Evelyn Wagaiyu | University of Nairobi, Kenya (original) (raw)

Papers by Evelyn Wagaiyu

Background Globally, individuals who do not possess authentic documentation of date of birth may ... more Background Globally, individuals who do not possess authentic documentation of date of birth may require age assessment before accessing certain rights or facing legal consequences. The determination of age requires customization and a systematic multidisciplinary approach. Hence, professional and human rights organizations have established relevant guidelines. In Kenya, there is lack of a documented local policy on age assessment; nevertheless, the dentists working in public hospitals often receive patients for age assessment. In order to improve on local practices, there is need to investigate current age assessment procedures. Therefore, the objective of this study was to look at the age assessment methods in use currently. Methods The study design was cross-sectional. Data was collected prospectively from new patients who visited eight (8) selected public dental health facilities for age assessment during the study period 2019–2020.Patients were sampled through convenience sampl...

Oral hygiene practices and risk of oral leukoplakia

Susceptibility to Chronic periodontitis (CP) has been associated with genetic polymorphisms in th... more Susceptibility to Chronic periodontitis (CP) has been associated with genetic polymorphisms in the proinflammatory cytokine, interleukin-1 (IL-1A and IL-1B) isoforms but little is known about their role in rural Africans. Therefore, the aim of this study was to resolve the association between genetic polymorphisms in IL-1A and IL-1B isoforms and chronic periodontitis in the Taita people of Kenya. Methods: This was a case-control study. After informed consent, a clinical examination was then conducted which included assessment of dental plaque, gingival inflammation, pocket depths and gingival recession. Buccal swab samples were then obtained. Deoxyribonucleic acid (DNA) was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction (PCR) amplification using specific primers to IL-1A (rs 1800587(-889) & rs17561(+4845)) and IL-1B (rs 16944 (-511) & rs 11443624(+3954)). The amplicons were digested using Nco1, Fnu4H1, Ava1 and Taq1 respectively. Restriction fragment length polymorphisms (RFLP) were recorded. Association analyses of the RFLP and clinical data were carried out. Results: No deviation from the Hardy Weinberg equilibrium was observed. Carriage of allele2 at IL-1B +3954 (i.e. combination of '2-2' or'1-2' at locus +3954) was associated with CP in the Taita participants (OR = 1.94, 95%CI=1.01-3.70, p=0.045). There were no confounders or effect modifiers in the Taita participants and no association with severity of CP was observed in this population. None of the composite genotypes were associated with CP in the Taita participants. Haplotype 3 (i.e. allele1 at all the four loci) was significantly associated with CP amongst the Taita (OR=2.4, 95%CI=1.1-5.14, p=0.022). Conclusion: The significant association of allele2 at IL-1B +3954 with CP in the Taita participants confirmed the importance of this genotype in disease pathogenesis.

OBJECTIVE The aim of this study was to investigate the association between IL-1β and IL-1α isofor... more OBJECTIVE The aim of this study was to investigate the association between IL-1β and IL-1α isoforms with chronic periodontitis in two Kenyan ethnic groups, Taitas and Swahilis. METHODS A case-control study in which participants were assessed for dental plaque, gingival inflammation, pocket depth and gingival recession after informed consent. Buccal swab samples were obtained and deoxyribonucleic acid was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction amplification using specific primers to IL-1 α rs1800587 (-889) and rs17561 (+4845) and IL-1β (rs16944 (-511) and rs11443624 (+3954). Restriction fragment length polymorphisms were recorded and association with clinical data was assessed. RESULTS Three hundred and ninety participants were recruited; four loci (-511, -889, +3953 and +4845) were analyzed per subject, equivalent to 1560 analysis events. No deviation from Hardy Weinberg equilibrium 1df was observed. Frequency of allele 2...

