{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:04:43Z","timestamp":1790600683673,"version":"4.1.0"},"reference-count":39,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T00:00:00Z","timestamp":1720569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>For children living in the urban slums of Nairobi (Kenya), primary health conditions are not guaranteed, and oral diseases add further concern at social and institutional levels beyond the general poverty conditions. This study aims at determining the factors that influence the oral health status of children living in Nairobi slums. A cross-sectional study on school-aged subjects was conducted in June 2022 in three urban slum areas of Nairobi through a pediatric dental screening. The PI (Plaque Index), CPITN (Community Periodontal Index of Treatment Needs), and dmft (decayed, missing, and filled teeth index\u2014deciduous) were considered as primary outcomes of dental health. Multivariate statistical analysis, based on ordinal and zero-inflated negative binomial regression models, was conducted to identify determinants of the oral outcomes in a wide set of potential predictors. A sample of 359 children aged 2\u201317 was examined. The PI was significantly associated with age, the type of bite, and the use of a toothbrush. The CPITN is influenced by different types of malocclusions, abnormal frenulum, dental trauma, and fluorosis. Dietary habits were found to significantly impact the susceptibility to dental caries. Fluorosis and a dental visit in the last year were highlighted as risk and protective factors, respectively, against higher rates of caries. The oral health features of children living in Nairobi slums are differently affected by socio-demographic conditions, dietary habits, dental characteristics, and oral care practices.<\/jats:p>","DOI":"10.3390\/dj12070211","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T09:23:08Z","timestamp":1720603388000},"page":"211","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Investigation of Oral Health in Children from Urban Slums of Nairobi, Kenya"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6251-4072","authenticated-orcid":false,"given":"Gianni","family":"Di Giorgio","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Pediatric Dentistry Postgraduate School, Sapienza University of Rome, Via Caserta, 6, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2211-0522","authenticated-orcid":false,"given":"Simona","family":"De Pasquale","sequence":"additional","affiliation":[{"name":"Viving APS, Piazza G. Winckelmann 5, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Viving APS, Piazza G. Winckelmann 5, 00162 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8710-4165","authenticated-orcid":false,"given":"Giulia","family":"Zumbo","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Pediatric Dentistry Postgraduate School, Sapienza University of Rome, Via Caserta, 6, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Mollica","sequence":"additional","affiliation":[{"name":"Department of Statistical Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"D\u2019Ecclesia","sequence":"additional","affiliation":[{"name":"Department of Statistical Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2679-7607","authenticated-orcid":false,"given":"Antonella","family":"Polimeni","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Pediatric Dentistry Postgraduate School, Sapienza University of Rome, Via Caserta, 6, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Boss\u00f9","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Pediatric Dentistry Postgraduate School, Sapienza University of Rome, Via Caserta, 6, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,10]]},"reference":[{"key":"ref_1","unstructured":"Diego, M. (2017). Exploding Africa, Logo Fausto Lupetti Editore."},{"key":"ref_2","unstructured":"(2023, July 10). Ratio of Registered Dentists to 100,000 Population in Kenya 2015\u20132020. Published by Lars Kamer, 13 December 2021. Available online: https:\/\/www.statista.com\/statistics\/1240318\/ratio-of-registered-dentists-to-100-000-population-in-kenya\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1744-8603-4-7","article-title":"Global affordability of fluoride toothpaste","volume":"4","author":"Goldman","year":"2008","journal-title":"Glob. Health"},{"key":"ref_4","unstructured":"(2022, October 01). Kenya National Oral Health Policy 2022\u20132030, Ministry of Health Republic of Kenya, April 2022. Available online: https:\/\/www.afro.who.int\/countries\/kenya\/publication\/kenya-national-oral-health-policy-2022-2030."