The risk factors and pattern of traumatic dental injuries in 10-12-year olds in Kano, Nigeria.

Background: Traumatic dental injuries (TDIs) rank among the most common conditions in children and adolescents. Nigerian dental trauma data are largely based on studies that were conducted in the southern parts of Nigeria. This study was designed to identify the risk factors and the pattern of TDIs among school-age children in northern Nigeria. Objectives: The objective of the study was to identify the risk factors for and to determine the pattern of dental injuries among 10-12-year-old males in Kano, northern Nigeria. Materials and Methods: Six hundred and ninety-six 10-12-year olds were selected through a multistage sampling of school children, street children and rehabilitated children in Kano and examined for TDIs using the WHO protocols. Data analysis was carried out using SPSS version 20. Statistical significance was considered when P < 0.05. Results: Six hundred and ninety-four 10-12-year olds participated in the study; The prevalence of TDIs was 6.6%. Being a street-child was associated with 30% higher risk for dental injuries (adjusted odds ratio [aOR] = 1.3; 95% confidence interval [CI] = 0.60 - 3.1; P = 0.48), whereas living as a rehabilitated street child (aOR = 0.41; 95% CI = 0.19 - 0.88; P = 0.02) and older age were associated with a reduced risk (aOR = 0.63; 95% CI = 0.39 - 1.01; P = 0.06) to injuries. The most common type of trauma was enamel-dentine injuries or Ellis II, and the most common cause was falls. Street children and low-age groups had more single-tooth injuries (85.7% and 85.0%, respectively). The commonly injured teeth were the maxillary right and left central incisors. Conclusion: Living on the street and young age were associated with the likelihood for injuries in male adolescents in Kano. The maxillary central incisors were the commonly affected teeth.

Dental Caries Prevalence, Severity, and Pattern Among Male Adolescents in Kano, Nigeria.

Background: Dental caries is the most common oral disease of mankind; however, there are limited data on the oral status of adolescents in northern Nigeria. Recently, the World Health Organization set the global caries goal as significant caries (SiC) index score of <3. This study was designed to appraise the magnitude of the disease among adolescents in northern Nigeria. Objectives: The objective of the study was to determine the prevalence, pattern, and severity of caries among 10-12-year-old adolescents in Kano, Nigeria. Materials and Methods: Six hundred and ninety-four school-aged children were selected through a multi-stage sampling of 10-12-year-old children in Kano and examined for dental caries using the WHO protocols. Data analysis was carried out using the Statistical Package for the Social Sciences (SPSS version 20 Inc. Chicago IL, USA). Results: The prevalence of caries was 22.9% with mean DMFT and SiC scores of 0.5 (±1.2) and 3.7 respectively. DMFT >0 ranged from 1 to 8. Tooth 85 (the right mandibular second primary molar) and tooth 36 (left mandibular permanent first molar) had the highest caries count for primary and permanent teeth respectively. More lesions occurred on the left mandible in primary and permanent teeth. The second primary molars and the first permanent molars were most affected by the disease. Conclusion: The prevalence of dental caries was low among male adolescents in Kano as evidenced by the low mean DMFT/dmft scores; however, the condition exceeded the recommended WHO thresholds. Caries occurred more frequently on teeth 85 and 36.

Experience and knowledge of child abuse and neglect: A survey among a group of resident doctors in Nigeria.

