Determination of Streptococcus Mutans and Lactobacillus Counts and their Association with Resting pH of Saliva and Dental Caries in Preschool Children in Lagos.

BACKGROUND: Caries is controlled by several factors including exposure to diets rich in carbohydrates, tooth susceptibility, and the presence of some oral flora bacteria such as Streptococcus mutans (S. mutans) and Lactobacilli sp. Tooth demineralisation occurs when the pH in the oral cavity is lower than the critical pH of 5.5 which occurs because of the production of acid by the acidogenic bacteria in the oral flora when they break down sugars (substrate) for energy. OBJECTIVE: The objective of this study was to determine the salivary Streptococcus mutans and Lactobacillus counts and their association with resting pH of saliva and dental caries in pre-school children in Lagos. MATERIALSAND METHODS: Fifty preschoolers with and without caries were recruited from the dental clinic and staff primary school in Lagos University Teaching Hospital, Idi-araba respectively. Saliva was collected in Thioglycollate media. The resting pH of the saliva was measured immediately in the clinic with a pH meter (Jenway pH meter, PHS 25). In the laboratory, the samples were streaked on Mitis salivarius bacitracin agar (MSB) and Rogosa agar for S. mutans and Lactobacillus respectively and incubated anaerobically for 48 hours at 37°C. Biochemical tests and morphological characteristics of colonies were used to identify S. mutans and Lactobacillus. RESULTS: The children were aged between 45 to 71 months with a mean age of 56.66 7.17 months. The mean age of the caries-free group was 55.48 7.57 months and that of caries active group was 57.84 6.76 months. The caries-active subjects recorded significantly higher bacterial counts of S. mutans and Lactobacillus compared to the cariesfree subjects. Streptococcus mutans and Lactobacillus showed a negative and highly significant correlation with resting pH (r = - 0.38 and r = - 0.32 value respectively). CONCLUSION: The resting pH of saliva in both groups was within normal values. Streptococcus mutans and Lactobacillus counts were significantly inversely correlated to the resting pH value of saliva. Streptococcus mutans and Lactobacillus counts were significantly higher in the caries active group. CONTEXTE: La carie est contrôlée par plusieurs facteurs dont l'exposition à des régimes riches en glucides, la sensibilité des dents et la présence de certaines bactéries de la flore buccale telles que Streptococcus mutans (S. mutans) et Lactobacilli sp.. La déminéralisation des dents se produit lorsque le pH dans la cavité buccale est inférieur au pH critique de 5,5 qui se produit à la suite de la production d'acide par les bactéries acidurogènes dans la flore buccale lorsqu'elles décomposent les sucres (substrat) pour l'énergie. BUT ET OBJECTIF: L'objectif de cette étude était de déterminer le nombre de Streptococcus mutans et de Lactobacillus et leur association avec le pH au repos de la salive et des caries dentaires chez les enfants d'âge préscolaire à Lagos. MATÉRIEL ET MÉTHODES: Cinquante enfants d'âge préscolaire avec et sans caries ont été recrutés respectivement à la clinique dentaire et à l'école primaire du personnel de l'hôpital universitaire de Lagos, Idiaraba. La salive a été recueillie dans un milieu au thioglycolate. Le pH au repos de la salive a été mesuré immédiatement en clinique avec un pHmètre (Jenway pH meter, PHS 25).Au laboratoire, les échantillons ont été striés sur gélose bacitracine Mitis salivarius (MSB) et gélose Rogosa pour S. mutans et Lactobacillus respectivement et incubés en anaérobiose pendant 48 heures à 37°C. Des tests biochimiques et des caractéristiques morphologiques des colonies ont été utilisés pour identifier S. mutans et Lactobacillus. RÉSULTATS: Les enfants étaient âgés de 45 à 71 mois avec un âge moyen de 56,66 ± 7,17 mois. L'âge moyen du groupe sans carie était de 55,48 ± 7,57 mois et celui du groupe avec carie active était de 57,84 ± 6,76 mois. Les sujets actifs carieux ont enregistré un nombre de bactéries significativement plus élevé de S. mutans et Lactobacillus par rapport aux sujets sans caries. Streptococcus mutans et Lactobacillus ont montré une corrélation négative et hautement significative avec la valeur du pH au repos (r = - 0.38 et r = - 0.32 respectivement) . CONCLUSION: Le pH au repos de la salive dans les deux groupes était dans les valeurs normales. Les numérations de Streptococcus mutans et de Lactobacillus étaient significativement inversement corrélées à la valeur du pH de la salive au repos. Les numérations de Streptococcus mutans et de Lactobacillus étaient significativement plus élevées dans le groupe actif carieux. Mots-clés: Numération bactérienne, Streptococcus mutans, Lactobacillus, pH delasalive,Enfants d'âgepréscolaire.

