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O objetivo deste estudo foi descrever a prevalência e severidade dos problemas de oclusão dentária em escolares no Estado de São Paulo, explorando a associação entre os indicadores epidemiológicos dos problemas de oclusão e as variáveis sócio-econômicas, demográficas e os indicadores de provisão de serviços odontológicos. Sua principal base de informações é o levantamento epidemiológico em saúde bucal realizado em 2002 pela Secretaria de Estado da Saúde de São Paulo, tendo como população de referência escolares de 5 (n=4936), de 12 anos (n=5779) e de 15 a 19 anos de idade (n=1823). Para examinar a oclusão dentária, foi aplicado o Índice de Estética Dentária. Para a idade de 5 anos, a prevalência de maloclusão severa no Estado de São Paulo foi 22% e de maloclusão em qualquer grau (leve ou severa) foi 43%. Aos 12 anos de idade, apontou-se maloclusão definida em 20% dos escolares examinados, maloclusão severa em 10% e maloclusão muito severa incapacitante em 7%. Para a faixa etária de 15 a 19 anos; apontou-se maloclusão definida em 13% dos escolares examinados, maloclusão severa em 6% e maloclusão muito severa ou incapacitante em 6%. No que diz respeito à análise dos dados agregados, o sentido geral deste estudo é de que o Índice de Estética Dentária, bem como seus componentes, não associaram significantemente com as medidas de desenvolvimento socioeconômico e de provisão de serviços odontológicos. / The aim of this study is to describe the prevalence and severity of malocclusion in schoolchildren of the state of São Paulo, and in the 34 towns included in the survey, exploring the association between epidemiologic indicators of dentofacial anomalies and covariates on socio-demographic characteristics and provision of dental services. Its main source of information was the epidemiologic survey on oral health performed in 2002 by the health department of the state of São Paulo, which assessed schoolchildren aged 5 (n=4936), 12 (n=5779) and 15-19 (n=1823) years old, which were enrolled in public and private schools. We also gathered socioeconomic information and data related to the provision of dental services in participating towns. Dental occlusion was assessed in terms of the Dental Aesthetic Index. For 5-year-old schoolchildren, the prevalence of severe malocclusion in the state of São Paulo was 22%, and the overall prevalence of malocclusion (mild or severe) was 43%. Definite malocclusion affected 20% of 12-year-old schoolchildren, severe malocclusion affected 10%, and very severe or handicapping malocclusion affected 7%. For 15- to 19-year-old adolescents, the prevalence of definite malocclusion was 13%, of severe malocclusion was 6%, and of very severe or handicapping malocclusion was 6%. Regarding data aggregated at the town level, the current study observed absent association between the Dental Aesthetic Index, as well as of its components, and indices of socioeconomic development and the provision of dental services.

O objetivo deste estudo foi descrever a prevalência e severidade dos problemas de oclusão dentária em escolares no Estado de São Paulo, explorando a associação entre os indicadores epidemiológicos dos problemas de oclusão e as variáveis sócio-econômicas, demográficas e os indicadores de provisão de serviços odontológicos. Sua principal base de informações é o levantamento epidemiológico em saúde bucal realizado em 2002 pela Secretaria de Estado da Saúde de São Paulo, tendo como população de referência escolares de 5 (n=4936), de 12 anos (n=5779) e de 15 a 19 anos de idade (n=1823). Para examinar a oclusão dentária, foi aplicado o Índice de Estética Dentária. Para a idade de 5 anos, a prevalência de maloclusão severa no Estado de São Paulo foi 22% e de maloclusão em qualquer grau (leve ou severa) foi 43%. Aos 12 anos de idade, apontou-se maloclusão definida em 20% dos escolares examinados, maloclusão severa em 10% e maloclusão muito severa incapacitante em 7%. Para a faixa etária de 15 a 19 anos; apontou-se maloclusão definida em 13% dos escolares examinados, maloclusão severa em 6% e maloclusão muito severa ou incapacitante em 6%. No que diz respeito à análise dos dados agregados, o sentido geral deste estudo é de que o Índice de Estética Dentária, bem como seus componentes, não associaram significantemente com as medidas de desenvolvimento socioeconômico e de provisão de serviços odontológicos. / The aim of this study is to describe the prevalence and severity of malocclusion in schoolchildren of the state of São Paulo, and in the 34 towns included in the survey, exploring the association between epidemiologic indicators of dentofacial anomalies and covariates on socio-demographic characteristics and provision of dental services. Its main source of information was the epidemiologic survey on oral health performed in 2002 by the health department of the state of São Paulo, which assessed schoolchildren aged 5 (n=4936), 12 (n=5779) and 15-19 (n=1823) years old, which were enrolled in public and private schools. We also gathered socioeconomic information and data related to the provision of dental services in participating towns. Dental occlusion was assessed in terms of the Dental Aesthetic Index. For 5-year-old schoolchildren, the prevalence of severe malocclusion in the state of São Paulo was 22%, and the overall prevalence of malocclusion (mild or severe) was 43%. Definite malocclusion affected 20% of 12-year-old schoolchildren, severe malocclusion affected 10%, and very severe or handicapping malocclusion affected 7%. For 15- to 19-year-old adolescents, the prevalence of definite malocclusion was 13%, of severe malocclusion was 6%, and of very severe or handicapping malocclusion was 6%. Regarding data aggregated at the town level, the current study observed absent association between the Dental Aesthetic Index, as well as of its components, and indices of socioeconomic development and the provision of dental services.