BACKGROUND: Child abuse and neglect (CAN) is a significant public health problem. Dentists are in good position to identify and report cases of CAN. AIM: The aim of this study was to determine the experience and knowledge of CAN among a group of Nigerian dental residents. MATERIALS AND METHODS: This was a cross-sectional study carried out among dentists attending a postgraduate update course. Data were collected to assess the knowledge of respondents on the forms of CAN, indicators and risk factors. Respondents' professional experiences were also assessed as well as actions taken and possible barriers to reporting suspected cases. RESULTS: Data were collected from 179 respondents, with a mean age of 33.1 ± 5.2 years. The respondents demonstrated good knowledge of the forms of child abuse, with an average score of 95.2%. The risk factors for CAN were correctly identified by 153 (85.5%) respondents as children with physical/mental disabilities, 151 (84.4%) as products of unwanted pregnancies, 128 (71.5%) as children from polygamous families and 122 (68.2%) as children from low socioeconomic families. Physical, sexual and emotional abuse and neglect were majorly identified as bruises behind the ears, 162 (90.5%); oral warts, 114 (63.7%); poor self-esteem, 158 (88.3%) and untreated rampant caries, 137 (76.5%), respectively. Seventy-four (46.5%) of the respondents did not evaluate children for CAN and only 12 (14.1%) of those who observed suspected cases of CAN reported to the social service. Lack of knowledge of referral procedures and concerns about confidentiality were the major barriers to reporting cases of CAN. CONCLUSION: The dentists had good theoretical knowledge of the indicators, risk factors and signs of CAN but lagged in clinical detection and reporting of such suspected cases. There is a need for continuing education and advancement of the postgraduate dental curriculum to improve the educational experiences with regard to CAN.

Oral health condition and treatment needs of Special Olympics athletes in Nigeria.

Special Olympics (SO) athletes in many parts of the world were reported to have poor oral health and high unmet treatment needs. This study was carried out to determine the oral health condition and treatment needs of SO athletes in Nigeria and to suggest ways of improving access to oral healthcare. Consenting athletes who participated in SO events in Nigeria from 2007 to 2008 received oral examination and evaluation by trained volunteers, using standardized Special Smiles screening forms and procedures designed for the event. A total of 1,286 athletes aged 3 to 71 years, 480 (37.3%) females and 806 (62.7%) males, participated in the screening. The majority (86.1%) cleaned their mouths once daily, 12.2% complained of pain, 21.1% had untreated decay, 6.6% had dental injury, 48.1% had gingival signs suggestive of periodontal disease, 15.8% required urgent treatment, and 43.7% required non-urgent treatment. We found that the oral health of SO athletes in this study was poorer than that of the general population in Nigeria.

Oral health status and treatment needs of children and young adults attending a day centre for individuals with special health care needs.

BACKGROUND: The oral health condition of individuals with special health care needs have been reported in literature to be influenced by various sociodemographic factors, including living conditions and severity of impairment. This study was carried out to determine the oral health status and treatment needs of children and young adults attending a day institution for those with special needs. METHODS: This study was carried out as part of an oral health screening program organized by the institution and consent was obtained from parents and guardians before the screening. All information was supplied by the parents during the screening using a questionnaire completed by the dentist. Oral examination was carried out on all consenting subjects in attendance on the days of screening in the school clinic with parents and teachers in attendance, using standard World Health Organisation oral health indices to assess dental caries, oral hygiene status, malocclusion and other oral health parameters. RESULTS: Fifty-four subjects aged 3-26 years (mean 12.28 +/- 6.82 years) and comprising 72.2% males and 27.8% females participated in the study. Over 90% were from parents of high and middle level educational background. Thirty-six (66.7%) were caries free, with a mean dmft score of 0.7 +/- 1.77 and mean DMFT score of 0.4 +/- 1.44 with no significant difference across gender (p = 0.5) and parents' educational status (p = 0.43). The mean OHI-S of the total population in this study was 1.36 +/- 0.16. Females had a mean score of 0.88 +/- 1.10 while males had a mean score of 1.55 +/- 1.24 with no significant difference (p = 0.6). Twenty-five (46.3%) had good oral hygiene, 17 (31.5%) had fair oral hygiene and 12 (22.2%) had poor oral hygiene, with no significant difference across gender (p = 1.11) and age groups (p = 0.07). Fifteen (27.8%) had gingivitis with no significant difference across age groups (p = 0.17). Forty-five (83.3%) had Angle's class I malocclusion, 6(11.1%) class II and 3 (5.6%) class III. Chronologic enamel hypoplasia was found in 9 (16.7%) of the total population. Up to 53.7% of the total population will require oral prophylaxis, 33.3% required restorations on their posterior teeth and 12.9% required veneers for labial facing of hypoplastic enamel. CONCLUSION: The subjects in this study had a high prevalence of dental caries and need for restorative care. They would benefit from parental education on diet modification, improvement of oral hygiene practices and regular dental visits.

