Randomized controlled trial on the effectiveness of silver diamine fluoride in arresting caries in Lagos, Nigeria

Treatment of dental caries in children still remains challenging due to lack of cooperation with conventional treatment modalities. Recently, the use of Silver Diamine Fluoride (SDF) has proved useful in addressing this challenge. Aim: This clinical trial aimed to evaluate the effectiveness of Silver Diamine Fluoride (SDF) in arresting caries in children in Lagos, Nigeria. Methods: This was a phase III balanced randomized controlled school based interventional study on 240 children. The study group was treated with SDF while GIC was used in the control group. Follow up visits in 2 weeks, 1 month, and 3 months were carried out to assess the treatment outcome. Inferential statistics with the use of Pearson Chi-square test and Independent Student t-test were used at 5% level of significance. Results: There was significant relationship between SDF and caries arrest in 2 weeks, 1 month and 3 months' assessment period (p = 0.001). The control group showed continuous decline (71.7%, 54.3% and 50.9%) in restorative success from 2 weeks to 3 months respectively. The mean ± SD and Confidence Interval (CI) of arrested caries in the SDF group were 113± 1.24 and 113.1 ­ 113.5 respectively. In the control group the mean ± SD and CI of restorative success were 69.3±11.8 and 67.2 ­ 71.4. The effect size was 5.24. Conclusion: The result of the study showed that SDF was effective in arresting caries in children without any harm and there was statistically significant difference in the use of 38% SDF in arresting caries in children

Can oral health-related quality of life be worsened by dental appointments?

BACKGROUND: Constraints in dental access and limitations associated with service delivery necessitate the use of an appointment system in patient care. This research aimed to identify association between treatment appointments and oral health-related quality of life (OHRQOL) in dental patients at the Lagos State University Teaching Hospital. MATERIALS AND METHODS: This was a descriptive study that surveyed 412 individuals. Socio-demographic, clinical history, and OHRQOL data was collected using a structured interviewer administered questionnaire. Visual analog scale (VAS) was used to assess inconvenience while the oral health impact profile-14 was used for OHRQOL assessment at baseline and at review. Data entry and analysis was done using SPSS while ANOVA and Chi-square tests were used to determined significant association. P < 0.05 was considered significant. RESULTS: Most (175; 45.2%) dental appointments were within a month although 59 (15.2%) individuals had to wait for more than 6 months. Using VAS, 87 (22.5%) individuals were moderately inconvenienced while 68 (17.6%) were extremely inconvenienced. At baseline, the most commonly reported oral health quality of life impacts were within the dimensions "physical pain" and "psychological discomfort." At review, there was increase in OHRQOL scores in the subdomains of pain (2.27 ± 1.80), self-consciousness (1.67 ± 1.15), discomfort on chewing (1.61 ± 1.13), and pronouncing words (1.49 ± 2.21). The highest mean impact score (2.27 ± 1.80) was observed in the subdomain of painful aching in the mouth. CONCLUSION: Dental appointments appear to result in worse OHRQOL. Since the appointment systems in public oral health facilities may have a direct bearing on OHRQOL of patients, quality control standards on dental appointments should be established and enforced.

Use of teachers as agents of oral health education: Intervention study among public secondary school pupils in Lagos.

BACKGROUND: Common oral diseases are preventable and if detected early are reversible and schools provide a setting in which the oral health behavior of pupils can be influenced. We aimed to assess the effectiveness of using teachers in place of oral health professionals to deliver oral health education (OHE) in public secondary schools in Lagos State. METHODS: This quasi-experimental study was conducted in four phases from September 2016-April 2017. A multistage sampling method was adopted to enlist the research participants from four enlisted schools, which were randomly assigned into two groups. Trained dentists delivered OHE in the first group of schools while trained teachers did in the second group and the impact of the intervention was assessed over six months. P values for significant differences were set at 0.05. RESULTS: At the 3 months evaluation, the mean oral health knowledge (OHK) scores were higher among pupils in the Teachers Intervention Schools (TIS) (71.3 ± 19.3) than that in the Dentist Intervention Schools (DIS) (61.3 ± 17.7) (P = 0.023). Subsequent evaluation sessions from baseline revealed a gradual increase in the proportion of pupils with positive oral health attitude scores; with a higher proportion of pupils in the DIS (34.5%) compared to the TIS (34.0%) at 6 months assessment time. At 6 months evaluation, the proportion of pupils with poor oral health practices decreased in both groups of schools (P = 0.104). CONCLUSION: The proportion of pupils with good OHK was higher in the TIS at post-intervention periods; this difference was statistically significant at 3 months. This result suggests that teachers are as effective as dentists in delivering OHE.

Association between dental caries, odontogenic infections, oral hygiene status and anthropometric measurements of children in Lagos, Nigeria

Dental caries is a significant public health problem afflicting about a third of the world's population which impacts nutrition, quality of life and systemic health. Aim: We explored associations between dental caries, odontogenic infections, oral hygiene and anthropometric measurements of children in Lagos, Nigeria. Methods: A pretested validated questionnaire was administered on 278 children who also received anthropometric assessment and dental examinations. Caries was scored according to WHO criteria and untreated dental caries by the Pulpal Exposure, Ulceration, Fistula, Abcess (PUFA/pufa) index. The weight for age (WAZ), height for age (HAZ), and weight for height (WHZ) parameters evaluated nutritional status. Categorical and continuous data were analysed by χ2-test and ANOVA. Regression analysis was done and statistical significance set at p ≤ 0.05. Results: The prevalence of Decayed, Missing, and Filled Teeth (DMFT + dmft) > 0 was 220 (79.1%) and the proportion of d+D teeth in dmft+DMFT index was 194 (70.0%). The prevalence of odontogenic infections due to caries (PUFA + pufa > 0) was 172 (61.8%). 74 (26.6%) children were stunted; 12 (4.3%) were underweight while 30 (10.8%) were wasted. Children with PUFA + pufa > 1 had increased risk of wasting (OR: 2.45; 95% CI: 1.16-4.88). Children with DMFT+dmft >5 were also significantly underweight with odds ratios of 2.34 (95% CI 1.04-4.33). Conclusions: There was significant association between untreated dental caries, odontogenic infections and stunting, wasting and being underweight among the children studied. Policy makers should be aware of the additional burden that oral neglect has on anthropometric indices