A STUDY OF THE PREVALENCE AND RISK FACTORS ASSOCIATED WITH DENTAL DISEASE IN RURAL COMMUNITIES IN NIGERIA (CASE STUDY OF ARAMOKO, EKITI STATE)

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

In addition to regular tooth cleaning, a significant proportion of Nigerians do not place much importance on oral health, unless they have serious conditions such as pain or discomfort (Abioye, 2020). Nevertheless, there are individuals who opt to alleviate the discomfort by using analgesics and would only seek dental treatment as a final option. According to Eddie et al. (2019), it is predicted that dental illnesses impact almost 3.5 billion individuals globally, with caries of permanent teeth being the prevailing problem. Due to the high prevalence rate, oral health disorders were given priority on the non-communicable disease list. This is because they have common risk factors with other NCDs, such as diabetes, cardiovascular illnesses, and cancer.

The correlation between dental health and overall health is complex, since the condition of an individual's oral health can either enhance their general health and well-being or have a detrimental impact on it (Jotham, 2018). The Federation Dentaire Internationale (2021) has formulated a definition of oral health, accompanied by a framework that highlights the interconnections between the three fundamental aspects of oral health: disease and condition status, physiological function, and psychosocial function. The oral health definition framework presented here illustrates that the total health and well-being of an individual is determined by a combination of factors that influence oral health, together with additional elements that moderate their impact (FDI, 2021). Hence, maintaining optimal dental health is directly correlated with overall well-being and improved quality of life for an individual (Roni, 2021).

Oral health refers to the condition of the mouth, teeth, and facial structures, which allows individuals to carry out vital functions like eating, breathing, and speaking. It includes psychological aspects such as self-assurance, overall health, and the ability to participate in social relationships and work without experiencing pain, discomfort, or embarrassment (WHO, 2023). Practicing proper oral hygiene might yield beneficial outcomes for other facets of overall health, such as the cardiovascular system (Son et al., 2021). Failure to adhere to adequate oral hygiene routines can lead to avoidable oral health issues that are easier to prevent than to fix. Poor oral hygiene causes an increased accumulation of plaque and debris in the oral cavity, including the mouth, teeth, and gums, which can contribute to the onset of dental illnesses. 

The World Health Organisation (WHO, 2023) defines dental diseases as a range of conditions and disorders, such as dental caries, periodontal disease, tooth loss, oral cancer, oro-dental trauma, noma, and birth defects such cleft lip and palate. Dental diseases are widespread non-communicable conditions worldwide, affecting around 3.5 billion people. Oral health issues are becoming more common globally, particularly in low- and middle-income nations. The main reason for this is the increase in population and the ageing population, which will continue to place a higher burden on oral health services. It is crucial to acknowledge that oral diseases disproportionately affect vulnerable and underprivileged groups. Individuals of lower socioeconomic status have a higher occurrence of oral disorders, and this association remains consistent throughout their lifespan, from early childhood to old age, regardless of the total income level of the country. dental diseases are linked to various environmental and lifestyle factors, such as nutritional status, tobacco smoking, alcohol intake, inadequate dental hygiene, stress, and systemic issues (Watt & Brown, 2020). Singh (2022) explained that many people have below-average oral health without being aware of their condition. As a result, this has harmful effects such as difficulty chewing and digesting food, as well as a reduced overall quality of life. Singh (2022) asserted that an individual's oral health care is impacted by their dental health attitude and behaviour, which are moulded by their experiences, cultural perception, familial beliefs, and lifestyle circumstances.

Oral health is an essential aspect of overall health and has a major impact on quality of life, self-confidence, and social interactions (Arthur et al., 2023). Nevertheless, oral illnesses continue to be a significant public health concern, especially in rural regions where there is often restricted availability of dental services. In Aramoko, a rural community in Ekiti State, Nigeria, dental problems are said to be widespread, worsened by a range of socio-economic and environmental conditions. Aramoko, a rural village in Ekiti State, Nigeria, encounters various obstacles in terms of accessing and providing healthcare. The high frequency of dental problems can be attributed to factors such as low socio-economic status, restricted access to health care facilities, and inadequate education regarding oral health. This study intends to provide a comprehensive understanding of the unique challenges pertaining to oral health in rural Nigeria, with a specific focus on Aramoko. The findings will serve as a benchmark for comparing oral health difficulties in other rural and urban regions. Therefore, the necessity for this investigation arises.

