Table 3 Summary of the 12 included peer-reviewed studies

Diendéré et al. [91]

Burkina Faso

2013

To describe oral hygiene practices and associated sociodemographic factors in the Burkinabè population

Descriptive, cross-sectional

Face-to-face interview and direct measure of a nationally representative sample of 4,677 adults

Utilization

•Only 2.1% (95% CI 1.7–2.6) of the survey participants visited a dentist in the past 6 months.

Pengpid et al. [92]

Sudan

2016

To investigate the prevalence and associated factors of dental service utilization

Population-based cross-sectional

Self-reported questionnaire, anthropometric and biochemical measures were given to a nationally representative sample of 7,722 adults

Utilization

•64.6% of the participants never used dental care; 22.0% had more than 12-month use, and 13.4% had past 12- month use.

•Among those who had ever used, the main reason for the last use was pain or trouble with teeth, gums, or mouth (66.9%), treatment or follow-up treatment (22.3%), and routine check-up treatment (5.0%).

Morgan et al. [9]

Rwanda

2016

To implement the first National Oral Health Survey of Rwanda to assess the oral disease burden and inform oral health promotion strategies

Descriptive, cross-sectional

Interviewer-administered questionnaire and oral health epidemiologic screening to a nationally representative sample of 2,097 participants

Utilization

•70.6% of the survey participants never visited an oral health provider for treatment.

•98.7% of those who visited a dental practitioner sought care for pain relief instead of preventive, restorative or non-emergent conditions.

•Of those who responded to the question why they were unable to access care, 60.3% reported that cost was the major reason for not receiving care despite nearly 70% of the population reportedly having insurance coverage that includes dental services.

•The challenging factors to accessing oral care include geographical terrain, climate, the scarcity and distribution of oral health workforce, and the lack of oral care infrastructure and promotion programs.

Ghotane et al. [93]

Sierra Leone

2017

To investigate the oral health needs of school children at key ages

National survey

Self- and parent-completed questionnaire and clinic examination to a nationally representative sample of 1,174 school children at 6-, 12-, and 15-years

Utilization

•Most 12- (66%) and 15-year-olds (73%) reported ‘never having been to a dentist’, with only 8% having attended a check-up in both age-groups.

•Attendance amongst 6-year-olds was lower, with only 3% of parents reporting their child had ever visited a dentist, and visited only when they had a problem.

Bassa et al. [94]

Areka town, Ethiopia

2020

To determine the relation of dental caries with nutritional status among school-age children at resource limited setting of southern Ethiopia

Community-based cross-sectional

Face-to-face interviewer-administered questionnaire and clinical

assessment to 761 randomly selected school-age children (6–12 years old)

Utilization

•92.6% of survey participants have never visited a dental clinic during the past year; among those who have visited, the majority went for emergency dental pain treatment (41.4%) and extraction (8.6%).

Mohammed et al. [95]

Mekelle city, Ethiopia

2016

To determine the dental service utilization and associated factors among school-aged children (6–15) years

School-based cross-sectional

Interviews and self-administered questionnaire to the parents of a multi-stage sampling of 398 school children (6–15 years old)

Utilization

•The overall dental service utilization among the surveyed children was 10.6% (95% CI 7.5–13.6) in the past year, and 89.4% of the children had never seen a dentist.

•The major reason (80.9%) for a dental visit is dental pain.

•There is no dental insurance covering the associated costs for dental care targeting children and other segments of the population.

•There are no school and community-based oral health programs in Ethiopia.

Salih et al. [96]

Khartoum State, Sudan

N/A

To assess the oral health status, prosthetic needs and the associated factors among older adults living in Khartoum State, Sudan

Health-Care-Center-based cross-sectional

Interview and clinical examination to 249 patients, co-patients and employees who were ≥ 60 years in the 14 selected primary healthcare centers

Utilization

•7.6% participants never received dental treatment, 37% had a dental visit within one year or less, and 55.4% had a dental visit more than one year before.

•The major reason (72.6%) for last dental visit is pain or trouble with teeth, gums, or mouth.

Khalifa et al. [97]

Seven provinces of the Khartoum State, Sudan

2009–2010

To assess the oral health status and risk factors for dental caries and periodontal disease among Sudanese adult residents in Khartoum State

Descriptive, cross-sectional

Interviews and clinical examinations were conducted on a stratified sampling of 1,888 Sudanese aged ≥ 16 years from public dental hospitals and dental health centers

Utilization

•Over sixty percent of subjects went to the dentist less frequently than every 2 years, 16.7% went more frequently than every 2 years, and 22.7% never went, indicating poor attendance.

•Only 9% went for regular checkups whereas > 91% of patients only went to the dentist when they were in pain.

•For the most recent dental visit, more than 55% of people had a single tooth extraction as their only treatment, and nearly 80% of them stated that this was the advice given by the dentist.

•Apparent lack of restorative or preventive dental care, and treatment is limited to pain relief or emergency care by tooth extraction.

•The lack of public funding for oral healthcare and dental insurance schemes influences dental attendance in Sudan.

•There is a lack of restorative treatment due to prohibitively high cost.

Ocwia et al. [98]

Nebbi District, Uganda

2020

To assess awareness, utilization and barriers to seeking oral health care among adults in Nebbi District, Uganda

Community-based cross-sectional

Interviewer-administered semi-structured questionnaire was used to collect data from a random sampling of 400 adults aged ≥ 18

Utilization

•Of the 51.5% who had experienced a toothache or discomfort 12 months prior to the study, only about half (52%) had sought healthcare from a dental clinic or facility.

•The major reason (86.7%) for seeking dental care was toothache.

•Dental caries (76.6%) and gum bleeding (14.9%) were the most frequent treated conditions, and the majority were treated by tooth extraction (73.7%).

Binagwaho et al. [99]

Rwanda

N/A

To introduce a new partnership between the U.S. and Rwandan faculties in forging human resources in health

Report

N/A

Workforce

•In 2011 there were 122 oral health professionals in Rwanda, including dental assistants, dental therapists, and surgeons, while the target of the collaborated training program was to reach 424 in 2018.

Ghotane et al. [100]

Sierra Leone

2015, 2017

To estimate needs‐led human resources for oral health

Quantitative modeling

National epidemiological survey data, Census demographic data

Workforce

•To meet the dental care needs of the overall population, an estimated 6,147 dentists would be required to deliver conventional care; 1,413 dentists required to deliver basic surgical and preventive care; 1,028 dentists required to deliver prevention care only.

Gallagher et al. [101]

Multi-country in the African Region

2002–2019

To review the oral health workforce comprising dentists, dental assistants and dental therapists, and dental prosthetic technicians in the African Region

Descriptive

Data from WHO Global Oral Health Workforce Survey and National Health Workforce Accounts

Workforce

•The workforce density of dentists (per 10,000 population) in the African region remains very low at 0.44.s