Research article

Impact of Atraumatic Restorative Treatment (ART) on the treatment profile in pilot government dental clinics in Tanzania

Emil Namakuka Kikwilu¹ , Jo Frencken² and Jan Mulder³

¹Department of Preventive and Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, P.O. Box 65014, Dar es Salaam, Tanzania

²Nijmegen International Centre for Oral Health Radboud University Nijmegen Medical Centre, College of Dental Sciences, Nijmegen, The Netherlands

³Department of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Centre, College of Dental Sciences, Nijmegen, The Netherlands

author email corresponding author email

BMC Oral Health 2009, 9:14doi:10.1186/1472-6831-9-14

Published:	8 June 2009

Abstract

Background

The predominant mode of treatment in government dental clinics in Tanzania has been tooth extraction because the economy could not support the conventional restorative care which depends on expensive equipment, electricity and piped water systems. Atraumatic Restorative Treatment (ART) was perceived as a suitable alternative. A 3.5-year study was designed to document the changes in the treatment profiles ascribed to the systematic introduction of ART in pilot government dental clinics.

Methods

Dental practitioners who were working in 13 government dental clinics underwent a 7-day ART training. Treatment record data on teeth extracted and teeth restored by the conventional and ART approaches were collected from these clinics for the three study periods. The mean percentage of ART restorations to total treatment, ART restorations to total restorations, and total restorations to total treatments rendered were computed. Differences between variables were determined by ANOVA, t-test and Chi-square.

Results

The mean percentage of ART restorations to total treatment rendered was 0.4 (SE = 0.5) and 11.9 (SE = 1.1) during the baseline and second follow-up period respectively (ANOVA mixed model; P < 0.0001). The mean percentage of ART restorations to total restorations rendered at baseline and 2^nd follow-up period was 8.4% and 88.9% respectively (ANOVA mixed model; P < 0.0001). The mean percentage of restorations to total treatment rendered at baseline and 2^nd follow-up was 3.9% and 13.0%, respectively (ANOVA mixed model; P < 0.0001). Ninety-nine percent of patients were satisfied with ART restorations, 96.6% willing to receive ART restoration again in future, and 94.9% willing to recommend ART treatment to their close relatives.

Conclusion

ART introduction in pilot government dental clinics raised the number of teeth saved by restorative care. Countrywide introduction of the ART approach in Tanzania is recommended.