Dental Caries, Traumatic Dental Injuries and Gingivitis among Street-Children in Kano, Nigeria.

BACKGROUND: Street-children (Almajirai) constitute a significant proportion of the adolescent population in northern Nigeria. They face health challenges, especially oral health, from being inadequately protected, supervised or directed by responsible adults. OBJECTIVES: The objective of the study was to determine the prevalence of dental caries, dental trauma, gingivitis and oral hygiene scores in street-children. METHODOLOGY: Three hundred and sixty-six school-aged children were selected through a multi-stage sampling of 10 to 12-year-old children from four modern and traditional qur'anic schools, and examined for oral conditions using the WHO protocol. The DMFT index, the modified Ellis criteria, the Gingival Bleeding Index and the Oral Hygiene Index-Simplified (OHI-S) were used to assess dental caries, traumatic dental injuries, gingivitis and oral hygiene scores respectively. Chi-squared tests and Odds Ratio were used to compare the difference and test the association between Almajirai groups. Data analysis was carried out using the Statistical Package for the Social Sciences (SPSS version 20). Statistical significance was considered when p < 0.05. RESULTS: One hundred and sixty eight (45.9%) traditional Almajirai and 198 (59.4%) modern-type Almajirai, participated in the study. Their mean age was 10.8(±0.8) years. The prevalence of dental caries was 25.4% with mean DMFT and SiC scores of 0.6 (±1.3) and 1.7 respectively. DMFT scores ranged from 0 to 12. The prevalence of traumatic dental injuries and gingivitis were 8.7% and 82.2% respectively, while the OHI-S score was 3.0. The odds for traumatic dental injuries were 41% less in the modern-type Almajirai (p=0.02); the modern-type Almajirai were twice as likely to develop gingivitis (aOR 95%CI =2.0, p=0.01). OHI-S scores showed poorer oral hygiene levels in the modern Almajirai (p=0.02). CONCLUSION: Dental caries, traumatic dental injuries, gingivitis and poor oral hygiene were prevalent among street-children in Kano. There is a high level of untreated dental disease in the study population.

CONTEXTE: Les enfants des rues constituent une proportion importante de la population adolescente du nord du Nigeria. Ils sont confrontés à des problèmes de santé, notamment de santé bucco-dentaire, du fait qu'ils ne sont pas suffisamment protégés, supervisés ou dirigés par des adultes responsables. OBJECTIFS: L'objectif de cette étude était de déterminer la prévalence des caries dentaires, des traumatismes dentaires, de la gingivite et des scores d'hygiène buccale chez les enfants des rues. MÉTHODOLOGIE: Trois cent soixante-six enfants d'âge scolaire ont été sélectionnés par un échantillonnage à plusieurs degrés d'enfants de 10 à 12 ans dans quatre écoles qur'aniques modernes et traditionnelles, et ont été examinés pour les conditions bucco-dentaires en utilisant le protocole de l'OMS. L'indice CAOD, les critères d'Ellis modifiés, l'indice de saignement gingival et l'indice d'hygiène buccale simplifié (IOB-S) ont été utilisés pour évaluer les caries dentaires, les lésions dentaires traumatiques, la gingivite et les scores d'hygiène buccale, respectivement. Les tests du chi carré et l'Odds Ratio ont été utilisés pour comparer les différences et tester l'association entre les groupes Almajirai. L'analyse des données a été réalisée à l'aide du progiciel statistique pour les sciences sociales (SPSS version 20). La signification statistique a été considérée lorsque p < 0,05. RÉSULTATS: Cent soixante-huit (45,9%) Almajirai traditionnels et 198 (59,4%) Almajirai de type moderne ont participé à l'étude. Leur âge moyen était de 10,8 (±0,8) ans. La prévalence de la carie dentaire était de 25,4 % avec des scores moyens de CAOD et de SiC de 0,6 (±1,3) et 1,7 respectivement. Les scores CAOD variaient de 0 à 12. La prévalence des lésions dentaires traumatiques et de la gingivite était de 8,7 % et 82,2 % respectivement, tandis que le score OHI-S était de 3,0. Les risques de lésions dentaires traumatiques étaient 41 % moins élevés chez les Almajirai de type moderne (p=0,02) ; les Almajirai de type moderne étaient deux fois plus susceptibles de développer une gingivite (aOR 95%CI =2,0, p=0,01). Les scores OHI-S ont montré des niveaux d'hygiène buccale plus faibles chez les Almajirai de type moderne (p=0,02). CONCLUSION: Les caries dentaires, les lésions dentaires traumatiques, les gingivites et une mauvaise hygiène bucco-dentaire étaient prévalentes chez les enfants des rues de Kano. Il existe un niveau élevé de maladies dentaires non traitées dans la population étudiée. Mots clés: Caries, enfants des rues, Almajirai, Adolescents, Hygiène buccale, Gingivite.

