Factors associated with dental clinic use by clients in Nigeria during the COVID-19 pandemic.

BACKGROUND: Nigeria, like many other countries, faced challenges in dental care provision during the COVID-19 pandemic, necessitating limited care to emergencies only. However, the impact of restricted access to dental services on oral health remains a concern, particularly with preventive maintenance care. This study aims to identify the factors associated with dental service utilization during the COVID-19 pandemic among patients attending dental clinics in Nigeria, and their sources of information about COVID-19. METHODS: This cross-sectional study recruited 500 participants who had visited dental clinics before and during the pandemic. Data were collected through telephone interviews and online questionnaires between September and December 2021. Inferential analyses were conducted using ordered logistic regression models to assess the association between the independent (awareness of emergency dental treatments, knowledge of COVID-19 transmission routes in dentistry, awareness of required preparations in dental practice settings, fear of COVID-19 infection in dental settings), and dependent (utilization of dental services during the pandemic) variables after adjusting for confounding variables (age, sex, educational status, COVID-19 vaccinations status and COVID-19 status of live-in residents). The sources of COVID-19 information by dental patients was also identified. Statistical significance was established at 95% confidence level with a p value < 0.05. RESULTS: Many participants were males (51.2%) and had tertiary education (61.6%). Fear of COVID-19 infection in dental settings was significantly associated with lower odds of utilizing dental care services during the pandemic (Adjusted Odds Ratio: -0.06, 95% Confidence Interval: -0.08, -0.01). The main sources of COVID-19 information were mass media and social networks, with only 42% receiving information from dental professionals. CONCLUSION: Fear of COVID-19 infection in dental settings significantly influenced dental service utilization during the pandemic. Strategies to address fear and improve communication channels between dental professionals and patients are essential for promoting oral health during similar crises.

Association between parity and tooth loss among northern Nigerian Hausa women.

BACKGROUND: Female reproduction is associated with physiological, metabolic, and nutritional demands that can negatively affect health and are possibly cumulative when parity is high. While it is probable that maternal oral health is similarly affected, available evidence is based on fairly low parity populations and likely confounders affecting oral health status were not considered. AIM: To determine the relationship between parity and tooth loss in a population with many high parity women. Contributions of age, reproductive and socioeconomic parameters, and oral health practices were considered. MATERIALS AND METHODS: This was a cross-sectional study involving 612 Hausa women of all parity levels aged 13-65 years. Women with ≥5 children were considered high parity. Sociodemographic status and oral health practices were collected using a structured interviewer-administered questionnaire. All teeth present, (excluding third molars) and missing teeth were noted, with inquiries regarding tooth loss etiology. Associations with tooth loss were evaluated through correlations, ANOVA, post hoc analyses and Student's t tests. Effect sizes were used to interpret the magnitude of differences. Multiple regression (negative binomial model) was used to investigate predictors of tooth loss. RESULTS: Hausa women had a low prevalence of tooth loss, despite poor oral hygiene, and limited dental care. Older, middle SES, and higher parity women experienced significantly more tooth loss. Additionally, increased duration of reproductively active years was significantly related to fewer remaining teeth. CONCLUSION: Higher parity was related to greater tooth loss in Hausa women. Women with ≥5 children experienced more loss than lower parity age mates.

Associations between a history of sexual abuse and dental anxiety, caries experience and oral hygiene status among adolescents in sub-urban South West Nigeria.

