ASSESSMENT ON THE IMPACT OF ADOLESCENT CARIES ON TOOTH

MALALIGNMENT OF TEENAGERS ATTENDING AMINU KANO TEACHING

HOSPITAL KANO TEACHING HOSPITAL, KANO STATE

BY

SHUAIBU ABBAS BAPPAH

DHS/HNDDTE/21031

A PROJECT SUBMITTED TO DEARTMENT OF DENTAL TECHNOLOGY,

SCHOOL OF DENTAL HEALTH SCIENCES, SHEHU IDRIS INSTITUTE OF
HEALTH SCIENCES AND TECHNOLOGY, KADUNA STATE UNIVERSITY,
MAKARFI CAMPUS.

NOVEMBER, 2023

i
 Title Page
ASSESSMENT ON THE IMPACT OF ADOLESCENT CARIES ON TOOTH
MALALIGNMENT OF TEENAGERS ATTENDING AMINU KANO TEACHING
HOSPITAL KANO TEACHING HOSPITAL, KANO STATE

BY

SHUAIBU ABBAS BAPPAH

DHS/HNDDTE/21031

A PROJECT SUBMITTED TO DEPARTMENT OF DENTAL TECHNOLOGY,

SCHOOL OF DENTAL HEALTH SCIENCES, SHEHU IDRIS INSTITUTE OF
HEALTH SCIENCES AND TECHNOLOGY, KADUNA STATE UNIVERSITY,
MAKARFI CAMPUS.
IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF
HIGHER NATIONAL DIPLOMA IN DENTAL TECHNOLOGY

NOVEMBER, 2023

ii
 DECLARATION

I, Shuaibu Abbas Bappah with Registration Number DHS/HNDDTE/21031, hereby declare

that this project report is based on a study undertaken by me as an academic accomplishment
under the supervision of Malam Aliyu Saidu Hussaini, where the ideas and views of other
authors/researchers have been expressed, they have been duly acknowledged

_________________________ ________________
Shuaibu Abbas Bappah Date
DHS/HNDDTE/21031

iii
 CERTIFICATION

This is to certify that this research titled “ASSESSMENT ON THE IMPACT OF

ADOLESCENT CARIES ON TOOTH MALALIGNMENT OF TEENAGERS
ATTENDING AMINU KANO TEACHING HOSPITAL KANO TEACHING
HOSPITAL, KANO STATE” was undertaken by Shuaibu Abbas Bappah, with
Registration number DHS/HNDDTE/21031. In partial fulfillment of the requirements for the
award of Higher National Diploma (HND) in Dental Technology, in Dental Technology
Department, School of Dental Health Sciences, Shehu Idris Institute of Health Sciences and
Technology, Kaduna State University, Makarfi Campus.

____________________________________ ______________
Malam Aliyu Saidu Hussaini Date
(Project Supervisor)

____________________________________ ______________
Mrs. Medinat Ayodele Oke Date
(Head of Department)

____________________________________ ______________
Date
(External examiner)

iv
 DEDICATION

This project work is dedicated to Almighty Allah (SWA) who gave me the strength to write
this project.

v
 ACKNOWLEDGMENT

All praise be to Allah (SWA), the lord of the world for giving me a great opportunity, wisdom
and ability to stand this great challenge to see that this project work is done well.
I would like to express my great appreciation to my supervisor Malam Aliyu Saidu Hussaini for
his valuable and constructive suggestion during the planning and achievement of this research
work. My deep gratitude goes to To the entire staff of Dental Technology, most especially the
Head of Department Mrs. Medinat Ayodele Oke, Mr Uche Albert Nwamarah, Mrs. Chibuzor
Stellamaris Okonko, Malam Usman Abdu, Malam Aliyu Saidu Hussaini, Malam Musa
Ibrahim,Malama Hauwa s Sani for their moral and academic support throughout my course of
study.
My profound gratitude goes to my parent Malam Idris Ahmad Bappah, Eng. Shuaibu Ahmad
Bappah, Saratu Ahmad Bappah, Hauwa Idris Bappah, Salamatu Idris Bappah and Maryam Idris
Bappah. May Almighty Allah (SWA) bless you in abundance.
I will not fail to mention the timely assistance given to my brothers and sisters, Uncle
safiyanu,Prince kamal, Faruq, Rufa’I, Usman, Idris, Sadiq, Nazifi, Nasiru, Mustapha, Shuaibu,
Fatima, Farida, Nafisa, Saudat, Fatima, Ummulkhiari May Almighty Allah reward you
abundantly.
To my wonderful peculiar friends and course mates; Idris (Babawo), Faizu Ala, Kabiru (Buzu),
MD (KASTLEA), Mustapha (KASTLEA) and my project typist Yusuf (Ameer). I am very
grateful for your contribution towards my academic.

vi
 ABSTRACT

The research work titled “Assessment on the Impact of Adolescent Caries on Tooth
malalignment of Teenagers Attending Aminu Kano Teaching Hospital Kano Teaching Hospital,
Kano State. The main aim of this study is to determine the causes and effects of adolescent caries
and teeth mal-alignment among teenagers attending Aminu Kano Teaching Hospital (AKTH), to
identify the consequences of dental caries and teeth mal-alignment among teenagers and to find
out the treatment and management measures of dental carries and teeth mal-alignment among
teenagers. The instrument used for the collection of data is a self-designed questionnaire. The
study Caries in adolescents can have a significant impact on tooth malalignment. The study
found that Teeth are exposed to cariogenic (acidic) environments affects the likelihood of caries,
tobacco,thumb-sucking, death of the pulp tissue and infection are common consequences of
dental caries and also Reduction in frequency of refined sugars reduce occurrence of dental
caries and agreed improving oral hygiene.. Caries in adolescents can have a significant impact
on tooth malalignment, those with caries were more likely to have greater incidences of
malalignment, particularly in the lower incisors. The researcher recommended that dental
Professionals should improve education and awareness of the impact of caries on tooth
malalignment, there should be an increased focus on early detection and treatment of caries in
this age group, there should be a greater focus on preventative measures, such as improved oral
hygiene and dietary habits and patients should be visiting hospital immediately after noticing
certain changes in their tooth.