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Demarchi, P., Garbarino, F., Mascolo, A., Silvestrini Biavati, F., and Ugolini, A. (2023). Fluorosis and Oral Health Status in Adolescents Living in a High-Fluoride Groundwater Area: A Case Study of Nairobi Suburbs (Kenya). Appl. Sci., 13.","DOI":"10.3390\/app13010368"},{"key":"ref_6","unstructured":"Pitts, N.B., Ismail, A.I., Martignon, S., Ekstrand, K., Douglas, G.V., and Longbottom, C. (2014). ICCMS\u2122 Guide for Practitioners and Educators, King\u2019s College London. Available online: https:\/\/www.iccms-web.com\/uploads\/asset\/592845add7ac8756944059.pdf."},{"key":"ref_7","unstructured":"World Health Organization (2013). Oral Health Surveys: Basic Methods, WHO Press. [5th ed.]."},{"key":"ref_8","first-page":"23","article-title":"The investigation of physiological effects by the epidemiological method","volume":"19","author":"Dean","year":"1942","journal-title":"Am. Assoc. Adv. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1902\/jop.1967.38.6.610","article-title":"The Gingival Index, the Plaque Index and the Retention Index Systems","volume":"38","year":"1967","journal-title":"J. Periodontol."},{"key":"ref_10","unstructured":"(2023, January 01). Guidelines for Periodontal Screening and Management of Children and Adolescents under 18 Years of Age. 2021. British Society of Periodontology and Implant Dentistry and British Society of Paediatric Dentistry. Available online: https:\/\/www.bsperio.org.uk\/professionals\/publications."},{"key":"ref_11","first-page":"2050","article-title":"Evaluation of Oral Health Status Based on the Decayed, Missing and Filled Teeth (DMFT) Index","volume":"48","author":"Moradi","year":"2019","journal-title":"Iran J. Public Health"},{"key":"ref_12","first-page":"E103","article-title":"Dental fluorosis: Exposure, prevention and management","volume":"14","author":"Rezende","year":"2009","journal-title":"Med. Oral Patol. Oral Cir. Bucal."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"248","DOI":"10.4103\/0976-433X.145129","article-title":"Molar incisor hypomineralisation: A review of its current concepts and management","volume":"5","author":"Krishnan","year":"2014","journal-title":"SRM J. Res. Dent. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"18389","DOI":"10.1111\/j.1600-0528.2004.00155.x","article-title":"The utility of the zero-inflated Poisson and zero-inflated negative binomial models: A case study of cross-sectional and longitudinal DMF data examining the effect of socioeconomic status","volume":"32","author":"Lewsey","year":"2004","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1111\/j.1600-0528.2009.00500.x","article-title":"What statistical method should be used to evaluate risk factors associated with dmfs index? Evidence from the National Pathfinder Survey of 4-year-old Italian children Community","volume":"37","author":"Solinas","year":"2009","journal-title":"Dent. Oral Epidemiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e000262","DOI":"10.1136\/fmch-2019-000262","article-title":"Variable selection strategies and its importance in clinical prediction modelling","volume":"8","author":"Chowdhury","year":"2020","journal-title":"Fam. Med. Community Health"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Akaike, H. (1998). Information theory and an extension of the maximum likelihood principle. Selected Papers of Hirotugu Akaike, Springer.","DOI":"10.1007\/978-1-4612-1694-0_15"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"673","DOI":"10.4314\/eamj.v78i12.8939","article-title":"Dietary patterns and dental caries in nursery school children in Nairobi, Kenya","volume":"78","author":"Ngatia","year":"2001","journal-title":"East Afr. Med. J."},{"key":"ref_19","first-page":"1","article-title":"Dietary Intake and Prevalence of Dental Caries among Five-Year-Old Children in Urban and Rural Areas of Uasin-Gishu County, Kenya","volume":"2","author":"Wakhungu","year":"2020","journal-title":"Eur. J. Agric. Food Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1159\/000318569","article-title":"Snacking habits and caries in young children","volume":"44","author":"Johansson","year":"2010","journal-title":"Caries Res."},{"key":"ref_21","first-page":"187","article-title":"The oral health knowledge and oral hygiene practices among primary school children age 5-17 years in a rural area of Uasin Gishu district, Kenya","volume":"7","author":"Okemwa","year":"2010","journal-title":"East Afr. J. Public Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1159\/000077766","article-title":"The Effect of Fluoride on the Developing Tooth","volume":"38","author":"Robinson","year":"2004","journal-title":"Caries Res"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1016\/j.identj.2022.04.010","article-title":"Dental Fluorosis and Its Associated Factors Amongst Libyan Schoolchildren","volume":"72","author":"Arheiam","year":"2022","journal-title":"Int. Dent. J."