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W D Sithole

Publications and source records attributed to W D Sithole.

10 recordsLinked to original sources

National oral health survey Zimbabwe 1995: dental caries situation.

Ten years after completion of the first national oral health survey, the second such survey was carried out in 1995. Application of a multi-stage sampling procedure resulted in 3,709 persons being examined according to the WHO oral health assessment form and criteria. The background variables studied were age, gender, type of location, socio-economic status. Comparison with results from major studies in other African nations are presented. It was concluded that the prevalence of dental caries in all age groups was high but that the severity was low. The prevalence of unmet treatment needs was very high with extraction as the predominant mode of treatment. The survey has shown that the vast majority of Zimbabweans are not receiving and/or are not seeking oral care.

Adolescent↗

National oral health survey Zimbabwe 1995: periodontal conditions.

Ten years after completion of the first national oral health survey, a second national oral health survey was carried out in 1995. Application of a multi-stage sampling procedure resulted in 3,709 persons being examined. WHO's oral health assessment form and CPITN index was used. The background variables studied were age (15-19, and 35-44-year olds), gender, type of location, socio-economic status and level of education. Results suggest that the periodontal health of adolescents was better in 1985 than in 1995. Overall, the prevalence of periodontal conditions in both age groups was high but its severity was low. The need for complex periodontal treatment was only 4 per cent for adults. The survey has shown that the vast majority of Zimbabweans are not receiving and/or are not seeking periodontal care.

Adolescent↗

ART restorations and glass ionomer sealants in Zimbabwe: survival after 3 years.

Atraumatic restorative treatment (ART) consists of removing demineralised tooth tissues with hand instruments only, restoring the prepared cavity and sealing the adjacent pits and fissures with an adhesive filling material. This relatively painless, no-handpiece, minimal intervention approach to controlling dental caries is described. ART was applied in an oral health care programme in Zimbabwe that was carried out amongst secondary school students from 1994 to 1997. A new glass ionomer (Fuji IX) was used as the restorative and sealant material. Sealants were placed in high caries risk students using the 'press-finger' technique. A total of 297 one-surface ART restorations and 95 glass ionomer sealants were placed in 142 and 66 students, respectively. After 3 years, the lost-to-follow-up percentages for one-surface ART restorations and glass ionomer sealants were 30.6% and 30.5%, respectively. Actuarial (life table) analysis resulted in 3-year survival rates of one-surface ART restorations of 88.3% (95% CI: 92.4%-84.2%), ranging from 94.3% to 65.4% per operator. A total of 28 ART restorations placed in 25 students failed. Reasons for failure related to the material and the operator (11 restorations or 5.3% each), and to caries adjacent to the restoration (one restoration or 0.5%). Reasons for failure were not recorded for five restorations (2.3%). Sealants were placed on surfaces diagnosed as early enamel lesions. After 3 years, 71.4% (95% CI: 81.7%-61.1%) of the fully and partially retained sealants survived with a range of 100% to 55.6% per operator. Of the sealed surfaces 96.3% (95% CI: 100%-92.2%) survived 3 years without developing caries. Experienced operators placed better ART restorations than inexperienced operators. This study has demonstrated that ART with a glass ionomer restorative material and sealants provided high quality preventive and restorative dental care to this student population. ART has become one of the treatment modalities available to oral health workers in managing dental caries.

Adolescent↗

Three-year survival of one-surface ART restorations and glass-ionomer sealants in a school oral health programme in Zimbabwe.

An oral health care programme in secondary schools using the atraumatic restorative treatment (ART) approach for dental caries was started in 1993. Glass ionomer (restorative type II, 1) was used as the restorative and sealant material. Sealants were placed using the 'press-finger' technique. Results after 3 years revealed a survival percentage for one-surface ART restorations of 85.3 (95% CL: 89.7-80.9%), which ranged from 96.1 to 69.3% per operator. Failures were related to 'unacceptable marginal defects' (8.1%), 'falling out' (6.1%) and 'excessive wear' (2.5%). Of the 33 failed one-surface ART restorations, 17 were material-related, 7 had caries and no information was available for 9 restorations. Sealants were placed only on surfaces diagnosed as early enamel lesions and on some small dentinal lesions. After 3 years, 50.1% (95% CL: 55.1-45.1%) of the fully and partially retained sealants survived with a range of 68.5-25.9% per operator. Regardless of the low rate of retention, the sealed surfaces had a 4 times lower chance of developing caries than unsealed surfaces with early enamel lesions over the 3-year period. The retention of sealants and the survival of one-surface ART restorations were influenced by an operator effect. The mean treatment time for one-surface ART restorations without chairside assistance was 22.1 min (range per operator of 19.8-23.6 min), whilst the mean time for placing sealants was 9.3 min (range per operator of 8.2-10.8 min). It is concluded that the ART approach and the use of glass-ionomer sealants have made preventive and restorative dental care available for this student population and further that ART seems to be appropriate for population groups currently not receiving preventive and restorative dental care.