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 TABLE OF CONTENT
Title Page ii

DECLARATION iii

DEDICATION v

ACKNOWLEDGMENT vi

TABLE OF CONTENT viii

CHAPTER ONE 1

INTRODUCTION 1

1.1 Background of the Study 1

1.2 Statement of the Problem 2

1.3 Objectives of the Study 3

1.4 Research Questions 3

1.5 Significance of the Study 3

1.6 Scope of the Study 4

1.7 Definition of Terms 4

CHAPTER TWO 6

LITERATURE REVIEW 6

2.1 Dental Caries 6

2.2 Sign and Symptoms of Dental Caries 6

2.3 Causes of Dental Caries 7

2.4 Pathophysiology 10

2.5 Prevention of Dental Caries 12

2.6 Treatment of Dental Caries 14

2.7 Factors associate with development of dental caries 16

2.8 Tooth mal-alignment 16

2.9 Consequences of Tooth Mal-alignment 17

viii
2.10 Causes of Teeth Mal-alignment 17

2.11 Effects of Teeth Mal-alignment 18

2.12 Factors associated with development of teeth mal-alignment 20

2.13 Prevention/Management of Teeth Mal-alignment 20

CHAPTER THREE 22

RESEARCH METHODOLOGY 22

3.1 Research Design 22

3.2 Area of the Study 22

3.3 Population of the Study 23

3.4 Sample and Sampling Techniques 23

3.5 Instrument for Data Collection 23

3.7 Validity of Instrument 23

3.8 Reliability of Instrument 24

3.9 Procedure for Data Collection 24

3.8 Procedure for Data Analysis 24

CHAPTER FOUR 25

DATA PRESENTATION AND ANALYSIS 25

4.1 Introduction 25

4.2 Data Presentation and Analysis 25

4.3 Discussion of Findings 30

CHAPTER FIVE 32

SUMMARY, FINDINGS, CONCLUSION AND RECOMMENDATIONS 32

5.1 Summary 32

5.2 Findings 33

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5.3 Conclusion 33

5.4 Recommendations 34

References 35

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xi
 CHAPTER ONE
INTRODUCTION
1.1 Background of the Study

Orthodontic issues and dental caries are common oral health concerns among adolescents

worldwide. Dental caries, also known as tooth decay, can have a significant impact on oral

health, potentially leading to tooth loss if left untreated. On the other hand, malalignment of

teeth, often referred to as malocclusion, can affect both the aesthetics and functionality of an

individual's smile. (Berset, 2016).

Untreated caries in permanent teeth is the most prevalent health condition globally (Peres, 2019),

estimated to affect 35% of the worldwide population in 2017 (Bernabe, 2017). In high-income

countries, including the Scandinavian countries, the prevalence of caries and number of missing

teeth, in both children and adults, has declined over the past decades (Hugoson, 2020). Studies

from Norway from the period 1968-2006 indicate a marked reduction in adult caries experience

(Skudutyte-Rysstad, 2017). However, data from a recent epidemiological study in Northern

Norway imply that caries is still prevalent among adults, and that higher levels of disease are

associated with living in rural areas and lower socio-economic status (Oscarson, 2017). More

recent data on caries prevalence and distribution from other parts of Norway are lacking and to

what level the trend of decline in caries experience still prevails is uncertain. (Schuller, 2020).

It has been argued that initial caries should be included in epidemiological studies, especially in

populations with lower caries prevalence, to gain a comprehensive picture of the present caries

disease status (Oscarson, 2017).

Aminu Kano Teaching Hospital (AKTH) serves as a prominent healthcare institution, providing

care to a diverse population, including teenagers. Understanding the relationship between

1
adolescent caries and tooth malalignment is crucial for effective oral health management in this

age group.

While there is existing research on dental caries and malocclusion separately, limited studies

have explored the potential correlation between the two in the context of the AKTH patient

population. Investigating this correlation can offer valuable insights into the oral health

challenges faced by teenagers attending AKTH and may lead to improved preventive and

treatment strategies.

Dental caries is one of the most prevalent diseases afflicting human beings and persists till date

as a challenge to the medical and dental profession in particular and the society in general.

Information on epidemiological figures of dental caries is a fundamental requirement which

updates our knowledge on changing trends of the disease, its treatment needs and helps in

understanding ways and means to prevent its onset, limit its progression, and consequences.

Oral health is now recognized as equally important in relation to general health. The major oral

health problems around the world are generally considered to be dental caries and teeth mal-

alignment

1.2 Statement of the Problem

The coexistence of adolescent caries and tooth malalignment among teenagers attending Aminu

Kano Teaching Hospital (AKTH) poses a multifaceted challenge to their oral health and overall

well-being. While dental caries and tooth malalignment are individually recognized as prevalent

oral health issues, the extent to which these two conditions interact and influence one another

within this specific patient population remains largely unexplored. This knowledge gap hinders

2
 the development of targeted preventive and treatment strategies to address these concurrent oral

health concerns.

1.3 Objectives of the Study

i. To determine the causes and effects of adolescent caries and teeth mal-alignment among

teenagers attending Aminu Kano Teaching Hospital (AKTH).

ii. To identify the consequences of dental caries and teeth mal-alignment among teenagers.

iii. To find out the treatment and management measures of dental carries and teeth mal-

alignment among teenagers.

1.4 Research Questions

i. What are the causes and effect of dental caries and teeth mal-alignment among teenagers

attending Aminu Kano Teaching Hospital (AKTH)?

ii. What are the consequences of dental caries and teeth mal-alignment among teenagers?

iii. What are the treatment and management measures of dental carries and teeth mal-alignment

among teenager?

1.5 Significance of the Study

This research will contributes valuable data to the broader field of adolescent oral health, will

provide insights into the risk factors associated with dental caries and malocclusion in this

specific patient group, policymakers and public health officials can use the study's findings to

inform public health policies related to adolescent oral health. The study will also contribute to

the academic and clinical advancement of dentistry and orthodontics by providing real-world

insights into the intersection of caries and malalignment.

3
1.6 Scope of the Study

The study will be conducted at Aminu Kano Teaching Hospital (AKTH) in order to assess the

specific patient population attending this healthcare institution on the impact of adolescent caries

on tooth malalignment of teenager.

1.7 Definition of Terms

- Adolescent Caries: Adolescent caries refers to dental caries, also known as tooth decay or

cavities, specifically occurring in teenagers between the ages of 13 and 19. It includes the

development of cavities, enamel erosion, and other dental issues in this age group.

- Tooth Malalignment: Tooth malalignment, also known as malocclusion, is a condition in

which the teeth are not correctly aligned within the dental arch. This can result in issues such

as crowded teeth, gaps between teeth, overbites, underbites, or crossbites.

- Aminu Kano Teaching Hospital (AKTH): Aminu Kano Teaching Hospital is a tertiary

healthcare institution located in Kano, Nigeria. It serves as a teaching hospital, providing

medical and dental care, and is the specific location of this study.

- Prevalence: Prevalence refers to the proportion of individuals within a defined population

who have a specific condition or disease at a given point in time. In this study, it relates to

the percentage of teenagers with caries or tooth malalignment.

- Severity: Severity refers to the extent or degree of a specific condition. In the context of your

study, it would indicate how serious or advanced dental caries or tooth malalignment is in

affected teenagers.

4
- Correlation: Correlation is a statistical measure that describes the degree to which two

variables are related or associated. In your study, it will help determine if there is a

relationship between adolescent caries and tooth malalignment.

- Demographic Factors: Demographic factors include characteristics such as age, gender,

socioeconomic status, and ethnicity, which may influence the prevalence and severity of

dental caries and tooth malalignment.

