Evaluating adults’ dental caries burden through the DMFT index: results from the Tanzanian 5th national oral health survey

Aim: Dental caries remains the most prevalent chronic disease worldwide, affecting adults and children across all regions. The DMFT index, representing the number of decayed, missing, and filled teeth, serves as a fundamental metric in oral epidemiology, providing an objective quantification of dental caries prevalence and severity. The aim of the current study is to evaluate the dental caries burden of the adult Tanzanian population through the DMFT index. Methods: A national pathfinder survey was conducted in mainland Tanzania using a cross-sectional design. The survey encompassed fourteen districts across thirteen regions. Site selection followed the World Health Organization’s (WHO) basic oral health survey methods, utilizing a modified stratified-cluster sampling approach. Electronic questionnaires were administered to all adult participants prior to their dental examinations. The questionnaires collected data on participants’ sociodemographic information, tooth brushing practices, and dentition status. Dental examinations were conducted in accordance with WHO standard criteria. Data cleaning and analysis were performed using SPSS version 23. Frequencies were calculated to determine the proportions of participants' mean and separate DMFT (Decayed, Missing, and Filled Teeth) components. Bivariate associations were examined using Student’s t-test and ANOVA to compare participants' DMFT components with their sociodemographic characteristics and oral health practices. Results: The study surveyed a total of 1,386 participants aged 30-34, 35-44 and 50+ comprising 713 females (51.4%) with most participants (49.1%) aged 50 years or older. The mean DMFT in the studied population was 4.63 (SD 5.4) with a dental caries experience of 76.6%. The Missing teeth component constituted the largest portion of the mean DMFT (52.4%), followed closely by the Decayed teeth component (45.8%). Tooth fillings were found in just 3.5% of those with dental caries experience. The mean DMFT score was significantly higher among females (5.31 ± 5.79), those aged 50 or more (5.93 ± 6.26) and with lowest level of education (5.78 ± 6.68). Brushing less than once daily (p<0.001), not using toothpaste (p<0.001) and not using a toothbrush daily (p<0.05) were all associated with increased DMFT scores. Conclusions: Dental caries is a significant public health issue in Tanzania. The predominance of missing and decayed teeth highlights the critical gaps in treatment and dental care service accessibility. There is a pressing need for increased public health investment in preventive and restorative dental care and enhanced community education on the importance of maintaining dental health.