Open Journal of Stomatology, 2012

Open Journal of Stomatology, 2014

Journal of Dentistry & Oral Health, 2014

Objectives: To determine the oral health status among schoolchildren in a rural Kenyan community ... more Objectives: To determine the oral health status among schoolchildren in a rural Kenyan community and examine the relationship between oral symptoms and perceived general health. Participants: 150 pupils, aged 12 years, in two primary schools in the Mbita District. Methods: Dental caries was assessed using the decayed, missing, and filled teeth (DMFT) index. Gingivitis was evaluated using the criteria used for oral examinations in Japanese schools. Information about oral health behavior was collected through a dental health questionnaire. Results: DMFT index values were 0.26 and 0.23 among boys and girls, respectively. Almost 90% of pupils had no dental caries. Frequency of tooth brushing was significantly associated with dental plaque accumulation. The percentage of subjects with dental plaque covering ≥30% of the labial surfaces of anterior teeth increased as the frequency of tooth brushing decreased. Conclusions: The overall mean DMFT index of 0.24 was lower than those reported in previous studies in Kenyan children, which may be explained by differences in socioeconomic status and dietary habits within our study group. Dental plaque was significantly related to the prevalence of gingivitis. These findings indicate the urgent need for oral health education programs in Kenyan schools that address chronic dental symptoms besides dental caries, such as gingivitis.

Susceptibility to Chronic periodontitis (CP) has been associated with genetic polymorphisms in th... more Susceptibility to Chronic periodontitis (CP) has been associated with genetic polymorphisms in the proinflammatory cytokine, interleukin-1 (IL-1A and IL-1B) isoforms but little is known about their role in rural Africans. Therefore, the aim of this study was to resolve the association between genetic polymorphisms in IL1A and IL-1B isoforms and chronic periodontitis in the Taita people of Kenya. Methods: This was a case-control study. After informed consent, a clinical examination was then conducted which included assessment of dental plaque, gingival inflammation, pocket depths and gingival recession. Buccal swab samples were then obtained. Deoxyribonucleic acid (DNA) was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction (PCR) amplification using specific primers to IL-1A (rs 1800587(-889) & rs17561(+4845)) and IL-1B (rs 16944 (-511) & rs 11443624(+3954)). The amplicons were digested using Nco1, Fnu4H1, Ava1 and Taq1 respectively. ...

Objective: The aim of the study was determining knowledge, attitude and use of mouthwash among de... more Objective: The aim of the study was determining knowledge, attitude and use of mouthwash among dental and medical students. Study design: This was a descriptive cross sectional study. Setting: The School of Dental Sciences and the School of Medicine of the University of Nairobi. Subject: All undergraduate students admitted in the schools of medicine and dentistry. Study methodology: A stratified random sampling method was used. Results: A majority (95%) of Dental students and 87.5% Medical students knew about mouthwashes. Ninety-two percent Medical and 87% Dental students would advise other students on mouthwash. Only 39% of the students brushed their teeth twice daily while 61% brushed once. From Dental School, tooth brushing at least twice a day was claimed by 27.5% while 72.5% students said they brushed only once per day. Only 16.3% of the Dental students and 12.5% Medical students practiced the use of mouthwashes while 37.5% Medical and 33.8% Dental students never used mouthwash...

Background Globally, individuals who do not possess authentic documentation of date of birth may ... more Background Globally, individuals who do not possess authentic documentation of date of birth may require age assessment before accessing certain rights or facing legal consequences. The determination of age requires customization and a systematic multidisciplinary approach. Hence, professional and human rights organizations have established relevant guidelines. In Kenya, there is lack of a documented local policy on age assessment; nevertheless, the dentists working in public hospitals often receive patients for age assessment. In order to improve on local practices, there is need to investigate current age assessment procedures. Therefore, the objective of this study was to look at the age assessment methods in use currently. Methods The study design was cross-sectional. Data was collected prospectively from new patients who visited eight (8) selected public dental health facilities for age assessment during the study period 2019–2020.Patients were sampled through convenience sampl...

Background: This study aimed to determine the present oral health status of the rural Kenyan elde... more Background: This study aimed to determine the present oral health status of the rural Kenyan elderly population and to investigate whether oral health status is associated with the perceived general health.Methods: A total of 131 individuals aged 65 years and over in Mbita District, Nyanza Province, Kenya, were randomly selected and visited at home. The home visit study, which was conducted from 2014 to 2016, included oral examination by a dentist and administration of a self-reporting questionnaire. The number of teeth present and functional tooth unit (FTU) points were calculated using the dental chart. Perceived general health, subjective masticatory ability, and periodontal symptoms were collected using a self-recorded questionnaire sheet.Fisher’s exact test and nonparametric test were used to determine the difference in percentage and means. The odds ratio of good general health based on the participants’ masticatory satisfaction was calculated by logistic analysis.Results: Sat...