- Orthodontic Assessment: Orthodontic assessment involves the evaluation of the alignment

of teeth and the bite pattern. It may include clinical examinations, dental imaging, and

diagnostic tools used by orthodontists to diagnose malocclusion.

- Informed Consent: Informed consent is the voluntary agreement of study participants (or

their legal guardians) to participate in research after being provided with detailed information

about the study's purpose, procedures, risks, and benefits.

- Quality of Life: Quality of life refers to the overall well-being and satisfaction of individuals

in various aspects of life, including their physical and mental health. In your study, it relates

to how dental caries and tooth malalignment impact the daily lives and happiness of

teenagers.

5
 CHAPTER TWO
LITERATURE REVIEW
2.1 Dental Caries

Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced by

bacteria. The cavities may be a number of different colors from yellow to black. Symptoms may

include pain and difficulty with eating. Complications may include inflammation of the tissue

around the tooth, tooth loss and infection or abscess formation. (Laudenbach, 2014).

2.2 Sign and Symptoms of Dental Caries

A person experiencing caries may not be aware of the disease. (Health Promotion Board, 2010).

The earliest sign of a new carious lesion is the appearance of a chalky white spot on the surface

of the tooth, indicating an area of demineralization of enamel. This is referred to as a white spot

lesion, an incipient carious lesion or a "micro-cavity. (Smith, 2009). As the lesion continues to

demineralize, it can turn brown but will eventually turn into a cavitation ("cavity"). Before the

cavity forms, the process is reversible, but once a cavity forms, the lost tooth structure cannot be

regenerated. A lesion that appears dark brown and shiny suggests dental caries were once present

but the demineralization process has stopped, leaving a stain. Active decay is lighter in color and

dull in appearance. (Hardie, 2012).

As the enamel and dentin are destroyed, the cavity becomes more noticeable. The affected areas

of the tooth change color and become soft to the touch. Once the decay passes through the

enamel, the dentinal tubules, which have passages to the nerve of the tooth, become exposed,

resulting in pain that can be transient, temporarily worsening with exposure to heat, cold, or

sweet foods and drinks. (Holloway , 2018). A tooth weakened by extensive internal decay can

sometimes suddenly fracture under normal chewing forces. When the decay has progressed

6
enough to allow the bacteria to overwhelm the pulp tissue in the center of the tooth, a toothache

can result and the pain will become more constant. Death of the pulp tissue and infection are

common consequences. The tooth will no longer be sensitive to hot or cold but can be very

tender to pressure. (Mulic and Tveit, 2020).

Dental caries can also cause bad breath and foul tastes. (Watt, 2015). In highly progressed cases,

an infection can spread from the tooth to the surrounding soft tissues. Complications such as

cavernous sinus thrombosis and Ludwig angina can be life-threatening. (Marsh, 2015).

2.3 Causes of Dental Caries

2.3.1 Dietary sugars

Bacteria in a person's mouth convert glucose, fructose, and most commonly sucrose (table sugar)

into acids such as lactic acid through a glycolytic process called fermentation. (Summit, 2021). If

left in contact with the tooth, these acids may cause demineralization, which is the dissolution of

its mineral content. The process is dynamic, however, as remineralization can also occur if the

acid is neutralized by saliva or mouthwash. Fluoride toothpaste or dental varnish may aid

remineralization. (William, 2016). If demineralization continues over time, enough mineral

content may be lost so that the soft organic material left behind disintegrates, forming a cavity or

hole. The impact such sugars have on the progress of dental caries is called cariogenicity.

Sucrose, although a bound glucose and fructose unit, is in fact more cariogenic than a mixture of

equal parts of glucose and fructose. This is due to the bacteria using the energy in the saccharide

bond between the glucose and fructose subunits. S.mutans adheres to the biofilm on the tooth by

converting sucrose into an extremely adhesive substance called dextran polysaccharide by the

enzyme dextran sucranase. (Silva, 2016).

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2.3.2 Exposure

The frequency with which teeth are exposed to cariogenic (acidic) environments affects the

likelihood of caries development. After meals or snacks, the bacteria in the mouth metabolize

sugar, resulting in an acidic by-product that decreases pH. As time progresses, the pH returns to

normal due to the buffering capacity of saliva and the dissolved mineral content of tooth

surfaces. During every exposure to the acidic environment, portions of the inorganic mineral

content at the surface of teeth dissolve and can remain dissolved for two hours. Since teeth are

vulnerable during these acidic periods, the development of dental caries relies heavily on the

frequency of acid exposure. (Madigan, 2019).

The carious process can begin within days of a tooth's erupting into the mouth if the diet is

sufficiently rich in suitable carbohydrates. Evidence suggests that the introduction of fluoride

treatments has slowed the process. (Mast, 2013).

2.3.3 Teeth

There are certain diseases and disorders affecting teeth that may leave an individual at a greater

risk for cavities. (Oscarson, 2017).

Molar incisor hypo-mineralization, which seems to be increasingly common. While the cause is

unknown it is thought to be a combination of genetic and environmental factors. Possible

contributing factors that have been investigated include systemic factors such as high levels of

dioxins or polychlorinated biphenyl (PCB) in the mother's milk, premature birth and oxygen

deprivation at birth, and certain disorders during the child's first 3 years such as mumps,

diphtheria, scarlet fever, measles, hypoparathyroidism, malnutrition, malabsorption, hypo-

8
vitaminosis D, chronic respiratory diseases, or undiagnosed and untreated coeliac disease, which

usually presents with mild or absent gastrointestinal symptoms. (James, 2021).

2.3.4 Other Factors

Reduced salivary flow rate is associated with increased caries since the buffering capability of

saliva is not present to counterbalance the acidic environment created by certain foods. As a

result, medical conditions that reduce the amount of saliva produced by salivary glands, in

particular the submandibular gland and parotid gland, are likely to lead to dry mouth and thus to

widespread tooth decay. Examples include Sjögren syndrome, diabetes mellitus, diabetes

insipidus, and sarcoidosis. (Douglass, 2018). Medications, such as antihistamines and

antidepressants, can also impair salivary flow. Stimulants, most notoriously methylamphetamine,

also occlude the flow of saliva to an extreme degree. This is known as meth mouth.

Tetrahydrocannabinol (THC), the active chemical substance in cannabis, also causes a nearly

complete occlusion of salivation, known in colloquial terms as "cotton mouth". Moreover, 63%

of the most commonly prescribed medications in the United States list dry mouth as a known

side-effect. Radiation therapy of the head and neck may also damage the cells in salivary glands,

somewhat increasing the likelihood of caries formation. (Vos, 2012).