INTRODUCTION: Sexual and oral health are important areas of focus for adolescent wellbeing. We assessed for the prevalence of sexual abuse among adolescents, oral health factors associated with this history, and investigated whether sexual abuse was a risk indicator for dental anxiety, caries experience and poor oral hygiene. METHODS: This was a cross-sectional study conducted between December 2018 and January 2019 among adolescents 10-19 years old in Ile-Ife, Nigeria. Survey data collected included respondents' age, sex, and socioeconomic status, oral health risk factors (dental anxiety, frequency of tooth brushing intake of refined carbohydrates in-between-meals, flossing, dental visits, smoking, alcohol intake, use of psychoactive substances), caries experience, oral hygiene status, history of sexual abuse, and sexual risk behaviors (age of sexual debut, history of transactional sex, last sexual act with or without condom, multiple sex partners). Regression models were constructed to determine the association between outcome variables (dental anxiety, presence of caries experience and poor oral hygiene) and explanatory variables (oral health risk factors and history of sexual abuse). RESULTS: The prevalence of sexual abuse in our cohort was 5.9%: 4.3% among males and 7.9% among females. A history of sexual abuse was associated with alcohol consumption (p = 0.009), cigarette smoking (p = 0.001), and a history of transactional sex (p = 0.01). High/severe dental anxiety was significantly associated with increased odds of a history of sexual abuse (AOR = 1.81; 95% CI 1.10, 2.98), but not with caries experience (AOR = 0.66; 95% CI 0.15, 2.97) nor poor oral hygiene (AOR = 1.68; 95% CI 0.95, 2.96). Dental anxiety was associated with increased odds of alcohol intake (AOR = 1.74; 95% CI 1.19, 2.56), twice daily tooth brushing (AOR = 1.48; 95% CI 1.01, 2.17) and daily consumption of refined carbohydrates in-between-meals (AOR = 2.01; 95% CI 1.60, 2.54). Caries experience was associated with increased odds of using psychoactive substances (AOR = 4.83; 95% CI 1.49, 15.62) and having low socioeconomic status (AOR = 0.40; 95% CI 0.18, 0.92). Poor oral hygiene was associated with increased odds of having middle socioeconomic status (AOR = 1.43; 95% CI 1.05, 1.93) and daily consumption of refined carbohydrates in-between-meals (AOR = 1.38; 95% CI 1.08, 1.78). CONCLUSION: Adolescents who are highly dentally anxious need to be screened for a history of sexual abuse to facilitate access to professional care and support.

Association between early childhood caries and malnutrition in a sub-urban population in Nigeria.

BACKGROUND: To determine the association between malnutrition and early childhood caries (ECC) in children resident in sub-urban, Nigeria. METHODS: This study was a subset of a larger cross-sectional study the data of which was generated through a household survey conducted in Ile-Ife, Nigeria. The study's explanatory variable was malnutrition (underweight, overweight, wasting and stunting) and the outcome variable was ECC. Poisson regression analysis was used to determine the association between ECC and malnutrition. Variables (sex, frequency of sugar consumption, maternal knowledge of oral hygiene, oral hygiene status) associated with ECC in the primary study were adjusted for to obtain the adjusted prevalence ratio (APR). RESULTS: Of the 370 children, 20 (5.41%) were underweight, 20 (5.41%) were overweight, 67 (18.11%) were wasting, 120 (32.43%) were stunted and 18 (4.86%) had ECC. Factors associated with ECC were being stunted, underweight, overweight and fair oral hygiene. The prevalence of ECC was lower in children who were stunted (APR: 0.14; 95% CI: 0.03-0.69; p = 0.02), almost seven times higher in children who were overweight (APR: 6.88; 95% CI: 1.83-25.85; p < 0.001), and predictively absent in children who were underweight (APR: 0; 95% CI: 0-0; p < 0.001) when compared with children who had normal weight. Non-significant risk indicators for ECC included consuming sugar between meals three times a day or more, having low socioeconomic status and being female. CONCLUSIONS: For this study population, the indicators of malnutrition - being stunted, underweight, overweight - and fair oral hygiene were risk indicators for ECC. The frequency of sugar consumption was not a significant risk indicator when malnutrition was included as an explanatory variable for ECC in the study population.

Impact of dental caries and its treatment on the quality of life of 12- to 15-year-old adolescents in Benin, Nigeria.

AIM: To assess the impact of caries and its treatment on quality of life (QoL) in 12- to 15-year-old children in Benin, Nigeria. DESIGN: This was a cross-sectional study involving 1790 children. Clinical examinations were conducted using the WHO criteria for diagnosis and coding of caries. The Decayed Missing Filled Teeth score of each child was calculated. The child Oral Impact on Daily Performance questionnaire was used to assess the QoL of children with caries pre- and post-treatment. Associations between age, sex, and socio-economic status and caries were analysed using bivariate and multivariate logistic regression analysis. RESULTS: The prevalence of caries in the study population was 21.9%. Approximately 57% of children with caries reported negative impact on their QoL pre-treatment. Eating (47.6%) was the most affected domain. The mean pre-treatment QoL score was 8.40 ± 10.34. Four weeks post-treatment, only 1.12% of participants reported negative impact of caries treatment on their QoL. The mean post-treatment QoL score was 0.22 ± 0.91 There was a significant difference between pre- and post-treatment QoL scores (P = 0.0001) with significant changes in all the eight domains studied. Age, sex, and socio-economic status had no significant impact on QoL pre- and post-treatment. CONCLUSIONS: Caries had a significant impact on the QoL of adolescents. Its treatment resulted in marked improvement in QoL.

