Cultural and Environmental Determinants of Dental Discoloration Among School-Aged Children in Nigeria

Cultural and Environmental Determinants of Dental Discoloration Among School-Aged Children in Nigeria by Ogbudu Gabriel Ada MPH, Ahmadu Bello University, Zaria; Nigeria, 2009 MB,BCH, University of Calabar, Nigeria, 1986. Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health, Epidemiology Walden University February 2018 Abstract Dental discoloration from fluorosis is a global public health problem. In Nigeria, 11.4% of the population is impacted by this disorder. Dental discoloration is caused by successive exposures to high fluoride concentrations during tooth development in utero and it is linked to the development of a variety of psychological and physiological problems, from dental aesthetics to a reduction in intelligence and skeletal changes. The purpose of this quantitative, cross-sectional study was to examine the cultural and environmental determinants of dental fluorosis in children in a rural community in Nigeria. A multilevel theoretical model was used to develop possible fluoride exposure pathways, such as good social services and dental care, as well as factors in the environment. The study was guided by 2 main research questions: What is the prevalence of fluorosis among Nigerian school-aged children? What is the severity of this fluorosis, and is it associated with the fluoride content of the soil, the water or the food? Data was collected by administering three surveys, on children aged 5 to15 years, their parent/guardian, and on community leaders. Chi-square and regression analysis tests were used to test for possible associations. The study findings showed a fluorosis prevalence rate of 86.6% in the 269 school children surveyed, with majority of these children between the ages of 8 to 13 years. The severity of children fluorosis was associated with the length of stay in the study area and the fluoride content in water, soil, and food. This study’s possible impact on social change include raising awareness to the problem and the possible ways to resolve it, such as through, improved dental care services and a supportive social environment like flocculation of community water sources.Dental discoloration from fluorosis is a global public health problem. In Nigeria, 11.4% of the population is impacted by this disorder. Dental discoloration is caused by successive exposures to high fluoride concentrations during tooth development in utero and it is linked to the development of a variety of psychological and physiological problems, from dental aesthetics to a reduction in intelligence and skeletal changes. The purpose of this quantitative, cross-sectional study was to examine the cultural and environmental determinants of dental fluorosis in children in a rural community in Nigeria. A multilevel theoretical model was used to develop possible fluoride exposure pathways, such as good social services and dental care, as well as factors in the environment. The study was guided by 2 main research questions: What is the prevalence of fluorosis among Nigerian school-aged children? What is the severity of this fluorosis, and is it associated with the fluoride content of the soil, the water or the food? Data was collected by administering three surveys, on children aged 5 to15 years, their parent/guardian, and on community leaders. Chi-square and regression analysis tests were used to test for possible associations. The study findings showed a fluorosis prevalence rate of 86.6% in the 269 school children surveyed, with majority of these children between the ages of 8 to 13 years. The severity of children fluorosis was associated with the length of stay in the study area and the fluoride content in water, soil, and food. This study’s possible impact on social change include raising awareness to the problem and the possible ways to resolve it, such as through, improved dental care services and a supportive social environment like flocculation of community water sources. Cultural and Environmental Determinants of Dental Discoloration Among School-Aged Children in Nigeria by Ogbudu Gabriel Ada MPH, Ahmadu Bello University, Zaria; Nigeria, 2009. MB,BCH, University of Calabar, Nigeria, 1986. Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health, Epidemiology Walden University February 2018 Dedication I wish to dedicate this work to my family, especially my wife Angela, for her unrelenting support and understanding of the challenges I have faced during this phase of my studies. I appreciate your inspiring encouragement and hard work that enable me to undertake this program. Acknowledgments I wish to firstly acknowledge the immense contribution made by my dissertation chair, Professor Amany Refaat, to see me through this dissertation process. I know how much of a headache I have caused her. I also wish to thank my initial committee member, Dr. Shipps, for her very critical and intense guidance on the methodology section which appropriately helped improve the quality of the work. I also wish to thank the IRB team for providing me with all necessary assistance to achieve my study goals. I have also benefitted greatly from the contributions of my second committee member Dr Donald Goodwin who helped with further corrections to my methodology and result section. I am also grateful for the comments by my University reviewer Dr Frazier Benjamin and the exposure provided by the Faculty of health sciences and the faculty members in the public health program for their gradual but sure guidance during my studies.