O Índice Dental Estético (DAI) tem sido amplamente usado em estudos envolvendo crianças e adolescentes, mas raramente usado em estudos com adultos. O propósito do presente estudo transversal foi avaliar a confiabilidade do DAI em uma amostra com 120 pacientes adultos, incluindo 46 do sexo masculino (38,3%) e 74 do sexo feminino (61,7%), entre 19 e 78 anos de idade (média de 49,2). Quase todos os pacientes apresentaram-se com muitas perdas dentárias e sem tratamento ortodôntico prévio. A prevalência e a severidade da má oclusão, a necessidade de tratamento ortodôntico, a autopercepção do paciente em relação à necessidade deste tipo de tratamento e a indicação, pelo cirurgião-dentista, foram avaliadas. Além disso, as opiniões subjetivas de 33 ortodontistas em 32 pacientes, por meio de fotografias intra e extrabucais e modelos de estudo foram também analisadas. Teste estatístico Kappa foi usado para avaliar o DAI e as opiniões dos profissionais. Testes qui-quadrado e de Fischer foram usados para verificar a correlação entre sexo, autopercepção e indicação do cirurgião-dentista e o escore do DAI. O teste t-student foi usado para investigar a correlação entre a idade e a necessidade de tratamento ortodôntico. A média do escore DAI foi de 38,5. Quase metade da amostra apresentou má oclusão severa ou muito severa, a qual sugeriu grande necessidade de tratamento ortodôntico. A confiabilidade intra e interexaminador do escore DAI e dos componentes foi muito alta (k>0,9). Inconsistências foram observadas na avaliação dos especialistas (k<0,4). Não houve diferenças estatisticamente significantes (P>0.05) nos escores do DAI entre sexo, idade, autopercepção da necessidade de tratamento, entretanto diferenças significantes foram encontradas em relação às indicações pelo cirurgião-dentista. Os resultados do presente estudo sugerem que a população de adultos com perdas dentárias tem elevada severidade da má oclusão e alta necessidade de tratamento ortodôntico. / Dental Aesthetic Index (DAI) has been broadly used in studies comprising children and adolescent patients but rarely used in adult studies. The aim of the present cross-sectional study was to evaluate the reliability of the DAI index in a sample of 120 adult patients, including 46 male (38.3%) and 74 female (61.7%), aged 19-78 years (mean 49.2). Several patients presented extensive dental missing and no orthodontic treatment. Prevalence, severity of malocclusion, orthodontic treatment need, self-perceived and dentist referral, were assessed. Further, subjective opinions of 33 orthodontists about 32 patients, based upon intra- and extra-oral photographs and study models were evaluated. Kappa statistics was used to assess the DAI and professional opinions. Chi-square test and Fischer test were used to test the correlation between DAI score and sex, self-perceived and dentist referral. Student ttest was used to test the correlation between age and orthodontic treatment need. The mean DAI score was 38.5. Almost half of the sample presented severe or very severe malocclusion, which suggests a substantial treatment need. Intra-rater and inter-rater reliability for DAI score and components was very high (k>0.9). Inconsistencies were observed in the professional evaluation (k<0.4). There were no statistically significant differences (P>0.05) in DAI scores between sex, age, selfperceived need, but significant differences were found between dentist referrals. The findings in the present study suggest that adult dental missing population have high severe malocclusion and high orthodontic treatment need for treatment.