Co-morbidities associated with molar-incisor hypomineralisation in 8 to 16 year old pupils in Ile-Ife, Nigeria.

BACKGROUND: This study aimed to identify the prevalence of oral co-morbidities in 8 to 16 years old children with Molar Incisor Hypomineralisation (MIH) and compare this with the prevalence of same oral lesions in children without MIH. METHOD: Study participants were selected through a multi-staged sampling technique. The children were asked if they had dentine hypersensitivity or any concerns about their aesthetics. Children were examined for MIH, caries, traumatic dental injury and their oral hygiene status. The association between MIH and each of the independent variables was determined. RESULTS: Only children with MIH had aesthetic related concerns and dentine hypersensitivity. The differences in the oral hygiene status (p < 0.001) and caries prevalence (p < 0.001) of children with and without MIH were statistically significant. The prevalence of traumatic dental injury did not differ statistically between children with MIH and those without MIH (p = 0.24). CONCLUSION: Children with MIH had more oral pathologies than children without MIH. These co-morbidities (dentine hypersensitivity, aesthetic concerns, caries and oral hygiene) are capable of impacting negatively on the quality of life of the children. Screening for children with MIH may help facilitate prompt access to treatment.

Prevalence, and early childhood caries risk indicators in preschool children in suburban Nigeria.

BACKGROUND: Early Childhood Caries (ECC) is defined as the presence of caries lesion in an primary tooth in children below the age of 71 months. It is a significant public health problem with consequences for the growth and development of affected children. The objective of this study was to determine the prevalence and ECC risk indicators in a suburban population in Nigeria. METHODS: The data of 497 children aged 6 months to 71 months who were recruited through a household survey conducted in Ile-Ife, Nigeria was analysed for prevalence of ECC and risk indicators. Information on children's ages, sex, socioeconomic status, tooth brushing habits, sugary snacks consumption, use of fluoridated toothpaste, birth rank, infant-feeding practices, breastfeeding practices, maternal age at childbirth, and maternal knowledge of oral health was obtained. Children's oral hygiene and caries status was also determined. Risk factors associated with ECC were determined using logistic regression analysis. RESULTS: Thirty-three (6.6%) children had ECC. Four (0.8%) had severe ECC. The four risk indicators for ECC were the child's gender, mothers' knowledge of oral health, consumption of sugary snacks in between meals more than three times a day, and the child's oral hygiene status. Females (PR: -0.06; 95% CI: -0.01- -0.01; p = 0.02), and children with mothers who had good knowledge of oral health (PR: -0.06; 95% CI: -0.11--0.008; p = 0.02) were less likely to have ECC. Children who consumed sugary snacks in between meals three times a day or more (PR: 0.05; CI: 0.003 - 0.01; P = 0.04) and children with fair oral hygiene (PR: 0.05; 95% CI: 0.005-0.10; p = 0.03) were more likely to have ECC. CONCLUSIONS: The prevalence of ECC in the study population was low. Promoting good oral hygiene practices and enhancing mothers' knowledge of oral health may help reduce further, the risk for ECC in the study population.

Brief communication: Emergence chronology of permanent teeth in Nigerian children.

This study measured the mean age, duration, and sequence of the emergence of permanent dentition in Nigerian children and compared the findings with other population groups. The cross-sectional study involved 1,078 Nigerian children, aged 4-16 years old, from selected primary and secondary schools in the Ife Central local government area in Ile-Ife, Osun State. In general, compared to boys, girls had an earlier mean age of emergence of all the permanent teeth. Children from high socioeconomic class had an earlier mean age of emergence for the maxillary incisors (6.43 and 7.58 years) and mandibular incisors (5.28 and 6.44 years) compared to children from middle and low socioeconomic classes, although socioeconomic effects were more mixed for premolars and molars. Compared to their counterparts in the USA, Australia, Belgium, and Iran, Nigerian children showed an earlier mean age of emergence of all the permanent teeth studied except for Pakistani boys, who had an earlier mean age of emergence of the maxillary premolars and second molar. Poorer economic status has been associated with delayed dental development; however, when compared to other populations, the Nigerian children in this study have earlier mean emergence ages than children from wealthier countries such as the USA and Australia.