To determine the effect of a natural extract toothpaste Parodontaxon the numbers of initial denta... more To determine the effect of a natural extract toothpaste Parodontaxon the numbers of initial dental plaque colonizers. Methods: AQuasiclinical trial type of study was conducted on 48 participants (age between 18 and 30 years). The study participants were students attending a technical training institute in Nairobi County, Kenya.Streptococcus mutans, Lactobacilli and Staphylococcus aureus were the three microorganisms chosen for culture and study. All visible supragingival dental plaque was collected using sterile swabs at baseline and at the end of three weeks. The plaque samples were then cultured and the colony forming units of Streptococcus mutans, Lactobacilli and Staphylococcus aureus were calculated before and after commercially available Parodontax ® use. The plaque index of Silness and Loe (1964) was used to determine oral health status while the gingival index (Loe and Silness, 1963) was used to determine gingival health. Results: There was a reduction in the mean gingival i...

This thesis is dedicated to my Husband Lukwiya whose unyielding love, support and encouragement e... more This thesis is dedicated to my Husband Lukwiya whose unyielding love, support and encouragement enriched my soul and inspired me to pursue and complete the research. v ACKNOWLEDGEMENTS This thesis has become a reality with the kind support and help of many individuals. I would like to extend my sincere thanks to all of them. Foremost, I am grateful to The Almighty God for giving me strengthand good health to the completion of this research. I thank the Intra-ACP mobility scheme for the financial support that enabled my pursuit of postgraduate studies. I am highly indebted to my supervisors Prof. Evelyn Wagaiyu, Dr. Tonnie K Mulli, Dr Regina Mutave for valuable guidance, cordial working relationship and constructive criticism throughout the study. My appreciation also goes to the Dean of the School, Dr Mutave, and Chairman of the Department of Periodontology, Community and Preventive Dentistry, Dr. Mua for their administrative support. To my classmates Dr. Asif and Dr. Kyale and Dr Muthima, I am grateful for your time, encouragement and spirit of teamwork. My sincere gratitude goes to the following people at KAVI, Institute of Clinical Research: The Director, Professor Omu Anzala for granting me the permission to carry out the laboratory analysisat KAVI, Laboratory manager, Mr. Bashir Farah for their valuable technical support. Immeasurable appreciation to Patrick Mwarua for his invaluable assistance during the assay procedures not forgetting the entire KAVI staff. Special thanks goes to Desmond K"Owino for sharing his knowledge and technical know-how in statistics and data analysis. Finally, and most important I wish to sincerely thank myfamily especially my mother, whoselove, support and prayers have been my backbone my entire life. vi TABLE CONTENTS

Open Journal of Stomatology

International Journal of Implant Dentistry, 2015

Background: Inter-foraminal implant placement poses a risk to the sublingual artery as it enters ... more Background: Inter-foraminal implant placement poses a risk to the sublingual artery as it enters the mandibular midline lingual foramen. Lack of consensus on the source of this artery poses a dilemma to surgeons during management of haemorrhagic episodes. Determination of the exact source of this artery is therefore pivotal. Methods: This was a cross-sectional descriptive study involving 34 adult human cadavers. The facial and lingual arteries were followed from the external carotid artery to determine whether they terminated as the sublingual artery. Statistical significance tests were done using the Mann-Whitney U test and Pearson product-moment correlation. Results: There were 30 (88.2 %) males and 4 (11.8 %) females (male/female = 15:2) aged between 25 and 40 years. The origin of the sublingual artery was mainly from the lingual artery (73.5 %), the submental artery (17.6 %), or an anastomotic branch from the two arteries (8.9 %). The mean distance between the mandibular midline lingual foramen (MMLF) and the inferior border of the mandible was 15.58 mm (range 11.03-19.62 mm). The mean thickness of the mandible at the level of the MMLF was 10.89 mm (range 8.00-12.91 mm). No statistically significant difference was found between the two genders with regard to the morphometric measurements. Conclusions: The sublingual artery that enters the MMLF was found to be the sublingual artery as either a branch of the lingual artery (73.5 %), the submental artery (17.6 %) or an anastomosis of the lingual and submental arteries (8.9 %).

