Browsing by Author "Myburgh, Neil"
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Item Awareness and knowledge of oral cancer among dental patients visiting Khartoum dental teaching hospital(University of the Western Cape, 2018) Babiker, Samah Abdelaziz Elsheikh; Myburgh, NeilBackground: Oral cancer is a major global healthcare problem. Its prevalence is increasing, and late-stage presentation is common. More than 500,000 patients are estimated to have oral cancer worldwide. Oral cavity squamous cell carcinoma (SCC) accounts for 90-94% of oral cancers. Survival rates for oral cancer are very poor, at around 50% and has not improved considerably in the previous decades even with advances in therapeutic interventions. Screening programs have been introduced for a number of major cancers and have demonstrated a compelling effect in their early detection. It’s now well established that the early detection of the malignancies is a competent way of improving the clinical outcome for patients. It’s believed that to reduce death and morbidity from this disease it is important to detect it at an early stage, when lesions are localized. Aim: To assess the level of awareness and knowledge of oral cancer among dental patients visiting Khartoum dental teaching Hospital. Method: A cross- sectional survey using a self-administered questionnaire with 18 questions was distributed to 193 patients between 18 and 65 years to collect the information. Results: The results indicate that there were more females (107; 55%) than males (86; 45%). There was a non-significant difference between alcohol consumption and awareness of oral cancer. However, the frequency results revealed that the majority of participants (98; 92 %), who reported they has heard about oral cancer, were females, while almost a quarter of participants (18; 21%) who had never heard about it, were males. This suggested that female patients were more aware of oral cancer than males. Participants, who declared hearing about oral cancer were more highly qualified educationally, whereas a quarter of them who declared they had never heard about it, were poorly qualified educationally.Item Community drinking water fluoridation in the Southern Cape and Karoo Region: a feasibility study(University of the Western Cape, 2002) Dennis, Gilbert J.; Myburgh, NeilThe prevalence of dental decay is high among lower socio-economic groups in the Southern Cape and Karoo region. 70 - 80% of State employed dentists' time in this region is spent on attempting to reduce the pain and sepsis within the communities for which the primary treatment modality is extraction of the tooth under emergency conditions. In developing countries the prevalence of dental decay is still high. There is a general downward trend of dental decay in developing countries; and it is associated with combinations of exposure to fluoridated water and/ or other forms of fluoride exposure (e.g. in fluoridated tooth paste), the provision of preventive oral health services, an increase in dental awareness through organized oral health education programs and the readily available dental resources. This study looked at the feasibility of implementing community water fluoridation in the Southern Cape and Karoo Region by describing the primary drinking water sources, the population distribution around these sources and the actual levels of fluoride found in the water samples. Each sample was coded and with the use of a global positioning system (GPS), a set of co-ordinates obtained for each. Other options with regard to fluoride supplementation were explored as an attempt to provide an alternative intervention option for exposure to fluoride where community drinking water fluoridation was not the first option. This information will be used to record and update existing tables for fluoride levels in community drinking water of the communities in the Southern Cape and Karoo region that is currently used as a guide for prescribing fluoride supplementation as a means of prophylaxis for the prevention and reduction of dental decay. This study re-iterated the diverse set of variables that communities living in rural areas have to live with. It supports the trend that in developing countries the DMFT (12 years) and dmft (6 years) are higher than those in the same age cohorts of developed countries. This study shows that the fluoride level in borehole water is generally higher than that of dams or reservoirs. Fluoride supplementation is required in the bigger, densely populated areas as the fluoride levels of the water in these areas are below optimal and their water systems can accommodate fluoridation. The long term gains of community water fluoridation at optimal levels for entire communities by far out way the risk of developing fluorosis at above optimal levels. There needs to be a systematic review of treatment needs and treatment modalities for each community so that at some point the need for prevention strategies will be sought out by program managers as best practice for improving the general health (i.e. and oral health) of their communities. There is no single approach for solving issues in communities with different sets