O Índice Dental Estético (DAI) tem sido amplamente usado em estudos envolvendo crianças e adolescentes, mas raramente usado em estudos com adultos. O propósito do presente estudo transversal foi avaliar a confiabilidade do DAI em uma amostra com 120 pacientes adultos, incluindo 46 do sexo masculino (38,3%) e 74 do sexo feminino (61,7%), entre 19 e 78 anos de idade (média de 49,2). Quase todos os pacientes apresentaram-se com muitas perdas dentárias e sem tratamento ortodôntico prévio. A prevalência e a severidade da má oclusão, a necessidade de tratamento ortodôntico, a autopercepção do paciente em relação à necessidade deste tipo de tratamento e a indicação, pelo cirurgião-dentista, foram avaliadas. Além disso, as opiniões subjetivas de 33 ortodontistas em 32 pacientes, por meio de fotografias intra e extrabucais e modelos de estudo foram também analisadas. Teste estatístico Kappa foi usado para avaliar o DAI e as opiniões dos profissionais. Testes qui-quadrado e de Fischer foram usados para verificar a correlação entre sexo, autopercepção e indicação do cirurgião-dentista e o escore do DAI. O teste t-student foi usado para investigar a correlação entre a idade e a necessidade de tratamento ortodôntico. A média do escore DAI foi de 38,5. Quase metade da amostra apresentou má oclusão severa ou muito severa, a qual sugeriu grande necessidade de tratamento ortodôntico. A confiabilidade intra e interexaminador do escore DAI e dos componentes foi muito alta (k>0,9). Inconsistências foram observadas na avaliação dos especialistas (k<0,4). Não houve diferenças estatisticamente significantes (P>0.05) nos escores do DAI entre sexo, idade, autopercepção da necessidade de tratamento, entretanto diferenças significantes foram encontradas em relação às indicações pelo cirurgião-dentista. Os resultados do presente estudo sugerem que a população de adultos com perdas dentárias tem elevada severidade da má oclusão e alta necessidade de tratamento ortodôntico. / Dental Aesthetic Index (DAI) has been broadly used in studies comprising children and adolescent patients but rarely used in adult studies. The aim of the present cross-sectional study was to evaluate the reliability of the DAI index in a sample of 120 adult patients, including 46 male (38.3%) and 74 female (61.7%), aged 19-78 years (mean 49.2). Several patients presented extensive dental missing and no orthodontic treatment. Prevalence, severity of malocclusion, orthodontic treatment need, self-perceived and dentist referral, were assessed. Further, subjective opinions of 33 orthodontists about 32 patients, based upon intra- and extra-oral photographs and study models were evaluated. Kappa statistics was used to assess the DAI and professional opinions. Chi-square test and Fischer test were used to test the correlation between DAI score and sex, self-perceived and dentist referral. Student ttest was used to test the correlation between age and orthodontic treatment need. The mean DAI score was 38.5. Almost half of the sample presented severe or very severe malocclusion, which suggests a substantial treatment need. Intra-rater and inter-rater reliability for DAI score and components was very high (k>0.9). Inconsistencies were observed in the professional evaluation (k<0.4). There were no statistically significant differences (P>0.05) in DAI scores between sex, age, selfperceived need, but significant differences were found between dentist referrals. The findings in the present study suggest that adult dental missing population have high severe malocclusion and high orthodontic treatment need for treatment.