East African medical journal

Open Journal of Stomatology, 2012

Background: Dental and cranio-maxillofacial diagnostic imaging constitutes an invaluable tool in ... more Background: Dental and cranio-maxillofacial diagnostic imaging constitutes an invaluable tool in the accurate diagnosis and management of a diverse range of conditions and diseases that afflict the oral and cranio-maxillofacial region. In order to improve on any existing facility, periodic audit evaluation is paramount. In this way proper and relevant service delivery can be achieved. Objective: To evaluate the range and volume of dental and cranio-maxillofacial diagnostic radiographic services offered at the University of Nairobi Dental Hospital (UNDH) in Kenya over a 5-year period (2006-2010). Methods: Retrospective survey involving manual examination of patient records at the Division of Dental and cranio-maxillofacial Radiology registry of the UNDH. Results: Over the study period, the range of diagnostic radiographic services offered comprised of both intra-and extraoral examinations. The total volume of radiographs taken was 48,874 among which 41,980 (86%) were intraoral and 6894 (14%) extraoral views. Among the intraoral views, 74% were bitewing, 25% periapical and only 1% were occlusal diagnostic views. The majority (95%) of the extraoral projections consisted of panoramic views and only 5% constituted other techniques. The volume of radiographs was high from January to September while November and December had the lowest number of examination requests. Conclusion: Intraoral radiography was the commonest examination with bitewings having been the majority while the panoramic tomography was the commonest extraoral examination performed.

East African medical journal, 1993

A survey of 904, 14-17 year old school children from secondary schools around Nairobi was done to... more A survey of 904, 14-17 year old school children from secondary schools around Nairobi was done to find out if there was any relationship between toothbrushing frequency and personal hygiene habits. The students completed a questionnaire anonymously in class. Female students brushed their teeth more often than the male students. 62.2% of the females and 50.1% of the males brushed their teeth more than once a day. Of those students who brushed their teeth more than once a day, 52% bathed daily, 22% used perfumes/deodorants daily and 50.1% always washed their hands after visiting the lavatory. No relationship was found between washing of hair and toothbrushing frequency. 69.7% males and 53.2% females gave toothache and tooth decay as the main reasons for mouth care. Those who brushed their teeth more frequently also visited the medical doctor regularly for routine check-ups. These findings indicated that toothbrushing was closely related to personal hygiene habits.

IOSR Journal of Dental and Medical Sciences, 2014

Genetic polymorphisms in interleukin-1 (IL-1A and IL-1B) isoforms have been associated with Chron... more Genetic polymorphisms in interleukin-1 (IL-1A and IL-1B) isoforms have been associated with Chronic Periodontitis (CP) in Caucasians, Asians and Arabs but little is known about their role in Africans. Therefore, this study was to resolve the association between genetic polymorphisms in IL-1A and IL-1B isoforms and chronic periodontitis in a Kenyan community. Methods: This was a case-control study. After informed consent, a clinical examination was conducted. Buccal swab samples were then obtained. Deoxyribonucleic acid was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction amplification using specific primers to IL-1A (loci-889 & +4845) and IL-1B (loci-511 & +3954). The amplicons were digested using Nco1, Fnu4H1, Ava1 and Taq1 respectively. Restriction fragment length polymorphisms (RFLP) were recorded. Association analyses of the RFLP and clinical data were carried out. Results: After screening 523 Swahili participants from old town Mombasa, 100 cases and 100 controls were included in the study. There was more plaque present in cases than controls with OR = 9.2 (95%CI = 3.7-23.1), p<0.001. Mild Chronic Periodontitis was present in 9(9%) participants, moderate CP in 35(35%) and the severe form of CP in 56(56%). Carriage of allele 1 at IL-1A-889 amongst the Swahili participants was associated with Chronic Periodontitis (OR = 3.16, 95%CI=1.644-6.083, p<0.001). Allele 1 at locus IL-1A-889 was associated with mild, (OR=5.2, 95%CI=1.445-18.71, p=0.005), moderate (OR=4.51, 95%CI = 2.08-9.79, p<0.001) and severe disease (OR=2.19, 95%CI=1.013-4.738, p=0.042). Furthermore, plaque level was an effect modifier in the association between IL-1B-511 polymorphism and CP. Conclusions: Increased susceptibility to Chronic Periodontitis was found in Swahili participants with allele 1 at IL-1A-889

