A recent cross-sectional survey conducted on schoolchildren in Bangui, the capital of the Central African Republic (CAR), revealed concerning trends related to dental health, highlighting the urgent need for improved oral health initiatives.
The study, conducted during November and December 2023, involved 556 participants aged between 5 and 13 years, comprised of 41.5% females and 58.5% males. The research utilized the World Health Organization's (WHO) dmft/DMFT indices to assess oral health status, discovering moderate prevalence rates of dental caries among the local youth.
The survey found the mean DMFT (Decayed, Missing, and Filled Teeth) index to be 0.58 ± 1.3, indicating a moderate level of dental issues primarily related to untreated caries. The dmft (decayed, missing, and filled teeth for primary teeth) stood at 1.92 ± 2.7, emphasizing the dental health crisis affecting this young population.
Key findings from the study demonstrated significant gender differences: females exhibited lower odds of caries concerning their deciduous teeth, with odds ratios (OR) indicating females had OR 0.47 (95% CI 0.33, 0.67) compared to their male counterparts. Conversely, females also had higher prevalence rates of caries affecting their permanent teeth (OR 1.47, 95% CI 0.88, 2.25). These metrics suggest distinct behavioral and biological factors influencing dental health across genders.
The survey also illuminated dietary habits as substantial determinants influencing caries experience among the children surveyed. The data suggested children with diverse breakfast diets demonstrated reduced risk of caries (OR 0.58, 95% CI 0.42, 0.82), whereas higher snack consumption was associated with increased caries risk (OR 1.41, 95% CI 1.10, 1.80). This correlation indicates dietary choices directly impact the oral health of schoolchildren.
Of special concern was the finding about tooth brushing behavior: only 59.72% of the subjects reported brushing their teeth once daily, with 94.24% of them using toothbrushes. Alarmingly, merely 3.96% of the participants had visited a dentist, indicating insufficient access to dental services—a complication exacerbated by the country’s socioeconomic instability.
The Central African Republic is grappling with political instability and chronic violence, leading to widespread poverty and inadequate health services. With over 36% of the population facing malnutrition, these factors contribute significantly to the high prevalence of oral diseases among children. The findings of this survey reflect the impacts of long-standing systemic issues and highlight the urgent need to address these multifactorial determinants.
Children from the Bangui-Rapides subdistrict showed the highest rates of tooth brushing (97.26%) and use of fluoridated toothpaste (78.12%), yet they also displayed the highest mean DMFT (94.12%) and caries-free rate (43.03%). This paradox underlines the complexity of oral health outcomes, signaling the need for multi-faceted health strategies.
This study marks the first comprehensive assessment of oral health among schoolchildren in the Central African Republic, providing invaluable data to guide health interventions. The results affirm the importance of integrating oral health within universal health coverage initiatives to address the pressing needs and health disparities evident within the nation.
Recommendations from the research urge the implementation of community programs focused on health education, routine dental check-ups, and dietary improvements. Strategies would ideally involve collaborations among national health authorities and international organizations, aiming to build sustainable oral health systems capable of responding to this pressing public health issue.
Enhancing oral health services is especially pertinent, considering the Global Oral Health Action Plan (2023-2030) emphasizes the inclusion of comprehensive dental care within primary healthcare frameworks. Addressing these challenges holistically could pave the way for improved health outcomes, tackling both the immediate oral health crisis and contributing to the broader socioeconomic frameworks within the Central African Republic.