of variables determining their needs and so too to the question of community water fluoridation. The recommendation is that at the community level (i.e. the communities should be empowered to do their own situational analysis and prioritize their needs) people need to make decisions for themselves with regard to the type of preventive strategy that they implement. Once they have the data and an intervention option is arrived at, they should lobby with their local health provider to implement that intervention option (e.g. Exposure to fluoride as a means of improving dental health) that they have identified in their towns or villages.Item Community drinking water fluoridation in the Southern Cape and Karoo Region: A feasibility study(University of the Western Cape, 2002) Dennis, Gilbert J; Myburgh, NeilThe prevalence of dental decay is high among lower socio-economic groups in the Southern Cape and Karoo region. 70 - S0% of State employed dentists' time in this region is spent on attempting to reduce the pain and sepsis within the communities for which the primary treatment modality is extraction of the tooth under emergency conditions. In developing countries the prevalence of dental decay is still high. There is a general downward trend of dental decay in developing countries; and it is associated with combinations of: exposure to fluoridated water and or other forms of fluoride exposure (e.g. in fluoridated tooth paste), the provision of preventive oral health services, an increase in dental awareness through organized oral health education programs and the readily available dental resources. This study looked at the feasibility of implementing community water fluoridation in the Southern Cape and Karoo Region by describing the primary drinking water sources, the population distribution around these sources and the actual levels of fluoride found in the water samples. Each sample was coded and with the use of a global positioning system (GPS), a set of co-ordinates obtained for each. Other options with regard to fluoride supplementation were explored as an attempt to provide an alternative intervention option for exposure to fluoride where community drinking water fluoridation was not the first option. This information will be used to record and update existing tables for fluoride levels in community drinking water of the communities in the Southern Cape and Karoo region that is currently used as a guide for prescribing fluoride supplementation as a means of prophylaxis for the prevention and reduction of dental decay. This study re-iterated the diverse set of variables that communities living in rural areas have to live with. It supports the trend that in developing countries the DMFT (12 years) and dmft (6 years) are higher than those in the same age cohorts of developed countries. This study shows that the fluoride level in borehole water is generally higher than that of dams or reservoirsItem An evaluation of the school oral health education programme in Thamaga, Botswana(University of the Western Cape, 1999) Moreri, Boikhutso Gladys; Myburgh, NeilThe evaluation aimed to assess the effectiveness of the school oral health education (ORE) programme in Thamaga, a rural village about 40km west of the capital Gaborone. The Oral Health Division (Botswana) had introduced the programme in schools throughout the country in 1984. The school ORE programme in Thamaga was introduced less than five years previously but not all schools could be covered before the time of the study. The delivery of weekly dental services at the primary hospital in the area had been inconsistent. The evaluation assessed the effectiveness of the programme in a cross-sectional study by comparing dental health knowledge, reported oral hygiene practices, DMFS scores and gingival bleeding index of randomly selected standard five schoolchildren, aged 10-16 years (n=135). Two schools in Thamaga were selected for the study, designated as programme (experimental) and non-programme (control) schools in this comparative study. The hypothesis proposed that children from the programme school will have better oral health (less dental caries and gingivitis), have better dental health knowledge and better oral hygiene practices than children from the non-programme school. The effects of this school ORE programme were measured firstly by a clinical examination for dental caries using the WHO DMFS index and for gingivitis using a bleeding index derived from the WHO CPI. This was to compare the proportion of children with these dental diseases in the two schools. Secondly, a close-ended questionnaire was administered to the children to assess most importantly, their knowledge of dental diseases (dental caries and gum disease) and their reported OH practices. The extent of correct dental health knowledge was minimal but about 88 percent of all the schoolchildren from both the programme and non-programme schools (n=135) reported their source of information as being the school. Generally, children from the non-programme school had higher average scores of correct responses on dental caries and gingivitis than those from the programme school. This difference in knowledge