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Oral
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Oral Health in the Global South
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Oral Health in the Global South

A special issue of Oral (ISSN 2673-6373).

Deadline for manuscript submissions: closed (20 October 2024) | Viewed by 16566

Special Issue Editors

Dr. Zuhair Natto

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Guest Editor
Department of Oral Health Policy and Epidemiology, Harvard University School of Dental Medicine, Boston, MA, USA
Interests: genetic epidemiology; infectious epidemiology; statistical genetics; cancer epidemiology; smokeless tobacco; clinical trials in periodontology and implant dentistry; quality of systematic reviews; and meta-analysis
Special Issues, Collections and Topics in MDPI journals
Dr. Kehinde Kazeem Kanmodi

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Guest Editor
School of Health and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
Interests: oral cancer; tobacco; alcohol; oral infection; oral and dental injury; sociobehavioural science; healthcare service; health policy; health administration; health education; health promotion; school health; rural health; global oral health; bibliometric analysis; systematic review; comprehensive narrative review
Special Issues, Collections and Topics in MDPI journals
Dr. Lawrence Achilles Nnyanzi

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Guest Editor
School of Health and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
Interests: oral cancer; tobacco; alcohol; oral infection; sociobehavioural science; healthcare service; health policy; health administration; health education; health promotion; school health; global oral health; bibliometric analysis; systematic review; comprehensive narrative review

Special Issue Information

Dear Colleagues,

It is a common saying that health is incomplete without oral health. This is true, as the mouth serves as a mirror of the body’s state of health, and as well the gateway to the body. Dental care professionals and public health/policy specialists play a very crucial role in ensuring the good oral health profile of the general population.

According to a recent report by the World Health Organization, there is an unequal distribution of the dental workforce globally. Based on the report, it was understood that the majority of the dental health workforce are in the Global North, while only very few are in the Global South. For example, only 1% of the total population of dentists are in Africa. Overall, this shows that there is a huge inequality gap in global oral healthcare.

Worisomely, a very recent report by the Global Burden of Disease Study Group revealed that about half of the world population experience diverse oral conditions. This group’s report, coupled with several other reports, further established that the burden of these oral conditions is concentrated in countries in the Global South. This is also another area of inequality that needs to be addressed.

The aim of this Special Issue is to create a collection of papers that address diverse areas of dental public health (community dentistry) with a focus on global health. Submissions regarding, but not limited to, oral epidemiology, oral health policy, oral health education, dental workforce development, dental care professions education, dental health insurance, neglected tropical oral diseases, and dental sociology are highly welcome.

Diverse manuscript types, including comprehensive narrative reviews, systematic reviews, bibliometric analyses, surveys, randomized control trials, commentaries, letters to editors, etc., can be submitted to this Special Issue.

Dr. Zuhair Natto
Dr. Kehinde Kazeem Kanmodi
Dr. Lawrence Achilles Nnyanzi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Oral is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • oral and dental injury
  • sociobehavioural science
  • oral healthcare service
  • oral health policy and administration
  • oral health education and promotion
  • global oral health
  • oral disease prevention
  • oral epidemiology

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Published Papers (7 papers)

