MSc, Dentistry, Faculty of Health Sciences, University of the Witwatersrand / The characterisation of oral and maxillofacial histopathology found in children has been reported from developed countries of the west and in some developing countries in Africa but as yet not from South Africa. A retrospective study was designed to evaluate the epidemiological features of paediatric oral and maxillofacial histopathology seen at the University of the Witwatersrand’s Division of Oral Pathology from January 1987 to December 2007. A total of 1,258 children ≤ 16 years of age with histologically confirmed disease in the oral and/or maxillofacial region were recorded, with a male to female ratio of 1:1,05. A progressive increase in the frequency of oral and maxillofacial lesions was seen with increase in the age of the patient. Most lesions were concentrated in the 13-16 year age group (41,5%). Pathology involving the jaw bones formed the largest category of all oral and maxillofacial pathologies (40% of the total number of cases) and was predominated by odontogenic cysts and tumours (61,8%). Odontogenic tumours showed a significantly higher frequency in children over 12-years of age (P=0,006). A higher frequency of unicystic ameloblastoma than in the literature was noted. The remaining pathology, in decreasing order of frequency, involved the oral and perioral soft tissues (31,6%), the salivary glands (18%), oral mucosa (8,9%) and dental hard tissues (1,7%). Most lesions of soft tissue and salivary gland were reactive / inflammatory in nature and were outweighed by fibro-epithelial polyps and extravasation mucoceles respectively. Nearly two-thirds of the oral mucosal lesions were benign Human Papilloma Virus-induced lesions. Malignant neoplasms comprised 4,1% of the total number of cases with Burkitt’s lymphoma emerging as the most common malignancy. Although the smallest number of biopsy specimens was obtained from children younger than 5-years of age, the likelihood of a malignant diagnosis in the latter age group was substantially higher than in older children.

Recent studies regarding research on oral microorganisms and the oral diseases are presented. The normal flora of the mouth and the oral environment are first described. Dental plaque and dental caries are primary causes of oral disease. Streptococcus mutans is the major contributor in the initiation and progression of dental caries. Lactobacillus, Actinomyces, and Veillonella are other genera of bacteria linked to dental caries. Periodontitis and gingivitis are periodontal diseases that are caused by oral microorganisms. New research has indicated that various antimicrobial agents and techniques to eliminate or lessen the severity of periodontal diseases. Premature delivery of low birth weight babies in pregnant women has been strongly linked to periodontal disease. Present and future microbiological tests are available to easily determine the causative organisms for most oral diseases that help in diagnosis and treatment of a particular disease.

<p><font face="Times New Roman"> <p align="left">The study revealed that learners and teachers from both high and low participating schools had positive oral health knowledge, attitudes and behaviour towards oral health. However, certain socio-environmental factors which are important determinants of oral health could explain the reasons for low participation in oral health programme by some schools. Therefore the Health Promoting Schools approach is a pragmatic way to promote oral health at schools in Swakopmund district because a Health Promoting School has a healthy public policy that creates a supportive environment for oral health, making healthy choices easier.</p> </font></p>

<p><font face="Times New Roman"> <p align="left">The study revealed that learners and teachers from both high and low participating schools had positive oral health knowledge, attitudes and behaviour towards oral health. However, certain socio-environmental factors which are important determinants of oral health could explain the reasons for low participation in oral health programme by some schools. Therefore the Health Promoting Schools approach is a pragmatic way to promote oral health at schools in Swakopmund district because a Health Promoting School has a healthy public policy that creates a supportive environment for oral health, making healthy choices easier.</p> </font></p>