was not statistically significant (p>O.05).It was apparent from the results of the interview that the majority of the children have misinformation about disease-specific signs and symptoms, causes and prevention of dental disease, the use and benefits of fluorides and dental floss. The majority of the children reported that they do self-examination of their teeth and gums daily and the commonly reported OH practices were the use of a toothbrush and toothpaste at least twice a day. However, these reported oral hygiene practices were not commensurate with the level of gingivitis recorded. Out of all the study participants, only one child from the programme school reported using a chewing stick for cleaning teeth. The majority of the children were found to have poor periodontal health indicated by gingivitis. About 90 percent and 82 percent of the children from the programme and non-programme schools respectively had gingivitis. Only 10 percent (programme) and 18 percent (nonprogramme) of the children did not have any bleeding-gingival sites (GBI=O). The poor oral hygiene found in children from the programme school might imply that the practical aspects of plaque control and oral hygiene were not intensive enough to motivate the children. Most children were found to have minimal caries; mean DMFS scores of 0.14 (SD=0.49) and 0.12 (SD=0.45) for programme and non-programme schools respectively and 91 percent caries-free for each of the two schools. These differences were not statistically significant (p>0.05). The low prevalence of caries and the minimal difference between groups might be attributed to the following; the low prevalence of dental caries at baseline and the action of fluoride in drinking water. The study indicates that the programme has had a minimal impact if any, in the programme school. The findings suggest a need to correct the prevailing basic misinformation about dental health and motivation of teachers and the dental team to be more involved in the programmes.Item An explorative study of the factors possibly contributing to the burden of maxillofacial infection presenting at the Tygerberg Oral Health Centre(University of Western Cape, 2020) Douglas-Jones, Martin; Behardien, Nashreen; Myburgh, NeilOver the last few decades, and throughout the world, there would seem to have been an increase in the number and severity of infections affecting the maxillofacial region. In the South African setting this seems to be especially evident in the state health system. Maxillofacial infection of odontogenic origin is largely preventable. If treated appropriately and early in the pathological process, the progression of the disease process is generally prevented and complications avoided. Management of maxillofacial infections once established has serious implications for patients and an already stressed health system. The reasons for this perceived increase in infections are likely multifactorial and it is hoped that this study may aid in understanding factors contributing to this burden.Item Nutrition, oral health and the young child(Wiley Open Access, 2007) Naidoo, Sudeshni; Myburgh, NeilOral health is integral to general health and essential to well-being and quality of life. Socio-behavioural and environmental factors play a significant role in oral disease and oral health.Dental caries is a global disease with few populations exempt from its effects. In developingcountries, as development increases so does dental caries and children are at the forefront of thedisease disadvantage. There is a growing need to identify high caries risk groups accurately tocommence prevention from a young age.The effect of early intervention in childhood on generaland dental health with both population and high-risk approaches also needs examining. As aneducational tool, the paediatric food-based dietary guidelines may play a significant role innutrition and oral health interventions. This paper provides information on nutrition, includingaccess to fluoride and use of sugar.Oral health concerns,such as early childhood caries,which areimportant for the young child, are also discussed.Item The oral health status and perceived oral health needs in older adults in Guguletu(University of the Western Cape, 1999) Kazaura, K. J.; Myburgh, NeilObjectives: previous studies have indicated that most of the older adult population has poor oral health but only a few of them demand care for their problems' The reason for this discrepancy has never been explained adequately. The objectives of the study were' first' to assess the perceived oral health needs (with regards to social, functional and psychological impacts of oral diseases) of older adults aged 55 years and above, second, to assess the oral hearth status (periodontal disease, dental caries and oral mucosa lesions) in an adult population aged 55 years and above. Third, compare the relationship between normative and perceived need. Methods: This was a quantitative cross-sectional, descriptive study and consisted of 100 older adults who were randomly selected from three areas in Guguletu' These areas included the home for the aged Ekumphumleni' NY1 and NY2 clinics Participants aged 55 