Comparative Analysis of Streptococcus Mutans and Streptococcus Sobrinus from Dental Plaque Samples of Nigerian Pre-school Children with and Without Caries.

BACKGROUND: Early childhood caries (ECC), despite being a preventable disease, remains prevalent in sub-Saharan Africa. This study compared the occurrence of Streptococcus mutans and Streptococcus sobrinus in dental plaque from caries free and caries active Nigerian preschool children. METHODS: Structured questionnaire were administered to eighty (80) mothers to inquire about the sociodemographic characteristics of their children. Diagnosis of dental caries was made according to the diagnostic criteria of the World Health Organization (WHO). Supragingival plaque sample collected from caries free children and children with dental caries (cavitated and non-cavitated lesions) using wooden toothpicks were cultured anaerobically. Samples were cultured in anaerobiosis and isolates obtained were identified based on molecular characterization performed by polymerase chain reaction (PCR) analysis. Statistical package for the social sciences (SPSS 25.0) was used for analysis. RESULTS: Streptococcus mutans was detected in 26(65.0%) children with early childhood caries, and S. sobrinus in 10(25.0%) children with early childhood caries. The presence of S. mutans and S. sobrinus occurring together was associated with a higher deft score. Occurrence of S. mutans did not show significant difference between children with ECC and caries free children (p=0.099), however, the proportion of children with ECC positive for S. sobrinus was significantly higher than that of caries free children (p= 0.003). CONCLUSIONS: S. mutans and S. sobrinus had a similar frequency of occurrence in children with ECC and caries free children. The occurrence of S. mutans alongside S. sobrinus in ECC is related to its severity.

CONTEXTE: La carie de la petite enfance (CPE), bien qu'étant une maladie évitable, reste prévalente en Afrique sub-saharienne. Cette étude a comparé la présence de Streptococcus mutans et Streptococcus sobrinus dans la plaque dentaire d'enfants nigérians d'âge préscolaire avec et sans caries. MÉTHODES: Des questionnaires structurés ont été administrés à quatrevingts (80) mères pour connaître les caractéristiques sociodémographiques de leurs enfants. Le diagnostic de la carie dentaire a été établi selon les critères de diagnostic de l'Organisation mondiale de la santé (OMS). Des échantillons de plaque supragingivale prélevés sur des enfants exempts de caries et des enfants atteints de caries dentaires (lésions cavitaires et non cavitaires) à l'aide de cure-dents en bois ont été mis en culture en anaérobiose. Les échantillons ont été mis en culture en anaérobiose. Les isolats obtenus ont été identifiés sur la base d'une caractérisation moléculaire effectuée par une analyse de réaction en chaîne par polymérase (PCR). Le progiciel statistique pour les sciences sociales (SPSS 25.0) a été utilisé pour l'analyse. RÉSULTATS: Streptococcus mutans a été détecté chez 26(65,0%) enfants atteints de caries de la petite enfance, et S. sobrinus chez 10(25,0%) enfants atteints de caries de la petite enfance. La présence simultanée de S. mutans et de S. sobrinus était associée à un score de déformation plus élevé. La présence de S. mutans n'a pas montré de différence significative entre les enfants atteints de CEC et les enfants indemnes de caries (p=0,099), cependant, la proportion d'enfants atteints de CEC positifs pour S. sobrinus était significativement plus élevée que celle des enfants indemnes de caries (p= 0,003). CONCLUSIONS: S. mutans et S. sobrinus ont une fréquence d'apparition similaire chez les enfants atteints de CEC et les enfants indemnes de caries. La présence de S. mutans et de S. sobrinus dans l'ECC est liée à sa gravité. MOTS CLÉS: Streptococcus mutans, Streptococcus sobrinus, caries de lapetite enfance, plaque supragingivale.