Magister Public Health - MPH / Background: Dental canes and gingivitis are reported to affect 60-90% of school children in most countries (World Health Organization, 2003). Learners in the Swakopmund district of Namibia were examined and it was found that 73% and 89% of them were affected by dental caries and gingivitis respectively (Ministry of Health and Social Services, 2003). This district has implemented an oral health programme at primary schools with the aim of reducing the prevalence of dental caries and gingivitis. Aim: To compare knowledge, attitudes and behaviour of teachers and learners in response to the school-based oral health programme at four primary schools in Swakopmund district. Study Design: This study is a cross-sectional survey that compared the responses of learners from high participating schools to those from low participating schools. The total sample was 186 participants comprising of 159 learners and 27 teachers. Data Collection: Structured, self-administered questionnaires were used for the teachers whilst learners were interviewed by the researcher and research assistants using structured questionnaires. Data on knowledge of risk factors for dental caries and gingivitis as well as attitude and behaviour towards prevention of these diseases at school were collected. Data analysis: Data were captured in Microsoft Excel Programme and imported to CDC Epi Info 2002 version 3.3 for analysis. Prevalence ratio (PR) was used as a preferable measure of effect at 95% confidence interval. Chi-square test was used to assess statistical significance of the proportional differences between high and low participating schools and the cut off point for statistical significance was a p-value < 0.05. 111 Results: Learners from low participating schools were more knowledgeable than learners from high participating schools in most of the knowledge questions and the results were statistically significant. There were positive oral health practices and attitudes reported by the learners with minimal differences between high participating and low participating schools and consequently the results were not statistically significant. The results for the variables knowledge, behaviour and attitudes for the teachers were not statistically significant. Teachers from both high and low participating schools exhibited high levels of knowledge and positive oral health behaviours and attitudes. However, teachers reported some shortcomings in the programme which included lack of: toothbrushes, parental involvement, time for oral health activities, regular workshops and educational materials. Conclusion: The study revealed that learners and teachers from both high and low participating schools had positive oral health knowledge, attitudes and behaviour towards oral health. However, certain socio-environmental factors which are important determinants of oral health could explain the reasons for low participation in oral health programme by some schools. Therefore the Health Promoting Schools approach is a pragmatic way to promote oral health at schools in Swakopmund district because a Health Promoting School has a healthy public policy that creates a supportive environment for oral health, making healthy choices easier.

Magister Scientiae Dentium - MSc(Dent) / A good oral health self-perception can contribute to improved knowledge of oral health self-care and practice as well as increase the proper use of dental care services. This study evaluated how adolescents from urban and peri-urban Maputo City assess their oral health status, behaviour and oral health risk factors. This is an analytic cross-sectional study, conducted in the urban and peri-urban schools of Maputo City involving adolescents in the age groups of 12 and 15-19 years old. The study was carried out in five schools, three Complete Primary schools and two Secondary schools from urban and peri-urban areas in Maputo City selected by convenience due to their geographic location. The size of the sample was 500 comprising 236 twelve year olds and 264 15-19 year olds. Data was collected using a self-completion questionnaire designed by the World Health Organization (WHO) and translated into Portuguese. The questionnaire included variables such as socio-demographic data (age, gender, location and parent or guardian level of education), self-assessment of oral health status and quality of life; self reported oral health behaviour and lifestyles, oral health risk factor knowledge (alcohol, tobacco and dietary), dental visits and daily impact of oral health. Chi-square for associations and a Spearman correlation tests were used to determine relationships between categorical data. All tests were assumed statistically significant at p≤0.05. The results showed that most of the adolescents classified their teeth (49.7%) and gum (38.2%) health as normal. There was no statistical difference between adolescents from urban and peri-urban schools (Spearman rs (399) = 0,114, p =0,02). The majority (n=322; 65.2%) of the adolescents clean their teeth twice a day. There was no difference between school level (primary and secondary school) and frequency of teeth cleaning. Most of the adolescents use a toothbrush (97.8%) and toothpaste (93.5%) to clean their teeth and only 11.9% also use dental floss but 52.1% didn´t know if their toothpaste was fluoridated or not. Smoking was reported by less than 1% of the adolescents. The main reason for dental service utilization, (reported by 67.5%) was pain or problems with teeth, gums or mouth. There was an association between oral health status and problems experienced in daily life because of their teeth and mouth. There was no significant difference for oral health assessment, risk factors and behaviours, between adolescents from urban and peri-urban schools. Although some satisfactory results were found, the need to strengthen oral health promotion in schools is high, especially considering the causes for dental service utilization were mostly pain and trouble with teeth in this group.

Abstract To date, most epidemiological studies have shown a weak or moderate association between dental diseases such as periodontal infections, dental caries and tooth loss, and atherosclerotic vascular diseases. However, the nature of this association is not known; it may be due to the biological effect of oral infections on initiation or progress of atherosclerosis or it may be non-causal due to determinants in common, either biological or behavioural. Methodological shortcomings, inconsistent results and a lack of definite proof from intervention studies have led to the conclusion that causality between dental diseases and atherosclerotic vascular diseases has not been established. The aim of this study was to produce evidence on the nature of the association between dental diseases and atherosclerotic vascular diseases. The study uses data from the 1966 Birth Cohort of Northern Finland (N = 11,637). The data were collected in 1997–1998, when the cohort members had reached 31 years of age. The respondents were asked through a postal questionnaire about their oral health. In addition, respondents were asked about their general health and oral and general health habits. The response rate was 75.3%. Those who lived in Northern Finland or the capital city region were invited to clinical health examination (N = 8,463). Altogether 5,696 subjects supplied the data, representing 67.3% of those who were invited to the clinical examination. While the study showed an association of self-reported gingivitis, dental caries and tooth loss with the prevalent angina pectoris, it also showed that these self-reported dental diseases were not important determinants for elevated C-reactive protein levels. This suggests that the associations that were found between dental conditions and prevalent angina pectoris are mainly caused by factors other than biological mechanisms related to infection or inflammation. The lack of a biological explanation related to infections or inflammatory processes suggests that other biological mechanisms or biases, including confounding, should be considered as an alternative explanation. However, it must be noted that the possibility that oral infections also contribute to the development of atherosclerosis should not be rejected either.

