Oral Pain Among Primary School-Aged Children and Adolescents in Tanzania: A Cross-Sectional Study

Abstract

Background: Oral diseases are the most common non-communicable disease globally, with dental caries being the most prevalent. Prevention is the most effective strategy for addressing oral diseases, and adolescence represents an important time for intervention. During adolescence is when self-efficacy begins to develop for adolescents and when most permanent teeth are present. Interventions aimed at this age group will be key in realizing oral health globally. Oral pain is commonly associated with dental caries, making it a useful proxy of estimating oral health challenges in our population. This study aims to estimate the prevalence of oral pain amongst adolescents in Tanzania and explore associated factors with oral pain. We also seek to understand the impact of oral pain on quality of life.Methods: This study uses baseline data collected from a larger randomized controlled trial testing the impact of ‘adolescent wellness visits’ on HIV testing and counseling uptake. Adolescent participants were in the last year of primary school (mean age 13 years). Our primary outcome of interest was self-reported oral pain in the past month, collected from the Dental Pain Questionnaire instrument (DePaQ). Univariable and multivariable regression analyses were conducted to assess the relationships between oral pain and various sociodemographic characteristics and oral-health related behaviors. Additionally, a chi-square test for trend was used to explore associations between the experience of oral pain and quality of life measures from the EuroQol 5 Dimension 5 Level Instrument (EQ- 5D-5L), (i.e. mobility, anixety/depression, pain/discomfort, usual activities, and self-care). Results: The prevalence of oral pain in our study population was 13% (95% Confidence Interval (CI): 11.0%, 15.9%). Regression analyses showed no significant associations between reported oral pain and many of the sociodemographic characteristics and oral-health related behaviors (i.e. sex, age, district, health insurance status, maternal occupation, paternal occupation, household hunger score, dental care, dental care tool used, or general self-efficacy). However, a significant association was found between perceived competence and reported oral pain (Prevalence ratio (PR): 1.211, 95% CI: 1.074, 1.366). In the adjusted models, district (PR: 1.589, 95% CI: 1.030, 2.458) and perceived competence (PR: 1.244, 95% CI: 1.048, 1.477) had significant associations with oral pain. The chi-square test for trend showed a positive association between reported oral pain and both the anxiety/depression scale and the pain/discomfort scale on the EQ-5D-5L quality of life instrument. Conclusions: Our study contributes to the growing body of literature on the prevalence of oral pain amongst adolescents in Tanzania. The significant association between oral pain and perceived competence suggests that adolescents who have confidence in their judgements and capabilities may be more likely to report oral pain due to their confidence in identifying and addressing issues. These findings support the need for oral health prevention among all adolescents, as oral pain was similarly distributed across most demographic characteristics. They also highlight the value of considering perceived competence as a potential avenue for addressing oral health challenges.