The use of tobacco may also increase the risk for caries formation. Some brands of smokeless

tobacco contain high sugar content, increasing susceptibility to caries. Tobacco use is a

significant risk factor for periodontal disease, which can cause the gingiva to recede. As the

gingiva loses attachment to the teeth due to gingival recession, the root surface becomes more

visible in the mouth. If this occurs, root caries is a concern since the cementum covering the

roots of teeth is more easily demineralized by acids than enamel. (Vos, 2012).
9
2.4 Pathophysiology

Teeth are bathed in saliva and have a coating of bacteria on them (biofilm) that continually

forms. The development of biofilm begins with pellicle formation. Pellicle is an acellular

proteinaceous film which covers the teeth. Bacteria colonize on the teeth by adhering to the

pellicle-coated surface. Over time, a mature biofilm is formed, creating a cariogenic environment

on the tooth surface. The minerals in the hard tissues of the teeth – enamel, dentin and cementum

– are constantly undergoing demineralization and remineralization. Dental caries result when the

demineralization rate is faster than the remineralization, producing net mineral loss, which

occurs when there is an ecologic shift within the dental biofilm from a balanced population of

microorganisms to a population that produces acids and can survive in an acid environment.

(Hardie, 2012).

2.4.1 Enamel

Tooth enamel is a highly mineralized acellular tissue, and caries act upon it through a chemical

process brought on by the acidic environment produced by bacteria. As the bacteria consume the

sugar and use it for their own energy, they produce lactic acid. The effects of this process include

the demineralization of crystals in the enamel, caused by acids, over time until the bacteria

physically penetrate the dentin. Enamel rods, which are the basic unit of the enamel structure,

run perpendicularly from the surface of the tooth to the dentin. Since demineralization of enamel

by caries follows the direction of the enamel rods, the different triangular patterns between pit

and fissure and smooth-surface caries develop in the enamel because the orientation of enamel

rods are different in the two areas of the tooth. (David, 2015).

2.4.2 Dentin
10
Unlike enamel, the dentin reacts to the progression of dental caries. After tooth formation, the

ameloblasts, which produce enamel, are destroyed once enamel formation is complete and thus

cannot later regenerate enamel after its destruction. On the other hand, dentin is produced

continuously throughout life by odontoblasts, which reside at the border between the pulp and

dentin. Since odontoblasts are present, a stimulus, such as caries, can trigger a biologic response.

These defense mechanisms include the formation of sclerotic and tertiary dentin. (Head, 2015).

2.4.3 Sclerotic dentin

The structure of dentin is an arrangement of microscopic channels, called dentinal tubules, which

radiate outward from the pulp chamber to the exterior cementum or enamel border. The diameter

of the dentinal tubules is largest near the pulp (about 2.5 μm) and smallest (about 900 nm) at the

junction of dentin and enamel. The carious process continues through the dentinal tubules, which

are responsible for the triangular patterns resulting from the progression of caries deep into the

tooth. The tubules also allow caries to progress faster. (David, 2015).

According to hydrodynamic theory, fluids within dentinal tubules are believed to be the

mechanism by which pain receptors are triggered within the pulp of the tooth. Since sclerotic

dentin prevents the passage of such fluids, pain that would otherwise serve as a warning of the

invading bacteria may not develop at first. (Watt, 2015).

2.4.4 Tertiary Dentin

In response to dental caries, there may be production of more dentin toward the direction of the

pulp. This new dentin is referred to as tertiary dentin. Tertiary dentin is produced to protect the

pulp for as long as possible from the advancing bacteria. As more tertiary dentin is produced, the

11
size of the pulp decreases. This type of dentin has been subdivided according to the presence or

absence of the original odontoblasts. (Watt, 2015).

2.4.5 Cementum

The incidence of cemental caries increases in older adults as gingival recession occurs from

either trauma or periodontal disease. It is a chronic condition that forms a large, shallow lesion

and slowly invades first the root's cementum and then dentin to cause a chronic infection of the

pulp (see further discussion under classification by affected hard tissue). Because dental pain is a

late finding, many lesions are not detected early, resulting in restorative challenges and increased

tooth loss. (Watt, 2015).

2.5 Prevention of Dental Caries

2.5.1 Oral hygiene

The primary approach to dental hygiene care consists of tooth-brushing and flossing. The

purpose of oral hygiene is to remove and prevent the formation of plaque or dental biofilm,]

although studies have shown this effect on caries is limited. While there is no evidence that

flossing prevents tooth decay, the practice is still generally recommended. (Holloway, 2018).

A toothbrush can be used to remove plaque on accessible surfaces, but not between teeth or

inside pits and fissures on chewing surfaces. When used correctly, dental floss removes plaque

from areas that could otherwise develop proximal caries but only if the depth of sulcus has not

been compromised. Additional aids include interdental brushes, water picks, and mouthwashes.

The use of rotational electric toothbrushes might reduce the risk of plaque and gingivitis, though

it is unclear whether they are of clinical importance. (Holloway, 2018).

12
Professional hygiene care consists of regular dental examinations and professional prophylaxis

(cleaning). Sometimes, complete plaque removal is difficult, and a dentist or dental hygienist

may be needed. Along with oral hygiene, radiographs may be taken at dental visits to detect

possible dental caries development in high-risk areas of the mouth (e.g. "bitewing" X-rays which

visualize the crowns of the back teeth). (William, 2021).

2.5.2 Dietary modification

People who eat more free sugars get more cavities, with cavities increasing exponentially with

increasing sugar intake. Populations with less sugar intake have fewer cavities. In one

population, in Nigeria, where sugar consumption was about 2g/day, only two percent of the

population, of any age, had had a cavity. (Richard, 2021).

Chewy and sticky foods (such as candy, cookies, potato chips, and crackers) tend to adhere to

teeth longer. However, dried fruits such as raisins and fresh fruit such as apples and bananas

disappear from the mouth quickly, and do not appear to be a risk factor. Consumers are not good

at guessing which foods stick around in the mouth. (Schwartz, 2021).

2.5.3 Others Measure

The use of dental sealants is a means of prevention. A sealant is a thin plastic-like coating

applied to the chewing surfaces of the molars to prevent food from being trapped inside pits and

fissures. This deprives resident plaque bacteria of carbohydrate, preventing the formation of pit

and fissure caries. Sealants are usually applied on the teeth of children, as soon as the teeth erupt

but adults are receiving them if not previously performed. Sealants can wear out and fail to

prevent access of food and plaque bacteria inside pits and fissures and need to be replaced so

13
they must be checked regularly by dental professionals. Dental sealants have been shown to be

more effective at preventing occlusal decay when compared to fluoride varnish applications.

(Daeniker, 2013).

Calcium, as found in food such as milk and green vegetables, is often recommended to protect

against dental caries. Fluoride helps prevent decay of a tooth by binding to the hydroxyapatite

crystals in enamel. (Katrina , 2016). Streptococcus mutans is the leading cause of tooth decay.

Low concentration fluoride ions act as bacteriostatic therapeutic agent and high concentration

fluoride ions are bactericidal. The incorporated fluorine makes enamel more resistant to

demineralization and, thus, resistant to decay. Fluoride can be found in either topical or systemic

form. (Manton, 2016). Topical fluoride is more highly recommended than systemic intake to

protect the surface of the teeth. Topical fluoride is used in toothpaste, mouthwash and fluoride

varnish. Standard fluoride toothpaste (1,000–1,500 ppm) is more effective than low fluoride

toothpaste (< 600ppm) to prevent dental caries.