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Research

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14 pages, 7909 KiB  
Article
Variables Associated with Jaw Clicking in a South Australian Population: A Cross-Sectional Study
by Taseef Hasan Farook, Lameesa Ramees and James Dudley
Oral 2024, 4(2), 217-230; https://doi.org/10.3390/oral4020018 - 10 May 2024
Cited by 3 | Viewed by 1617
Abstract
Background: The influence of medical and dental factors on jaw clicking within the South Australian population remains unexplored, and there is a lack of research on the impact of occlusal therapy on dynamic jaw movement parameters in this population. Purpose: This study investigated [...] Read more.
Background: The influence of medical and dental factors on jaw clicking within the South Australian population remains unexplored, and there is a lack of research on the impact of occlusal therapy on dynamic jaw movement parameters in this population. Purpose: This study investigated the potential significant associations between specific aspects of patient histories, occlusal therapy, and self-reported or observed jaw clicking in a population from the state of South Australia. Methods: Seventy individuals aged 18 to 65 participated in a cross-sectional study. Data collection included comprehensive medical, social, and dental histories, followed by evaluations of jaw function. Twenty-six out of the seventy individuals reported jaw clicking. Electrognathography assessed maximum mouth opening, surface electromyography evaluated masticatory muscle function, and joint vibration analysis measured individual joint vibration amplitudes and integrals. Logistic regression models analysed overall variable effects, while sub-models focused on predictors related to occlusal therapy, specifically orthodontic intervention. Independent t-tests and Mann–Whitney U tests compared jaw functions between participants who received occlusal therapy and those who did not. Results: The number of third molars extracted, vitamin D deficiency, and self-reported mental health disorders (R2 = 0.414, p = 0.048) emerged as significant predictors for jaw clicking. Factors associated with occlusal therapy showed no significant association with jaw clicking (R2 = 0.59, p = 0.027). Furthermore, there were no significant differences observed in mouth opening (t-stat = −0.439, p = 0.662), muscle activity, and joint vibration analysis between participants who underwent occlusal therapy and those who did not. Conclusions: Within the selected study population and limited sample size, the number of third molars extracted, vitamin D deficiency, and self-reported mental health disorders were associated with jaw clicking. Full article
(This article belongs to the Special Issue Oral Health in the Global South)
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11 pages, 1043 KiB  
Article
Comparative Analysis of Dental Health Outcomes from Two Outreach Camps in Zanzibar, Tanzania: 2019 and 2023
by Nutayla Al Harthy, Mohammed Al Ismaili and Abubaker Qutieshat
Oral 2024, 4(2), 185-195; https://doi.org/10.3390/oral4020015 - 24 Apr 2024
Viewed by 1921
Abstract
Background: In low- and middle-income countries, oral health is frequently marginalized due to limited dental care access. This cross-sectional study assesses the outcomes of dental outreach camps in Zanzibar, Tanzania, organized in 2019 and 2023, to understand their impact on addressing local oral [...] Read more.
Background: In low- and middle-income countries, oral health is frequently marginalized due to limited dental care access. This cross-sectional study assesses the outcomes of dental outreach camps in Zanzibar, Tanzania, organized in 2019 and 2023, to understand their impact on addressing local oral health needs over a four-year span. Methods: The study involved a thorough examination and analysis of clinical dental health data from both outreach camps. In 2019, 224 patients were examined, and in 2023, the number increased to 354. The assessment covered various dental health parameters, including dental caries, DMFT/dmft indices, enamel fluorosis, dental trauma, oral mucosa lesions, and non-carious tooth surface loss. Results: The analysis demonstrated a significant reduction in dental caries among adolescents and teens, decreasing from 62.5% in 2019 to 35.59% in 2023 (p < 0.0001). Similarly, the prevalence of teeth missing due to caries showed marked reductions from 40.2% to 9.04% in adolescents and teens (p < 0.0001) and from 25.89% to 11.86% among preschool and school-aged children (p = 0.004). Moreover, a significant change was observed in the Basic Erosive Wear Examination (BEWE) scores, with cases showing no erosive tooth wear (BEWE = 0) decreasing from 49.1% to 33.3% (p = 0.016), and cases with initial loss of enamel surface texture (BEWE = 1) increasing from 47.3% to 61% (p = 0.044). Conclusions: The outreach camps conducted in 2019 and 2023 showed tangible improvements in certain dental health metrics, particularly a reduction in dental caries and missing teeth due to caries among adolescents and teens. However, the uptick in non-carious tooth surface loss points to emerging dental health concerns. These results underline the importance of sustained and targeted dental health interventions to improve oral health outcomes in underserved communities such as Zanzibar. Full article
(This article belongs to the Special Issue Oral Health in the Global South)
17 pages, 804 KiB  
Article
Factors Determining the Willingness of Nigerian Clinicians to Recommend Protected Oral Sex: An Online Exploratory Study
by Kehinde Kazeem Kanmodi, Jacob Njideka Nwafor, Ugochukwu Anthony Eze, Babatunde Abiodun Amoo, Afeez Abolarinwa Salami, Bello Almu, Mike Eghosa Ogbeide, Precious Ehi Obute, Timothy Aladelusi, Oladimeji Adebayo and Lawrence Achilles Nnyanzi
Oral 2022, 2(4), 299-315; https://doi.org/10.3390/oral2040029 - 15 Dec 2022
Cited by 3 | Viewed by 3552
Abstract
Oral sex, a risky sexual behaviour, is now a common sexual behaviour in Nigeria. Nigerian clinicians play crucial roles in the promotion of healthy sexual behaviours among the lay public. This study seeks to identify those factors that determine the willingness of Nigerian [...] Read more.
Oral sex, a risky sexual behaviour, is now a common sexual behaviour in Nigeria. Nigerian clinicians play crucial roles in the promotion of healthy sexual behaviours among the lay public. This study seeks to identify those factors that determine the willingness of Nigerian clinicians to recommend protected oral sex to patients with history of oral sex practice. This study surveyed 330 clinicians in Nigeria, using an e-questionnaire circulated via WhatsApp and Telegram. The collected data were analysed using SPSS version 21 software. The majority (89.1%) of the respondents were willing to recommend protected oral sex for patients engaging in oral sex. Amidst all of the factors (sociodemographic factors, sexual history, etc.) investigated, only one factor (which was the uncertainty about the risk level of oral sex) was found to predict the willingness to recommend protective measures to patients on oral sex (OR = 3.06, p = 0.036). In conclusion, only few factors were found to influence Nigerian clinicians in engaging in patient education on safer oral sex practices. Full article
(This article belongs to the Special Issue Oral Health in the Global South)
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Review