Background: Oral health is a part of general health and it is therefore important that nurses are able to detect abnormalities in the mouth to refer to dental care. Aim: The aim of this study was to examine oral health knowledge regarding oral diseases and oral hygiene among nursing students at two universities - InHolland University and University of Victoria [UVic]. Method: This study has a quantitative cross-sectional design based on a questionnaire. Chi-square tests were made to discover differences between the two universities. Results: The study consists of a total of 105 questionnaires. The participants had good knowledge of oral hygiene. Concerning knowledge about dental caries, gingivitis, and periodontitis, limited knowledge and several statistical significant differences between the universities were found. The extent of the oral health education was between 1-10 hours in the respective universities. Several nurses considered that they did not feel ready or were unsure if they have enough knowledge about oral health for their future work. Conclusion: The study has shown that the nursing students at both InHolland University and UVic have basic knowledge regarding oral hygiene but moderate knowledge in oral diseases regarding development and prevention of dental caries, gingivitis and periodontitis. / Bakgrund: Oral hälsa är en del av allmän hälsa och därför är det viktigt att sjuksköterskor kan upptäcka eventuella avvikelser i munnen för att remittera vidare till tandvård. Syfte: Syftet med studien var att undersöka kunskap om oral hälsa gällande orala sjukdomar och munhygien bland sjuksköterskestudenter vid InHolland University och University of Victoria [UVic]. Metod: En kvantitativ tvärsnittsstudie med enkät som datainsamlingsmetod genomfördes bland tredje års sjuksköterskestudenter vid InHolland University och UVic. Chi-2 tester utfördes för att jämföra variabler mellan universiteten. Resultat: Studien består av totalt 105 enkäter. Resultatet avseende munhygien visade på goda kunskaper inom ämnet. Resultatet avseende kunskaper om karies, gingivit samt parodontit visade på en begränsad kunskap och skillnader återfanns mellan universiteten. Omfattningen av utbildning inom oral hälsa på programmen låg mellan 1-10 timmar på båda universiteten. Flera sjuksköterskestudenter ansåg att de inte kände sig redo eller var osäkra på om de var redo att tillämpa sina kunskaper inom oral hälsa, genom att upptäcka och jobba preventivt, i framtida arbetet. Slutsats: Studien visar att sjuksköterskestudenter har grundläggande kunskaper avseende munhygienen men måttlig kunskap inom orala sjukdomar avseende uppkomst och prevention av karies, gingivit och parodontit.

