Determinants of Dental Caries among Patients Attending Malindi Sub-County Dental Clinic, Kenya

Abstract

Good oral health is one of the essential building blocks of living well. Oral health is fundamental to the ability to breathe, eat, swallow, speak or even smile. Despite importance of this oral diseases are on the rise with 47.3% of adults and 23.9% of children suffer from dental caries in Kenya. Most of the oral conditions are largely preventable by simple, effective, and low-cost measures. There is untreated dental diseases especially dental caries which leads to severe physical, social, and psycho-biological disorders. The aim of this study was to establish determinants of dental caries among patients attending Malindi sub-county dental clinic, Kenya. A mixed cross-sectional analytical study design was used. Study data were collected using standard questionnaire and cleaned before analysis. Regression analysis to determine socio-demographic factors, reported underlying medical conditions and dental risk behavior factors associated with presence of dental caries was conducted using generalized linear models and a logit link function. All categorical variables were reported as counts with their respective percentages. The regression coefficients from the regression models were log-transformed and reported as Risk Ratios and their respective 95% confidence intervals. Univariable analysis was conducted for each independent variables and crude Risk Ratios reported. The multivariable regression model included independent variables with a p-value <0.1 in the univariable model. Statistical significance was evaluated using 95 % confidence interval and a two-tailed p-value <0.05. In-depth interviews were conducted, translated into English then later transferred to Nvivo qualitative data management software version 12 for thematic analysis International, Melbourne, Australia) for management, cleaning and coding. The coded data was analyzed verbatim. The study recruited 223 participants, 117 (52.5%) female and 106 (47.5%) males. Majority of participants were aged 30 to 49, 76 (34.1%) and the least were aged ≥50 years that is 35 (15.7%). The prevalence of dental caries was 72.6% with majority aged 18 to 29 years old. This study found out that socio-demographic factors such as low income and cash as mode of payment of hospital fees are associated with dental caries among patients attending Malindi sub-county dental clinic, Kenya. Dental risk behavior factors associated with dental caries among patients were found to be the patients who had never visited the dental clinic having a higher likelihood of dental caries compared to those who visit when necessary (OR = 2.05, 95% CI: 1.15–3.65, p = 0.014). Clinical factor associated with dental caries were statistically significant among patient who had diabetes as indicated by an odds ratio (OR) of 6 (95% CI: 2.50 - 15.00, p < 0.001). Socio-demographic factors such as low income and cash as mode of payment of hospital fees are associated with dental caries. This study found out that those who had never visited the dental clinic had a higher likelihood of dental caries compared to those who visit dental clinic when necessary. Clinical factor associated with dental caries were statistically significant among patient who had diabetes. This study recommends Ministry of Health to increase access to affordable dental care services by lowering the cost of care. Integrating Social Health Authority, subsidies with other insurance scheme and out of pocket to provide wide coverage and increase campaign on important of regular dental checkup.