The present study identified four major oral health problems, which include oral health problems secondary to dental caries, orofacial injuries, periodontal maladies and malocclusions in and around Ambo Town. These oral health problems could create short term and prolonged physical and psychological discomfort to the patients. Among others, pain, tooth loss and infection were the most common consequences of these oral health disorders, which can result in difficulties in chewing, swallowing, and speaking. In addition, some of these oral health disorders could disturb the sleep and productivity of patients. Distraction of the hard and soft tissues of the mouth can lead to long lasting disability and in rare cases, to death.
The result of the current study showed that high percentage (58.1%) of the study individuals had untreated dental caries; but earlier reports of untreated dental caries that were recorded by meta-analysis in Ethiopia (40.98%) (14) or East Africa (45.7%) (15) were lower than the percentage recorded by this study. The high percentage of untreated dental caries in our study could be due to the fact that this study focused on patients who attended the health care facilities for certain oral health compliant.
In this study, a higher proportion of dental caries was observed among urban residents, which is similar to a previous study in Ethiopia (16). In contrast to these observations, higher proportion of dental caries were observed in rural areas in a study conducted at Butajira, Ethiopia (17). The authors suggested that less access to cariogenic foods as compared to the urban residence could be one of the reason for higher incidence of dental caries in the study area.
According to this study, females are at increased risk of dental caries compared to males. Similarly, other studies elsewhere have demonstrated that the percentage of dental caries were higher among women than in men (18–20). This has been explained by a different salivary composition and flow rate, hormonal fluctuations, dietary habits, genetic variations, and particular social roles among their family (18–20). On the other hand, Bogale et al., 2021, reported that there was no difference in male and female regarding to dental caries experience (17).
The prevalence of oral health problems secondary to dental caries increased with age, which could be due to further progress of the disease because of lack of treatment and the pattern of the condition is also cumulative throughout life by its nature (21). This finding is in line with result of the longitudinal study that reported of the trajectory increment of dental caries as the age of the study participants increased (22).
Untreated dental caries lead to the occurrence of acute apical periodontitis, irreversible pulpitis and acute apical abscess. These disorders were the most frequent diagnoses of this study in patients with untreated dental caries. This implies underutilization of oral health facilities and late presentation at the facilities with resultant complication. Hence, public education is recommended so that the public get knowledge on the need of regular dental care for prevention of dental caries as well as acquire knowledge on the need to visit dental health care facilities for the treatment of dental caries. The other possible reason for the observation of high percentage of dental caries could be limited access to dental care services in terms of affordability and availability (23) particularly in rural population. Besides, in developing countries, there is low oral health workforce, inadequate oral health facilities and most dental clinics are located in urban areas; so rural people who need dental care may have to visit a dentist in major neighboring cities (24).
Maxillofacial injuries and traumatic dental injuries are some of the most important emergency cases in dental departments. This study revealed that injury related problems were the second most common oral health problems in and around Ambo Town. Interpersonal violence (82%) was the most common cause of dental trauma in the study area. This observation was similar with the observation of a study conducted earlier in northwest Ethiopia (25). However, in contrast to the result of the present study, the most common cause of dental trauma in Uganda was reported to be road traffic accident (26); while injury due to fall down was the major causes of trauma in Nigeria (27) and Kenya (28). In the present study, being a resident of rural district and having a gender male were significantly associated with prevalence of orofacial injuries. Besides it had a significant association with age; as age increased the occurrence decreased.
Periodontal disorders were observed in 10.6% of subjects, which is lower than the percentage of periodontal disorders reported earlier from northwest Ethiopia (29), Addis Ababa (30) and Arsi (31). The prevalence of periodontal disease was seen to increase as the ages of the study subjects’ increase. Similar observations were made by other authors in previous studies (32, 33, 34). Nonetheless, age itself does not affect the periodontal condition, rather it is the cumulative effect of untreated disease reflecting the effect of age on disease severity (35). Moreover, the result of the present study showed that females were at increased risk of developing periodontal disease than males. Similarly, studies conducted in northwest Ethiopia (36) and India (37) reported increase in the prevalence of periodontal disease in females. This might be explained by hormonal changes during pregnancy and lactation which increases the incidence of periodontal change.
This research has certain limitations which need to be acknowledged. Firstly, the study was conducted by reviewing medical record of patients who visited health facilities. There could be possibilities of errors in the records of the study subjects that may influence the analysis, results and conclusion of the study. Secondly, the study was conducted on individuals who visited dental health care facilities for different abnormalities related to the oral health. These subjects could not represent the general population as they had at least one type of oral health problem. As the result, it was not possible to estimate the prevalence of oral health problem in the study area. Estimating the prevalence of oral health problems in and around Ambo District may contribute to inform policy makers in the region to design interventions and remedial actions. To date, there are no comprehensive data on the prevalence of oral health problems and associated factors in the region.