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No. of bitstreams: 1 alinemariadocouto.pdf: 4768441 bytes, checksum: 13afb9b4e64eff7116678c265efef1bb (MD5) Previous issue date: 2015-09-14 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O objetivo deste estudo foi avaliar a prevalência de maloclusão e a necessidade de tratamento ortodôntico normativa em estudantes de 12 anos de idade das escolas da rede pública da cidade de Juiz de Fora e verificar a relação de aspectos psicossociais como, nível socioeconômico, acesso aos serviços de saúde bucal, satisfação da criança com a aparência dos dentes e percepção da necessidade de tratamento ortodôntico pela criança e pelo responsável, além do fator gênero, com a maloclusão e a necessidade de tratamento ortodôntico normativa. Foi realizado um estudo transversal cuja população foi constituída por 311 crianças de 12 anos de idade, matriculadas no Ensino Fundamental em escolas públicas de Juiz de Fora. A amostragem do estudo foi realizada por conglomerado, com sorteio proporcional das escolas participantes dentre as escolas públicas da cidade. Para a coleta dos dados, foram usados os seguintes instrumentos: os responsáveis responderam a um questionário sobre nível socioeconômico, acesso aos serviços de saúde do menor e, uma pergunta sobre a necessidade de tratamento ortodôntico da criança. Foi realizado, também, um exame clínico ortodôntico no escolar utilizando o Índice de Estética Dental (DAI) e aplicado o questionário relacionado à aparência de seus dentes (OASIS), o questionário do Índice de Necessidade de Tratamento Ortodôntico-Componente Estético (IOTN-AC) e uma pergunta sobre a percepção da criança em relação à necessidade de tratamento ortodôntico. A análise estatística foi realizada através do teste Qui-Quadrado e do Teste Exato de Fischer. Verificou-se alta prevalência (61,4%) de maloclusão e de necessidade de tratamento ortodôntico normativa em estudantes de 12 anos de idade na cidade de Juiz de Fora. Os aspectos psicossociais como, nível socioeconômico (p=0,142), acesso aos serviços de saúde bucal (p=0,090) e percepção da necessidade de tratamento ortodôntico pela criança (p=0,165), além do fator gênero (p=0,267), não foram associados estatisticamente com a maloclusão e a necessidade de tratamento ortodôntico normativa. Já a satisfação da criança com a aparência dos dentes (p=0,002) e a percepção da necessidade de tratamento ortodôntico pelo responsável (p<0,031) se associaram significativamente com a maloclusão e a necessidade de tratamento ortodôntico normativa. A percepção da necessidade de tratamento ortodôntico, tanto pela criança (94,2%) quanto pelo responsável (90,7%) foi maior que a necessidade de tratamento ortodôntico normativa (61,4%). A indicação da necessidade de tratamento ortodôntico realizada por critérios exclusivamente normativos, não abrange os aspectos subjetivos da maloclusão, uma vez que ignora as necessidades percebidas pelos indivíduos, tal como as implicações psicossociais das disfunções dentofaciais. / The objective of this study was to evaluate the prevalence of malocclusion and the need for orthodontic regulatory treatment for students of 12 years of public schools in the city of Juiz de Fora and verify the relationship of psychosocial factors as socioeconomic status, access to services oral health, children's satisfaction with appearance of teeth and perceived need for orthodontic treatment for the child and the responsibility, beyond gender factor, with malocclusion and the need for orthodontic treatment rules. A cross-sectional study was conducted whose population consisted of 311 children 12 years of age, enrolled in primary education in public schools in Juiz de Fora. The study sample was performed by conglomerate with proportional draw of the participating schools from public schools in the city. To collect the data, the following instruments were used: the guardians answered a questionnaire on socioeconomic status, less access to health services, and a question about the need for child's orthodontic treatment. Was also carried out an orthodontic clinical examination in the school using the Dental Aesthetic Index (DAI) and applied the questionnaire related to the appearance of your teeth (OASIS), the questionnaire Treatment Need Index Orthodontic-component Aesthetic (IOTN-AC) and a question about the child's perception of the need for orthodontic treatment. Statistical analysis was performed using the chi-square test and Fisher exact test. There was a high prevalence (61.4%) of malocclusion and need for orthodontic treatment rules for students 12 years of age in the city of Juiz de Fora. The psychosocial aspects as socioeconomic status (p=0.142), access to oral health services (p=0.090) and perceived need for orthodontic treatment for children (p=0.165), and the gender factor (p=0.267), not they were statistically associated with malocclusion and rules need for orthodontic treatment. Already the satisfaction of the child with the appearance of teeth (p=0.002) and the perceived need for orthodontic treatment by the head (p<0.031) were significantly associated with malocclusion and the need for orthodontic treatment rules. The perceived need for orthodontic treatment, both for the child (94.2%) and by the head (90.7%) was greater than the need for orthodontic treatment rules (61.4%). The indication of the need for orthodontic treatment performed by exclusively normative criteria does not cover the subjective aspects of malocclusion, since it ignores the needs perceived by individuals as the psychosocial implications of dentofacial disorders.

