Malocclusion and Dental Services Utilization: Prevalence and Associated Factors Among School Children in Tanzania

Abstract

Purpose: To assess the prevalence and factors associated with malocclusion and dental services utilization among primary school children in Dar es Salaam. Materials and methods: A secondary data analysis was conducted using R software version 4.3.3 to analyze data of students from nine schools in Dar es Salaam region, Tanzania. Information on demographics, dental clinic visits, and malocclusion traits were abstracted. Descriptive measures - frequency and proportion were used to summarize the categorical variables and the log-binomial regression to assess the association between independent variables and the two binary outcomes – malocclusion and attending dental clinic, at a significance level of p less than 0.05. Results: A total of 620 school children were enrolled: 63.2% were female and 60.6% were aged 11 to 12 years. Two-thirds of the population (66.5%) had malocclusion and less than a quarter (23.1%) never attended a dental clinic. Children whose fathers had primary education had 25% increased risk for malocclusion, whereas those of less educated mothers had 34% (95% CI; 0.47-0.93) decreased chances of attending dental clinics. Conclusion:The burden of malocclusion and associated effects on oral health-related quality of life is high, demonstrating the need for targeted interventions. Socioeconomic empowerment and improving dental services are inevitable as they impact the oral health related quality of life.

Keywords

• Burden
• Dental services utilization
• Malocclusion

References

1. Cenzato N, Nobili A, Maspero C. Prevalence of dental malocclusions in different geographical areas: scoping review. Dent J (Basel). 2021;9(10). doi:10.3390/dj9100117.
2. Mtaya M, Brudvik P, Astrøm AN. Prevalence of malocclusion and its relationship with socio-demographic factors, dental caries, and oral hygiene in 12- to 14-year-old Tanzanian schoolchildren. Eur J Orthod. 2009;31(5):467–476. doi:10.1093/ejo/cjn125.
3. Pegoraro NA, Santos CMD, Colvara BC, Rech RS, Faustino-Silva DD, Hugo FN, et al. Prevalence of malocclusion in early childhood and its associated factors in a primary care service in Brazil. CoDAS. 2021;34(2):e20210007. doi:10.1590/2317-1782/20212021007.
4. Yemitan TA, Oyapero AO. Prevalence of malocclusion in Africa: a systematic review and meta-analysis. Magna Scientia Adv Res Rev. 2022;5(1):30–35. doi:10.30574/msabp.2022.5.1.0041.
5. Alhammadi MS, Halboub E, Fayed MS, Labib A, El-Saaidi C. Global distribution of malocclusion traits: a systematic review. Dent Press J Orthod. 2018;23(6):40.e1–40.e10. doi:10.1590/2177-6709.23.6.40.e1-10.onl.
6. Tefera AT, Bekele BG, Derese K, Andualem G. Prevalence of occlusal features and their relation to sociodemographic variables in Northwest Ethiopia: a cross-sectional study. Clin Cosmet Investig Dent. 2021;13:459–468. doi:10.2147/CCIDE.S332552.
7. Alshammari A, Almotairy N, Kumar A, Grigoriadis A. Effect of malocclusion on jaw motor function and chewing in children: a systematic review. Clin Oral Investig. 2022;26(3):2335–2351. doi:10.1007/s00784-021-04356-y.
8. George AM, Felicita AS, Tania SM, Priyadharsini JV. Genetic factors associated with skeletal Class II malocclusion: a systematic review. Indian J Dent Res. 2021;32(3):399–406. doi:10.4103/ijdr.IJDR_59_20.

