Oral health practices and associated factors among residents of informal settlements in Kampala, Uganda

Abstract

Background Poor oral practices have remained a significant and silent public health challenge in informal settlements. Globally, oral health diseases have increasingly become one of the most prevalent yet preventable chronic diseases. Oral diseases are commonly associated with risk behaviors such as using tobacco and alcohol frequent consumption, and consuming sugary foods and beverages, poor oral health practices, poor oral health-seeking behaviors, low social economic status, inadequate exposure to fluoride, and their underlying social, environmental and commercial determinants. There is scanty knowledge about oral health practices, therefore this study aimed at assess the oral health practices and associated factors among residents living in the informal settlements of the Kampala district, Uganda. Methods A descriptive cross-sectional study was conducted among residents of informal settlements in Kampala district. A total of 425 respondents were interviewed who met the study criteria. Subsequent qualitative focus group discussions were conducted to further explain the quantitative results. Data was collected using structured questionnaires using both quantitative and qualitative methods to assess the oral practices of residents in the informal settlements of Kampala. Responses were entered using the Kobocollect software which was installed on mobile devices (smart phones). Descriptive statistics to measure oral practices were assessed. Bivariate and multivariate analysis was also conducted to assess the factors influencing poor oral health practices. Results The prevalence of poor oral hygiene was 50.8%. Among the 425 respondents, 65.6% were females, 40.5% had attained secondary level as their highest level of education, 84.9% knew that oral health was closely related to individual’s quality of life, 68.7% knew that high alcohol misuse and tobacco intake increased the risk of oral cancer. Ninety six percent, correctly responded that the teeth should be brushed twice a day, 75.5% brushed once a day, 37.9% had visited a dental practitioner for check-up. The key qualitative findings of the facilitators included; availability of brushing materials, raising awareness, time for brushing, affordability of mouth cleaning materials, change of tooth brush, toothbrush bristles, occupational prerequisites, marital requirements to brush before bed, and high taxes on the consumption of alcohol and sugary food stuffs, while the barriers included; the low importance of oral practices, lack of information on oral practices, frequent consumption of alcohol misuse and substance use, the cost of buying brushing materials and access to oral services, limited or no access to oral health services in the community, poor attitude to brushing, poor quality of tooth paste used, timely access of oral health services was difficult. Conclusion This study revealed that 50.8% of the respondents had poor oral practices. This was because 8.7% respondents who are resided in informal settlements had no formal education, poor knowledge on oral practices and diseases, and had a poor perception that self-care was important. This study suggests that there should be an integration of oral health into existing community development programs, which are inclusive to both with no education and formal education, oral health screening, distribution of oral heath kits and making these self-care kits more accessible to the community, and the continuous research and monitoring on the prevalence of oral health diseases should be done.