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Zumpe, L., Bensel, T., Wienke, A., Mtaya-Mlangwa, M., and Hey, J. (2021). The Oral Health Situation of 12-Year-Old School Children in the Rural Region of Ilembula in Southwestern Tanzania: A Cross-Sectional Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182212237"},{"key":"ref_25","first-page":"1589","article-title":"The Impact of Oral Health Education on Children from the Slums of Thane: A Survey Study","volume":"4","author":"Tirpude","year":"2018","journal-title":"Int. J. Sci. Res. Sci. Technol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/idj.12208","article-title":"Sugar consumption and dental caries experience in Kenya","volume":"66","author":"Macigo","year":"2016","journal-title":"Int. Dent. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"269","DOI":"10.3109\/00016359209012772","article-title":"Dental caries in primary school children in Nairobi, Kenya","volume":"50","author":"Valderhaug","year":"1992","journal-title":"Acta Odontol. Scand."},{"key":"ref_28","first-page":"13","article-title":"Dental caries and oral health: An ignored health barrier to learning in Nigerian slums: A cross sectional survey","volume":"7","author":"Olatosi","year":"2022","journal-title":"PAMJ-ONE Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"47","DOI":"10.3329\/bmrcb.v40i2.25182","article-title":"Prevalence of Gingivitis, Plaque accumulation and Decayed, Missing and Filled Teeth among slum population in Bangladesh","volume":"40","author":"Hannan","year":"2014","journal-title":"Bangladesh Med. Res. Counc. Bull."},{"key":"ref_30","first-page":"114","article-title":"Oral Health Status and Oral Hygiene Practices among Urban Slum Dwellers in Rawalpindi, Islamabad, Pakistan: Oral Health and Hygiene Practices among Urban Slum Dwellers","volume":"3","author":"Habib","year":"2022","journal-title":"Pak. J. Health Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"25","DOI":"10.4314\/eamj.v87i1.59950","article-title":"Dental caries, gingivitis and the treatment needs among 12-year-olds","volume":"87","author":"Owino","year":"2010","journal-title":"East Afr. Med. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"303","DOI":"10.3109\/00016359109005923","article-title":"Oral hygiene practices and periodontal health in primary school children in Nairobi, Kenya","volume":"49","author":"Valderhaug","year":"1991","journal-title":"Acta Odontol. Scand."},{"key":"ref_33","first-page":"907","article-title":"A comparative study of the efficacy of plaque control by a chewing stick and a tooth brush","volume":"67","author":"Kaimenyi","year":"1990","journal-title":"East Afr. Med. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1111\/j.1600-051X.1991.tb00112.x","article-title":"Mouthbreathing, lip seal and upper lip coverage and their relationship with gingival inflammation in 11-14 year-old schoolchildren","volume":"18","author":"Wagaiyu","year":"1991","journal-title":"J. Clin. Periodontol."},{"key":"ref_35","unstructured":"World Health Organization, Regional Office for Africa (2016). Promoting Oral Health in Africa: Prevention and Control of Oral Diseases and Noma as Part of Essential Noncommunicable Disease Interventions, World Health Organization, Regional Office for Africa. Available online: https:\/\/iris.who.int\/handle\/10665\/205886."},{"key":"ref_36","unstructured":"Regional Committee for Africa, 66 (2023, July 01). Regional Oral Health Strategy 2016\u20132025: Addressing Oral Diseases as Part of Noncommunicable Diseases: Report of the Secretariat. World Health Organization, Regional Office for Africa. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/250994."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.identj.2023.03.011","article-title":"Health-Promoting Schools Project for Palestine Children\u2019s Oral Health","volume":"73","author":"Abuhaloob","year":"2023","journal-title":"Int. Dent. J."},{"key":"ref_38","first-page":"47","article-title":"Improving the provision of the Basic Package of Oral Care (BPOC) in Cambodia","volume":"59","author":"Chher","year":"2009","journal-title":"Int. Dent. J."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Turton, B., Patel, J., Sieng, C., Tak, R., and Durward, C. (2021). School Based Tooth Brushing and Annual Silver Diammine Fluoride Application as a Highest Priority Package for Achieving Universal Oral Health Care for Cambodian Children. Front. Oral. Health, 2.","DOI":"10.3389\/froh.2021.667867"}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/12\/7\/211\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:12:33Z","timestamp":1760109153000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/12\/7\/211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,10]]},"references-count":39,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["dj12070211"],"URL":"https:\/\/doi.org\/10.3390\/dj12070211","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,10]]}}}