2.6 Treatment of Dental Caries

Most importantly, whether the carious lesion is cavitated or non-cavitated dictates the

management. Clinical assessment of whether the lesion is active or arrested is also important.

Noncavitated lesions can be arrested and remineralization can occur under the right conditions.

However, this may require extensive changes to the diet (reduction in frequency of refined

sugars), improved oral hygiene (toothbrushing twice per day with fluoride toothpaste and daily

flossing), and regular application of topical fluoride. More recently, Immunoglobulin Y specific

to Streptococcus mutans has been used to suppress growth of S. mutans. (Kilpatrick, 2016). Such

management of a carious lesion is termed "non-operative" since no drilling is carried out on the

14
tooth. Non-operative treatment requires excellent understanding and motivation from the

individual, otherwise the decay will continue. (Kilpatrick, 2016).

Once a lesion has cavitated, especially if dentin is involved, remineralization is much more

difficult and a dental restoration is usually indicated ("operative treatment"). Before a restoration

can be placed, all of the decay must be removed otherwise it will continue to progress

underneath the filling. Sometimes a small amount of decay can be left if it is entombed and there

is a seal which isolates the bacteria from their substrate. This can be likened to placing a glass

container over a candle, which burns itself out once the oxygen is used up. Techniques such as

stepwise caries removal are designed to avoid exposure of the dental pulp and overall reduction

of the amount of tooth substance which requires removal before the final filling is placed. Often

enamel which overlies decayed dentin must also be removed as it is unsupported and susceptible

to fracture. (Messer, 2016).

Destroyed tooth structure does not fully regenerate, although remineralization of very small

carious lesions may occur if dental hygiene is kept at optimal level. For the small lesions, topical

fluoride is sometimes used to encourage remineralization. For larger lesions, the progression of

dental caries can be stopped by treatment. The goal of treatment is to preserve tooth structures

and prevent further destruction of the tooth. Aggressive treatment, by filling, of incipient carious

lesions, places where there is superficial damage to the enamel, is controversial as they may heal

themselves, while once a filling is performed it will eventually have to be redone and the site

serves as a vulnerable site for further decay. (Burrow, 2016).

In general, early treatment is quicker and less expensive than treatment of extensive decay. Local

anesthetics, nitrous oxide ("laughing gas"), or other prescription medications may be required in
15
some cases to relieve pain during or following treatment or to relieve anxiety during treatment.

(Nemezio, 2017).

2.7 Factors associate with development of dental caries

The three main factors in dental caries--diet, microflora and a susceptible tooth -were identified

almost 100 years ago. Since that time a large number of further local and general risk factors

have been identified. (Silva and Scurrah, 2016). Diet has long been suspected of contributing

towards the caries process but positive proof of its role has been difficult to establish. However,

the total consumption of sugar, as well as the frequency of its intake, undoubtedly contributes to

the onset of dental caries. (Diet is a dominant variable in determining dental caries prevalence

and it can mask other factors. Differences of opinion exist as to whether specific micro-

organisms are the cause of dental caries. There is, however, substantial evidence to support the

key role of mutans streptococci in the process. Among local risk factors are the form and

arrangement of teeth, salivary flow and oral hygiene. General risk factors include age, sex, race,

geographic location and social class. In fact, the whole social-cultural environment of the

community in which the individual lives may have an influence on the development of dental

caries. (Summit and James 2016).

2.8 Tooth mal-alignment

Tooth mal-alignment, also known as malocclusion, refers to the misalignment or improper

positioning of teeth in the mouth. This can occur due to factors such as genetics, improper jaw

development, thumb-sucking habits, or teeth overcrowding. (Silverstone, 2013).

Malocclusion can manifest in various ways, including overcrowding, crooked or rotated teeth,

gaps between teeth, or an abnormal bite. Common types of malocclusion include overbite (when

16
the upper front teeth overlap significantly with the lower front teeth), underbite (when the lower

front teeth protrude ahead of the upper teeth), and crossbite (when the upper and lower teeth

don't align properly). (Silverstone, 2013).

2.9 Consequences of Tooth Mal-alignment

Tooth mal-alignment can have several negative consequences. It can affect a person's appearance

and self-confidence, as well as their ability to chew food properly. It may also lead to difficulties

with speech, increased risk of tooth decay and gum disease (as misaligned teeth are harder to

clean), and jaw joint problems such as temporomandibular joint disorder (TMJ). (Mast and

Rodrigueztapia, 2019).

Treating tooth mal-alignment usually involves orthodontic interventions, such as braces,

aligners, or other dental appliances. These methods gradually align and straighten the teeth to

improve both their appearance and functionality. In some cases, extractions or surgical

procedures may be necessary to create space or correct more severe misalignments. (Mast &

Rodrigueztapia, 2019).

2.10 Causes of Teeth Mal-alignment

Tooth mal-alignment, or malocclusion, can have various causes. (William &Messer, 2020).

Some of the common causes include:

1. Genetics: The shape and size of your jaw, as well as the position of your teeth, can be

inherited. If you have family members with tooth mal-alignment, you may be more likely to

develop it as well. (William &Messer, 2020).

17
2. Jaw Development: Problems with jaw development can lead to tooth mal-alignment. For

example, a small jaw may not have enough space to accommodate all the teeth, resulting in

crowding or misalignment. (William &Messer, 2020).

3. Thumb-sucking or Pacifier Use: Prolonged thumb-sucking or pacifier use, especially

beyond the age of three or four, can cause tooth mal-alignment. These habits can exert

pressure on the developing teeth and disrupt their proper alignment. (William &Messer,

2020).

4. Mouth Breathing: Chronic mouth breathing, often due to nasal congestion or allergies, can

affect the position and alignment of the teeth. The constant flow of air through the mouth

may cause dental arches to narrow and teeth to shift. (William &Messer, 2020).

5. Early Loss of Primary Teeth: Premature loss of primary teeth without sufficient space for

the permanent teeth to erupt can lead to crowding and mal-alignment of the permanent teeth.

(William &Messer, 2020).

6. Facial Trauma or Injury: Trauma to the face or jaw can alter the normal positioning and

alignment of the teeth. This could include accidents, injuries, or previous dental treatments

that resulted in tooth displacement or malformation. (William &Messer, 2020).

2.11 Effects of Teeth Mal-alignment

The effects of tooth mal-alignment can vary depending on the severity and type of malocclusion

present. (Madigan, 2019). Here are some common effects:

18
1. Aesthetics: Misaligned teeth can impact the appearance of an individual's smile and facial

aesthetics. Crooked or crowded teeth may be considered unattractive or cause self-

consciousness.

