Prevalence and associated determinants of oral health conditions among sicklers aged 10-18 in Western Kenya

Abstract

Introduction: Sickle Cell Disease (SCD) presents a major public health challenge in sub-Saharan Africa, with high childhood prevalence in Kenya. Oral health complications in SCD are common yet poorly documented, especially in resource-limited settings. This study assessed the prevalence and determinants of oral health conditions among children with SCD in Kisumu County. Methods: a cross-sectional study included 355 children (10-18 years) with SCD from six Kisumu County clinics, selected via systematic sampling. Data collection used structured questionnaires and clinical examinations (caries: decayed, missing, and filled teeth (DMFT)/dmft index; plaque: Turesky´s modified index). SPSS v30 analyzed data, using multiple regression to identify predictors. Results: dental caries prevalence was 40% (mean DMFT=1.09, primarily decayed teeth). Plaque affected 98% (mean score=1.74); 68.7% had moderate/severe plaque. Most (79.4%) had never visited a dentist; only 6.2% received professional cleaning. Barriers to care affected 89.6%, mainly cost (51.8%) and inaccessibility (35.2%). Significant caries predictors included limited facility access (OR=0.25) and motivation for healthy teeth (OR=11.06). Plaque and DMFT are significantly associated with caregiver occupation, brushing frequency, fluoride use, and dental visit history. Conclusion: oral health conditions are highly prevalent among children with SCD in Kisumu County, strongly linked to limited care access, low socioeconomic status, and inadequate self-care. Integrating oral health promotion and services into SCD care programs is urgently needed.