Oral health condition and treatment needs of a group of Nigerian individuals with Down syndrome.

OBJECTIVE: This study was carried out to determine the oral health condition and treatment needs of a group of individuals with Down syndrome in Nigeria. METHOD: Participants were examined for oral hygiene status, dental caries, malocclusion, hypoplasia, missing teeth, crowding and treatment needs. Findings were compared with controls across age group, sex and educational background of parents. RESULT: Participants with Down syndrome had poorer oral hygiene than controls, with no significant sex difference. Oral hygiene was similar in the lower age groups but deteriorated with age in the Down syndrome group. CONCLUSION: Individuals with Down syndrome in Nigeria have poorer oral health and more treatment needs than controls. They would benefit from frequent oral health assessment.

Knowledge and behavior of Nigerian dentists concerning the treatment of children with special needs.

BACKGROUND: Children with special needs (CSN) are reported to receive less adequate dental care due to various behavioral problems and barriers created by dental professionals. This study was carried out to determine the knowledge and behaviour of Nigerian dentists concerning the treatment of CSN. METHODS: Questionnaires consisting of open and closed ended questions requesting socio-demographic information, type of practice, undergraduate and postgraduate training, self-rated knowledge and behaviour concerning care of CSN, were hand delivered to 359 dentists in the 3 geographical zones of Nigeria over a period of 8 weeks. Responses were compared across age groups, gender, type of practice and training received. RESULT: Two hundred and eighty questionnaires were returned completed, constituting 79.9% response rate. Most of the respondents were aged 30-39 years (44.3%). There were more males (56.1%) and more recent graduates of 10 years and below (78.5%). Over 80% of respondents had treated children with disabilities, those with physical disabilities being most encountered. Only 19.3% of respondents rated their knowledge of management of CSN as adequate, with no significant difference across age groups and gender, but with a significantly higher number of older graduates reporting to have adequate knowledge (p < 0.05). Those who had undergraduate training in care of CSN were 69.5% compared with only 12.8% who had post graduate training. Only 11.8% rated their undergraduate training as adequate. Thirty seven percent of respondents rated the CSN they had treated as very challenging. A higher proportion of older graduates (of more than 10 years post graduation) and those who rated their undergraduate training as inadequate used sedation and general anaesthesia. Seventy one percent of respondents were willing to treat CSN, with no significant difference across age groups, gender and training, but with a significantly higher percentage among those who had rated their knowledge as adequate. Most of those who were unwilling to treat CSN felt their management was tedious and challenging. CONCLUSION: From this study, very few dentists reported to have adequate knowledge of management of CSN, irrespective of age, gender and place of practice. A significant number of those with more experience rated their knowledge as adequate. Although most dentists rated the children's behaviour as challenging, they indicated their willingness to treat them in their practices.

Use of oral health care services and oral findings in children with special needs in Lagos, Nigeria.

This study was carried out to determine the use of oral healthcare services by children with special needs in Lagos, Nigeria. In this study, 125 structured questionnaires were sent to parents of children in two public day schools for CSN in Lagos. Once the questionnaires were returned, oral examinations were scheduled. The findings were compared to a control group of healthy children from two public schools in the same environment. One hundred and nine CSN and 134 controls, aged 5 to 19 years, participated in the study. The majority of the children had parents who had a low educational level. Fewer than 5% of the children had ever been to the dentist, and had only attended because of some symptoms. Non-attendance in 59.6% and 58% of CSN and controls respectively was reported to be due to absence of dental problem, 28% and 33.5% expressed ignorance about dentists and 8% of the parents of CSN identified finance and transportation as a problem. There were no significant differences between the two groups (p>0.05). It was found that 54% of CSN and 9% of controls had poor oral hygiene (p<0.05); dmft/DMFT was 0.25 in the controls and 0.12 in CSN (p>0.05). Untreated fractured teeth and missing teeth were more prevalent in CSN (p<0.05), while enamel hypoplasia was more prevalent in the controls (p<0.05). This study concluded that CSN and children from lower socioeconomic levels did not adequately utilize dental facilities in Lagos. Preventive programs in schools and the development of dental clinics in or near their schools could help.