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24 pages, 724 KiB  
Review
Mycophenolate Mofetil in the Management of Oral Mucocutaneous Diseases: Current Evidence and Future Perspectives
by Khalid Aljohani, Ghada H. Naguib, Abdulghani I. Mira, Abeer Alnowaiser, Mohamed T. Hamed, Ahmed O. Abougazia, Ghaida A. Alzarani, Raghad M. Noorsaeed and Rayyan A. Kayal
Oral 2025, 5(2), 35; https://doi.org/10.3390/oral5020035 - 15 May 2025
Viewed by 314
Abstract
Background/Objectives: Mycophenolate mofetil (MMF) has emerged as a valuable immunosuppressive agent used in the management of oral mucocutaneous diseases, particularly in autoimmune and inflammatory conditions, such as pemphigus vulgaris (PV), oral lichen planus (OLP), mucous membrane pemphigoid (MMP), systemic lupus erythematosus (SLE), erythema [...] Read more.
Background/Objectives: Mycophenolate mofetil (MMF) has emerged as a valuable immunosuppressive agent used in the management of oral mucocutaneous diseases, particularly in autoimmune and inflammatory conditions, such as pemphigus vulgaris (PV), oral lichen planus (OLP), mucous membrane pemphigoid (MMP), systemic lupus erythematosus (SLE), erythema multiforme (EM) and recurrent aphthous stomatitis (RAS). This review consolidates the current evidence regarding MMF’s efficacy, safety and clinical applications across these conditions. Methods: A comprehensive review of literature was performed, focusing on the mechanism of action, dosing strategies, therapeutic outcomes and adverse effects associated with MMF therapy in oral mucocutaneous diseases. The potential of therapeutic drug monitoring (TDM) in optimizing MMF therapy and minimizing adverse effects was also explored. Results: The review demonstrates that MMF is effective in inducing disease remission in up to 80% of patients with PV, with notable steroid-sparing effects. In OLP, MMF provided significant clinical improvement, especially in patients with severe and refractory forms of the disease. For MMP, MMF showed an 89% response rate, particularly when combined with corticosteroids, though gastrointestinal side effects were noted in some patients. In SLE, MMF was effective in managing both renal and non-renal manifestations, with favorable remission rates observed in patients receiving MMF therapy. For EM, MMF’s effectiveness was limited, with only a small number of patients responding to therapy. In RAS, there is limited evidence of MMF’s efficacy, with only partial improvement in severe cases reported. MMF is a promising immunomodulatory therapy for oral mucocutaneous diseases, particularly in reducing corticosteroid dependence and improving patient outcomes. However, the variability in the study designs, dosages and patient populations complicates the generalization of these findings. Conclusions: There is a pressing need for randomized controlled trials to validate MMF’s efficacy and long-term safety across all disease categories. The integration of therapeutic drug monitoring (TDM) shows potential for improving disease control and minimizing adverse effects, making it a key consideration for future research. Full article
(This article belongs to the Special Issue Oral Health in the Global South)
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24 pages, 505 KiB  
Review
Cultural Themes Related to Oral Health Practices, Beliefs, and Experiences in Nigeria: A Scoping Review
by Taofeek Kolawole Aliyu, Olusegun Stephen Titus, Oluwabunmi Tope Bernard, Omolola Titilayo Alade, Adebola Oluyemisi Ehizele and Moréniké Oluwátóyìn Foláyan
Oral 2025, 5(2), 23; https://doi.org/10.3390/oral5020023 - 2 Apr 2025
Viewed by 773
Abstract
The objective of this scoping review was to map out the cultural themes related to oral health practices, beliefs, and experiences in Nigeria; explore mythologies about oral health in Nigeria; identify the perceived cultural significance of oral health within the Nigerian communities; and [...] Read more.
