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No description available.

Dental caries prevalence in many developing countries is low but an increased prevalence has recently been reported from some of these countries. This is in contrast to the data from the industrialised countries which show a consistent decrease in caries prevalence, particularly in urban populations. The phenomenon of a low caries experience in areas having an optimal fluoride concentration in water is well documented. On the other hand, many reports show that higher than optimal levels of fluoride in drinking water are associated with varying degrees of fluorosis (Murry et. al, 1991). In developing countries, a high prevalence of periodontal disease has been reported in both teenagers and adults. The present study compared the caries profile, periodontal disease and fluorosis among children and adults residing in low, "optimal" and high fluoride areas in four villages in the Mankwe region, North-West Province of South Africa. The population of the Mankwe region was approximately 63 000 in 1993 and fifty percent of whom were children (Development Bank of South Africa, 1994). The climateis hot and dry, and until recently, people depended on underground and rain water. Access to tap water was costly. Oral health facilities were limited and there were inadequate oral health personnel. The method of sampling, examination techniques, instruments used and the statistical analysis were carried out under supervision of experienced epidemiologist and in consultation with expert statisticians. The indices used included the Decayed, Missing and Filled Teeth (DMFT, drnft), Community Periodontal Index of Treatment Needs (CPITN) (WHO 1987; Ainamo et al, 1982), Dean's Index (Dean et al. 1942) and the Tooth Surface Index of Fluorosis (TSIF) (Horowitz et at,1984). A total of 360 subjects aged 6-7,12-13 and 30-55 years were examined. More than 90 percent of the 6-7 year old children were caries-free in the permanent dentition at all four study villages. Both ttmft and DMFT scores were very low. DMFT values for the 12-13 year old group was also well within the WHO goals in all the villages but increased in the adult group. The D-component was dominant in all groups with the occlusal surfaces most affected. There was a high percentage of periodontal disease but with low severity. Less than 30 percent of the adults aged 30-55 years demonstrated bleeding on probing at all the four villages. In the 30-55 year age groups, calculus was predominantly found at Lerome and less than 32 percent and 20 percent had shallow and deep pockets respectively at all the four villages. All those in the 12-13 and 30-55 year age groups were assessed as needing oral hygiene instructions and less than 20 percent of the adults needed advanced periodontal care. When using Dean's index in the 12-13 year age group, the highest percentage with fluorosis was found at Ruighoek which had an excessive amount of fluoride in drinking water, but fluorosis was also pronounced at Lerome. The central incisors were more affected than the lateral incisors when using the TSIF. Also, mandibular first molars were more affected than maxillary first molars. In the 30-55 year olds, there was a decrease in the severity of fluorosis with age at the high fluoride villages, but all of the adults examined had brown discolouration at Ruighoek. Based on the finding of this study it is suggested that greater efforts be made to introduce proven preventive treatment programmes in these communities. More human resources particularly in the form of auxiliaries should also be employed in order to promote oral health education and provide basic periodontal intervention. The fluorosis problem could be addressed by introducing potable water and the unsightly brown discolouration in adolescents could be eliminated by either bleaching, composite veneers or crowns, However, the latter solution is expensive and Is dependent on sophisticated equipment and highly trained dental personnel.

published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

published_or_final_version / Dental Materials Science / Master / Master of Science in Dental Materials Science