Adolescent↗

National oral health survey Zimbabwe 1995: quality of restorations.

In 1995, a second national oral health survey was carried out, ten years after the first. Application of a multi-stage sampling procedure resulted in 3709 persons being examined. The restorations were assessed using the criteria described by Kroeze et al (1990). Only ditches on the tooth/restoration margins that were wider than 0.4 mm were considered to be carious. The background variables studied were age, gender, type of location, socioeconomic status (SES) and level of education. The prevalence of restorations in all persons examined was 3.4 per cent. Restorations were found much more often among urban (95.5 per cent) than rural people (4.5 per cent) and also among those living in high (75 per cent) compared to low SES suburbs (25 per cent). Amalgam was more often used (89 per cent) than composite resin (10 per cent). The most frequently observed type of restoration was Class I (45 per cent) followed by Class II (39 per cent) and Class III (7 per cent). The prevalence of satisfactory restorations was 83.9 per cent. Failures were due to 'fractured restorations' (6.3 per cent), 'caries at the margin' and 'breakdown of restoration margin', both 4 per cent. Amongst adults, multiple-surface amalgam restorations failed more often than single-surface ones. It is concluded that the prevalence of restorations found was very low. There is a need to extend the provision of preventive and restorative oral health care by a more equitable distribution of oral health personnel and by making more finance available to rural and low-SES suburban areas.

Adolescent↗

Oral health status among secondary school students in Harare, Zimbabwe.

In 1993 a demonstration oral care programme to evaluate the ART procedure for dental caries under field conditions began among secondary school students in Greater Harare. The programme was preceded by an oral epidemiological survey. Of the 569 students examined, with a mean age of 13.9 years, 58.7 per cent were caries free. The mean DMFS and DMFT scores were 1.4 and 1.1, respectively. Very few missing and filled teeth were observed. Excluding those with pulp involvement, small dentinal lesions which could not be penetrated with an excavator at the time of examination, constituted 49 per cent of the mean DMFS score. 84 per cent of dentinal lesions needing treatment were judged to be treatable using the ART procedure. Using the index of Green and Vermillion (1964), the mean plaque score was 5.6 with substantial variation observed between the schools. Calculus was observed among 89.5 per cent of the students examined. 18 per cent of them had a central diastema in the maxilla. Crowding or spacing in the upper and lower anterior region of the jaws was observed in 67.5 per cent and 60.5 per cent of the students, respectively. 15.8 per cent were dissatisfied with the position of their teeth whilst 15 per cent indicated that they would like to undergo corrective treatment. It was concluded that these secondary students lack preventive and curative oral care and that the vast majority of the dentinal lesions observed could be treated using the ART procedure.

Adolescent↗

Atraumatic restorative treatment and glass-ionomer sealants in a school oral health programme in Zimbabwe: evaluation after 1 year.

An oral health care programme in secondary schools using the atraumatic restorative treatment (ART) technique for dental caries was started in 1993. Glass-ionomer was used as the restorative and sealant material. Sealants were placed using the "press finger' technique. Results after 1 year revealed a survival percentage for one-surface ART restorations of 93.4 whilst the complete and partial retention percentages for sealants were 60.3 and 13.4, respectively. No caries was observed in teeth restored using ART, and only 0.8% of surfaces diagnosed as having early enamel lesions at the start of the programme and sealed consequently had progressed into active dentinal lesions after 1 year. The sealant retention percentage and the survival percentage of ART restorations were influenced by an operator effect. The majority of restorations were carried out without administering local anaesthesia. The mean treatment time for one-surface ART restorations was 22.1 min (range per operator of 19.8-23.6 min), whilst the mean time for placing sealants was 9.4 min (range per operator of 8.2-10.8 min). Post-operative sensitivity was reported for 6% of the teeth restored. 95% of the students were satisfied with ART as a treatment modality. It is concluded that ART may in part be the answer to the unavailability of restorative care for many population groups globally.

Adolescent↗

Good teeth without dentists.

A pilot programme of preventive dental care is reported from Zimbabwe. The target groups were schoolchildren, who were approached through the school health system, and preschool children who were reached via community-based health workers. Educational materials and methods were worked out in close collaboration with local staff. It was considered essential to anchor the programme in established administrative structures.

Child↗

Oral health manpower projection methods and their implications for developing countries: the case of Zimbabwe.

Manpower projections for oral health are generally held to be more accurate than those for other health sectors since the diseases involved and their treatment times can be predicted more precisely. Nevertheless most oral health manpower projections are either overestimates or are not in line with the resources of individual countries, especially in developing countries. Zimbabwe was taken as the study case, and oral health manpower projections were made using two of the most commonly employed methods and one new approach. The projections obtained using the three methods were all different, and even the lowest projection is beyond the resources of the country. It is recommended that in making oral health manpower projections, the facilities available to accommodate these personnel should also be taken into account.

Dental Hygienists↗