Factors Influencing Oral Hygiene Practices Among Adults Patients Attending Public Health Facilities in Burera District, Rwanda
Abstract
Background
Dental caries and periodontal diseases have historically been considered the most important
global oral health burdens. Worldwide, 60–90% of school children and nearly 100% of
adults have dental cavities (WHO, 2012). National surveys and smaller studies have shown
the prevalence of dental caries (decayed, missing, or filled teeth—DMFT) in Africa, to be
quite low, but with substantial regional variations. Also, oral health problems are significant
cause of morbidity particularly in sub-Saharan Africa (Samuel et al, 2006), and recent
studies on dental caries prevalence are limited, with most focusing on specific
subpopulations. Therefore, various factors, including practitioner attitudes, low public
awareness in improving oral hygiene practices, low priority for dental health, and cost, have
much contributed to the increase of dental health problems.
Objective:
The research aimed at assessing the factors influencing oral hygiene practices among
adults in Burera District, Rwanda.
Methodology:
Qualitative and quantitative research approach were used with descriptive
cross sectional research design to describe factors influencing oral hygiene practices, and to
determine relationship between oral diseases and poor oral hygiene practices among adults
attending health centers in Burera district. Random sampling was used to select these health
centers representing 26.3% of all health centers of Burera district to obtain a sampled
population distributed in different area of the district to minimize sampling bias.
Quantitative data was entered and analysed in using SPSS and presented in form of tables.
Results:
The association between age and brushing frequency were statistically significant
(p≤0.001). Association was also found gender and brushing frequency (p=0.046). There was
no association found between the marital status, occupation and brushing frequency with
p=0.076 and p=0.057 respectively. Among the participants who had primary or no formal
education, majority of them never brush their teeth or brush them sporadically. There was
strong association between education level, wealth quintile and brushing frequency with
p<0.001 respectively. There was significance association between brushing frequency and
tobacco use (p=0.017), perception on dental visit (p=0.044), self-assessed oral hygiene
(p<0.001), and how far is the nearest health facility with dental care (p=0.048). But there
was no significance association between brushing frequency and Satisfaction of services
received during dental visit (p=0.074) as well as eating and drinking sweet things behavior
(p=0.077)
Conclusions and Recommendations
Majority adults in Burera district assess their oral hygiene status positively but a small
number report using toothbrushes for maintaining good oral hygiene and display poor dental
visiting habits. This study confirms low rates of tooth brushing and dental attendance among
adults in different socio-economic and demographic strata across Burera district. The study
found that although age, sex, educational status, wealth quintile are important determinants
of oral hygiene practice among adults in Burera district, other factors play an important role
as well. Various factors identified, such as poor knowledge of brushing frequency,
techniques and duration, poor self-assessed oral hygiene, poor accessibility and poor
satisfaction of dental services, and weak beliefs in the importance of regular tooth brushing
as well as dental visit and co-occurrence of general health risk behavior can be used to guide
interventions to improve oral health hygiene practice among adults. The government should
consider measures to provide affordable fluoridated toothpaste targeting people from low
income families.
Health care providers at Health Center level should be trained on basic skills in oral hygiene
in order for them to appropriately implement the integrated oral health education content in
the community.