were interviewed using the structured questionnaire consists of 32 questions and clinical examination done. Frequency tables were computed and analyzed. The relationship between variables like oral health status, perceived and variety of socio-demographic variables and measures of psych-social impact of oral diseases were analysed by using the chi square test and square ratio. Results : The ability to perceive that they had a problem and the recently of the last visit to the dentist was associated with perceived need for dental care. There was a significant relationship between the presence of symptoms which were painful and perceived need for dental care mouth,p value:0.015;gums,pvalue=0.001;teeth,pvalue=0.0006)The positive attitude towards dental care and regular dental hygiene was an indicator of positive attitudes towards oral hearth care. In this study a substantial difference between perceived and normative need was also observed' 88% of the respondents perceived a need for dental care and 99% were assessed as needing treatment (normative need) but only z9o/o demanded the c,oe' 630% were dissatisfied with their functional ability to chew and expressed a need for dentures' conclusion: The aim of this study was to assess the oral health status and perceived oral health needs among older adults in Guguletu. The oral health status was poor in most were interviewed using a structured questionnaire consisting of 32question was examination done. Frequency tables were computed and analysed' The relationship between variables participants and the demand for care was lolv even though perceived need was high' The study has shown that social, functional and psychological factors influenced for care in this adult population. The cost for dentalcare and access to these services are major barriers to the demand of care perceived oral hearth needs and the impact of oral diseases are important influences in the assessment of oral health needs in the elderly' The assessment of oral health needs as perceived by the elderly facilitates the planning and implementation dental services with special consideration on the cost and accessibitity of oral healthcare.Item The oral health status of Xhosa speaking adults in Crossroads(University of the Western Cape, 1989) Myburgh, Neil; Cohen, BertramThere is an absence of both dental services and systematic planning to meet the oral health needs of the Black* population ~f greater Cape Town. Little epidemiological data exists upon which such planning can be based. This study describes the prevalence and treatment need related to tooth decay and periodontal disease ofaXhosa-speaking* squatter community on the outskirts of Cape Town. An age and sex stratified sample of 290 adults attending the SACLA clinic in Crossroads were examined. Examiner variability was measured by a percentage intra-examiner agreement for the DMFT of 95% and for the CPITN 84%. Cohen's kappa statistic, for tooth-specific caries detection errors was k = 0.877. The mean DMFT was 11.8 and varied little with sex or age below 55 years. After this age, the DMFT climbs steeply due largely to the rapid increase in the M value (missing teeth). The results show that for every tooth needing to be extracted, two teeth per subject required a restoration. Only three subjects already had some restorations. Periodontal health was reflected by a high prevalence of calculus (TN2 = 99%; MNS = 5.2) for the whole sample. Deep pockets were detected in 13% of those aged between 15 and 29 years, but only at a relatively low intensity (MNS = 0.1). This prevalence reached a high 60% for those aged between 45 and 64 years (MNS = 1.7). All subjects require oral hygiene instruction and gross scaling in at least four sextants, according to CPITN criteria. In conclus~on it is noted that there is a shortage of relevant epidemiological information necessary to the planning of oral health services to improve the oral health of the Xhosa-speaking community in the Western Cape. Caries prevalence rates are already high in young adults and a high tooth mortality rate and an absence of fillings, suggests that extraction is the only form of treatment made available to this community. The absence of appropriate prevention strategies such as water fluoridation is reflected in these results. The existence of small amounts of severe periodontal disease in young adults is of concern. The high prevalence of mild (and preventable) periodontal disease, seems to reflect a low awareness of the condition and/or a lack of resources to control it. It is no coincidence that such poor oral health was observed in this, a poor, peri-urban squatter community. This study, serves as a sad reminder of the maldistribution of oral health and socia-economic resources in South Africa. The socia-economic and political character of this community is reflected by the epidemiological picture of oral health observed in the study. It is clear that further data must be collected, especially a clear assessment of community-expressed needs. Active planning must take place urgently to integrate oral health with Primary Health Care to rectify the serious misuse and maldistribution of oral health