Project title:  A systematic introduction of the ART approach in govenrment dental clinics in Tanzania. Doctorate Thesis at the Radboud University Nijmegen (2009). Promotor Prof Dr N. Creugers, Supervisor Dr J.E. Frencken; Radboud University Nijmegen Medical Centre

Investigator: Emil Kikwilu







Aim:
To lay the foundation for introducing preventive dentistry, BPOC / ART to all dental personnel in all the provinces, regions and districts of Tanzania and to have preventive dentistry, BPOC / ART taught at the national oral health training institutions.

Objectives:
The short-term objective is:
- To capacitate the dental practitioners in selected pilot regions in applying and teaching ART/ BPOC;
- To identify operational obstacles that hinder the practice of restorative care/ ART/ BPOC as perceived by dental practitioners in pilot regions.

The long-term objective is:
- To contribute to the overall oral health status of Tanzanians by providing dentists with skills to apply and teach appropriate preventive and curative skills, aimed at preventing tooth loss.

Results:
Preparatory meetings and especially the ART workshop showed a high turnout rate of participants/ former ART trainees. It was clear from the discussions following the workshop that participants were enthusiastic to see to it that ART is fully practiced in all parts of Tanzania. Further it became clear that the obstacles for smooth practice of ART were hinged on ensuring that glass-ionomer cement was available in Tanzania in adequate quantities and of good quality. Participants were disturbed to learn that the toothpaste manufactured in Tanzania had very low levels of free fluoride that was not useful in controlling dental caries among users, despite frequent advertisements depicting that locally manufactured toothpaste were effective in controlling dental caries.

The short-term objectives have been met. 32 dental practitioners in Tanga, Dar es Salaam and Morogoro have been trained to apply ART and caries preventing methods (BPOC) in their practices. Many Tanzanian patients in the Morogoro, Dar es Salaam and Tanga region have been treated with ART so far. Teeth have been saved that otherwise would have been lost. Operational obstacles have been identified. 

To what extent the long-term objective, to contribute to the overall oral health status of Tanzanians, has been reached, cannot be assessed yet. Therefore, data are needed on the effect on the oral health status and related quality of life of patients treated with the ART method, and on the number of (extra) patients treated. This is one of the objectives of the follow-up research