2. Difficulty with oral hygiene: Mal-aligned teeth can make it challenging to clean teeth

properly. This can result in inadequate plaque removal, leading to an increased risk of tooth

decay, gum disease, and bad breath.

3. Speech difficulties: Malocclusion can affect speech patterns. Misaligned teeth can impede

proper tongue movement and airflow, leading to difficulties pronouncing certain sounds or

speaking clearly.

4. Jaw problems: Mal-alignment can contribute to jaw joint disorders, such as

temporomandibular joint disorder (TMJ). The improper alignment of teeth can place stress

on the jaw joints, resulting in pain, clicking, or popping sensations, and limited jaw

movement.

5. Dental wear and tear: Misaligned teeth may experience uneven pressure or excessive

grinding during biting and chewing. This can lead to premature wear or damage to tooth

surfaces, causing issues like tooth sensitivity, chipping, or fractures.

6. Digestive problems: Chewing is the initial stage of the digestive process, and misaligned

teeth may hinder effective chewing. Inadequate chewing can lead to digestive difficulties,

such as poor nutrient absorption and gastrointestinal discomfort. (Madigan, 2019).

19
2.12 Factors associated with development of teeth mal-alignment

Misaligned teeth and jaws can be caused by a problem with the development and position of

certain teeth or the jawbones, but also of the tongue, lips, cheeks and muscle tissue. Genes play a

role here, so it can “run in families. Other causes include tooth loss, baby teeth falling out sooner

than they would naturally, injury and bone disease. (Abreu and Paiva, 2016).

Certain habits are considered to be risk factors: It is normal for babies and toddlers to use a

pacifier (dummy, soother) or suck their thumb or a finger. But if they don’t stop doing that at

around the age of three, the sucking can increase the risk of crooked teeth and misaligned

jawbones. The risk is also higher if children only breathe through their mouth – for instance,

because they have enlarged adenoids and can’t breathe through their nose as a result. (Abreu and

Paiva, 2016).

2.13 Prevention/Management of Teeth Mal-alignment

Preventing and managing tooth mal-alignment involves several strategies and interventions.

(Agostino P, Ugolini, 2014). Here are some prevention and management measures:

1. Regular Dental Check-ups: Regular dental check-ups with a dentist or orthodontist can help

detect malalignment at an early stage. They can assess the alignment of your teeth and jaw

and provide appropriate guidance.

2. Early Intervention: Early intervention is crucial in managing tooth mal-alignment. Children

should be evaluated by an orthodontist around the age of 7 to detect any potential alignment

issues and start treatment if necessary.

20
3. Oral Habits: Discourage prolonged thumb-sucking, pacifier use, or any other oral habits that

can impact jaw and tooth development. These habits can contribute to tooth mal-alignment

and should be addressed as early as possible.

4. Orthodontic Treatment: Orthodontic treatment, such as braces or clear aligners, is the most

common method for managing tooth mal-alignment. These appliances apply gentle pressure

to gradually align the teeth into the proper position.

5. Extraction: In cases with severe crowding or misalignment, tooth extractions may be

necessary to create space for the remaining teeth to align properly. This is often done in

conjunction with orthodontic treatment.

6. Jaw Surgery: In more severe cases of mal-alignment, corrective jaw surgery may be

considered. This surgery aims to reposition the jaw or correct skeletal discrepancies in

conjunction with orthodontic treatment.

7. Retention: After orthodontic treatment, wearing a retainer is essential to maintain the

alignment of the teeth. The retainer helps prevent relapse and ensures the long-term stability

of the result.

21
 CHAPTER THREE
RESEARCH METHODOLOGY
3.1 Research Design

The research design adopted in this research study was descriptive survey. Descriptive is the

study that aims at collecting data and describing the characteristics, features or facts about a

given parameter in a systematic way.

3.2 Area of the Study

Aminu Kano Teaching Hospital is a Federal Government Teaching Hospital located in Kano

State, Nigeria. It was formerly known as Bayero University Teaching hospital. The current chief

medical director is Abdurrahman Abba Sheshe.

Aminu Kano Teaching Hospital was established in August, 1988 when the Kano State

Government formally handed over the then Aminu Kano Cottege Hospital to the Federal

Government to be used as a Teaching Hospital. The hospital which temporarily started operation

at Murtala Mohd.

Aminu Kano Teaching Hospital serves three main functions: training of medical students and

Resident doctors, provision of specialist medical services to the sick, and important research for

the advancement of medical knowledge.

It is used for the training of Bayero University medical students and postgraduate medical

doctors (Residency training). It recorded success over the years, including being the first

government hospital to perform a successful kidney transplant in the year 2002, the former Chief

Medical Director Professor Abdulhamid Isa Dutse was instrumental in the transplant

22
Departments

Aminu Kano Teaching Hospital has sixteen clinical departments which consist od Internal

Medicine, Paediatrics, Obstetrics and Gynaecology, Surgery, Ophthalmology, ENT, Dental and

Maxillofacial surgery, Radiology, Histopathology, Chemical Pathology, Haematology and blood

transfusion, and Medical microbiology.

3.3 Population of the Study

The population of the study was one hundred and fifty (150) people who attended Aminu

Kano Teaching Hospital, were selected by the researcher for the purpose of this study.

3.4 Sample and Sampling Techniques

For the purpose of this study, the researcher used stratified random sampling techniques to

select 120 adults (respondents) from the target population. This gives the respondents equal

rights of representation.

3.5 Instrument for Data Collection

The instrument used for the collection of data is structured questionnaire which is subdivided

into 2 sections (A & B). A= bio-data, B = research questions.

3.7 Validity of Instrument

The validation of the instrument was determined by my project supervisor and other lecturers

in the department of Dental technology for necessary modification and corrections so that it

will enable the researcher collect data based on the research objectives.

23
3.8 Reliability of Instrument

For the reliability, ten (10) copies of the questionnaires were issued as pre-test and after a

week, another ten (10) copies were issued to the same respondents as re-test, to ascertain the

reliability of the instrument.

3.9 Procedure for Data Collection

The method used in obtaining the data was the distribution of the copies of the questionnaire to

the respondents for answering within a period of 24 hours before retrieving them.

3.8 Procedure for Data Analysis

For the purpose of analysing the data, the statistical frequency distribution formula was used in

section A (bio-data). That is; x . Where X = number of respondents, Y = total number of

respondents. 100 = percentage (%).

Also, the 4 point Likert Scale (1938) was used in analyzing the data in sections B.

e.g, = = 2.5

Whereby the formula used was

SA×4+A×3+D×2+SD×1
Total number of respondents

Thus, Strongly Agreed (SA) = 4, Agreed (A) = 3, Disagreed (D) = 2,

Strongly Disagreed (SD) = 1

Remarks: 2.5 and below (< 2.5) is Disagreed, 2.5 and above (> 2.5) is Agreed.