The objective of this scoping review was to map out the cultural themes related to oral health practices, beliefs, and experiences in Nigeria; explore mythologies about oral health in Nigeria; identify the perceived cultural significance of oral health within the Nigerian communities; and determine the implications of study findings for oral health promotion and intervention strategies. This was a scoping review. A systematic literature search was conducted in PubMed, Cochrane Library, Web of Science, Google Scholar, and CINAHL. Published studies in peer-reviewed journals written in English that investigated culture and oral health were included. All forms of literature reviews, editorials, or opinion pieces were excluded. Information on the study characteristics and population characteristics, cultural determinants of oral health, oral health outcomes, and the methods used to assess cultural factors and oral health outcomes was extracted. A narrative synthesis of the findings was conducted to identify key themes in the literature. The 37 articles, published between 1998 and 2024, that met the eligibility criteria wrote on the prevalence of a culture of self-medication and self-care, myths that affect utilization of oral health services, cultures that expose people to increased risk of poor oral health, and cultural norms, beliefs, and practices that facilitate oral health. The findings emphasize the need for culturally tailored strategies to improve oral health literacy and reduce disparities. This review underscores the potential to foster community engagement, trust, and sustainable improvements in oral health outcomes by aligning oral health promotion efforts with Nigeria’s culture. In conclusion, cultural norms, beliefs, and practices can be barriers and facilitate oral health in Nigeria. Identifying and understanding the norms, beliefs, and practices that affect oral health can help improve oral health education and promotion so that they are culturally relevant and effective. Full article
(This article belongs to the Special Issue Oral Health in the Global South)
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17 pages, 1543 KiB  
Review
Oral Cancer Disease among the Poor: A Sri Lankan Context
by Kalpani Senevirathna, Yovanthi Anurangi Jayasinghe, Shalindu Malshan Jayawickrama, Hemantha Amarasinghe and Ruwan Duminda Jayasinghe
Oral 2023, 3(3), 420-436; https://doi.org/10.3390/oral3030034 - 4 Sep 2023
Cited by 2 | Viewed by 5290
Abstract
Oral cancer (OC) is the 16th most common cancer worldwide. In Sri Lanka, OC is the most prevalent cancer among men and the eighth among women. In most instances, OC is preceded by clinically recognizable disorders appearing on the oral mucosa, termed oral [...] Read more.
Oral cancer (OC) is the 16th most common cancer worldwide. In Sri Lanka, OC is the most prevalent cancer among men and the eighth among women. In most instances, OC is preceded by clinically recognizable disorders appearing on the oral mucosa, termed oral potentially malignant disorders (OPMD). The distribution of OC among low- and middle-income socioeconomic groups contributes to various factors. Poor oral health literacy, a lower quality of higher education, and the economic burden results in neglected oral health. The further economic recession has led to the formation of risk habits, such as chewing betel quid, smoking and the consumption of alcohol, among these groups to minimize stress levels. But with a lack of oral health awareness, the incidences of OC increase in this category. This review elaborates on a few cross-sectional studies conducted in various locations in Sri Lanka, discussing the low awareness of neglected oral health, the usage of tobacco in a smokeless and non-smokeless manner, consuming alcohol, and the chewing of betel nuts. This review aims to overcome the barriers in these low- and middle-income socioeconomic groups in developing nations such as Sri Lanka by creating more awareness and minimizing the incidence and diagnosis and treatment at early stages to improve the quality of life as well as longevity. Full article
(This article belongs to the Special Issue Oral Health in the Global South)
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Other