Comparison of the treatment outcomes of the conventional stainless steel crown restorations and the hall technique in the treatment of carious primary molars.

BACKGROUND: Dental caries is a multifactorial disease that causes reversible decalcification and cavitation of susceptible teeth exposed to sugary substrates over a period of time in the oral cavity. It gives clinical and social burdens to the child patients and their parents/carers. Stainless steel crown (SSC) restoration is one of the restorative treatment options in the management of carious primary molars. AIMS: The Hall technique is a biologic method of managing primary teeth by sealing in the caries with preformed metal crowns (SSCs). The objectives of this study were to assess and compare the primary and secondary treatment outcomes of stainless steel crown restorations using the conventional method and the Hall technique in primary molars immediately after placement and over a 12-month period using both clinical and radiological parameters. METHODS: The study was a randomized control clinical trial using a split mouth approach. A total of 25 stainless steel crown restorations using the conventional method and 25 stainless steel crown restorations using the Hall technique were placed in 25 subjects aged 3-8 years with a pair or pairs of unrestored enamel or dentinal carious primary molars matched for tooth type, dental arch, and extent of caries. All subjects were monitored and reviewed every 3 months for 12 months. RESULTS: Twenty three subjects returned for follow-up. There was no statistically significant difference (P-value > 0.05) between the conventional SSC restoration and the Hall technique for both the primary outcomes/major failures (irreversible pulpitis, dental abscess, peri-radicular radiolucency, and crown loss with tooth unrestorable) and secondary outcomes/minor failures (crown loss and tooth restorable, crown perforation, secondary/marginal caries, and reversible pulpitis). But, there was a statistical significant difference in the average time taken for the placement of the restorations between the two groups (P-value 0.001). CONCLUSION: Both the conventional SSC restorations and the Hall technique can be provided for all the subjects in this study. The Hall Technique compared favorably well with the conventional SSC restoration in clinical and radiological outcomes. The Hall Technique appears to offer an effective treatment option for managing dental caries in primary molar teeth especially in a resource challenged environment where electricity and treatment under general aaesthesia can sometimes be a problem.

Comparison of the Treatment Assessments of the Conventional Stainless-Steel Crown Restorations and the Hall Technique.

BACKGROUND: Stainless steel crown (SSC) restoration is one of the restorative treatment options in the management of carious primary molars. The Hall technique is a biologic method of managing carious primary teeth by sealing in the caries with SSCs without the routine local anaesthesia and tooth preparations. The objectives of this study was to compare the treatment assessments of the conventional stainless steel crown restoration with Hall technique using subjects' discomfort during treatments and parents' treatment perception, treatment acceptability and satisfaction with the treatment. METHODS: The study was a comparative analytical study involving the placement of 25 SSC restorations using the conventional method and 25 SSC restorations using the Hall technique in 25 subjects aged 3-8 years with a pair or pairs of unrestored enamel or dentinal carious primary molars matched for tooth type, dental arch and extent of caries. Discomfort during the placements of the SSCs was assessed by the subjects while treatment perception, acceptability and satisfaction were assessed by the parents with the use of questionnaires. RESULTS: There was statistically significant difference (p-value 0.00001) between the conventional method and the Hall technique for the discomfort outcomes. There was no statistically significant difference for treatment perception (p=0.73), acceptability (0.72) and satisfaction (0.60). CONCLUSION: The Hall Technique compared favourably well with the conventional method in treatment perception, acceptability and satisfaction but it gave higher level of discomfort in some of the subjects. The Hall Technique appears to be a good method for managing dental caries in primary molar teeth especially in a resource challenged environment where electricity and access to care are contending issues.