1.2 Statement of the problem

Despite being a prevalent public health concern, oral health disorders are sometimes overlooked in the development of public health policies. According to reports, there has been a large increase in the prevalence of oral health illnesses, including periodontal diseases, oral cancer, and caries, from 2010 to 2020. This growth has occurred with the rise of major non-communicable diseases such as diabetes.

Dental illnesses have a greater impact on individuals who are economically underprivileged and socially marginalised (Ogundele, 2019). There exists a robust and constant correlation between socioeconomic status (including income, occupation, and educational level) and the occurrence and intensity of oral illnesses. This correlation persists from early infancy to old age and primarily impacts the population residing in rural regions (Ojo, 2020). Famuyiwa (2023) states that the uneven allocation of oral health practitioners and inadequate healthcare facilities in rural areas result in limited availability of essential oral health treatments. High out-of-pocket expenses for oral health care might significantly impede individuals' ability to obtain necessary care (Mike., 2021). One of the main causes of catastrophic health expenses is the cost of essential dental care, which can lead to a higher likelihood of becoming poor and facing financial difficulties.

Research has indicated that the majority of dental diseases and conditions have similar risk factors that can be changed, such as tobacco use, alcohol consumption, and an unhealthy diet that is high in free sugars. These risk factors are also commonly associated with the four main non-communicable diseases: cardiovascular disease, cancer, chronic respiratory disease, and diabetes (Sholanke et al., 2023). Furthermore, there is a reciprocal association between diabetes and the development and progression of periodontal disease (Mike., 2021). There is a direct correlation between excessive sugar consumption and the development of diabetes, obesity, and dental cavities (Darren, 2021).  Adeyinka (2023) argues that the occurrence of major oral diseases is on the rise in rural communities mainly because of insufficient exposure to fluoride (in water and toothpaste), the limited availability and affordability of food with high sugar content, and inadequate access to oral healthcare services in the community. The promotion of sugary food and drinks, as well as tobacco and alcohol, has resulted in an increasing intake of products that contribute to oral health issues and other non-communicable diseases (NCDs). This study aims to examine the prevalence and risk factors related to dental disease in rural communities in Nigeria, with a specific focus on the case study of Aramoko, Ekiti State. 

Objectives of the study

The primary objective of this study is to critically evaluate the prevalence and risk factors associated with dental disease in rural communities in Nigeria (case study of Aramoko, Ekiti state). Specific objectives of this study are to:

To assess the prevalence of dental disease in Aromoko, Ekiti

To identify factors that influence the prevalence of dental disease in Aramoko, Ekiti State 

To assess the various dental diseases experienced among the residents of Aramoko, Ekiti State

To assess the impact of dental disease on the quality of life in Aramoko, Ekiti State.

To provide recommendations for improving oral health outcomes and promoting preventive measures in Aramoko, Ekiti State

1.4 Research Questions

The following research questions will be answered in this study:

What is level of prevalence of dental disease in Aromoko, Ekiti?

What are the factors that influence the prevalence of dental diseases in Aramoko, Ekiti State?

What are the various dental diseases experienced among the residents of Aramoko, Ekiti State?

What is the impact of dental disease on the quality of life in Aramoko, Ekiti State?

What are the recommendations for improving oral health outcomes and promoting preventive measures in Aramoko, Ekiti State?

1.5 Research Hypotheses

The following research null hypotheses have been formulated to guide the study:

Ho: There are no significant factors that influence the prevalence of dental disease in Aramoko, Ekiti State.

Ha: There are significant factors that influence the prevalence of dental disease in Aramoko, Ekiti State.