resources required to improve the oral health of this population.Item Perception of occlusal appearance among schoolchildren in Limpopo Province(University of Western Cape, 2011) Sehowa, Nelly Mokgadi; Myburgh, NeilThe aim of this study is to determine the perceptions of different occlusal appearance observed by schoolchildren aged 13 -16yrs in the Capricorn District of Limpopo Province in South Africa. The study determined schoolchildren’s perceptions of different occlusal appearances, by assessing the self-perception of schoolchildren toward their occlusal appearance using the Aesthetic Component (AC) of the Index of Orthodontic Need (IOTN). These were compared with the perceptions held by schoolchildren across age, gender and place of residence in Limpopo Province.Item 'Risk of oral cancer associated with tobacco smoking and alcohol consumption- A case control study in the western Cape, South Africa'(University of the Western Cape, 2003) Chandran, Rakesh; Myburgh, NeilTobacco and alcohol consumption are well-established, high-ranking health risk behaviour in developed countries and the developing countries are catching up rapidly. There is very strong evidence in the literature to show that these behaviours feature prominently in the web of causation of many diseases either proximally or distally contributing substantially to global morbidity and mortality. Oral cancer is an important preventable cancer proven to be directly associated with tobacco and alcohol in many overseas studies. The study examines this association in detail for the population of the Western Cape Province in South Africa in order to establish the existence, extent, dose and the duration of use relationship and the possibility of synergistic effect of these two often co-existing risk behaviours in the causation of oral cancer. A hospital based, analytical case control study using histologically confirmed cases originating from a single homogenous population group of the Western Cape was designed, Necessary data on 67 cases were collected from the Cancer Unit of Groote Schuur Hospital in Cape Town and that of 67 controls from other clinics in the same hospital using an interview schedule specifically prepared and tested in the same hospital. The cases and controls were individually matched for age, gender and ethnicity. The statistical analysis of the data shows that: (1) There is strong relationship between oral cancer and smoking (Odds Ratio 4.63, 1.74-t230 95% C.I) and alcohol use (Odds Ratio 7.21, 3.07-16.93 C.I); (2) The risk increases by six fold when the duration of use is more than 35 years in case of tobacco and eleven fold with more than 30 years of alcohol use; (3) The quantity of tobacco (> 10 cigarettes/day) and alcohol (> 500 grams/week) increases the risk of oral cancer by two fold and twenty four fold respectively; (4) Very few people in the study were able to quit the habit and thus the existence of risk reduction with cessation of the habit could not be proven statistically; (5) Statistically significant synergism exists among the people who indulge in smoking and alcohol use (Odds Ratio 9.61, 2.909-31.73 C.I). The findings of the study strongly support the efforts of the South African government to implement the tobacco legislation strictly and its campaign for responsible drinking. Concerted efforts though media campaign and education among the adolescents are strongly recommended. This study did not examine the effect of poor oral hygiene in the development of oral cancer and further research is suggested.Item Self-assessment of oral health status, behaviours and oral health risk factors among adolescents from urban and peri-urban public schools in Maputo City(University of the Western Cape, 2019) Mepatia, Amália Issufo; Myburgh, NeilA good oral health self-perception can contribute to improved knowledge of oral health self-care and practice as well as increase the proper use of dental care services. This study evaluated how adolescents from urban and peri-urban Maputo City assess their oral health status, behaviour and oral health risk factors. This is an analytic cross-sectional study, conducted in the urban and peri-urban schools of Maputo City involving adolescents in the age groups of 12 and 15-19 years old. The study was carried out in five schools, three Complete Primary schools and two Secondary schools from urban and peri-urban areas in Maputo City selected by convenience due to their geographic location. The size of the sample was 500 comprising 236 twelve year olds and 264 15-19 year olds. Data was collected using a self-completion questionnaire designed by the World Health Organization (WHO) and translated into Portuguese. The questionnaire included variables such as socio-demographic data (age, gender, location and parent or guardian level of education), self-assessment of oral health status and quality of life; self reported oral health behaviour and lifestyles, oral health risk factor knowledge (alcohol, tobacco and dietary), dental visits and daily impact of oral health. Chi-square for associations and a Spearman correlation tests were used to determine relationships between categorical data. All tests were