Attitude and Behavior to Oral Health of 456 Patients Who Presented for Tooth Extraction at 2 Health Facilities in Southwestern Nigeria.

INTRODUCTION: Tooth loss can indicate the population's oral health situation; majority of patients presenting for tooth extraction have poor oral health behavior and dental service utilization. Understanding the factors responsible for the poor attitude may help in designing targeted intervention to improve their oral health behavior. This study aims to find out the effects of dental health attitude and behavior on tooth mortality in a cohort of adults attending the oral surgery clinic for tooth extraction in 2 health facilities in southwestern Nigeria. PATIENTS AND METHOD: Cross-sectional study of consecutive adult patients who presented at the oral surgery clinic for tooth extraction. Clinical and demographic data, oral health habits, and pattern of previous dental clinic attendance were collected. Data analysis was done using SPSS version 19.0. Variables were subjected to univariate and multivariate logistic regression to evaluate factors influencing dental habit and dental service utilization. RESULTS: The study comprised a total of 453 respondents, consisting of 239 nonattenders, 196 in-trouble attenders, and 18 regular attenders, with majority (59.4%) of them being low earners or not gainfully employed. Majority (64.8%) of the in-trouble attenders had attained tertiary education. Attendance pattern had no influence on the number of extractions needed. CONCLUSION: Despite high educational attainment and availability of dental services, most patients presenting for extraction have poor oral health habit and are problem-oriented attenders. Socioeconomic disparities and poor dental habits appear to be part of the major factors responsible for poor dental behavior among the study subjects.

Developing a competency-based medical education curriculum for the core basic medical sciences in an African Medical School.

The College of Medicine of the University of Ibadan recently revised its MBBS and BDS curricula to a competency-based medical education method of instruction. This paper reports the process of revising the methods of instruction and assessment in the core basic medical sciences directed at producing medical and dental graduates with a sound knowledge of the subjects sufficient for medical and dental practice and for future postgraduate efforts in the field or related disciplines. The health needs of the community and views of stakeholders in the Ibadan medical and dental schools were determined, and the "old" curriculum was reviewed. This process was directed at identifying the strengths and weaknesses of the old curricula and the newer competences required for modern-day medical/dental practice. The admission criteria and processes and the learning methods of the students were also studied. At the end of the review, an integrated, system-based, community-oriented, person-centered, and competency-driven curriculum was produced and approved for implementation. Four sets of students have been admitted into the curriculum. There have been challenges to the implementation process, but these have been overcome by continuous faculty development and reorientation programs for the nonteaching staff and students. Two sets of students have crossed over to the clinical school, and the consensus among the clinical teachers is that their knowledge and application of the basic medical sciences are satisfactory. The Ibadan medical and dental schools are implementing their competency-based medical education curricula successfully. The modifications to the teaching and assessment of the core basic medical science subjects have resulted in improved learning and performance at the final examinations.

Updates on the epidemiology and pattern of traumatic maxillofacial injuries in a nigerian university teaching hospital: a 12-month prospective cohort in-hospital outcome study.

Many studies have been undertaken in Nigeria on maxillofacial trauma. However, only a few have considered both the skeletal and soft tissue injuries (in general) involving all the aspects of the maxillofacial region or considered other etiological sources of trauma apart from road traffic crashes. Fewer still have reviewed the outcome of management of facial injuries in our low-resource environment. This study sets out to examine the recent trends in both the clinical and epidemiological patterns of all facial injuries from all causes seen in a low-resource practice of a developing country. It also assessed the in-hospital treatment outcomes, and the levels of the patients' satisfaction with treatment received in this setting. Over a 12-month period, the clinical records of consecutive patients who were evaluated and treated for maxillofacial injuries in our unit were prospectively acquired, entered into predesigned forms and subsequently analyzed. There were 259 patients (79.5% males) during the study period. The mean age was 32.21( ± 16.588) years. Overall, motor bike crashes, 42.1%, were the commonest source of these traumas; and armed robbery was the commonest form (69.0%) of assault. Mandibular fractures were the commonest maxillofacial fractures (37.8%) whereas head injury had the highest frequency among the associated injuries (71.4%). Closed reduction and immobilization was deployed in 88.0% of those who had treatment and majority was satisfied with the esthetic outcome of the treatment received. Mean length of hospital stay was 12.6 ( ± 4.423) days. Maxillofacial trauma poses a significant socioeconomic burden on affected individuals in this study population. This is made worse by the presence of associated injuries in the other body systems. More local studies on the outcome of management of maxillofacial trauma will improve the available literature in this region.

Concomitant injuries associated with maxillofacial fractures in Abuja, Nigeria.

BACKGROUND: Injury is the leading cause of death and disability and the third most common cause of death Little attention has been given to the concomitant injuries associated with maxillofacial fractures in scientific literatures. OBJECTIVES: For effective planning and efficient management of the patients, there is need to study the pattern ofthese injuries. METHODS: Consecutive patients who sustained one or more facial bone fractures over a period of 2 years were prospectively studied. RESULTS: There were 103 patients out of which 96 sustained concomitant injuries giving an incidence of 93.2%.There were 75 (78.1%) males and 21 (21.9%) females with a M:F of 3.6:1. The mean + (SD) age was 30.8 +13.0 with a range of 2.0 to 68.0 years. Road Traffic Crashes was the commonest (n = 81, 84.4%) cause of injury. Soft tissue of the face, with an incidence of 62.1% (n = 64) was the commonest concomitant injury. It was followed by neurologic injury (n = 51, 49.5%) and ophthalmic injury (n = 38, 36.9%) while abdominal injury (n = 2, 1.9%) was the least common. Majority (87.5%) of the ophthalmic injury patients sustained midfacial fracture while 12.5% of the them sustained mandibular fractures. Pulmonary and cervical injuries were found to be associated more with mandibularfractures. CONCLUSION: Concomitant injuries occur commonly with maxillofacial fractures and they were found to have significant effect on the management of the fractures. A multidisciplinary approach will bring about a very efficient management of patients.

Pattern of Assault-induced Oral and Maxillofacial Injuries in Ado-Ekiti, Nigeria.

BACKGROUND: Assault, though a major cause of maxillofacial injuries in the developed nations, has not been adequately investigated among Nigerian population. This study aimed to analyze the pattern of maxillofacial injuries caused by assault in our institution. METHODS: A descriptive clinical survey of patients with assault-induced oral and maxillofacial injuries presenting to our maxillofacial surgery clinic/emergency ward was carried out. Demographic data and pattern of injuries obtained from patients' record and department trauma database were analyzed. RESULTS: 156 patients presented with oral and maxillofacial injuries between October 2009 and December 2010. Thirty-four cases were due to assault and male to female ratio was 1.8:1. The mean age of the patients was 21.4±6.26 years (age range 2-48 years). 23.6% (n=8) of the injuries were due to domestic violence between spouses while 35.3% (n=12) resulted from fight. Students unrest and armed robbery attack accounted for six cases each (17.7%, n=6), while there were two cases due to child battering. 64.3% (n=22) of the injuries sustained involved soft tissues while 35.7% involved hard tissues. Contusion was the most common isolated soft tissue injury accounting for 56% (n=10) while dentoalveolar fracture was the most encountered hard tissue injury (62.5%, n=16). CONCLUSION: There is need for preventive strategies to reduce the incidence of assault-induced maxillofacial injuries.