Background Globally, individuals who do not possess authentic documentation of date of birth may ... more Background Globally, individuals who do not possess authentic documentation of date of birth may require age assessment before accessing certain rights or facing legal consequences. The determination of age requires customization and a systematic multidisciplinary approach. Hence, professional and human rights organizations have established relevant guidelines. In Kenya, there is lack of a documented local policy on age assessment; nevertheless, the dentists working in public hospitals often receive patients for age assessment. In order to improve on local practices, there is need to investigate current age assessment procedures. Therefore, the objective of this study was to look at the age assessment methods in use currently. Methods The study design was cross-sectional. Data was collected prospectively from new patients who visited eight (8) selected public dental health facilities for age assessment during the study period 2019–2020.Patients were sampled through convenience sampl...

Oral hygiene practices and risk of oral leukoplakia

Susceptibility to Chronic periodontitis (CP) has been associated with genetic polymorphisms in th... more Susceptibility to Chronic periodontitis (CP) has been associated with genetic polymorphisms in the proinflammatory cytokine, interleukin-1 (IL-1A and IL-1B) isoforms but little is known about their role in rural Africans. Therefore, the aim of this study was to resolve the association between genetic polymorphisms in IL-1A and IL-1B isoforms and chronic periodontitis in the Taita people of Kenya. Methods: This was a case-control study. After informed consent, a clinical examination was then conducted which included assessment of dental plaque, gingival inflammation, pocket depths and gingival recession. Buccal swab samples were then obtained. Deoxyribonucleic acid (DNA) was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction (PCR) amplification using specific primers to IL-1A (rs 1800587(-889) & rs17561(+4845)) and IL-1B (rs 16944 (-511) & rs 11443624(+3954)). The amplicons were digested using Nco1, Fnu4H1, Ava1 and Taq1 respectively. Restriction fragment length polymorphisms (RFLP) were recorded. Association analyses of the RFLP and clinical data were carried out. Results: No deviation from the Hardy Weinberg equilibrium was observed. Carriage of allele2 at IL-1B +3954 (i.e. combination of '2-2' or'1-2' at locus +3954) was associated with CP in the Taita participants (OR = 1.94, 95%CI=1.01-3.70, p=0.045). There were no confounders or effect modifiers in the Taita participants and no association with severity of CP was observed in this population. None of the composite genotypes were associated with CP in the Taita participants. Haplotype 3 (i.e. allele1 at all the four loci) was significantly associated with CP amongst the Taita (OR=2.4, 95%CI=1.1-5.14, p=0.022). Conclusion: The significant association of allele2 at IL-1B +3954 with CP in the Taita participants confirmed the importance of this genotype in disease pathogenesis.

OBJECTIVE The aim of this study was to investigate the association between IL-1β and IL-1α isofor... more OBJECTIVE The aim of this study was to investigate the association between IL-1β and IL-1α isoforms with chronic periodontitis in two Kenyan ethnic groups, Taitas and Swahilis. METHODS A case-control study in which participants were assessed for dental plaque, gingival inflammation, pocket depth and gingival recession after informed consent. Buccal swab samples were obtained and deoxyribonucleic acid was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction amplification using specific primers to IL-1 α rs1800587 (-889) and rs17561 (+4845) and IL-1β (rs16944 (-511) and rs11443624 (+3954). Restriction fragment length polymorphisms were recorded and association with clinical data was assessed. RESULTS Three hundred and ninety participants were recruited; four loci (-511, -889, +3953 and +4845) were analyzed per subject, equivalent to 1560 analysis events. No deviation from Hardy Weinberg equilibrium 1df was observed. Frequency of allele 2...