Prevalence of Dental Caries among Visually Impaired Institutionalized Adolescents in Lagos State.

OBJECTIVES: To assess and compare caries prevalence among institutionalized visually impaired and sighted 10dash;19 year old children in Lagos State, Nigeria. METHODS: A cross sectional study of institutionalized visually impaired and sighted 10-19-year-old adolescents was carried out using the World Health Organisation (WHO) Basic Oral Methods caries diagnostic criteria. A random sample of 10-19-year-old visually impaired and sighted institutionalised children was carried out. The mean decayed, missing, filled teeth (dmft/DMFT) and significant caries (SiC) indices of both groups were obtained and compared with Chi-square test using SPSS version 20. RESULTS: Mean age of visually impaired participants was 16 years while that of sighted was 12.5 years. The male to female ratio was 1:1 among the visually impaired participants and 1:1.5 among the sighted. Caries prevalence of 28.8% (64/222), mean dmft/DMFT 1.98±1.25 and 27.5% (63/229), mean dmft/DMFT 1.90±1.28 were obtained for the sighted and visually impaired 10dash;19 years old children respectively. The significant caries (SiC) indices for both groups were 3.3. CONCLUSION: Caries prevalence among the visually impaired and sighted adolescents in this study was considerable with no significant differences between them. Both populations had significant caries experiences. There is therefore need for oral health promotion among both sighted and visually impaired institutionalized adolescents in this environment.

Translation and Validation of the Nigerian Pidgin English Version of the Early Childhood Oral Health Impact Scale (NAIJA ECOHIS).

OBJECTIVES: The Early Childhood Oral Health Impact Scale (ECOHIS) has been used in different countries and in different versions to assess the impact of oral health conditions on preschoolers. This study aimed to develop the Nigeria Pidgin English version of ECOHIS and investigate its psychometric properties. METHODS: The Nigerian Pidgin English version (NAIJA ECOHIS) was developed from the English version using the forward-backward translation technique. One hundred and four children aged 2-5 years attending a clinic were recruited for the study and the new version was administered to their parents/caregivers. Validity of the instrument was assessed based on the relationship between the NAIJA-ECOHIS scores and the global health rating scores using Spearman's rank correlation. The internal consistency reliability was tested using Cronbach's alpha coefficient while the test-retest reliability was assessed using intraclass correlation coefficient by using scores of fifty participants who reported no change in their symptoms after one week. RESULTS: The NAIJA-ECOHIS version was created with some modifications to the original version. The association between the NAIJA ECOHIS scores and the two global questions as well as the correlation between the child and family sections were statistically significant (p <0.001). Cronbach's alpha coefficient for the child section, family section and Total NAIJA ECOHIS scores were 0.83, 0.79 and 0.86 respectively demonstrating good internal consistency. CONCLUSION: The NAIJA ECOHIS version was valid and reliable for assessing oral health related quality of life of preschool children whose parents/caregivers speak the Nigerian Pidgin English.

Tooth crown dimensions in a selected population of Nigerians with Down Syndrome.

OBJECTIVE: To determine and compare tooth crown dimensions in primary and permanent dentitions of subjects with Down Syndrome (DS) and a selected Nigerian population without DS. MATERIALS AND METHODS: A sample of subjects with DS and a control group were selected from the Down Syndrome Resource Centre and the Dental Clinic of the Lagos University Teaching Hospital, Lagos respectively. Dental stone models were made from maxillary and mandibular alginate impressions of the population samples after obtaining consent from the subjects and their parents/caregivers. Measurement of tooth dimensions (Mesiodistal, Buccolingual and Clinical Crown Heights) was carried out using an electronic digital caliper. The descriptive statistics were obtained and compared for all parameters using SPSS version 17. RESULTS: The mean mesiodistal tooth dimensions were smaller in the permanent dentition of subjects with DS and the difference in dimensions was statistically significant in most tooth types. The mean tooth dimensions in the primary dentition were generally smaller in DS individuals except in the mesiodistal tooth dimensions of maxillary central incisors and canines, mandibular canines and the clinical crown heights of the maxillary central incisors and 2nd molars. CONCLUSION: The tooth dimensions were generally smaller in both primary and permanent dentitions of subjects with DS than in controls without DS.