Contemporary conceptual models of health emphasize the importance of patient-based outcomes and recognize the complexity involved in their assessment. Various health conditions, personal, social, and environmental factors, are all thought to contribute to individual’s quality of life. However, the impact of orthodontic treatment on Oral Health-related Quality of Life (OH-QOL) outcomes in children has not yet been systematically studied. Hence, this research was planned to assess the effect orthodontic treatment has on pediatric OH-QOL outcomes. Further, the important moderational role of children’s psychological assets on OH-QOL reports is explored. Following completion of a preliminary study to confirm the psychometric properties of the Child Perception Questionnaire (CPQl1-14), the current two-phase study was undertaken. This consisted of a cross-sectional study examining the relationship among Self-Esteem (SE), malocclusion, and OH-QOL, and a longitudinal study examining the influence of orthodontics and children’s Psychological Wellbeing (PWB) on OH-QOL reports. This PhD dissertation is presented in the “Publishable Style”. The journals which hold the copyrights for the papers published from this thesis have given permission for the reproduction of the text and figures for this dissertation. The preliminary data confirmed that the CPQ11-14 is sensitive to change when used with children receiving orthodontic treatment. Our cross-sectional findings indicated that the impact of malocclusion on OH-QOL is substantial in children with low SE and identified SE as a salient determinant of OH-QOL in children seeking orthodontic treatment. Longitudinal data, on the other hand, detected significant improvement of OH-QOL outcomes after orthodontic treatment. As postulated, these improvements were most evident for the social and emotional domains of OH-QOL. However, covariate analysis emphasized the important role psychological factors play in moderating OH-QOL reports, as children with better PWB were more likely to report better OH-QOL regardless of their orthodontic treatment status. These results substantiate the validity of contemporary models of patient-based outcomes linking biological, personal, social, and environmental factors. Researchers and clinicians are encouraged to adopt this forward thinking approach when dealing with children with oro-facial conditions. Further studies with larger samples and longer follow-ups would be of value to expand on these findings.

Contemporary conceptual models of health emphasize the importance of patient-based outcomes and recognize the complexity involved in their assessment. Various health conditions, personal, social, and environmental factors, are all thought to contribute to individual’s quality of life. However, the impact of orthodontic treatment on Oral Health-related Quality of Life (OH-QOL) outcomes in children has not yet been systematically studied. Hence, this research was planned to assess the effect orthodontic treatment has on pediatric OH-QOL outcomes. Further, the important moderational role of children’s psychological assets on OH-QOL reports is explored. Following completion of a preliminary study to confirm the psychometric properties of the Child Perception Questionnaire (CPQl1-14), the current two-phase study was undertaken. This consisted of a cross-sectional study examining the relationship among Self-Esteem (SE), malocclusion, and OH-QOL, and a longitudinal study examining the influence of orthodontics and children’s Psychological Wellbeing (PWB) on OH-QOL reports. This PhD dissertation is presented in the “Publishable Style”. The journals which hold the copyrights for the papers published from this thesis have given permission for the reproduction of the text and figures for this dissertation. The preliminary data confirmed that the CPQ11-14 is sensitive to change when used with children receiving orthodontic treatment. Our cross-sectional findings indicated that the impact of malocclusion on OH-QOL is substantial in children with low SE and identified SE as a salient determinant of OH-QOL in children seeking orthodontic treatment. Longitudinal data, on the other hand, detected significant improvement of OH-QOL outcomes after orthodontic treatment. As postulated, these improvements were most evident for the social and emotional domains of OH-QOL. However, covariate analysis emphasized the important role psychological factors play in moderating OH-QOL reports, as children with better PWB were more likely to report better OH-QOL regardless of their orthodontic treatment status. These results substantiate the validity of contemporary models of patient-based outcomes linking biological, personal, social, and environmental factors. Researchers and clinicians are encouraged to adopt this forward thinking approach when dealing with children with oro-facial conditions. Further studies with larger samples and longer follow-ups would be of value to expand on these findings.