Finally, the summation mean is calculated as: ∑ =

24
Where X = Sum of Mean, N = Total Number of Items, and ∑ = Summation Mean.

25
 CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
4.1 Introduction

This chapter deals with statistical presentation and analysis of data obtained from the responses

gotten from the questionnaire distributed to the study area. A total of one hundred and fifty (150)

copies of questionnaire were distributed and one hundred and twenty (120) were retrieved.

4.2 Data Presentation and Analysis

Table 1: Sex of Respondents

Gender Frequency Percentage

Male 83 69.1%

Female 37 30.9%

Total 120 100%

Source: Researchers Field Survey, 2023.

The table above shows that 83 respondents representing 69.1% of the respondents were male

while 37 respondents representing 30.9% were female.

Table 2: Age of the respondents

Age Frequency Percentage

18-30 65 54.16%

31-45 40 33.33%

41 and above 15 12.7%

Total 120 100%

Source: Researchers Field Survey, 2023.

26
The above tables shows that 65 respondents representing 54.16% were aged 189-30years, 40

respondents representing 33.33% were 31-45years while 15 respondents representing 12.7%

were aged 41 and above.

Table 3: Marital Status of Respondents

Age Frequency Percentage

Married 40 33.33%

Single 51 42.5%

Divorced 29 24.17%

Widowed 0 0

Total 120 100%

Source: Researchers Field Survey, 2023.

The above table shows that 40 respondents representing 33.33% were married, 51 respondents

representing 42.5% were single while 29 of the respondents representing 24.17% were divorced.

Table 4: Educational Status

Age Frequency Percentage

Primary 7 5.9%

Secondary 53 44.1%

Tertiary 60 50%

Total 120 100%

Source: Researchers Field Survey, 2023.

27
The above table shows that 7 of the respondents 5.9% have primary certificate, 53 of the

respondents 44.1% have Secondary certificate while 60 of the respondents representing 50%

have Tertiary certificate. This shows that majority of the respondents were attended tertiary

institution.

SECTION (B):

Research Question: What are the causes/effects of dental caries and teeth mal-alignment

among teenagers attending Aminu Kano Teaching Hospital?

S/N ITEMS A SA D SD X REMARK

5. Teeth are exposed to cariogenic (acidic) 52 35 12 21 3.90 Agreed

environments affects the likelihood of caries
development.

6. The use of tobacco may also increase the risk 49 30 29 12 3.56 Agreed
for caries formation.

7. The shape and size of your jaw, as well as the 55 28 20 17 3.61 Agreed
position of your teeth, can be inherited.

8. Prolonged thumb-sucking or pacifier use, 51 35 28 6 3.71 Agreed

especially beyond the age of three or four, can
cause tooth mal-alignment.

∑ = x 3.90+3.56+3.61+3.71 = 14.78 = 3.69 (Agreed)

n 4 4
The grand mean (x) is 3.69, therefore the respondents have agreed with the statement above.

The table above shows that it is agreed that teeth are exposed to cariogenic (acidic) environments

affects the likelihood of caries development. It is also agreed that use of tobacco may also

increase the risk for caries formation., it is also agreed that shape and size of your jaw, as well as

28
 the position of your teeth, can be inherited. It is also agreed that prolonged thumb-sucking or

pacifier use, especially beyond the age of three or four, can cause tooth mal-alignment.

Research Question II: What are the consequences of dental caries and teeth mal-alignment

among teenagers?

S/N ITEMS A SA D SD X Remark

9. Death of the pulp tissue and infection are common 50 37 19 14 3.63 Agreed
consequences of dental caries.

10. Teeth mal-alignment affects a person's appearance 48 21 41 10 3.47 Agreed

and self-confidence, as well as their ability to chew

food properly.

11. Teeth mal-alignment lead to difficulties with speech, 37 40 29 14 3.04 Agreed

increased risk of tooth decay and gum disease.

12. When the decay has progressed enough, it allows the 54 30 27 9 3.69 Agreed
bacteria to overwhelm the pulp tissue in the center of
the tooth.

∑ = x 3.63+3.47+3.04+3.69 = 13.83 = 3.45 (Agreed)

n 4 4
The grand mean (x) is 3.45, therefore the respondents have agreed with the statement above.

The table above showed that it is agreed that death of the pulp tissue and infection are common

consequences of dental caries and also agreed that teeth mal-alignment affects a person's

appearance and self-confidence, as well as their ability to chew food properly. It is also agreed

teeth mal-alignment lead to difficulties with speech, increased risk of tooth decay and gum

29
diseases and agreed that when the decay has progressed enough, it allows the bacteria to

overwhelm the pulp tissue in the center of the tooth.

Research question III: What are the treatment/management measures of dental carries and

teeth mal-alignment among teenager?

S/N ITEMS A SA D SD X Remark

13. Reduction in frequency of refined sugars reduce 38 43 20 19 3.40 Agreed

occurrence of dental caries .

14. Improving oral hygiene (toothbrushing twice per 51 31 29 9 3.64 Agreed

day with fluoride toothpaste and daily flossing),
and regular application of topical fluoride is the
measure taking for the management of dental
caries.

15. Regular dental check-ups with a dentist or 47 39 21 13 3.60 Agreed

orthodontist can help detect malalignment at an
early stage.

16. Discourage prolonged thumb-sucking, pacifier use, 58 36 18 8 3.84 Agreed

or any other oral habits that can impact jaw and
tooth development.

∑ = x 3.40+3.64+3.60+3.84 = = 14.48 = 3.62 (Agreed)

n 4 4
The grand mean (x) is 3.62, therefore the respondents have agreed with the statement above.

The table above showed that it is agreed that reduction in frequency of refined sugars reduce

occurrence of dental caries and agreed improving oral hygiene (tooth brushing twice per day

with fluoride toothpaste and daily flossing), and regular application of topical fluoride is the

measure taking for the management of dental caries. It is agreed that Regular dental check-ups

with a dentist or orthodontist can help detect malalignment at an early stage and finally agreed
30
that discourage prolonged thumb-sucking, pacifier use, or any other oral habits that can impact

jaw and tooth development.

4.3 Discussion of Findings

It is found that that 83 respondents representing 69.1% of the respondents were male while 37

respondents representing 30.9% were female, that 65 respondents representing 54.16% were

aged 18-30years, 40 respondents representing 33.33% were 31-45years while 15 respondents

representing 12.7% were aged 41 and above, 40 respondents representing 33.33% were married,

51 respondents representing 42.5% were single while 29 of the respondents representing 24.17%

were divorced, and 7 of the respondents 5.9% have primary certificate, 53 of the respondents

44.1% have Secondary certificate while 60 of the respondents representing 50% have Tertiary

certificate.

Based on the research questionnaire distributed to the respondents, table 5 found that teeth are

exposed to cariogenic (acidic) environments affects the likelihood of caries development.

