AN EXAMINATION OF THE IMPACT OF ORAL HYGIENE ON DENTAL CARIES IN A SUBURBAN POPULATION IN NIGERIA

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Dental caries is a multifaceted and persistent oral illness that is the most common chronic disease among children (Martin, 2018). tooth caries is the targeted degradation of vulnerable tooth tissues caused by acidic substances produced by bacteria during the breakdown of carbohydrates in the diet (Paul et al. 2018). Despite the presence of various oral disorders that impact people globally, dental caries remains the most widespread oral disease among children and adolescents, causing discomfort, inadequate nutrition, missed school days, and a decline in quality of life (Petersen et al., 2023).

Dental caries is a disease caused by multiple variables, including cultural, social, behavioural, dietary, and biological risk factors. These factors contribute to the development and advancement of the illness (Ismail et al. 1997). Additional variables contributing to this issue are inadequate dental care practices (Parisotto et al. 2010; Arora et al. 2011) and limited educational attainment among mothers (Congiu et al. 2014; Baggio et al. 2015). The family structure of a kid is a crucial social component that greatly impacts the oral health of children. It plays a vital role in determining the level of physical and emotional support necessary to deal with an illness, its treatment, and the financial burden associated with it (Mayo et al., 2000). The findings of a study conducted among children in Brazil indicate that dental caries is more prevalent among children from single-parent households and those with parents who have poor levels of education, particularly if the mothers are illiterate (Maciel et al., 2001).

In Nigeria, a notable proportion (9%) of children lack biological parents, and many children under the care of guardians do not receive the necessary attention that children living with their biological parents do (Thomas, 2020). Folayan et al. (2020) asserts that caries prevalence was greater among those who were either only-children or the youngest in their families. However, the study did not find any evidence of an elevated caries risk associated with higher or lower birth ranks. The dental caries experience of the study participant was substantially associated with factors such as family size, birth rank, age difference between the subject and next oldest sibling, and parent's age at birth of the subject (Wellington 2022). Furthermore, a separate study conducted in Nigeria (Afolayan et al., 2017) found that the presence of more siblings was associated with a higher likelihood of developing caries, while birth rank was linked to the use of toothpaste containing fluoride. Similarly, Victor et al. (2021) identified several factors that were considered to be predictors for dental caries, including gender, age, oral hygiene habits, use of fluorides, dietary habits, geographical factors, and parental modelling.

Dental caries has been found to be influenced by both poor oral hygiene and age. Research has demonstrated that the dmft/DMFT (decayed, missing, filled teeth) index decreases as individuals age (Jablonski-Momeni et al., 2018). Additionally, there is a correlation between the likelihood of developing dental caries and engaging in inadequate oral hygiene practices, as well as consuming sugary foods and beverages (Victor et al., 2021; Mwakayoka et al., 2017). Therefore, this study aimed to evaluate the factors that contribute to dental caries in children and adolescents, with the intention of utilising the results to avoid dental caries. This study specifically investigated the influence of oral hygiene on dental caries, as well as the relationship between socio-demographic characteristics (such as age, gender, socio-economic position, birth rank, family size, and type of parenting) and the prevalence of dental caries among the participants of the study. Oral hygiene plays a crucial role in maintaining dental health, and inadequate habits can result in a range of dental illnesses, such as dental caries. Dental caries, often known as tooth decay, is a prevalent chronic ailment that affects people of all ages on a global scale. It is crucial to comprehend the influence of oral hygiene habits on the occurrence of dental caries in suburban areas of Nigeria, where lifestyle and access to healthcare facilities vary from both rural and urban settings. Therefore, the necessity for this investigation arises.

1.2 Statement of the problem

Various research has consistently shown a strong association between insufficient oral hygiene practices and the onset of dental caries. Regular and systematic brushing, flossing, and the use of fluoride toothpaste are essential practices for preventing dental decay. Studies undertaken in several regions, including Nigeria, indicate that socio-economic factors, educational achievement, and access to dental care significantly influence oral hygiene habits and the prevalence of dental caries.

Research indicates that tooth decay has been linked to factors such as age, gender, low family income, and living in rural areas (Oseni, 2019). Tooth loss diminishes the quality of life and impacts the overall well-being of an individual. This could impact their mastication patterns and overall appearance.  According to Miracle (2020), tooth loss can negatively impact one's self-esteem, which in turn might discourage social interactions and hinder the ability to complete everyday tasks.  Untreated caries or periodontal disease can result in tooth loss, which causes both functional and aesthetic problems and has a substantial impact on the quality of life related to oral health (Oseni, 2019). Komolafe et al (2023) propose that insufficient oral hygiene habits, such as infrequent brushing, improper brushing techniques, lack of flossing, and limited utilisation of fluoride, can lead to the development of dental caries. The adoption of these practices is often influenced by a lack of awareness and education regarding proper oral hygiene, as well as limited access to dental healthcare services and supplies (Ajani & Bassey, 2019). The suburban population, located in the transitional zone between urban and rural settings, faces unique challenges and opportunities related to oral health. Nevertheless, Nsikak (2023) asserts that dental health research fails to sufficiently include this particular population.