The prevalence, pattern and clinical presentation of developmental dental hard-tissue anomalies in children with primary and mix dentition from Ile-Ife, Nigeria.

BACKGROUND: The study of dental anomalies is important because it generates information that is important for both the anthropological and clinical management of patients. The objective of this study is to determine the prevalence and pattern of presentation of dental hard-tissue developmental anomalies in the mix dentition of children residing in Ile-Ife, a suburban region of Nigeria. METHODS: Information on age, sex and socioeconomic status was collected from 1,036 children aged four months to 12 years through a household survey. Clinical examination was conducted to assess the presence of dental anomalies. Associations between age, sex, socioeconomic status, prevalence, and pattern of presentation of the developmental hard-tissue dental anomalies were determined. RESULT: Two hundred and seventy six (26.6%) children had dental anomalies. Of these, 23.8% had one anomaly, 2.5% had two anomalies, and 0.3% had more than two anomalies. Of the children with anomalies, 49.3%were male, 50.7%were female, and 47.8%, 28.6% and 23.6% were children from low, middle and high socioeconomic classes, respectively. More anomalies were seen in permanent than primary dentition. Anomalies of tooth structure were most prevalent (16.1%); anomalies which affect tooth number were least prevalent (1.3%). Dens evaginatus, peg-shaped lateral, macrodontia, and talon cusp were more prevalent in the permanent dentition, and dens evaginatus peg-shaped lateral and macrodontia were more prevalent in the maxilla. There were significantly more macrodontia anomalies in males and in children of high socioeconomic status. CONCLUSION: This large survey of dental hard-tissue anomalies found in the primary dentition and mixed dentition of children in Nigeria provides anthropological and clinical data that may aid the detection and management of dental problems of children in Nigeria.

Association between knowledge of caries preventive practices, preventive oral health habits of parents and children and caries experience in children resident in sub-urban Nigeria.

BACKGROUND: The objectives of this study were to assess the association between children and parents' knowledge of caries preventive practices, the parents' caries preventive oral health behaviours and children's caries preventive oral health behaviour and caries experience. METHOD: Three hundred and twenty four participants aged 8-12 years, 308 fathers and 318 mothers were recruited through a household survey conducted in Suburban Nigeria. A questionnaire was administered to generate information on fathers, mothers and children's knowledge of caries prevention measures and their oral health behaviour. Clinical examination was conducted on the children to determine their dmft/DMFT. Analysis was conducted to determine the predictors of the children's good oral health behaviour. RESULT: The mothers' oral health behaviours were significant predictors of the children's oral health behaviours. Children who had good knowledge of caries prevention measures had significant increased odds of brushing their teeth twice daily or more. The children's caries prevalence was 13.9%, the mean dmft was 0.2 and the mean DMFT was 0.09. None of the dependent variables could predict the presence of caries in children. CONCLUSION: The study highlights the effect of maternal oral health behaviour on the oral health behaviour of children aged 8 years to 12 years in suburban Nigeria. A pilot study is needed to evaluate how enhanced maternal preventive oral health practices can improve the oral health preventive practices of children.

Barriers to restorative care as perceived by dentists in Nigeria.

PURPOSE: To identify the barriers to restorative care as perceived by dentists working in urban and semi-urban dental hospitals in Nigeria. MATERIALS AND METHODS: The study was cross sectional and the sample consisted of 189 of 280 dentists who consented to, filled out and returned the questionnaire mailed to them. The questionnaire consisted of fifteen itemed statements and the respondents were asked to what extent they agreed or disagreed with each item on a four-point Likert scale; 'not at all', 'slight extent', 'some extent' and 'great extent'. Five barrier factors were extracted from the questionnaire. These were 'beliefs of patients', 'knowledge of patients', 'equipment/materials', 'attitude' and 'motivation of practitioner'. Two questions were not grouped with the barrier factors: 'dentistry is being looked down on by administration' and 'patients prefer extraction to filling'. RESULTS: The barrier factor 'attitude of patients' had the highest score (mean = 3.73), followed by the 'knowledge of patients' (mean = 3.27). The barrier factor 'belief of patients' had the lowest score (mean = 2.43). CONCLUSION: Within the limitations of the study, the barrier factor 'attitude of patients' was the most important barrier to restorative care as perceived by dentists working in urban and semi-urban regions of Nigeria.

Parity, dental caries and implications for maternal depletion syndrome in northern Nigerian Hausa women.