assumed statistically significant at p≤0.05. The results showed that most of the adolescents classified their teeth (49.7%) and gum (38.2%) health as normal. There was no statistical difference between adolescents from urban and peri-urban schools (Spearman rs (399) = 0,114, p =0,02). The majority (n=322; 65.2%) of the adolescents clean their teeth twice a day. There was no difference between school level (primary and secondary school) and frequency of teeth cleaning. Most of the adolescents use a toothbrush (97.8%) and toothpaste (93.5%) to clean their teeth and only 11.9% also use dental floss but 52.1% didn´t know if their toothpaste was fluoridated or not. Smoking was reported by less than 1% of the adolescents. The main reason for dental service utilization, (reported by 67.5%) was pain or problems with teeth, gums or mouth. There was an association between oral health status and problems experienced in daily life because of their teeth and mouth. There was no significant difference for oral health assessment, risk factors and behaviours, between adolescents from urban and peri-urban schools. Although some satisfactory results were found, the need to strengthen oral health promotion in schools is high, especially considering the causes for dental service utilization were mostly pain and trouble with teeth in this group.Item Sensitivity to sweet and bitter taste in mother/child pairs and its influence on their caries status(University of the Western Cape, 2018) Varghese, Vineeth; Myburgh, NeilIntroduction: Dental caries has one the highest incidences in children and the host’s diet may be a major factor in determining susceptibility to the disease. A proposed tool to screen and identify high risk individuals uses a bitter compound 6-n-propylthiouracil (PROP). The goal of this screening tool is to identify mothers and children who are Non-tasters (those who cannot taste PROP) and to educate them about their possible affinity towards sugar substances and its harmful effects on oral and general health. It is suggested that Non-taster children could be prioritized when providing preventative dental treatment. Aim: To validate the use of PROP as a screening tool for determining high caries risk individuals by identifying the taster status of mothers and children, their preference towards sugar, and its impact on their caries status. Methodology: 75 mother/ child pairs were recruited to participate in this study. Caries experience, sugar preference and taster status were determined for all the subjects. Comparisons were made between mothers and their children to find a possible association. Results: Caries experience was greater in individuals who were Non-tasters when compared to Super-tasters. A significant association between taster status and DMFT score was established (p<0.000). A significant association between taster status and sugar preference was established (p<0.000). A positive correlation with regard to taster status, sugar preference and caries experience was observed in mother/child pairs. Conclusion: Similarities in the mother's and child’s PROP taster status and its association with sugar preference allows such a screening test to identify individuals who are at high risk of developing dental caries. Early identification of mothers who are Non-tasters may allow the introduction of early intervention strategies and assist in the early detection of potentially high-risk children, especially in environments where resources are limited.Item Sensitivity to sweet and bitter taste in mother/child pairs and its influence on their caries status(University of the Western Cape, 2018) Varghese, Vineeth; Myburgh, NeilIntroduction: Dental caries has one the highest incidences in children and the host’s diet may be a major factor in determining susceptibility to the disease. A proposed tool to screen and identify high risk individuals uses a bitter compound 6-n-propylthiouracil (PROP). The goal of this screening tool is to identify mothers and children who are Non-tasters (those who cannot taste PROP) and to educate them about their possible affinity towards sugar substances and its harmful effects on oral and general health. It is suggested that Non-taster children could be prioritized when providing preventative dental treatment. Aim: To validate the use of PROP as a screening tool for determining high caries risk individuals by identifying the taster status of mothers and children, their preference towards sugar, and its impact on their caries status. Methodology: 75 mother/ child pairs were recruited to participate in this study. Caries experience, sugar preference and taster status were determined for all the subjects. Comparisons were made between mothers and their children to find a possible association. Results: Caries experience was greater in individuals who were Non-tasters when compared to Super-tasters. A significant association between taster status and DMFT score was established (p<0.000). A significant association between taster status and sugar preference was established (p<0.000). A positive correlation with regard to taster status, sugar preference and caries experience was observed in mother/child pairs.