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16 pages, 2205 KiB  
Systematic Review
Prevalence of Dental Caries Among 6–11-Year-Olds in Nigeria: A Systematic Review and Meta-Analysis
by Adebola Oluyemisi Ehizele, Ezekiel Taiwo Adebayo, Ifeoluwa Eunice Adewole, Olunike Rebecca Abodunrin, Folahanmi Tomiwa Akinsolu, Francisca Nwaokorie, Omolola Titilayo Alade, Abideen Olurotimi Salako, Joanne Lusher, Oliver Chukwujekwe Ezechi and Morẹ́nikẹ́ Oluwátóyìn Foláyan
Oral 2024, 4(4), 600-615; https://doi.org/10.3390/oral4040047 - 6 Dec 2024
Viewed by 1670
Abstract
Objective: This systematic review and meta-analysis aimed to assess the prevalence of dental caries among 6–11-year-old children in Nigeria and its distribution by sex, socioeconomic status, and geopolitical zones. Method: A systematic search was conducted in MEDLINE (PubMed), Google Scholar, and Cochrane Library [...] Read more.
Objective: This systematic review and meta-analysis aimed to assess the prevalence of dental caries among 6–11-year-old children in Nigeria and its distribution by sex, socioeconomic status, and geopolitical zones. Method: A systematic search was conducted in MEDLINE (PubMed), Google Scholar, and Cochrane Library (CENTRAL) to identify relevant studies published between 2012 and 2022. Cohort, cross-sectional, and observational studies reporting dental caries prevalence data among 6–11-year-olds in Nigeria were included. Using the random effects model, prevalence was analysed based on sex, socioeconomic status, and the country’s six geopolitical zones. The primary outcome was the pooled prevalence of dental caries. Meta-analysis was performed using the random effects model, and study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The systematic review was registered with PROSPERO (CRD42023396948). Results: Data were pooled from 8 of 1237 screened articles. The pooled prevalence of dental caries was 1.5% (95% CI: −1.2–4.1). Prevalence was higher among males (1.5%, 95% CI: −1.4–4.3) compared to females (1.4%, 95% CI: −1.6–4.4). It was 0.1% (95% CI: −1.0–1.1) among those with high socioeconomic status, 0.2% (95% CI: −1.6 to 1.9) among those with middle socioeconomic status, and 0.6% (95% CI: −2.8 to 3.9) among those with low socioeconomic status. The prevalence also ranged from 1.1% (95% CI: −1.8 to 4.1) in southwest, 1.1% (95% CI: −5.4 to 7.6) in south-south, 2.3% (95% CI: −7.1 to 11.6) in southeast, and 2.3% (95% CI: −7.1 to 11.7) in northwest. Conclusions: Caries intervention among adolescents in Nigeria may need to be tailored to address the observed sex, socioeconomic status, and geopolitical zone disparities. Full article
(This article belongs to the Special Issue Oral Health in the Global South)
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