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Purpose: To assess esthetic perceptions among Tanzanian adults regarding missing teeth using a cross-sectional clinical study of a convenience sample of 5,532 subjects in the Northern coastal zone of Tanzania. Materials and Methods: The dental status of urban and rural Tanzanian adults (5,532 subjects, ages between 20 and 80 years) was recorded. A structured interview was used to assess esthetic perception (yes/no complaint) considering the location and number of missing teeth. Logistic regression analysis was applied to determine the effects of the variables age (2 groups: = 45 years vs > 45 years), gender, socioeconomic status (high/middle vs low), and residence (urban vs rural) on the number of complaints. Results: Of the subjects with 1 or more missing maxillary anterior teeth, 54% reported a complaint. Dissatisfaction was reported by significantly more subjects = 45 years of age and subjects with high/middle socioeconomic status. Gender and residence had no significant influence. Of the subjects with missing maxillary premolar(s) (no missing anterior teeth), 25% reported esthetic complaints (missing first premolar: 24%; missing second premolar: 11%; missing first and second premolar on the same side: 44%). Dissatisfaction was significantly greater in women, subjects ⩽ 45 years of age, and subjects with high/middle socioeconomic status. Residence had no significant influence. Fewer than 1% of the subjects were dissatisfied with missing maxillary molars. Conclusion: Among this group of Tanzanian adults, absence of teeth played a considerable role in the esthetic appreciation of their dentition. Complaints were associated with both number and location of missing teeth. [ABSTRACT FROM AUTHOR]

Objective. To determine the use of toothpaste, the reasons behind its irregular use, the cost perceptions, and the fluoride concentrations in locally manufactured toothpaste. Material and Methods. A total of 978 dental patients attending 13 dental clinics for 2 weeks in June 2007 completed a pre-tested questionnaire on toothpaste use. Toothpaste was collected from shops in Dar es Salaam and analyzed at the laboratory of the Dental School in Amsterdam. Logistic regression was applied to determine the relative importance of independent variables on usage and perceptions about the cost of toothpaste. Results. Eighty-six percent of respondents used toothpaste daily. Of the 130 who used toothpaste less than once a day, 57.7% gave financial reasons for their irregular use. Toothpaste was perceived as expensive by 34.8% of respondents. Urban residents were five times more likely than rural residents to use toothpaste. Younger respondents were more likely than older respondents: to perceive toothpaste as important, to brush their teeth, to use toothpaste, and to brush their teeth regularly. All toothpaste manufactured in Tanzania had free fluoride concentrations below 400 ppm. Conclusions. Most respondents used toothpaste regularly and one-third regarded it as expensive. Toothpaste manufactured in Tanzania had free fluoride concentrations below the optimum levels for dental caries prevention. For a well-functioning Basic Package of Oral Care, the authority responsible for oral health has to take measures aimed at lowering the price of toothpaste, and toothpaste manufacturers have to ensure that their products have the optimal fluoride concentration for dental caries prevention. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the magnitude of the barriers to the practice of Atraumatic Restorative Treatment (ART) as perceived by dental practitioners working in pilot dental clinics, and determine the influence of these barriers on the practice of ART., Material and Methods: A validated and tested questionnaire on barriers that may hinder the practice of ART was administered to 20 practitioners working in 13 pilot clinics. Factor analysis was performed to generate barrier factors. These were patient load, management support, cost sharing, ART skills and operator opinion. The pilot clinics kept records of teeth extracted; teeth restored by conventional approach and teeth restored by ART approach. These treatment records were used to compute the percentage of ART restorations to total teeth treated, percentage of ART restorations to total teeth restored and percentage of total restorations to total teeth treated. The mean barrier scores were generated and compared to independent variables, using the t-test. The influence of barriers to ART-related dependent variables was determined using Pearson correlation coefficients., Results: Mean barrier values were low, indicating low influence on ART practice. Female practitioners had higher scores on patient load than male practitioners (p = 0.003). Assistant Dental Officers had higher scores on cost sharing than Dental Therapists (p = 0.024). Practitioners working in urban clinics had higher mean scores on patient load than those who worked in rural clinics (p = 0.0008). All barrier factors were negatively correlated with ART practice indices but all had insignificant association with ART practice indices., Conclusion: The barriers studied were of low magnitude, with no significant impact on practice of ART in dental clinics in the pilot area.

The aim of this study was to describe the attitude and subjective norm of dental practitioners towards practicing the atraumatic restorative treatment (ART) in Tanzania. A pre-tested questionnaire on attitudes and subjective norms to practice ART was mailed to all 147 dental practitioners working in the regional and district government clinics. The independent variables were: gender, working experience, qualification and ever heard of ART. The dependent variables were: attitude, subjective norm and intention to practice ART. Chi-square tests and multiple regression analysis were used to test for effects between independent and dependent variables. Significance level was set at 5%. A total of 138 practitioners returned completed questionnaires. More experienced dental practitioners encountered moderate social pressure than less experienced dental practitioners, who met strong social pressure (p=0.045). A total of 73.2% of dental practitioners felt that ART was worth introducing in Tanzania, 92.8% recommended ART training for all dental practitioners and 97.8% recommended inclusion of ART in dental curricula. Positive attitude, strong subjective norm and high intention to practice ART were recorded in 76.3%, 28.1% and 90.6% of the practitioners, respectively. Only subjective norm had a statistically significant influence on the intention to practice ART (p<0.0001). The results indicated that dental practitioners were willing to have ART introduced in Tanzania and had positive attitudes towards practicing this technique. Nevertheless, their intention to perform ART was strongly influenced by social pressures. Therefore, in order to have a successful introduction of ART in Tanzania, people who matter in the daily practice of dental practitioners need to accept and appraise the ART approach positively.