Oral Health in the context of Adolescent health Isaac Okullo BDS, ADHSM, MPH, PhD

Oral Health It is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing WHO

Worldwide, 60–90% of school children and nearly 100% of adults have dental cavities. Dental cavities can be prevented by maintaining a constant low level of fluoride in the oral cavity. Severe periodontal (gum) disease, which may result in tooth loss, is found in 15–20% of middle-aged (35-44 years) adults. Globally, about 30% of people aged 65–74 have no natural teeth. Oral disease in children and adults is higher among poor and disadvantaged population groups. Risk factors for oral diseases include an unhealthy diet, tobacco use, harmful alcohol use and poor oral hygiene, and social determinants.

most common oral diseases Dental cavities 80% Periodontal (gum) disease 29% Oral cancer Oral infectious diseases Trauma from injuries Hereditary lesions

Adolescent Oral Health youths between the ages of 10 to 18.

The adolescent patients are peculiar for various reasons

High caries potential Immature permanent tooth enamel Total increase in susceptible tooth surfaces Environmental factors such as diet Health seeking behaviour Low priority for oral hygiene Social factors

Risk for traumatic injury and periodontal conditions increase most common injuries to permanent teeth occur secondary to falls, followed by traffic accidents, violence, and sports psychodynamic factors

Tendency for poor nutritional habits Consumption of high quantities of refined carbohydrates and acid-containing beverages

Genetic conditions Significant esthetic, functional, physiologic, or emotional dys-function are potential difficulties for the adolescent Complex treatment e.g orthodontics

Behaviour Behavioral considerations include anxiety and phobia Intraoral and perioral mutilations

Use of tobacco, alcohol, and other drugs Significant oral, dental, and systemic health consequences and death are associated with all current forms of tobacco use

Evidence Study by IO Looking at adolescents in Kampala and Lira aged 13 to 19 years 80% of the students had DMFT >0; 85% and 76% in Kampala and Lira respectively Mean DMFT scores were 2.4 in Kampala and 3.3 in Lira Sugar consumption was higher in females and in students of highly educated parents

Study by MB Among secondary school students aged 12–25 years (mean 17 years) in central and western Uganda 28.8% showed clinical features of EOP 2.3% generalized EOP, 4.2% localized EOP, and 154 (22.3%) incidental EOP Males more affected than females (33.8% vs. 22.2% EOP prevalence tended to increase with increasing age; no association found between EOP prevalence and socioeconomic status Molars and mandibular incisors generally demonstrated the highest occurrence of ≥ 4 mm attachment loss