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Dental caries experience and associated factors in adults: a cross-sectional community survey within Ethiopia

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Birke Bogale, Fasikawit Engida, Charlotte Hanlon, Martin J. Prince, Jennifer E. Gallagher

Original languageEnglish
Article number180
JournalBMC Public Health
Issue number1
PublishedDec 2021

Bibliographical note

Funding Information: We would like to acknowledge the UK Foreign, Commonwealth and Development?Office, Chevening Secretariat for fully funding the lead author?s (BB) MSc in Dental Public Health; also, St Paul?s Hospital Millennium Medical College, Addis Ababa, Ethiopia and King?s College London, London, UK. Funding Information: JEG, CH and MJP at King’s also receive the ASSET project funding. CH additionally receives support from AMARI (African Mental Health Research Initiative) as part of the DELTAS (Developing Excellence in Leadership, Training and Science) Africa Initiative [DEL-15-01]. JEG additionally receives funding from Public Health England (Dental Public Health Academic Funding). Funding Information: This research was funded by the National Institute for Health Research (NIHR) Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa, King’s College London (GHRU 16/136/54) using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care or Public Health England. Funding Information: The ‘Health System Strengthening in sub-Saharan Africa – ASSET’ project in Ethiopia is led by King’s College London within the National Institute for Health Research (NIHR) Global Health Research grant. It is a collaborative project with Addis Ababa University, and it provides an opportunity to support the country’s healthcare system through health system strengthening interventions across its three phases: diagnostic, piloting and implementation. The aim of the dental component within the diagnostic phase of the surgical care survey was to examine the burden of oral disease and explore access to dental care and its possible barriers in a rural and urban population within Ethiopia to inform health system strengthening. This will be facilitated using the baseline information to inform the second and third phases of the ASSET project successively. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Background: Ethiopia is a developing sub-Saharan African country with increasing prevalence of non-communicable diseases (NCDs), including oral conditions. Oral health and dental care have been given little consideration, and there is limited information relating to population oral health and use of dental services in the country. The aim of this study was to examine the burden and associated factors of dental caries experience and investigate access to dental care amongst adults within Ethiopia. Methods: This community-based oral health survey is a baseline study for the ASSET - Health System Strengthening in sub-Saharan Africa project undertaken in the Butajira area, south-central Ethiopia. A stratified random sample of households and individuals participated in the study. The survey instruments were mainly based on the WHO Oral Health Survey Methods manual (5th ed.). Face-to-face interviews and clinical dental examinations were conducted. The data were analysed for descriptive statistics; and Poisson regression models were built to assess the association of dental caries and predictor variables in adults (≥18 years). Results: Most of the study population (n = 626) were female (63.9%), married (71.4%) and Muslim (76.0%). Just over half (53.2%) lived in rural areas and many (44.4%) had no formal education. A majority (74.0%) reported never utilising dental care services, and the main reason was never experiencing any dental problem (71.3%). Sixty percent (n = 377) of the adults had experienced dental caries, 88.0% (n = 332) of whom had untreated carious teeth. Pain or discomfort was reported by 16.5, and 7.2% had one or more PUFA component. Most (59.9%) adults with dental caries experience reported tooth pain or discomfort during the last year. In the fully adjusted Poisson regression model, increasing age, dental care utilisation and Khat chewing had positive significant associations with dental caries experience, whilst education status was negatively associated (p < 0.05). Conclusion: This study demonstrated a high burden of dental caries and considerable consequences resulting from untreated disease in this population of adults. There was evidence of social inequity, limited utilisation of dental care and oral health awareness. This highlights the need for oral health system strengthening focusing on health promotion and expanding overall access to care.

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