Dental caries, also known as tooth decay, is a significant public health concern worldwide and poses significant challenges in Nigeria (Preye, 2021). The incidence of dental caries in suburban regions can be influenced by multiple factors, particularly oral hygiene behaviours, which are influenced by a wide range of socio-economic conditions, educational levels, and access to healthcare services (Tonepiri et al., 2021). Despite the importance of dental caries, there is a lack of study on the specific impact of oral hygiene practices on its frequency among suburban groups in Nigeria. Hence, the need for this inquiry arises.

1.3 Objectives of the study

The primary objective of this study is to critically examine the impact of oral hygiene on dental caries in a suburban population in Nigeria. Specific objectives of this study are to:

To determine the prevalence of dental caries among the suburban population in Nigeria

To evaluate the oral hygiene practices among individuals in the suburban population

To assess the impact of dental caries on the oral health-related quality of life among individuals in the suburban population.

To provide recommendations for oral health promotion strategies and interventions in Nigeria

1.4 Research Questions

The following research questions will be answered in this study:

What is level of prevalence of dental caries among the suburban population in Nigeria?

What are the oral hygiene practices among individuals in the suburban population?

What is the impact of dental caries on the oral health-related quality of life among individuals in the suburban population?

What are the recommendations for oral health promotion strategies and interventions in Nigeria?

1.5 Research Hypotheses

The following research null hypotheses will be formulated to guide the study.:

Ho: Dental caries have no significant impact on the quality of life among individuals in the suburban population in Nigeria.

Ha: Dental caries have significant impact on the quality of life among individuals in the suburban population in Nigeria.

1.6 Significance of the study

This study not only focuses on an important public health problem, but also establishes a basis for specific treatments, policy suggestions, and community-based educational efforts aimed at enhancing oral health results in suburban Nigeria.

Nigeria, similar to numerous other developing nations, confronts obstacles pertaining to oral health infrastructure and the availability of dental care. An investigation on oral hygiene behaviours and their influence on dental caries, particularly among a suburban Nigerian population, contributes to the comprehensive comprehension of oral health dynamics in diverse environments. Dental caries, also known as tooth decay, is a major public health concern worldwide, impacting individuals of all ages, including children and adults. Studying the impact of oral hygiene behaviours on the occurrence of dental caries in a suburban community in Nigeria can offer useful insights into preventive measures. 

Moreover, the results of this study have the potential to impact oral health policies and programmes aimed at enhancing oral hygiene behaviours and decreasing the prevalence of dental caries in suburban Nigeria. For example, if certain oral hygiene practices are proven to be successful in decreasing dental caries, it would be beneficial to include these practices in public health programmes.

Additionally, the research can also help to increase awareness among the suburban Nigerian population regarding the significance of oral hygiene in the prevention of dental caries. Education grounded in empirical research has the ability to encourage individuals to embrace healthier oral hygiene habits, which could result in enhanced oral health outcomes. 

Finally, this study enhances the existing scientific information by potentially establishing connections or determining causal factors between oral hygiene practices (such as the frequency of brushing, use of fluoride products, etc.) and the occurrence of dental caries in a suburban Nigerian setting. This data can provide valuable insights for future research endeavours and public health strategies focused at mitigating tooth caries.

1.7 Scope of the study

Broadly, this study focus is to critically examine the impact of oral hygiene on dental caries in a suburban population in Nigeria. Specifically, this study seeks determine the prevalence of dental caries among the suburban population in Nigeria, evaluate the oral hygiene practices among individuals in the suburban population in Nigeria, assess the impact of dental caries on the oral health-related quality of life among individuals in the suburban population and provide recommendations for oral health promotion strategies and interventions in Nigeria.

The study is carried out in Nigeria.

1.8 Limitations of the study

As with any human undertaking, the researchers faced various minor restrictions during the investigation. The main restriction was the lack of significant literature on the subject, due to the restricted availability of data regarding an examination of the impact of oral hygiene on dental caries in a suburban population in Nigeria. Hence, a large allocation of time and labour was necessary to ascertain the proper materials, books, or information and gather data. 

Furthermore, this study is hampered by its small sample size and narrow geographical reach, focused primarily on Ikot Ediom, Ibesikpo Local Government Area, Akwa Ibom state. Therefore, the conclusions of this study cannot be applied to other scenarios, thus necessitating further inquiry. 

Moreover, the researcher's restrictions were primarily due to financial restraints, as they are a student without any source of money to sustain themselves. The excessive transportation costs at the research location, worsened by the prevalent inflation in Nigeria, provided a substantial obstacle in fulfilling the expenses related with transportation.

Finally, the researcher encountered a time constraint due to the requirement to complete this research while still completing the obligations of attending lectures and engaging in other educational activities.

1.9 Definition of terms

Oral health: Oral health is the state of the mouth, teeth and orofacial structures that enables individuals to perform essential functions such as eating, breathing and speaking, and encompasses psychosocial dimensions such as self-confidence, well-being and the ability to socialize and work without pain, discomfort and embarrassment.

Oral disease (Dental Disorder): Oral diseases encompass a range of diseases and conditions that include dental caries, periodontal (gum) disease, tooth loss, oral cancer, oro-dental trauma, noma and birth defects such as cleft lip and palate.

Dental caries: Dental caries is a prevalent chronic infectious disease resulting from tooth-adherent cariogenic bacteria that metabolize sugars to produce acid, which, over time, demineralizes tooth structure.