9. Pipovic J, Uhac M, Perkovic V, Zigante M, Stefanovic N, Spalj S. Impacts of childhood malocclusion on the family. J Orofac Orthop. 2024;85(3):213–222. doi:10.1007/s00056-022-00422-6.
10. Saghiri M, Eid J, Tang C, Freag P. Factors influencing different types of malocclusion and arch form: a review. J Stomatol Oral Maxillofac Surg. 2021;122(2):185–191. doi:10.1016/j.jormas.2020.07.002.
11. Singh A, Purohit B. Is malocclusion associated with dental caries among children and adolescents in the permanent dentition? A systematic review. Community Dent Health. 2021;38(3):172–177. doi:10.1922/CDH_00340Singh06.
12. Leck R, Paul N, Rolland S, Birnie D. The consequences of living with a severe malocclusion: a review of the literature. J Orthod. 2022;49(2):228–239. doi:10.1177/14653125211042891.
13. Liu H, Li JX. Non-surgical treatment of an Angle Class III malocclusion in adults. Int J Clin Exp Med. 2013;6(9):738–743.
14. Mtaya M, Astrom AN, Brudvik P. Malocclusion, psychosocial impacts and treatment need: a cross-sectional study of Tanzanian primary schoolchildren. BMC Oral Health. 2008;8:14. doi:10.1186/1472-6831-8-14.
15. Nyamuryekung’e K, Kahabuka F. Accessing oral healthcare. In: Healthcare Access. 2022:223. doi:10.5772/intechopen.98615.
16. Sá-Pinto A, Rego T, Marques L, Martins C, Ramos-Jorge M, Ramos-Jorge J. Association between malocclusion and dental caries in adolescents: a systematic review and meta-analysis. Eur Arch Paediatr Dent. 2018;19(2):73–82. doi:10.1007/s40368-018-0333-0.
17. Valério P, Peričić TP, Rossi A, Grippaudo C, Campos JdST, do Nascimento IJB. Effectiveness of early intervention on malocclusion and its impact on craniofacial growth: a systematic review. Contemp Pediatr Dent. 2021;2021:1–18. doi:10.51463/cpd.2021.61.
18. Mashoto KO, Mwakatobe AJ. Orthodontic treatment compliance and duration among adolescent and young patients. Tanzan J Health Res. 2023;24(4):348–354. doi:10.4314/thrb.v24i4.5.
19. Edward M, Agyapong D, Paul IK, Idris I, Boris GK, Kengo NE, et al. Oral health in Tanzania: unmasking its neglected dimension. Public Health Chall. 2024;3(3):e70000. doi:10.1002/puh2.70000.
20. Rwekaza G, Mtaya-Mlangwa M. Association between malocclusion, self-perception, self-esteem and sociodemographic factors among primary schoolchildren in Dar es Salaam. Iran J Orthod. 2023;18(1):1–10. doi:10.22034/ijo.2023.1973618.1094.
21. Yin J, Zhang H, Zeng X, Yu J, Wang H, Jiang Y, et al. Prevalence and influencing factors of malocclusion in adolescents in Shanghai, China. BMC Oral Health. 2023;23(1):590. doi:10.1186/s12903-023-03187-5.
22. Broutin A, Blanchet I, Canceill T, Noirrit-Esclassan E. Association between dentofacial features and bullying from childhood to adulthood: a systematic review. Children (Basel). 2023;10(6):934. doi:10.3390/children10060934.
23. Khan M, Fida M. Assessment of psychosocial impact of dental aesthetics. J Coll Physicians Surg Pak. 2008;18(9):559–564.
24. Tristão SKP, Magno MB, Pintor AVB, Christovam IF, Ferreira DMT, Maia LC, et al. Is there a relationship between malocclusion and bullying? A systematic review. Prog Orthod. 2020;21(1):26. doi:10.1186/s40510-020-00323-7.
25. Anand T, Garg AK, Singh S. Effect of socioeconomic, nutritional status, diet, and oral habits on the prevalence of different types of malocclusion in schoolchildren. Acta Biomed. 2022;93(3):e2022161. doi:10.23750/abm.v93i3.13027.
26. Germa A, Kaminski M, Nabet C. Impact of social and economic characteristics on orthodontic treatment among children and teenagers in France. Community Dent Oral Epidemiol. 2010;38(2):171–179. doi:10.1111/j.1600-0528.2009.00515.x.
27. Kamuzora A. Enhancing longevity among pensioners: determinants in Ilala Municipal Council, Tanzania. EAJAHME. 2024;7(1):1–9. doi:10.58498/eajahme.v7i1.54.