Magister Chirurgiae Dentium - MChD / Purpose: To assess the oral health status of 4-15-year-old schoolchildren in the Western Region of the Eastern Cape Province, by determining the prevalence of dental caries, periodontal disease, dental fluorosis, malocclusion and oral mucosal lesions and to create baseline data for planning oral health services in this region. Materials and Methods: The prevalent analytic survey was undertaken on 822 schoolchildren between the ages of 4-15 years in 27 different schools. The sample size selected for this region by the Department of Statistics, University of Pretoria, for the National Oral Health Survey of 1999/2000 was used. The data on 209, 210, 209 and 194 scholars in the 4-5, 6, 12 and 15-year-old age groups respectively were collected. The World Health Organization's (1997) criteria were used to determine the prevalence of caries, periodontal treatment needs, the dental fluorosis, malocclusion and prevalence of oral mucosal lesions. Six calibrated and trained examiners recorded the data on a survey form. The WHO survey forms were used for data collection. The data were analysed and processed by the author on Microsoft Excel 2000. Results: The sample size consisted of 1.35 % Asian, 51.89 % Black, 26.07 % Coloured and 20.06 % White scholars. Nearly equal amounts of males (48.3 %) and females (51.7%) were examined. The dental caries prevalence in the primary dentition of 4-5-year-olds with an average age of 4.43 years was 40.67%, with a mean dmft of 3,56. The dental caries prevalence in the permanent dentition of6-, 12- and 15-year-oldage groups was 67.62%, 46.05% and 67.92% respectively. The mean DMFT for 6-, 12- and 15 year olds were 0.05, 1.19 and 2.02 respectively. Gender differences and differences in prevalence of dental caries between the populations groups were recorded. The Coloured children experienced the highest dental caries prevalence. In the 4-5- and 15-year-old groups the males were affected more than the females by dental caries. Prevalent differences were recorded between rural and urban areas in the same population group. The prevalence of periodontal disease in 373, 12-15-year-olds was 79.09%. Only 4.02 % were in need of dental hygiene instructions and polishing. Dental education, dental hygiene instructions, dental scaling and polishing were needed by 75.07% of the children. Dental fluorosis prevalence in 450, 6-15-year-olds was 13.03%. Dental fluorosis did not affect 86.97% of the scholars; 10.63% had mild fluorosis and 2.05% was severely affected. The mean fluoride concentration in the drinking water in this region were 1.07 mgIL, ranging between 0.3-3 mgIL. Definite malocclusion was recorded in only 0.48% of the 12-year-old group, whom needed elective treatment. In the 12-year-olds, 99.52% needed no or slight treatment for no or minor malocclusions. The majority of children had no oral mucosal lesions (91.55%). The prevalence of oral mucosal lesions was 8.5% in this survey. The most frequent conditions were traumatic lesions (1.96%), dento-alveolar abscess (1.22%) and herpes labialis (1.22%). The intra-examiner reliability for caries, dental fluorosis, periodontal treatment needs and prevalence of malocclusions was 97.66%, 100%, 88.89% and 86.67% respectively. The inter-examiner reliability was 98.75%, 98.34%, 100%, 100% and 100% respectively for the five examiners. Conclusion: This survey indicated a higher prevalence of dental caries in the primary dentition (63.48%), than the permanent dentition (41.3%). The mean dmft was 3.65 and the DMFT 1.2, which indicated a low mean caries experience for these children. The WHO goal for the year 2000 for the 6-year-olds of 50% being caries free has not reached for only 32.56% were caries free. The mean DMFT of 1.2 for 12-year-olds in this survey is below the WHO goal of a mean DMFT of 1.5 or less. The lack of available preventative service provision, were ) indicated by the low percentage of fissure sealants (2.8%). The need for dental treatment was highlighted by the need mostly for one-surface restorations. Preventative treatment, two-surface fillings and extractions were also needed. Periodontal disease was a major public oral health concern for this region for a prevalence of 79.09% was recorded for the 12-15-year-olds. The majority of the children affected by periodontal disease (75.07%) were in need of professional cleaning and calculus removal. The prevalence of dental fluorosis was 8.2%, 19.87% and 13.05% for 6-, 12- and IS-year age groups respectively. The prevalence of malocclusion was 0.48% for the 12-year-old group. The prevalence of oral mucosa lesions was 8.5% for 4-15-year-old schoolchildren. Therefore, the conclusion can be made that dental fluorosis; malocclusions and oral mucosal lesions were no public concern in this region. The major public oral health concerns were dental caries in the primary dentition and periodontal disease in all age groups. Recommendations: Dental services in this region should be directed towards prevention of dental caries in the primary dentition and periodontal disease in all age groups. The focus of dental services should be primarily on preventative programs and treatments. The public dental treatments needs indicated in this survey, namely scaling and polishing, restorations and extractions, consists of the primary health care package delivery. Currently, no evaluation tool exists to monitor the efficiency of oral health programs, no baseline data for the Province exists. Therefore, the urgent need for dental research and oral health service planning and delivery are recommended.