Prevention of dental caries: knowledge, practice and opinion of paediatricians in Lagos.

BACKGROUND: Dental caries is the most prevalent oral disease in children and this is preventable. Paediatricians are the first professionals whom children visit and are in good position to begin the process of prevention of dental caries if they recognize and encourage good preventive habits. OBJECTIVE: To determine the knowledge, practice and opinion of pediatricians in prevention of dental caries. MATERIALS AND METHODS: A cross sectional survey was undertaken among pediatricians in Lagos. Questionnaires were administered to pediatricians practicing in Teaching hospitals, general and private hospitals in Lagos. The questionnaire assessed their personal details, knowledge about caries, practice guidelines and opinion towards its prevention. RESULTS: Less than one-third (27.7%) of the pediatricians knew that bacteria causing caries can be transmitted from mother to child. Only about one-third (30.8 %) of the paediatricians examine children's teeth for dental caries. Majority (87.7%) were of the opinion that paediatricians have a role in promoting oral health. A total of 59% of the paediatricians had moderate knowledge, while (71%) of them had poor practice and their opinion for prevention of dental caries was positive in more than two-thirds of them (71%). CONCLUSION: We concluded that most paediatricians in Lagos had moderate knowledge, poor practice and lacked proper awareness about prevention of dental caries. Recommendation: we recommend that preventive dentistry topics in oral health promotion and prevention of dental caries be part of their postgraduate curriculum, continued dental health education programme for paediatricians, referral of related cases to paediatric dentists and oral health related topics be published in paediatric medical journals.

Knowledge and attitude of some nigerian school teachers on the emergency management of avulsed permanent incisor.

BACKGROUND: Tooth avulsion has been known to be the most severe of all dental injuries. The immediate action taken at the accident site will determine the prognosis of the tooth. Replantation of an avulsed tooth is the treatment of choice. AIM & OBJECTIVES: To assess the knowledge and attitude of primary and secondary (Basic educational) school teachers on the emergency management of avulsed permanent incisors. SETTING: Twenty public and private basic educational schools were randomly selected from Lagos State. SUBJECTS & METHODS: Descriptive cross-sectional study. A 23 item self administered questionnaire was distributed to teachers to determine their knowledge and attitude on the emergency management of avulsed permanent incisors. Data was analysed using SPSS (Statistical Package for Social Sciences), Version 21.0. The responses obtained were tabulated and expressed as frequency distributions and then computed in percentages. Chi-square was used to test the association between knowledge of the schools teachers regarding the emergency management of avulsed permanent incisors and their socio-demographic variables. Multivariate analysis was used to adjust for confounding variables. The level of significance was set at P ≤0.05. RESULTS: A total of 320 teachers answered the questionnaires. Most of the teachers were female (63.1%). Only (30.9%) had received first aid training which included emergency management of dental trauma. Forty- two percent (134) didn't know that an avulsed permanent tooth could be replanted. Twenty teachers (44.4%) would clean an avulsed tooth with toothbrush and toothpaste. A greater proportion of the respondents 130 (40.6%) would transport an avulsed tooth using a clean white handkerchief. The overall knowledge of the school teachers was poor (84%).There was a statistically significant association between the knowledge of the school teachers and the inclusion of emergency management of dental trauma in the first aid training of the teachers P=0.05. Predictors of teachers' level of knowledge of emergency management of avulsed teeth were receipt of advise on management of traumatic dental injuries (OR= 2.5, CI=1.19-4.28) and type of school (OR=0.93, CI=0.206-0.750). CONCLUSION: The school teachers had insufficient knowledge about the emergency management of avulsed permanent teeth. School oral health campaigns with regards to emergency management of avulsed teeth will help improve teachers' knowledge and modify their behaviour.

Variations of crown dimensions of permanent dentitions in a selected population of Nigerian children.