Open Journal of Stomatology, 2012

Open Journal of Stomatology, 2014

Journal of Dentistry & Oral Health, 2014

Objectives: To determine the oral health status among schoolchildren in a rural Kenyan community ... more Objectives: To determine the oral health status among schoolchildren in a rural Kenyan community and examine the relationship between oral symptoms and perceived general health. Participants: 150 pupils, aged 12 years, in two primary schools in the Mbita District. Methods: Dental caries was assessed using the decayed, missing, and filled teeth (DMFT) index. Gingivitis was evaluated using the criteria used for oral examinations in Japanese schools. Information about oral health behavior was collected through a dental health questionnaire. Results: DMFT index values were 0.26 and 0.23 among boys and girls, respectively. Almost 90% of pupils had no dental caries. Frequency of tooth brushing was significantly associated with dental plaque accumulation. The percentage of subjects with dental plaque covering ≥30% of the labial surfaces of anterior teeth increased as the frequency of tooth brushing decreased. Conclusions: The overall mean DMFT index of 0.24 was lower than those reported in previous studies in Kenyan children, which may be explained by differences in socioeconomic status and dietary habits within our study group. Dental plaque was significantly related to the prevalence of gingivitis. These findings indicate the urgent need for oral health education programs in Kenyan schools that address chronic dental symptoms besides dental caries, such as gingivitis.

Susceptibility to Chronic periodontitis (CP) has been associated with genetic polymorphisms in th... more Susceptibility to Chronic periodontitis (CP) has been associated with genetic polymorphisms in the proinflammatory cytokine, interleukin-1 (IL-1A and IL-1B) isoforms but little is known about their role in rural Africans. Therefore, the aim of this study was to resolve the association between genetic polymorphisms in IL1A and IL-1B isoforms and chronic periodontitis in the Taita people of Kenya. Methods: This was a case-control study. After informed consent, a clinical examination was then conducted which included assessment of dental plaque, gingival inflammation, pocket depths and gingival recession. Buccal swab samples were then obtained. Deoxyribonucleic acid (DNA) was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction (PCR) amplification using specific primers to IL-1A (rs 1800587(-889) & rs17561(+4845)) and IL-1B (rs 16944 (-511) & rs 11443624(+3954)). The amplicons were digested using Nco1, Fnu4H1, Ava1 and Taq1 respectively. ...

Objective: The aim of the study was determining knowledge, attitude and use of mouthwash among de... more Objective: The aim of the study was determining knowledge, attitude and use of mouthwash among dental and medical students. Study design: This was a descriptive cross sectional study. Setting: The School of Dental Sciences and the School of Medicine of the University of Nairobi. Subject: All undergraduate students admitted in the schools of medicine and dentistry. Study methodology: A stratified random sampling method was used. Results: A majority (95%) of Dental students and 87.5% Medical students knew about mouthwashes. Ninety-two percent Medical and 87% Dental students would advise other students on mouthwash. Only 39% of the students brushed their teeth twice daily while 61% brushed once. From Dental School, tooth brushing at least twice a day was claimed by 27.5% while 72.5% students said they brushed only once per day. Only 16.3% of the Dental students and 12.5% Medical students practiced the use of mouthwashes while 37.5% Medical and 33.8% Dental students never used mouthwash...

Background Globally, individuals who do not possess authentic documentation of date of birth may ... more Background Globally, individuals who do not possess authentic documentation of date of birth may require age assessment before accessing certain rights or facing legal consequences. The determination of age requires customization and a systematic multidisciplinary approach. Hence, professional and human rights organizations have established relevant guidelines. In Kenya, there is lack of a documented local policy on age assessment; nevertheless, the dentists working in public hospitals often receive patients for age assessment. In order to improve on local practices, there is need to investigate current age assessment procedures. Therefore, the objective of this study was to look at the age assessment methods in use currently. Methods The study design was cross-sectional. Data was collected prospectively from new patients who visited eight (8) selected public dental health facilities for age assessment during the study period 2019–2020.Patients were sampled through convenience sampl...

Background: This study aimed to determine the present oral health status of the rural Kenyan elde... more Background: This study aimed to determine the present oral health status of the rural Kenyan elderly population and to investigate whether oral health status is associated with the perceived general health.Methods: A total of 131 individuals aged 65 years and over in Mbita District, Nyanza Province, Kenya, were randomly selected and visited at home. The home visit study, which was conducted from 2014 to 2016, included oral examination by a dentist and administration of a self-reporting questionnaire. The number of teeth present and functional tooth unit (FTU) points were calculated using the dental chart. Perceived general health, subjective masticatory ability, and periodontal symptoms were collected using a self-recorded questionnaire sheet.Fisher’s exact test and nonparametric test were used to determine the difference in percentage and means. The odds ratio of good general health based on the participants’ masticatory satisfaction was calculated by logistic analysis.Results: Sat...

