Perceived oral health and disease experience among adults in Sierra Leone: An exploratory study

Oral health often receives low priority in fragile countries like Sierra Leone (SL), which have constrained health systems and resources.

To explore both normative and perceived oral health needs of adults in SL to guide strategies for the development of future oral health programmes and services.

This study was conducted across all four regions of SL.

This study utilised a self-completion questionnaire exploring access to dental care, oral hygiene practices, diet, risk behaviours, general and dental health and oral health-related quality of life. Clinical examinations used the International Caries Detection and Assessment System (ICDAS) and the PUFA (pulp, ulcer, fistula, abscess) Index, among other tools. Descriptive statistics summarised key variables, while bivariate analyses explored associations using STATA and Statistical Package for Social Sciences (SPSS).

One hundred and sixty one participants aged between 19 years and 70 years (mean = 35.6 years) completed the questionnaire survey. Two-thirds (75%, n = 121) reported having 'never been to a dentist', 40% (n = 62) experiencing toothache and 68% (n = 82) consuming one or more sugary items at least once a day, particularly males. Urban participants reported good dental health (63%), while 17% - 29% of rural participants reported significant impacts on daily life due to oral health issues. Of the 45 participants who underwent a clinical examination, 84% (n = 38) had cavitated dental caries into dentine with over five heavily diseased teeth on average (D_5-6MFT = 5.2).

This survey suggests a high level of perceived need and untreated dental disease among participating adults, limited dental care access, notable sugar consumption and significant impacts on quality of life.

This study highlights the necessity for a national-level adult dental health survey to better inform the planning of oral health services in support of adults in SL.