Evaluation of caries experience among school children in the Central African Republic

The Central African Republic is one of the least developed nations in the world in which more than 60% of its population live in poverty, in the middle of political instability, chronic violence and conflicts. Endemic governance defects have triggered a bad health landscape, which is characterized by alarming high mothers -like rates and reduced life expectancy. Access to health and education is similarly influenced by these systemic challenges. The Swift Socioconomic and Nutritional transitions limit the Central African Republic when addressing the escalation of chronic diseases in addition to the permanent challenge of infectious diseases and malnutrition of children, which is called double disease load^19.20.

This study presents the first data record on the oral health status of school children in the Central African Republic. Caries prevalence trends can not only be attributed to the examined age cohorts, but also to the economic and geographical access to dental care services, behavioral practices, usage patterns of health care, nutritional habits and lifestyle decisions.

The study mainly revealed data on the state of health of oral health based on the DMFT/DMFT index. In this regard, the results mainly indicate a difference between the populations of 6 and 12 years. In particular, the DMFT is higher after 6 years compared to the DMFT after 12 years. Such data are comparable to neighboring countries^21.22. This phenomenon can be attributed to a lack of health awareness and the preservation of primary teeth, combined with the parental perception that primary teeth can be exchanged with permanent teeth and consequently a reduced significance can be exchanged²³. The examination showed an increased prevalence of caries in men aged 6 years and in women after 12 years. Gender differences in the prevalence of dental caries were documented in detail, which shows a consistent trend, in which women in different age groups have an increased susceptibility and have a stronger prevalence of carial lesions compared to their male counter²⁴. These results are partly based on patterns that have been observed in East Africa²⁵. The reasons for the increased prevalence of dental caries in girls are still incomplete. Proposed explanations include earlier tooth outbreak, longer exposure to cariogenic processes, differences in eating habits, hormonal or physiological deviations as well as differences in the characteristics of the prayer, tooth enamel or salt field²⁶. Conversely, the increased frequency of the snack consumption observed in the male population (Table 2) could be responsible for the connection with an increased risk of caries.

In all observed cases, the prevalence of primary and permanent filled and lack of teeth was almost impossible, which was probably due to the almost total lack of tooth providers. Although the overarching importance of schools and families is recognized as potential risk factors for caries, their statistical importance has not been defined. The direct causality between socio -economic conditions and caries cannot be finally determined. The available results indicate a cumulative impact on caries development²⁷. Inadequate toothbrush methods are associated with an increased prevalence of caries²⁸. The use of toothbrushes and fluoridated toothpaste was evenly distributed through both genders within the sample, whereby almost ubiquitarians use the toothbrush and three liters inscribed subjects to use fluoridated toothpaste. In addition, inadequate toothbrush methods are associated with an increased prevalence of caries²⁸.

The data underline a greater concentration of protective factors in the bangui consumption arrondissement (Fig. 2) compared to other districts of capital in relation to the use of fluoridated toothpaste and toothbrushes. However, it is the same area of ​​the city, in which the highest average DMFT and the caries -free rate are also observed. Therefore, what indicates the presence of health determinants that were not recorded by the study.

In accordance with the global action plan for oral health (2023–2030), the improvement of oral health in the Central African Republic requires a multifaceted approach, including health education, infrastructure development and access to preventive and curative dental services. It is important to take into account the broader context of the challenges of health care in the country and to tackle oral health as part of the general health improvement. The effort could be made by national health organizations, NGOs and international agencies.

The training of dentists is financially stressful and there is no cost efficiency compared to the demand for the oral health of the population. As a country with a low income, the Central African Republic benefits from a team -based approach that includes tooth therapists, hygienists, dental nurses and social workers. Community programs improve population provision and promote the participation of the community. School -based programs achieve susceptible populations and have cumulative positive effects. Such initiatives are based in oral hygiene promotion, routine examinations and proper practices of domestic care. As has been implemented in the Central African Republic for many years, the inclusion of UN agencies and NGOs can bring advantages with regard to care, access to care and equity when improving the health system. However, the large number of actors represent challenges in terms of organizational structure, economic resource planning, personnel management and intervention planning.

Taking into account frequent risk factors and the shift in progress in the direction of the double disease burden in the Central African Republic, it is crucial to integrate oral diseases into broader initiatives that aim to reduce non -transferable diseases. The inclusion of a fundamental series of dental service in primary health care offers the opportunity to optimize the existing medical infrastructure and thus reduce the stress on the mouth diseases. This approach increases regular monitoring of oral health and expands access to dental services, which deals with the dangerous tendency to separate oral health from general health²⁹.

Access to water, hygiene and hygiene (Wash) is still a challenge in Africa. Only 31% of the population used securely managed sanitary facilities and 28% of basic hygiene in 2022, which indicate the presence of considerable differences in access to fundamental hygiene services in countries in various income clips³⁰. Accurate data on waist services in the Central African Republic are not available. The availability of running water in educational institutions can improve the proper implementation of oral hygiene practices. In addition, the availability of a centralized water network for the implementation of water fluoride measures is of essential importance to prevent dental caries.

Urbanization and globalization can lead to increasing western nutritional patterns by the increased consumption of processed food, sugary drinks and calorie -shaped snacks⁵. Such changes in eating habits can contribute significantly to the prevalence of non -transferable diseases such as caries, obesity and diabetes. The students of the primary school show openness to learn the negative effects of the consuming sugar-sweetened drinks³¹. The integration of educational initiatives into the school curriculum could possibly reduce your consumption and consequently reduce the prevalence of caries, since the eating habits often form in childhood.

Although innovative and pioneering in the Central African Republic, this study is not without restrictions. The subjects were only recruited from the capital Bangui, which means that representativity was only concentrated on the urban population. This decision was made on the basis of the serious security restrictions. Nevertheless, the overturning of the sample size ensured better representativity compared to the estimated. In addition, it is not possible to calculate the consistency of the study participants in relation to the professional status of the supervisors/tutors due to the lack of reliable national data. Finally, oral health is an outstanding metric for susceptible differences in various social determinants that include the level of education and economic reputation³². Therefore, the multidisciplinary approach of the Central African Republic is based in accordance with the Global Action Plan for Oral Health for the implementation of oral health on the leading principles of adapting interventions in order to cover the health needs of the population.

Although a standardized questionnaire was used, there may have been inaccuracies when measuring risk factors. In addition, the actual fluoride content in toothpaste often falls below the levels specified on product labels³³. There are currently no local market studies in which precisely evaluated whether the fluoride content of these products corresponds to the expected standards. In this first epidemiological study, however, the importance of improving the interventions against caries in pediatric age groups is emphasized by an approach to public health, which is adapted to the complex local conditions, which include innovations in the workforce, and integrating the integration of oral health into primary health care and thus integrating the word of the UHC framework.