Introduction Intraoral soft tissue infections (OSTI) are a common problem in dentistry and oral surgery. These abscesses are mostly exacerbated dental infections (OIDC), and some emerge as postoperative infections (POI) after tooth extraction (OITR) or apicoectomy (OIRR). The main aim of this study was to compare OIDC with POI, especially looking at the bacteria involved. An additional question was, therefore, if different antibiotic treatments should be used with OSTI of differing aetiologies. The impact of third molars on OSTI was evaluated and also the rates of POI after removal of third molars were specified. Materials and methods Patient data was collected from the patients' medical records and the results were statistically evaluated with SPSS (SPSS version 21.0; SPSS, IBM; Chicago, IL, USA). The inclusion criterion was the outpatient treatment of a patient with an exacerbated oral infection; the exclusion criteria were an early stage of infiltration without abscess formation; and a need for inpatient treatment. Results Periapical exacerbated infections, especially in the molar region were the commonest cause of OIDC. In the OITR group, mandibular tooth removal was the commonest factor (p=0.016). Remarkably, retained lower wisdom teeth led 91 to significant number of cases in the OITR group (p=0.022). Conclusions In our study we could not define differences between the causal bacteria found in patients with OIDC and POI. Due to resistance rates we conclude that amoxicillin combined with clavulanic acid seems to be the antibiotic standard for exacerbated intraoral infections independent of their aetiology. / Einführung Intraorale Weichteilinfektionen (OSTI) sind ein häufiges Problem in der Zahnmedizin und Kieferchirurgie. Diese Abszesse sind meist dentalen Ursprungs(OIDC), einige wiederum treten als postoperative Infektionen (POI) nach einer Zahnextraktion (OITR) oder Wurzelspitzenresektion (Oirr) auf. Das Hauptziel dieser Studie war es OIDC mit POI zu vergleichen. Ein weiteres Ziel war es, die unterschiedlichen antibiotischen Behandlungen bei OSTI unterschiedlicher Ätiologien gegeneinander abzuwägen. Die Auswirkungen der dritten Molaren auf OSTI wurde ebenfalls untersucht, und auch die Rate von POI nach Entfernung der dritten Molaren wurden angegeben. Material und Methode Die Patientendaten wurden durch die Analyse der Aufzeichnungen und Akten erhoben. Die Ergebnisse wurden statistisch ausgewertet mit SPSS (SPSS Version 21.0, SPSS, IBM, Chicago, IL, USA). Einschlusskriterium war die ambulante Behandlung eines Patienten mit dem Krankheitsbild einer intraoralen Infektion. Die Ausschlusskriterien waren ein frühes Stadium der Infiltration ohne Abszessbildung und die Notwendigkeit einer stationären Behandlung. Ergebnisse Apikale Parodontitiden, vor allem im Bereich der Molaren waren die häufigste Ursache für OIDC. In der OITR Gruppe war Zahnentfernung die häufigste Ursache (p = 0,016). Bemerkenswerterweise führte die Entfernung von unteren Weisheitszähnen zu einer erheblichen Anzahl von Fällen in der OITR Gruppe (p = 0,022). Schlussfolgerungen In unserer Studie konnten wir keine Unterschiede zwischen der bakteriellen Flora bei Patienten mit OIDC und POI erörtern. Aufgrund der aktuellen Resistenzraten, ziehen wir die Schlussfolgerung, dass Amoxicillin kombiniert mit Clavulansäure das Antibiotikum der Wahl für intraorale Infektionen, unabhängig von deren Ätiologie, zu sein scheint.

Objetivo: Evaluación de la osificación de la sutura media palatina y la discrepancia transversal maxilar en pacientes de 18 a 40 años de un centro radiológico de Lima - Perú. Materiales y métodos: Se realizó un estudio observacional de corte transversal. La muestra estuvo constituída por 234 tomografías computarizadas de haz cónico en pacientes de 18 a 40 años de edad, donde se realizó el análisis de Penn CBCT para la evaluación de la discrepancia transversal maxilar mientras que la clasificación de Angelieri se utilizó para evaluar la osificación de la sutura media palatina. Se utilizaron las pruebas de Chi cuadrado, U Mann Whitney y Correlación de Spearman para evaluar si existe relación entre las variables de estudio. Resultados: La discrepancia transversal fue de 7.27mm. Por otro lado, se encontró que en el rango de 18 a 28 años de edad prevalece el estado B con 65 pacientes, mientras que en el rango de 29 a 40 años hubieron 50 pacientes del mismo estado. Así mismo, existe asociación entre la discrepancia transversal maxilar con el género, mientras que la osificación de la sutura media palatina no está relacionada al género. Conclusiones: Se concluye que no se encontró una asociación entre la osificación de la sutura media palatina, la discrepancia transversal y la edad, esto indica que cada variable es independiente. Por otro lado, existe asociación entre la discrepancia transversal maxilar y el género. / Objective: Evaluation of the ossification of the mid-palatal suture and the maxillary transverse discrepancy in patients aged 18 to 40 years from a radiological center in Lima-Peru. Materials and methods: An observational cross-sectional study was conducted. The sample consisted of 234 conical beam CT scans in patients aged 18 to 40 years, where the CBCT Penn analysis was performed for the evaluation of the maxillary transverse discrepancy, while the Angelieri classification was used to evaluate the ossification of the mid palatal suture. Chi Square, Mann–Whitney U, and Spearman Correlation tests were used to assess whether there was a relationship between the study variables. Results: The transverse discrepancy was 7.27 mm. On the other hand, it was found that in the range of 18 to 28 years of age, state B prevails with 65 patients, while in the range of 29 to 40 years there were 50 patients of the same state. Likewise, there was an association between the maxillary transverse discrepancy with the gender, while the ossification of the mid-palatal suture was not related with the gender. Conclusions: It was concluded that no association was found between the ossification of the mid-palatal suture, the transverse discrepancy, and age; this indicates that each variable is independent. On the other hand, there was an association between maxillary transversal discrepancy and gender. / Tesis