BACKGROUND: Female reproductive history, especially high parity, affects general health and may impact negatively on oral health. While parity has been positively linked to tooth loss, the specific association between parity and caries has not been adequately investigated. AIM: To determine the association between parity and caries in a population of higher parity women. Influences of likely confounders (age, socio-economic status, reproductive parameters, oral health practices and sugar consumption between meals) were considered. METHODS: This was a cross-sectional study involving 635 Hausa women of varying parity aged 13-80 years. Socio-demographic status, oral health practices and sugar consumption were obtained using a structured interviewer-administered questionnaire. All decayed, missing and filled teeth due to caries (excluding third molars) were noted, and tooth loss etiology was queried. Associations with caries were evaluated through correlation, ANOVA, post hoc analyses and Student's t tests. Effect sizes were considered for magnitude of differences. Multiple regression (binomial model) was used to investigate predictors of caries. RESULTS: Hausa women had a high prevalence of caries (41.4%) despite low sugar consumption; nonetheless the overall mean DMFT score was very low (1.23 ± 2.42). Older, higher parity women experienced more caries, as did those with longer reproductive spans. Additionally, poor oral hygiene, use of fluoride toothpaste and frequency of sugar consumption were significantly associated with caries. CONCLUSION: Higher parity (>6 children) was associated with higher DMFT scores. These results suggest that a form of maternal depletion, expressed as heightened caries susceptibility and subsequent tooth loss, occurs with higher parity.

Associations between maternal mental health, child dental anxiety, and oral health of 6- to 12-year-olds in Nigeria.

Maternal mental health affects their children's oral health. This study assessed the associations between maternal mental health and dental anxiety level, dental caries experience, oral hygiene, and gingival status among 6- to 12-year-old children in Nigeria. This was a cross-sectional study that recruited mother-child dyad participants through a household survey conducted in Ile-Ife, Nigeria. Data collected included the independent (maternal mental health risk, depressive symptoms, and child's dental anxiety), and dependent (caries experience, oral hygiene status, and gingival health status) variables. Multivariate logistic regression analysis was conducted to determine the associations between dependent and independent variables after adjusting for confounders (mothers' age, child's age, sex, and socioeconomic status). Statistical significance was set at p < 0.05. Of the 1411 mothers recruited, 1248 (88.4%) had low mental health risk, and 896 (63.5%) had mild depressive symptoms. As for the children, 53 (3.8%) had caries, 745 (52.8%) had moderate to high dental anxiety, 953 (63.0%) had gingivitis and 36 (2.6%) had poor oral hygiene. The maternal mental health risk was not significantly associated with the child's caries experience (AOR: 1.012; 95%CI: 0.860-1.190; p = 0.886), poor oral hygiene (AOR:1.037; 95%CI: 0.975-1.104; p=0.250), and moderate/severe gingivitis (AOR:0.887; 95%CI: 0.764-1.030; p = 0.115). Maternal depression status was not significantly associated with the child's caries experience (AOR: 0.910; 95%CI: 0.802-1.033; p = 0.145), poor oral hygiene (AOR: 1.016; 95%CI: 0.976-1.057; p = 0.439), and moderate/severe gingivitis (AOR: 0.963; 95%CI: 0.861-1.077; p = 0.509). Maternal mental health risk and depression do not seem to be risk factors for schoolchildren's oral health in Nigeria. Further studies are needed to understand these findings.

Differences in risk indicators associated with electronic cigarette use and tobacco smoking among adolescents and young people in Nigeria.

INTRODUCTION: The study determined the proportion of adolescents and young persons (AYP) in Nigeria who use e-cigarettes and smoke tobacco; and identified factors associated with the use of e-cigarettes and tobacco smoking. METHODS: AYP aged 11-23 years were recruited to participate in an online survey. The independent variables were respondents' health, HIV and COVID-19 status and their level of anxiety. The dependent variables were tobacco smoking and use of e-cigarettes. Binary logistic regression was used to determine the associations between the dependent and independent variables after adjusting for confounders (age, sex, educational level and vulnerability status). RESULTS: There were 2206 respondents of which 568 (19.8%) used e-cigarettes and 787 (27.4%) smoked tobacco. Individual (18-23 years, having a health condition, high anxiety and being vulnerable) and familial (having father, mother, siblings or friends who used e-cigarettes) factors were associated with both the use of e-cigarettes and tobacco smoking. Tobacco smoking was a significant risk indicator for e-cigarettes use and vice versa. COVID-19 infection (adjusted OR, AOR: 3.602) and living with HIV (AOR: 1.898) were associated with higher odds of using e-cigarettes. Males (AOR: 1.577), 15-17 years (AOR: 6.621) and moderate anxiety (AOR: 2.500) were associated with higher odds of tobacco smoking. AYP with health conditions had higher odds of using e-cigarettes (AOR: 1.514) while AYP with moderate anxiety had lower odds of using e-cigarettes (AOR: 0.627). CONCLUSION: The proportion of AYP in Nigeria who used e-cigarettes and smoked tobacco is high. Public health interventions that target the common risk factors for e-cigarettes use and tobacco smoking among AYP in Nigeria are urgently needed.

