interventions may be needed to reduce the risk for caries in this population.
Highlights
Caries in the permanent teeth is the most prevalent oral health problem globally [1], and the prevalence of untreated caries in the permanent dentition peaks in adolescence [2]
While behavioral interventions may reduce the risk of gingivitis, struc‐ tural interventions may be needed to reduce the risk for caries in this population
The study indicates that the prevalence of caries increases with age and may be higher among adolescents with low socioeconomic status
Summary
Caries in the permanent teeth is the most prevalent oral health problem globally [1], and the prevalence of untreated caries in the permanent dentition peaks in adolescence [2]. Untreated caries has negative impact on quality of life [3] increasing the risk of tooth loss, with associated negative psychological [5, 6], social [6], nutritional [7], and physical [5] consequences. It is an adverse event often occurring at the physiologically and socially vulnerable life-period of adolescence, with potentially long-term health impact [4]. In sub-Saharan Africa, increasing urbanization and a concomitant rise in the consumption of refined carbohydrates has contributed to an increase in the prevalence of oral diseases [9]
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