BACKGROUND: Race, gender, genetic/ environmental factors contribute to tooth variations which could be in size or shape. However, little has been reported on dimensional variations in permanent dentitions among Nigerians. OBJECTIVE: To investigate the pattern of variability of mesiodistal and buccolingual tooth dimensions of permanent dentition in Nigerians. METHODS: Mesiodistal (MD) and buccolingual (BL) tooth dimensions were obtained from teeth on dental stone models of selected 400 healthy adolescents aged 12-15 years using an electronic digital caliper. The descriptive statistics and the variability (determined from the Coefficient of Variation; SD/mean x100) were obtained using SPSS version 13. RESULTS: The mean tooth dimensions were larger in the males than in the females in all tooth types except in mean MD tooth dimension of maxillary second premolars which was larger in the females though not significant (p = 0.70). The coefficient of variation (CV) in the mean MD and BL dimensions ranged from 5.02 in the mandibula rfirst molars to 7.68 in the maxillary lateral incisors and from 5.38 to 11.07 in the maxillary first molars and the mandibular central incisors respectively. The least variable teeth in MD dimensions were the maxillary first molars in males (CV = 4.94) and mandibular first molars in females (CV = 4.88), while the highest variability was seen in the maxillary second premolars in females (CV = 10.46). In BL dimension the maxillary first molars were the least variable in both genders (CV = 5.22 in males, CV = 5.24 females) while the maxillary lateral incisors of males had the highest variability(CV = 11.90). CONCLUSION: The pattern of variation showed that the later-forming teeth in each tooth class showed more variability than the mesial members. The mesiodistal tooth dimensions were less variable than the buccolingual tooth dimensions.

Comparison of normative and self-perceived dental needs among adolescents in Lagos, Nigeria.

AIMS AND OBJECTIVES: Professionally determined needs as well as self-perceived oral health needs play significant roles in the assessment of needs for dental care. The aim of this study was to compare the self-perceived oral health needs by the adolescents with professionally determined needs by the oral health-care giver. SUBJECTS AND METHODS: This was a community-based cross-sectional study involving 504 adolescents who were selected through multistage random sampling from secondary schools in Lagos State. Self-assessed oral health needs was measured by the participants' response to the question(s): How can you describe the condition of your teeth/gum? Their response was compared to the findings of an intra-oral examination of the participants (after an informed consent) carried out under field conditions by one examiner employing DMFT and CPITN indices for Dental Caries and Periodontal status respectively. RESULTS: The prevalence of Dental Caries was 11.9% while that of Periodontal disease was 60.4%. The Sensitivity, Specificity, Positive and Negative Predictive Values for Dental Caries were 30%, 85%, 21.4% and 89.9% respectively; and 21.7%, 80.9%, 63.4%, and 32.9% respectively for Periodontal status. CONCLUSION: Self-perceived oral health needs assessed by questionnaire among adolescents was found to be at variance with the clinically determined needs. Promotion of oral health awareness among adolescents with emphasis on recognition of signs and symptoms of common dental diseases using the school as a base is strongly advised.

Behavior management techniques employed by nigerian dentists for their child patients / Técnicas de manejo do comportamento utilizadas por dentistas nigerianos em pacientes infantis

Objective: To determine the different behavior management techniques employed by dentists in Nigeria for their child patients. Method: One hundred and fifty questi onnaires were hand delivered to dentists in different locations in Nigeria. Information required include respondent's bio data, years post graduation, behavior management techniques employed, and reasons for choice of technique. Results: A total of 128 (85.3%) were returned completed, comprising 53.2% females and 46.8% males, in age groups, < 30 years (25%), 30-39 years (48.4%), 40-49 years (19.5%) and 50 years and above (7.1%). Thirty five (27.3%) practiced in health centers, 88 (68.8%) in teaching hospitals and 5 (3.9%) in private hospitals. Majority (98.4%) attended to child patients and 29.6% rated their patients as uncooperative. The most frequently used behavior management technique was 'tell-show-do'. (73.4%) followed by positive reinforcements (35.9%), modeling (31.2%), desensitization (18.7%), restraints (13.2%), sedation (11.7%) and 'hand over mouth' (4.6%). Only 3.2% used general anesthesia. The major factors influencing choice of behavior management technique was age of child (78%), convenience to dentists (28%), availability of facilities (25.8%), and acceptability by parents/child (18.8%). Only 25.8% rated their facilities as adequate. Conclusion: The 'tell-show-do' technique was practiced by majority of respondents in this study. Improvements of facilities may increase the number of dentists employing pharmacological methods of management.