To determine the effect of a natural extract toothpaste Parodontaxon the numbers of initial denta... more To determine the effect of a natural extract toothpaste Parodontaxon the numbers of initial dental plaque colonizers. Methods: AQuasiclinical trial type of study was conducted on 48 participants (age between 18 and 30 years). The study participants were students attending a technical training institute in Nairobi County, Kenya.Streptococcus mutans, Lactobacilli and Staphylococcus aureus were the three microorganisms chosen for culture and study. All visible supragingival dental plaque was collected using sterile swabs at baseline and at the end of three weeks. The plaque samples were then cultured and the colony forming units of Streptococcus mutans, Lactobacilli and Staphylococcus aureus were calculated before and after commercially available Parodontax ® use. The plaque index of Silness and Loe (1964) was used to determine oral health status while the gingival index (Loe and Silness, 1963) was used to determine gingival health. Results: There was a reduction in the mean gingival i...

This thesis is dedicated to my Husband Lukwiya whose unyielding love, support and encouragement e... more This thesis is dedicated to my Husband Lukwiya whose unyielding love, support and encouragement enriched my soul and inspired me to pursue and complete the research. v ACKNOWLEDGEMENTS This thesis has become a reality with the kind support and help of many individuals. I would like to extend my sincere thanks to all of them. Foremost, I am grateful to The Almighty God for giving me strengthand good health to the completion of this research. I thank the Intra-ACP mobility scheme for the financial support that enabled my pursuit of postgraduate studies. I am highly indebted to my supervisors Prof. Evelyn Wagaiyu, Dr. Tonnie K Mulli, Dr Regina Mutave for valuable guidance, cordial working relationship and constructive criticism throughout the study. My appreciation also goes to the Dean of the School, Dr Mutave, and Chairman of the Department of Periodontology, Community and Preventive Dentistry, Dr. Mua for their administrative support. To my classmates Dr. Asif and Dr. Kyale and Dr Muthima, I am grateful for your time, encouragement and spirit of teamwork. My sincere gratitude goes to the following people at KAVI, Institute of Clinical Research: The Director, Professor Omu Anzala for granting me the permission to carry out the laboratory analysisat KAVI, Laboratory manager, Mr. Bashir Farah for their valuable technical support. Immeasurable appreciation to Patrick Mwarua for his invaluable assistance during the assay procedures not forgetting the entire KAVI staff. Special thanks goes to Desmond K"Owino for sharing his knowledge and technical know-how in statistics and data analysis. Finally, and most important I wish to sincerely thank myfamily especially my mother, whoselove, support and prayers have been my backbone my entire life. vi TABLE CONTENTS

Open Journal of Stomatology

International Journal of Implant Dentistry, 2015

Background: Inter-foraminal implant placement poses a risk to the sublingual artery as it enters ... more Background: Inter-foraminal implant placement poses a risk to the sublingual artery as it enters the mandibular midline lingual foramen. Lack of consensus on the source of this artery poses a dilemma to surgeons during management of haemorrhagic episodes. Determination of the exact source of this artery is therefore pivotal. Methods: This was a cross-sectional descriptive study involving 34 adult human cadavers. The facial and lingual arteries were followed from the external carotid artery to determine whether they terminated as the sublingual artery. Statistical significance tests were done using the Mann-Whitney U test and Pearson product-moment correlation. Results: There were 30 (88.2 %) males and 4 (11.8 %) females (male/female = 15:2) aged between 25 and 40 years. The origin of the sublingual artery was mainly from the lingual artery (73.5 %), the submental artery (17.6 %), or an anastomotic branch from the two arteries (8.9 %). The mean distance between the mandibular midline lingual foramen (MMLF) and the inferior border of the mandible was 15.58 mm (range 11.03-19.62 mm). The mean thickness of the mandible at the level of the MMLF was 10.89 mm (range 8.00-12.91 mm). No statistically significant difference was found between the two genders with regard to the morphometric measurements. Conclusions: The sublingual artery that enters the MMLF was found to be the sublingual artery as either a branch of the lingual artery (73.5 %), the submental artery (17.6 %) or an anastomosis of the lingual and submental arteries (8.9 %).