1.6 Significance of the study

This study is important because it fills a crucial void in oral health research by explicitly examining rural areas in Nigeria, particularly Aramoko in Ekiti State. It plays a role in enhancing public health, increasing community consciousness, informing policy choices, progressing research, and advocating for fairness in oral healthcare.

Gaining insight into the frequency of dental disorders and the related factors that contribute to them in rural communities such as Aramoko, Ekiti State, is essential for the purpose of public health planning. It aids in determining the distinct oral health requirements of rural people, who frequently encounter distinctive obstacles such as restricted availability of dental care facilities, inadequate oral hygiene practices, and food habits that may contribute to tooth disorders. 

Furthermore, this research has the potential to enhance public understanding of oral health concerns among the population. The project aims to educate citizens and promote preventive measures, such as frequent dental check-ups, correct oral hygiene practices, and dietary adjustments, by sharing information regarding the incidence of dental disorders and their influence on oral health.

Moreover, with its emphasis on rural regions, this study aims to tackle health disparities and inequities in the availability of oral healthcare services. The text underscores the significance of ensuring fair and equal access to dental care and identifies specific areas where interventions might be focused to enhance oral health outcomes for disadvantaged groups. 

Furthermore, the data obtained from your study can provide valuable insights to policymakers and healthcare providers regarding the precise oral health requirements of rural people in Nigeria. This information can provide guidance for the formulation of specific policies, distribution of resources for dental care services, and execution of community-based oral health programmes in order to enhance oral health outcomes.

Moreover, this study contributes to the existing knowledge on oral health in rural areas of Nigeria. The study offers empirical evidence that can be utilised by students, researchers, policymakers, and healthcare professionals that are interested in comprehending the epidemiology of dental illnesses and risk variables in comparable rural settings.

1.7 Scope of the study

Broadly, this study focus is to critically evaluate the prevalence of dental disease and risk to oral health in rural communities in Nigeria. Specifically, this study seeks assess the prevalence of dental disease in Nigeria, identify factors that influence the prevalence of dental diseases in Nigeria, assess the various dental diseases experienced in Nigeria, assess the impact of dental disease on the quality of life in Nigeria and provide recommendations for improving oral health outcomes and promoting preventive measures in Nigeria.

The study is carried out in Aromoko, Ekiti state, Nigeria. The respondents of this study are adolescents and youths in Aromoko Ekiti.

1.8 Limitations of the study

As with any human undertaking, the researchers faced various minor restrictions during the investigation. The main restriction was the lack of significant literature on the subject, due to the restricted availability of data regarding a study of the prevalence and risk factors associated with dental disease in rural communities in Nigeria. Hence, a large allocation of time and labour was necessary to ascertain the proper materials, books, or information and gather data. 

Another limitation experienced by the researcher is language barrier. The researcher encountered challenges in connecting with the members of Aromoko community since they have little or no knowledge of the English language. In order to communicates with respondents of the study, the researcher had to pay for the services of an interpreter.

Furthermore, this study is hampered by its small sample size and narrow geographical reach, focused primarily on Aromoko, Ekiti state. Therefore, the conclusions of this study cannot be applied to other scenarios, thus necessitating further inquiry. 

Moreover, the researcher's restrictions were primarily due to financial restraints, as they are a student without any source of money to sustain themselves. The excessive transportation costs at the research location, worsened by the prevalent inflation in Nigeria, provided a substantial obstacle in fulfilling the expenses related with transportation.

Finally, the researcher encountered a time constraint due to the requirement to complete this research while still completing the obligations of attending lectures and engaging in other educational activities.

1.9 Definition of terms

Oral health: Oral health is the state of the mouth, teeth and orofacial structures that enables individuals to perform essential functions such as eating, breathing and speaking, and encompasses psychosocial dimensions such as self-confidence, well-being and the ability to socialize and work without pain, discomfort and embarrassment.

Oral disease: Oral diseases encompass a range of diseases and conditions that include dental caries, periodontal (gum) disease, tooth loss, oral cancer, oro-dental trauma, noma and birth defects such as cleft lip and palate.

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