Differences in Oral Lesions Associated with Tobacco Smoking, E-Cigarette Use and COVID-19 Infection among Adolescents and Young People in Nigeria.

COVID-19 infection is associated with oral lesions which may be exacerbated by tobacco smoking or e-cigarette use. This study assessed the oral lesions associated with the use of e-cigarettes, tobacco smoking, and COVID-19 among adolescents and young people in Nigeria. A national survey recruited 11-23-year-old participants from the 36 States of Nigeria and the Federal Capital Territory, Abuja. Data were collected using Survey Monkey®. Binary logistic regression analysis was conducted. Statistical significance was set at p-value less than 0.05. There were 2870 participants, of which 386 (13.4%) were tobacco smokers, 167 (5.8%) e-cigarette users, and 401 (14.0%) were both e-cigarette and tobacco users; and 344 (12.0%) had ever tested positive to COVID-19. Adolescents and young people who smoked tobacco had more than twice the odds of reporting gingival inflammation, oral ulcers, dry mouth, and changes in taste than those who did not smoke. Those who used e-cigarettes had 1.5 times higher odds of reporting oral lesions. Respondents who had COVID-19 infection had higher odds of reporting gingival inflammation and lower odds of reporting dry mouth than those who did not have COVID-19 infection. These findings were significant, and may help clinicians to screen for tobacco use and COVID-19 among adolescents and young people in Nigeria.

A survey of teething beliefs and related practices among child healthcare workers in Ile-Ife, Nigeria.

PURPOSE: To determine the perceptions/beliefs and related practices of child healthcare workers regarding teething problems in Ile-Ife, Nigeria. MATERIALS AND METHODS: This cross-sectional study consisted of 103 out of 140 child healthcare workers at the Obafemi Awolowo University Teaching Hospitals Complex who responded to a structured self-administered questionnaire. The child healthcare workers comprised dentists, paediatricians, community health physicians, pharmacists and community health nurses. The data were analysed using STATA (Intercooled release 9) for Windows. RESULTS: A total of 77 (74.8%) child healthcare workers believed in systemic signs and symptoms of teething in children. A majority of the dentists (79.3%) and pharmacists (96.2%) believed in teething problems. None of them based their belief on evidence-based scientific principles, but instead on personal experience (36.4%), books (26%), local myths (20.8%) and school/workshop (16.8%). Fever (18.2%) and diarrhoea (15.6%) were the most prevalent symptoms and signs believed to be associated with teething. Fifty-seven of the child healthcare workers routinely prescribed various drugs for teething problems. The most prescribed drugs were paracetamol (70.2%), antibiotics (14.0%) and teething mixture (7.0%). CONCLUSIONS: Most child healthcare workers in the study believed in teething problems and the beliefs were not based on evidence. They also prescribed various drugs for teething problems.

Oral health practices and oral hygiene status as indicators of suicidal ideation among adolescents in Southwest Nigeria.