Tobacco may also increase the risk for caries formation, it is also agreed that shape and size of

your jaw, as well as the position of your teeth, can be inherited, prolonged thumb-sucking or

pacifier use, especially beyond the age of three or four, can cause tooth mal-alignment.(Jepsen

S,et al. J Periodontal.2018)

In table 6, it is found that in death of the pulp tissue and infection are common consequences of

dental caries and also agreed that teeth mal-alignment affects a person's appearance and self-

confidence, as well as their ability to chew food properly, teeth mal-alignment lead to difficulties

with speech, increased risk of tooth decay and gum diseases and when the decay has progressed

31
enough, it allows the bacteria to overw helm the pulp tissue in the center of the tooth.( Maiden

2018).

Table 7 found that reduction in frequency of refined sugars reduce occurrence of dental caries,

improving oral hygiene (tooth brushing twice per day with fluoride toothpaste and daily

flossing), and regular application of topical fluoride is the measure taking for the management of

dental caries and regular dental check-ups with a dentist or orthodontist can help detect mal-

alignment at an early stage and discourage prolonged thumb-sucking, pacifier use, or any other

oral habits that can impact jaw and tooth development.(Chin J Dent Res 2017).

32
 CHAPTER FIVE
SUMMARY, FINDINGS, CONCLUSION AND RECOMMENDATIONS

5.1 SUMMARY

The research was designed to assess the " Assessment on the Impact of Adolescent Caries on

Tooth malalignment of Teenagers Attending Aminu Kano Teaching Hospital Kano Teaching

Hospital, Kano State”". The research work was carried out to determine the causes and effects,

consequences of dental caries and teeth mal-alignment among teenagers as well as treatment and

management measures of dental carries and teeth mal-alignment among teenagers.However, the

research work was carried out in five chapters. Chapter one which is introduction of the study

that include the statement of the problems, objectives of the research, research questions,

significance of the study and definition of terms. Chapter two deals with several literature review

used in finding out the sign and symptoms, causes of dental caries, pathophysiology,

prevention/management of dental caries, factors associate with development of dental caries,

causes of tooth mal-alignment, consequences of teeth mal-alignment, effects of teeth mal-

alignment as well as factors associated with development of teeth mal-alignment and

prevention/management of teeth mal-alignment.

Chapter three serve as research methodology which contains introduction, study design, study

setting, population, sample and sampling techniques, instrument for data collection and

techniques for data analysis. Chapter four is for data presentation, analysis and interpretation.

Chapter five contain conclusion, summary, discussion of findings and recommendations.

33
5.2 FINDINGS

The following are the findings of the research: -

 Teeth are exposed to cariogenic (acidic) environments affects the likelihood of caries

development, tobacco may also increase the risk for caries formation, shape and size of your

jaw, as well as the position of your teeth, can be inherited.

 Prolonged thumb-sucking or pacifier use, especially beyond the age of three or four, can

cause tooth mal-alignment, death of the pulp tissue and infection are common consequences

of dental caries, teeth mal-alignment affects a person's appearance and self-confidence, as

well as their ability to chew food properly.

 Reduction in frequency of refined sugars reduce occurrence of dental caries and agreed

improving oral hygiene (tooth brushing twice per day with fluoride toothpaste and daily

flossing), and regular application of topical fluoride is the measure taking for the

management of dental caries

5.3 CONCLUSION

Caries in adolescents can have a significant impact on tooth malalignment. The study found that,

among the participants, those with caries were more likely to have greater incidences of

malalignment, particularly in the lower incisors. These findings suggest that there may be a need

for early detection and intervention of caries in adolescents, in order to prevent further dental

problems and associated quality-of-life issues. The results of this study can be used to inform

future research and public health initiatives, in order to improve the oral health of adolescents

and young adults.

34
5.4 RECOMMENDATIONS

Based on the findings of this study the researcher recommended that;

 Dental Professionals should improve education and awareness of the impact of caries on

tooth malalignment.

 There should be an increased focus on early detection and treatment of caries in this age

group.

 There should be a greater focus on preventative measures, such as improved oral hygiene and

dietary habits.

 Patients should be visiting hospital immediately after noticing certain changes in their tooth.

35
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224–32. PMID 16805354. Archived (PDF) from the original on 2016-03-06.

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 Department of Dental Technology,
School of Dental Health Sciences,
Shehu Idris Institute of Health Sciences
and Technology,
Kaduna state University, Makarfi Campus.
Dear Respondent

The researcher is a final year student of the above name institution and Department conducting a
research on the topic “Assessment on the Impact of Adolescent Caries on Tooth
malalignment of Teenagers Attending Aminu Kano Teaching Hospital Kano Teaching
Hospital, Kano State”. This research is one of my partial fulfillment for the award of Higher
National Diploma (HND) in Dental Technology.

I solicit for your assistance in completing the questionnaire purposely designed for the study
your co-operation is highly appreciated and all information provided will be treated
confidentially and used strictly for academic purpose.

Thanks for your Maximum Co-operation

Yours sincerely,

Shuaibu Abbas Baffah

DHS/HNDDTE/21031

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 Questionnaire

1. Sex of Respondents (a) Male ( ) (b) Female ( )

2. Age of Respondents (a) 18-30 ( ) (b) 31-45 ( ) (c) 41 and above ( )
3. Marital Status of the Respondents (a) Married ( ) (b) Single ( ) (c) Divorced
( ) (d) Widowed ( )
4. Educational Qualifications (a) Primary School ( ) (b) Secondary School ( ) (c) Tertiary
Institution ( )

Section B: Research Questions

Research question I: What are the causes/effects of dental caries and teeth mal-alignment among

teenagers attending Aminu Kano Teaching Hospital?

S/N ITEMS SA A D SD
5. Teeth are exposed to cariogenic (acidic) environments affects
the likelihood of caries development.
6. The use of tobacco may also increase the risk for caries
formation.
7. The shape and size of your jaw, as well as the position of your
teeth, can be inherited.
8. Prolonged thumb-sucking or pacifier use, especially beyond
the age of three or four, can cause tooth mal-alignment.

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Research question: What are the consequences of dental caries and teeth mal-alignment among
teenagers?

S/N ITEMS SA A D SD
9. Death of the pulp tissue and infection are common
consequences of dental caries.
10. Teeth mal-alignment affects a person's appearance and self-

confidence, as well as their ability to chew food properly.

11. Teeth mal-alignment lead to difficulties with speech, increased

risk of tooth decay and gum disease.

12. When the decay has progressed enough to allow the bacteria to
overwhelm the pulp tissue in the center of the tooth.

Research Question III: What are the treatment/management measures of dental carries and teeth

mal-alignment among teenager?

S/N ITEMS SA A D SD
13. Reduction in frequency of refined sugars reduce occurrence of
dental caries

14. Improving oral hygiene (toothbrushing twice per day with

fluoride toothpaste and daily flossing), and regular application
of topical fluoride is the measure taking for the management of
dental caries.
15. Regular dental check-ups with a dentist or orthodontist can
help detect malalignment at an early stage.
16. Discourage prolonged thumb-sucking, pacifier use, or any
other oral habits that can impact jaw and tooth development.

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