Dentine hypersensitivity and associated factors: a Nigerian cross-sectional study.

INTRODUCTION: Prevalence of dentine hypersensitivity (DH) may be on the increase as a result of changing lifestyles. This study aimed to assess the prevalence of DH and relative importance of associated factors in 18-35 year old Nigerians and compare to findings from a similar European study. METHODS: Following ethical approval, 1349 subjects from the six geopolitical zones in Nigeria participated in this cross sectional study. DH was clinically evaluated by cold air tooth stimulation, patient pain rating (yes/no) and investigator rated pain using the Schiff ordinal scale (0-3). Erosive tooth wear using the BEWE index was assessed. A questionnaire regarding the nature of the DH, erosive dietary intakes, tooth brushing habits and other factors was completed by patients. Bivariate analysis was conducted. RESULTS: 32.8% of patients reported pain on tooth stimulation and 32.9% scored ≥1 on Schiff scale for at least one tooth. Questionnaire reported sensitivity was 41.2%. There were statistically significant associations between Schiff score and clinically elicited DH (p < 0.001); and BEWE erosive tooth wear score and clinically elicited DH (p < 0.001). There were significant associations between DH and some oral hygiene practices such as brushing frequency, brush movement and brushing after breakfast. Fresh fruit and fruit/vegetable juice intake also showed significant association. CONCLUSION: The most important risk factors of DH for this population in Nigeria appear to be the frequency and characteristics of tooth brushing. This should be considered in its prevention and management.

Knowledge, diagnosis and management of dentine hypersensitivity: a national survey of dentists in Nigeria.

AIM: To assess the knowledge of Nigerian dentists regarding dentine hypersensitivity (DH) and their methods of diagnosis and management. METHODS: A cross-sectional questionnaire-based study of dentists practicing in all six geopolitical zones of Nigeria was conducted. The questionnaire focussed on participant's demography, exposure to patients with DH, knowledge-based questions, diagnosis and management of DH. Data analysis using EPI Info statistical software determined frequencies and proportions. Associations between discrete variables were assessed using the chi-square test (P ≤ 0.05). RESULTS: A total of 1,057 dentists responded; the majority (83.8%) had practiced for up to 15 years, and 92.0% reported that, on average, between one and 10 of their patients each week complained of DH. The majority (92.8%) of dentists described DH as stimulated brief pain from the tooth; 24.2% expressed that DH can be treated by altering the number of dentinal tubules. A diagnosis of DH is made by tapping (20.6%) or scratching (73.4%) the tooth. Although radical treatments, such as extraction (24.7%) and root canal therapy (34.5%), were mentioned by some, the majority identified aetiological and predisposing factors (98.8%) and provided diet (95.1%) and oral hygiene (95%) counselling as part of the management of DH. Evaluation of 36 knowledge-based questions revealed that only 1.8% of the respondents provided at least 25 correct answers. Knowledge was significantly associated with respondent age and number of years in practice (P ≤ 0.05) but was not associated with the number of patients with DH seen per week (P = 0.46). CONCLUSION: Dentists practicing in Nigeria exhibited knowledge gaps concerning DH and its diagnosis and management.

Comparison of pattern of failure of resin composite restorations in non-carious cervical lesions with and without occlusal wear facets.

OBJECTIVES: Many studies have reported the clinical problems associated with resin composite restorations in NCCLs. None has compared these clinical problems in NCCLs with and without occlusal wear facets. The present study sets out to determine the proportion of NCCLs that presents occlusal wear facets, and to compare the failure pattern of resin composite restorations in NCCLs with and without occlusal wear facets. METHODS: Teeth with NCCLs were classified into two groups, those with and without occlusal wear facets. Both groups were restored using micro hybrid resin composite. The restorations were evaluated at the end of 2 years concerning post-operative sensitivity, retention, marginal integrity, marginal discolouration, wear, and secondary caries, using the USPHS criteria. Statistical analysis compared the ratings of each criterion between the two groups using Pearson's χ(2) or Fisher's exact test. RESULTS: About one-third (33.8%) of teeth with NCCLs presented with occlusal wear facets, more NCCLs with occlusal wear facets in mandibular teeth (44.7%) than maxillary teeth (24.5%). Retention rate of composite resin restorations in NCCLs with and without occlusal wear facets was 63.9% and 74.4% respectively at the end of 2 years. More marginal discolouration and defects were observed in restorations in NCCLs with occlusal wear facets, the differences were not statistically significant (p>0.05). CONCLUSIONS: The decline in ratings of marginal discolouration and defects, and the lower retention rate of restorations in NCCLs with occlusal wear facets may support the role of occlusal stress and tooth flexure as a cause of failure of restorations in NCCLs. CLINICAL SIGNIFICANCE: The ability to distinguish between stress induced lesions (with occlusal wear facets) and other cervical lesions will have important ramifications for the success of their restorations because they are not subjected to the same physical forces that are responsible for the deterioration of the restoration.

Prevalence and causes of fractured permanent incisors in 12-year-old suburban Nigerian schoolchildren.

The aim of the study was to assess the prevalence and causes of traumatic dental injuries to the permanent dentition of 12-year-old school children in Ile-Ife, a suburban population in the south west of Nigeria. A dental trauma cross-sectional survey was carried out through clinical examination of upper and lower permanent incisors and interviews with 415 (212 boys, 203 girls) 12-year-old children attending private and public secondary schools in Ile-Ife, in 2004/2005 by one calibrated examiner. Garcia-Godoy's classification was used. The prevalence of traumatic dental injuries was 12.8%. There was no statistical difference in the prevalence between boys and girls P > 0.05. The most common cause of injuries was falls (49.1%), followed by traffic accidents (13.2%), collision against objects or people (11.3%) and misuse of teeth 9.4%. The commonest type of injury was enamel fracture alone (9.9%), followed by enamel-dentine fracture (4.8%). Majority of the accidents occurred at home (60.4%), followed by school (26.4%). The prevalence of traumatic dental injuries was on the increase among suburban Nigerian children in Ile-Ife and it has a potential to be considered an emerging public health problem.

Failures related to crowns and fixed partial dentures fabricated in a Nigerian dental school.

The purpose of this investigation was to document the failure rate and length of service of crowns and fixed partial dentures (FPDs) fabricated in a Nigerian dental school. The reasons for failure of the initial restorations and their length of service were also ascertained. Also, the numbers of retainers, pontics, and the types of restoration were recorded. Poor esthetics was the most frequent cause of failure, 66 units (40.5%); followed by fracture, 58 units (35.6%); and dental caries, 25 units (15.4%). These outcomes were contrary to findings previously reported in studies from western countries where dental caries was principally responsible for failures (22.0% to 38.0% of cases). The resin-retained FPDs had the shortest mean years of service at 2.7 years, while the three-unit metal-ceramic FPDs had the greatest longevity at 8.6 years. The overall mean years of service for replaced restorations were 5.6 years. The study found a decrease in the mean years of service as the number of units in the fixed-fixed partial dentures increased. This is in sharp contrast to previous reports where no relationship existed between length of service and the number of units in a FPD.