BACKGROUND: Oral health is a less-recognized correlate of overall and mental wellbeing. This study aimed to assess the relationship between suicidal behavior (ideation and attempt) and oral health practices and status, and to determine the effect of sex on these associations among Nigerian adolescents. METHODS: Household survey data were collected from 10 to 19-year-old adolescents in southwestern Nigeria. Dependent variables were daily tooth brushing, daily consumption of refined carbohydrates between meals, and oral hygiene status (measured by plaque index). The independent variable was lifetime suicidal ideation/attempt, dichotomized into 'yes' and 'never'. 'Daily tooth brushing' and 'daily consumption of refined carbohydrates between meals' were included in two separate logistic regression models, and 'oral hygiene status' was included in a linear regression model. The models were adjusted for sex, age, and socioeconomic status. The linear regression model was also adjusted for frequency of daily tooth-brushing and of consumption of refined carbohydrates between meals. Interactions between sex and suicidal ideation/suicide attempt in association with dependent variables were assessed. Significance was set at 5%. RESULTS: We recruited 1,472 participants with mean age (standard deviation) of 14.6 (2.6) years. The mean plaque index was 0.84 (0.56), and 66 (4.5%) adolescents reported ever having suicidal ideation/attempt. Suicidal ideation/attempt was associated with significantly lower likelihood of tooth brushing (OR = 0.48, 95% CI: 0.26, 0.91), higher likelihood of consuming refined carbohydrates between meals (OR = 2.30, 95% CI: 1.29, 4.10), and having poor oral hygiene (B = 0.18, 95% CI: 0.05, 0.32). Among males, suicidal ideation/attempt was associated with less likelihood of eating refined carbohydrates between meals (OR = 0.96, 95% CI: 0.35, 2.61). Conversely, it was associated with a significantly higher likelihood of this outcome (OR = 4.85, 95% CI: 2.23, 10.55) among females. CONCLUSION: The study findings suggest that poor tooth brushing habits and poor oral hygiene are indicators for risk of suicidal behavior for adolescents in Nigeria, while high sugar consumption may be an additional risk factor for adolescent females. These findings support the role of dental practitioners as members of healthcare teams responsible for screening, identifying and referring patients at risk for suicidal ideation/attempt.

Tooth loss among Nigerians treated in teaching hospitals: a national pilot study.

AIM: The aim of this study was to identify the causes and patterns of tooth loss among Nigerian adults. BACKGROUND: Tooth loss continues to be a major problem in clinical dentistry and has received significant attention in everyday dental practice. In Nigeria there is a discernible lack of current data that would explain the reasons and patterns of tooth loss from its different geopolitical zones. METHODS AND MATERIALS: The reasons for tooth extractions during a period of 12 months were obtained from the hospital records of teaching and specialist hospitals in Nigeria's six geopolitical zones and the Federal Capital Territory (FCT). Data were analyzed using Statistical Package for the Social Sciences for Windows (SPSS) version 9.0. RESULTS: A total of 4,204 teeth were extracted from 3,431 patients. Of these teeth 52.4 percent were lost due to dental caries while 30.2 percent were removed because of periodontal disease, 5.0 percent were missing as a result of trauma, and 3.9 percent were impacted and required extraction. The remaining 8.5 percent were extracted for a variety of reasons such as orthodontic treatment, overeruption, neoplasms, supernumerary teeth, attrition, a cystic lesion, and hypoplasia. Dental caries was the most common diagnosis given for tooth loss in the South-South (79 percent), South-East (68 percent), North-East (47 percent), North-West (69 percent), and North-Central (35 percent) zones followed by periodontal disease. In contrast, periodontal disease was the most common cause of tooth loss in the South-West zone (65 percent) and in the FCT (55 percent), followed by dental caries at 22 percent and 33 percent, respectively. CONCLUSION: Although teeth were extracted based on a variety of diagnoses, dental caries was identified as the common reason cited for tooth loss in Nigeria and to a lesser extent periodontal disease. Also different reasons were given for tooth loss among the various geographical zones. CLINICAL SIGNIFICANCE: Tooth loss among Nigerians was attributed largely to dental caries and secondarily to periodontal disease. Both conditions can be prevented if diagnosed early enough and treatment is instituted in a timely manner.

A proposed one-stop-shop approach for the delivery of integrated oral, mental, sexual and reproductive healthcare to adolescents in Nigeria.

The interconnectedness of oral, mental, sexual, and reproductive health (OMSRH) in adolescents prompts exploration of novel approaches to facilitate comprehensive access of this population to the relevant health services. This paper proposes an integrated one-stop-shop approach to increasing adolescents' access to OMSRH care by leveraging on dental clinics as a template for integration, using a non-stigmatized platform to deliver stigmatized healthcare. Novel healthcare delivery models are needed to enhance adolescents' access to the comprehensive prevention and treatment services that they critically need. Effective, integrated health care for this population is lacking, especially across various health areas. This is a proposal for leveraging dental clinics for integrated OMSRH care, using facility-based services, to adolescents. Emphasis will be placed on reducing stigma as a barrier to service accessibility, acceptability, equitability and appropriateness. Empirical studies will be required to test the feasibility, validity and effectiveness of this proposed model.