Mandibular facial talon cusp: case report.

BACKGROUND: Talon cusp is a supernumerary structure projecting from the dento-enamel junction to a variable distance towards the incisal edge of an anterior tooth. Studies have shown that it consists of enamel, dentine and a variable amount of pulp tissue. Hyperactivity of the enamel organ during morphodifferentiation has been attributed to its formation. Most previous reports have been made concerning the occurrence of this structure on primary and permanent teeth and mostly on the palatal aspect. Only few have been reported on the facial aspect of the teeth. When it occurs, the effects are mainly aesthetic and functional and so early detection and treatment is essential in its management to avoid complications. CASE PRESENTATION: An unusual case of talon cusp on the facial aspect of a mandibular central incisor is reported. Its presence resulted in attrition of the opposing tooth. Reduction of the cusp and topical application of fluoride gel was initiated. CONCLUSION: The management and treatment outcome of talon cusp depends on the size, presenting complications and patient cooperation.

Oral health care knowledge and practices of a group of deaf adolescents in Lagos, Nigeria.

OBJECTIVE: This study sought to determine the oral health care knowledge and practices of a group of deaf adolescents in Lagos. METHODS: The study involved 50 students of Wesley School 1 for the Deaf, Lagos (26 males and 24 females, aged 10-19 years, mean 13.3 +/- 2.8). Information about previous dental care, oral hygiene, and snacking habits were obtained through a questionnaire and sign language by the teachers. RESULTS: Only 12 percent of pupils had received dental care. Eight percent and 72 percent, respectively, gave correct answers to causes of tooth decay and bleeding gums. Ninety-four percent brushed their teeth once daily, with no significant sex difference (P > .05). Reported dental problems include bleeding gums (36%), tooth discoloration, and tooth decay. The majority of pupils (60%) preferred biscuits and soft drinks as snacks. More than 90 percent were willing to have a dental check-up. CONCLUSIONS: The oral health knowledge and practices of this group of children will improve through a controlled school-based oral health education program.

Anthropometric finding in Nigerian children with sickle cell disease.

PURPOSE: Sickle cell disease (SCD) subjects have been widely reported to present with various anthropometric deficits, including malocclusion and stunting, compared to their unaffected peers. This study was carried out to examine these reports in Lagos. METHODS: A hospital-based cross-sectional study was carried out in 3 outpatient SCD units of one teaching and two general hospitals. All established SCD subjects aged 1 to 18 years (n = 177) were examined on consecutive clinic days. Controls (unaffected subjects; n = 122) were obtained from well-baby and surgical emergency clinics. Facial profile, occlusion, height, weight, head and mid-upper arm (MUA) circumference measurements were noted. RESULTS: A prognathic maxillary profile was found to be more prevalent in SCD subjects (21%) than controls (4%; P < .05). Class II malocclusion was found in 21% of SCD subjects compared to 2% of controls (P < .05). The overall mean height, weight and head circumference of SCD subjects and controls were not significantly different (P > .05). However, at age 18 years, the weight of the SCD group was significantly less than that of the control group (P < .05). The mean MUA circumference was significantly higher in the control group (20.04 cm +/- 3.80) than in SCD subjects (17.91 cm +/- 2.96; P < .05). CONCLUSIONS: There was a higher prevalence of maxillary protrusion. and Class II malocclusion in SCD subjects than controls. Height and weight were not significantly different in both groups except at 18 years when SCD subjects weighed less than controls.