Tooth loss, associated factors and prosthetic treatment need among patients receiving methadone maintenance therapy in Dar es Salaam, Tanzania

Abstract

Background: Tooth loss is a common issue among the general population in Tanzania, often resulting from dental caries, periodontal diseases, or trauma. Patients with substance use disorders are at an increased risk of tooth loss due to several factors, including impaired oral hygiene practices, dry mouth, and sugar cravings. These factors contribute to dental caries and periodontal diseases, which can ultimately lead to tooth loss. Additionally, individuals with substance use disorders are frequently involved in violent incidents and may sustain injuries that result in tooth loss. This study aims to assess tooth loss, its associated factors, and the need for prosthetic treatment among patients receiving methadone maintenance therapy at clinics in Dar es Salaam, Tanzania, from December 2019 to June 2021
Materials and Methods: This hospital-based descriptive cross-sectional study involved 427 patients receiving methadone maintenance therapy at clinics in Dar es Salaam, Tanzania. Participants were interviewed using a structured questionnaire and intra-orally examined with a dental mirror and probe. The findings were recorded on a clinical examination sheet. Data were analyzed using Chi-square tests and logistic regression analyses in SPSS software version 23. A p-value of less than 0.05 was considered statistically significant.
Results: Four hundred and twenty-seven study participants were analyzed, with a mean age of 41. Of these, 80.8% were male. Approximately 61.4% of the participants had a primary education or less. About 88.8% had lost one or more teeth, with a significant difference in tooth loss observed between age groups (p=0.001). The mean number of teeth lost among participants was 8.95, with a standard deviation 7.772. Mandibular molars were the most lost teeth, accounting for 74%, followed by maxillary molars at 64.9%. Dental caries was the predominant cause of tooth loss, responsible for 58.3% of cases. Kennedy class III was the most common classification for partial edentulism on the upper jaw (52.5%) and lower jaw (49.8%). Only 6.3% of participants had dental prostheses, with acrylic removable partial dentures being the most common type on the upper jaw (81.8%) and lower jaw (88.9%).
Conclusions: The prevalence of tooth loss among patients with substance use disorders is high, with the common causes being similar to those in the general population: dental caries, periodontal diseases, and traumatic injuries. Only a tiny percentage of the participants have dental prostheses, indicating a significant need for prosthetic treatment in this group.