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Infant Dental Enucleation in Sweden: Perspectives on a Practice among Residents of Eastern African Origin
Örebro University, School of Health Sciences.
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Infant dental enucleation (IDE) is a practice consisting of the removal of deciduous canine tooth buds in infants. Practiced mainly in Eastern Africa, the purpose is to treat or to prevent bodily symptoms and diseases. IDE can cause both general and oral complications. The occurrence of IDE among Eastern African immigrants in a few European countries has been reported. However, knowledge surrounding the practice in Sweden was poor. The overall aim of this work was to explore IDE in the Swedish context. Four studies were conducted. Paper I presents a review of scientific publications. An overview of IDE was gained, and some knowledge gaps were identified. Paper II describes a cross-sectional study to determine the prevalence of IDE in small children. Dental records of 1133 children (mean age 4.6 years, SD 1.4) from a multi-ethnic area were studied. Missing deciduous canines without any registered reason were documented. One or more deciduous canines were missing in 21% of the children with known Eastern African origin (n=101), compared to only three children in the rest of the population (n=1032). Six adults of Somali origin were interviewed to explore their experiences and perceptions of IDE (paper III). These experiences and perceptions were categorised in four essentially different ways: an effective and necessary treatment, a disputed tradition, an option to failure and a desperate measure. Their experiences and perceptions were found to be highly influenced by contexts. In the final study (paper IV), the knowledge, experiences and attitudes among dental and health care personnel were examined. Questionnaires were sent to licensed personnel working in emergency departments, midwifery and child health centres, school health services and public dental health services in ten municipalities. Less than 20% had any knowledge of IDE, while 12.5% of the respondents encountering children had seen at least one patient subjected to IDE. Different attitudes were reported between clinical settings regarding responsibilities and possibilities concerning the management and prevention of IDE. From the findings presented in this thesis, it was concluded that there is a need for initiatives to increase awareness of and knowledge on IDE among dental and health care professionals. Legally obligated responsibilities in these professions regarding IDE need to be clarified, and initiatives should include guidelines regarding both the management of IDE and its prevention in Sweden. Educational programmes should also be produced for residents of Eastern African origin to change their perceptions of IDE, and a culturally sensitive approach should be adopted to ensure that such programmes are effective.

Place, publisher, year, edition, pages
Örebro: Örebro University , 2017. , 92 p.
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 68
Keyword [en]
Infant, Africa, Traditional Medicine, Cuspid, Postoperative Complications, Child Advocacy, Emigrants and Immigrants, Sweden
National Category
Other Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-53504ISBN: 978-91-7529-170-3OAI: oai:DiVA.org:oru-53504DiVA: diva2:1046725
Public defence
2017-02-03, Campus USÖ, hörsal C3, Södra Grev Rosengatan 30, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2016-11-15 Created: 2016-11-15 Last updated: 2017-01-13Bibliographically approved
List of papers
1. Infant dental enucleation: A literature review on a traditional remedial practice in East Africa
Open this publication in new window or tab >>Infant dental enucleation: A literature review on a traditional remedial practice in East Africa
2014 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 72, no 3, 168-178 p.Article, review/survey (Refereed) Published
Abstract [en]

Objective. To summarize and review the literature on infant dental enucleation, a traditional remedial procedure prevalent mainly in East Africa.

Materials and methods. Literature searches were made electronically using general and specialized search engines. The main search was performed through a systematic strategy in PubMed, comprising tabulated keywords, search codes, and translated and transliterated terms. Criteria for the selection of studies were designed to provide a general understanding of the procedure. The findings were synthesized into two sections: a summary of the population prevalence studies, and a thematic literature review.

Results. An overview of the known prevalence and clinical specifications was established. Insight was gained into the purpose of the procedure and the factors influencing its performance. Diverging suggestions were seen with regard to the rationale for use of infant dental enucleation between different populations. Moreover, reports of complications and consequences involving the general health and the dentoalveolar structures of patients were examined.

Conclusions. Prevalence, clinical features and risks of infant dental enucleation point to a need for greater awareness of the procedure. Further, there is a need for specific guidelines regarding management of suspected cases within dental and healthcare communities.

Place, publisher, year, edition, pages
London: Informa Healthcare, 2014
Keyword
African traditional medicine, attitude to health, cuspid, post-operative complications, tooth germ surgery
National Category
Dentistry
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-34848 (URN)10.3109/00016357.2013.817603 (DOI)000333047400002 ()
Note

Funding Agencies:

Public Dental Health Organizations of the county of Västmanland, Sweden

Public Dental Health Organizations of the county of Örebro, Sweden

Available from: 2014-04-28 Created: 2014-04-25 Last updated: 2017-01-03Bibliographically approved
2. Infant dental enucleation in an East African population in Sweden: a cross-sectional study on dental records
Open this publication in new window or tab >>Infant dental enucleation in an East African population in Sweden: a cross-sectional study on dental records
Show others...
2014 (English)In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 24, no 3, 209-214 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To examine the prevalence of infant dental enucleation (IDE) of primary canines, an East African traditional remedial procedure, in a multiethnic population of children in Sweden.

Design: A cross-sectional study was conducted of dental records of 1133 patients (mean age 4.6years, SD +/- 1.4) attending one public dental service clinic in Sweden. The clinic was located in an area with a large multiethnic community. All were born within the years 2002-2006 and had received a check-up in one of the years 2007-2009. A registry was made of missing primary canines where no reason could be found. In documented cases, information about ethnic origin was extracted. Statistical grouping was made according to known East African ethnicities.

Results: At least 36 ethnicities were recorded. Twenty-four (2.1%) patients were missing one or more canines according to the criteria for IDE. Significant difference was seen when comparison was made between patients of known East African ethnicities, of whom 20.8% (21/101) manifested findings consistent with the criteria, and the rest of the population (3/1032; P<0.001).

Conclusions: Prevalence of cases suggestive of IDE among patients of East African origin points to a need for increased awareness within dental and healthcare communities.

Place, publisher, year, edition, pages
Hoboken: Wiley-Blackwell, 2014
Keyword
NORTHERN UGANDA; WEST ETHIOPIA; CHILD HEALTH; MUTILATION; MORBIDITY; MORTALITY; MAASAI; SUDAN; EBINO; JUBA
National Category
Dentistry
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-34940 (URN)10.1111/ipd.12063 (DOI)000333828800007 ()
Note

Funding Agency:

Public Dental Services of Västmanland and Örebro in Sweden

Available from: 2014-05-05 Created: 2014-05-05 Last updated: 2017-01-03Bibliographically approved
3. Experiences and perceptions of infant dental enucleation among Somali immigrants in Sweden: A phenomenographic study
Open this publication in new window or tab >>Experiences and perceptions of infant dental enucleation among Somali immigrants in Sweden: A phenomenographic study
(Swedish)Manuscript (preprint) (Other academic)
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-54270 (URN)
Available from: 2017-01-03 Created: 2017-01-03 Last updated: 2017-01-03Bibliographically approved
4. Knowledge, experiences and attitudes of dental and health care personnel in Sweden towards infant dental enucleation
Open this publication in new window or tab >>Knowledge, experiences and attitudes of dental and health care personnel in Sweden towards infant dental enucleation
(English)Manuscript (preprint) (Other academic)
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-54271 (URN)
Available from: 2017-01-03 Created: 2017-01-03 Last updated: 2017-01-03Bibliographically approved

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