East African medical journal

Open Journal of Stomatology, 2012

Background: Dental and cranio-maxillofacial diagnostic imaging constitutes an invaluable tool in ... more Background: Dental and cranio-maxillofacial diagnostic imaging constitutes an invaluable tool in the accurate diagnosis and management of a diverse range of conditions and diseases that afflict the oral and cranio-maxillofacial region. In order to improve on any existing facility, periodic audit evaluation is paramount. In this way proper and relevant service delivery can be achieved. Objective: To evaluate the range and volume of dental and cranio-maxillofacial diagnostic radiographic services offered at the University of Nairobi Dental Hospital (UNDH) in Kenya over a 5-year period (2006-2010). Methods: Retrospective survey involving manual examination of patient records at the Division of Dental and cranio-maxillofacial Radiology registry of the UNDH. Results: Over the study period, the range of diagnostic radiographic services offered comprised of both intra-and extraoral examinations. The total volume of radiographs taken was 48,874 among which 41,980 (86%) were intraoral and 6894 (14%) extraoral views. Among the intraoral views, 74% were bitewing, 25% periapical and only 1% were occlusal diagnostic views. The majority (95%) of the extraoral projections consisted of panoramic views and only 5% constituted other techniques. The volume of radiographs was high from January to September while November and December had the lowest number of examination requests. Conclusion: Intraoral radiography was the commonest examination with bitewings having been the majority while the panoramic tomography was the commonest extraoral examination performed.

East African medical journal, 1993

A survey of 904, 14-17 year old school children from secondary schools around Nairobi was done to... more A survey of 904, 14-17 year old school children from secondary schools around Nairobi was done to find out if there was any relationship between toothbrushing frequency and personal hygiene habits. The students completed a questionnaire anonymously in class. Female students brushed their teeth more often than the male students. 62.2% of the females and 50.1% of the males brushed their teeth more than once a day. Of those students who brushed their teeth more than once a day, 52% bathed daily, 22% used perfumes/deodorants daily and 50.1% always washed their hands after visiting the lavatory. No relationship was found between washing of hair and toothbrushing frequency. 69.7% males and 53.2% females gave toothache and tooth decay as the main reasons for mouth care. Those who brushed their teeth more frequently also visited the medical doctor regularly for routine check-ups. These findings indicated that toothbrushing was closely related to personal hygiene habits.

IOSR Journal of Dental and Medical Sciences, 2014

Genetic polymorphisms in interleukin-1 (IL-1A and IL-1B) isoforms have been associated with Chron... more Genetic polymorphisms in interleukin-1 (IL-1A and IL-1B) isoforms have been associated with Chronic Periodontitis (CP) in Caucasians, Asians and Arabs but little is known about their role in Africans. Therefore, this study was to resolve the association between genetic polymorphisms in IL-1A and IL-1B isoforms and chronic periodontitis in a Kenyan community. Methods: This was a case-control study. After informed consent, a clinical examination was conducted. Buccal swab samples were then obtained. Deoxyribonucleic acid was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction amplification using specific primers to IL-1A (loci-889 & +4845) and IL-1B (loci-511 & +3954). The amplicons were digested using Nco1, Fnu4H1, Ava1 and Taq1 respectively. Restriction fragment length polymorphisms (RFLP) were recorded. Association analyses of the RFLP and clinical data were carried out. Results: After screening 523 Swahili participants from old town Mombasa, 100 cases and 100 controls were included in the study. There was more plaque present in cases than controls with OR = 9.2 (95%CI = 3.7-23.1), p<0.001. Mild Chronic Periodontitis was present in 9(9%) participants, moderate CP in 35(35%) and the severe form of CP in 56(56%). Carriage of allele 1 at IL-1A-889 amongst the Swahili participants was associated with Chronic Periodontitis (OR = 3.16, 95%CI=1.644-6.083, p<0.001). Allele 1 at locus IL-1A-889 was associated with mild, (OR=5.2, 95%CI=1.445-18.71, p=0.005), moderate (OR=4.51, 95%CI = 2.08-9.79, p<0.001) and severe disease (OR=2.19, 95%CI=1.013-4.738, p=0.042). Furthermore, plaque level was an effect modifier in the association between IL-1B-511 polymorphism and CP. Conclusions: Increased susceptibility to Chronic Periodontitis was found in Swahili participants with allele 1 at IL-1A-889