Objetivo: Determinar as diferentes técnicas de manejo do comportamento utilizadas por cirurgiões-dentistas nigerianos em seus pacientes infantis. Método: Cento e cinquenta questionários foram enviados a cirurgiões-dentistas em diferentes regiões da Nigéria. As informações requisitadas incluíam dados do respondente, pós-graduação, técnicas de manejo do comportamento utilizadas e motivos para a escolha da técnica. Resultados: Um total de 128 (85,3%) questionários foram devolvidos preenchidos, dos quais 53,2% eram de mulheres e 46,8% de homens, em relação à faixa etária, < 30 anos (25%), 30-39 anos (48,4%), 40-49 anos (19,5%) and 50 anos ou mais (7,1%). Trinta e cinco profissionais (27,3%) exercia a profissão em centros de saúde, 88 (68,8%) em hospitais escola e 5 (3,9%) em hospitais privados. A maioria (98,4%) atendia crianças e 29,6% classificaram seus pacientes como não cooperadores. A técnica mais utilizada foi a do 'falar-mostrar-fazer' (73,4%) seguida pelo regorço positivo (35,9%), modelagem (31,2%), desensibilização (18,7%), contenção (13,2%), sedação (11,7%) e ?mão sobre a boca? (4,6%). Somente 3,2% utilizam anestesia geral. Os principais fatores influenciadores quando da escolha da técnica foram a idade da criança (78%), a conveniência do profissional (28%), disponibilidade de instalações (25,8%), e aceitação pelos pais/criança (18,8%). Apenas 25,8% avaliaram suas instalações como adequadas. Conclusão: A técnica 'falar-mostrar-fazer' é utilizada pela maioria dos profissionais. A melhoria das instalações poderia aumentar o número de cirurgiões-dentistas que utilizam técnicas farmacológicas de manejo comportamental.

Hypodontia in an adolescent with the HbSC genotype: a case report.

The haemoglobin SC (HbSC) genotype is a variant form of haemoglobin disorder that often presents less frequent clinical symptoms of sickle cell disease (SCD) than the homozygous state (HbSS). Various dental abnormalities, such as enamel hypoplasia, hypomineralization, midline diastema and delayed eruption of the teeth, have been associated with SCD. This report presents the case of an adolescent patient with HbSC who had hypodontia, transposition of a permanent canine, retained primary teeth, multiple carious lesions and poor oral hygiene complicated by sickle cell crisis. This report focuses on the need for preventive care in such patients to reduce functional and aesthetic complications.

Comparative study of oral hygiene status of HbSS subjects and controls.

There is paucity of information on the oral health status of individuals with the HbSS gene in Nigeria. This study was carried out to determine the state of their oral hygiene, compare this with unaffected people and create awareness of importance of oral health care in the patients and their parents. Three hundred and thirty-six subjects, aged 1-45 years and comprising 185 HbSS and 151 controls took part in this study. They were seen in three hospitals in Lagos-General Hospital Lagos, Massey Street Children Hospital and Lagos University Teaching Hospital. They were examined using the Simplified Oral Hygiene Index, (OHIS). Mean OHI-S scores for HbSS subjects and controls were 1.24+/-0.95 and 0.66+/-0.58 respectively (P< 05). There was no significant difference in OHI-S score across the socio-economic classes of both groups (P> 05). Females in both groups had cleaner mouths than males. It is concluded that the controls had cleaner mouths than those with HbSS. Socio-economic class did not influence their oral hygiene. It is recommended that preventive oral health care should be included in the management of HbSS patients.

Comparison of the periodontal treatment needs of normal and handicapped children in Lagos.

The periodontal treatment needs of normal children and those who have mental and multiple handicaps are compared. There were 7.8% handicapped children who did not require any periodontal treatment compared with 1.5% of normal children. Similarly, a higher proportion of normal children (78.6%) compared with 59.4% of handicapped children needed professional oral prophylaxis and oral hygiene education. It was also found from the study that there was a greater need for professional oral prophylaxis in normal children and handicapped children living in institutions than in handicapped children staying with their parents at home. It was concluded that both normal and handicapped children require supervised oral hygiene measures till effective oral hygiene habit is established.