A Community Survey on Association of Sociodemographic Characteristics with Risk Perception and Awareness about Oral Cancer in Lagos, Nigeria

ABSTRACT Objective: To assess the level of oral cancer awareness and risk factors perception and the relationship between this awareness and the sociodemographic and behavioral characteristics. Material and Methods: This descriptive study was conducted among rural and urban residents in Lagos State, Nigeria. A multi-stage random sampling method was utilized. The sociodemographic and behavioral characteristics of respondents, as well as their knowledge about oral cancer risk factors, were assessed with a validated questionnaire. The bivariate association was done using an independent t-test and one-way ANOVA. Multivariate regression was used to determine the association between predictor variables and oral cancer knowledge scores. The statistical significance level is set at p<0.05. Results: 590 participants between 18 and 82 years (mean age 34.5 ±13.7) completed the survey. The prevalence of cigarette smoking was 25.7%, of which 16 (1.5%) were heavy smokers (20+ cigarettes per day). The prevalence of alcohol consumption was 66.1%, with 57 (9.7%) being heavy drinkers, consuming drinks for 5-7 days of the week. A high proportion of the respondents (>60%) exhibited gaps in their knowledge of oral cancer. Uneducated participants had lower oral cancer knowledge than those with >12 years of formal education (aOR = 5.347; 95% CI: 4.987-6.240). Participants who were smokers had lower oral cancer knowledge compared with non-smokers (aOR = 3.341; 95% CI: 2.147-4.783); Participants who consumed alcohol had more deficient oral cancer knowledge compared with non-drinkers (aOR = 1.699; 95% CI: 1.087-2.655); While heavy smokers aOR = 4.023; 95% CI: 3.615-4.825) and heavy drinkers aOR = 4.331; 95% CI: 3.158-5.939) had lower oral cancer knowledge compared with those who did not abuse both substances. Conclusion: A high proportion of the respondents exhibited gaps in their knowledge of oral cancer in their responses. Delayed diagnosis of oral cancer can be reduced by increasing the awareness and knowledge of the populace about risk factors and also in the recognition of its signs and symptoms.

Adolescents' exposure to secondhand smoke and its association with susceptibility to smoking and mental health in Lagos, Nigeria.

Introduction: this study assessed the relationship between exposure to secondhand smoking (SHS) and its association with self-reported anxiety, depression and susceptibility to smoking among adolescents in Lagos, Nigeria. Methods: depression among study subjects was determined using the Patient Health Questionnaire-9 (PHQ-9) while the Generalized Anxiety Disorder - 7 (GAD-7) was used to determine anxiety levels. Susceptibility to smoking cigarettes was also determined while the Statistical Package for the Social Science (SPSS) 26.0 software was used for data analysis. Significant associations were determined at P-values <0.05. Results: of the 300 adolescents surveyed (mean age 12.9±1.43), 7.6 % were regularly exposed to SHS, of which 3.0% were daily exposed to SHS indoors. In multivariable analyses, indoor SHS exposure for ≥ 1 hour daily was associated with increased odds for susceptibility to smoking (AOR=3.793; 95%-CI: 0.98-14.60; p= 0.052) and increased odds for depression (AOR=1.303; 95%-CI: 0.84-2.01; p= 0.228) and slightly reduced odds for anxiety (AOR=0.952; 95%-CI: 0.62-1.47; p=0.822). Conclusion: secondhand smoking exposure was associated with higher odds of susceptibility to smoking cigarettes and depression among adolescents exposed to SHS, especially among females living in cramped accommodations. Further validation of these findings should however be determined by cohort study designs.

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

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.

Impact of severity of malocclusion and self-perceived smile and dental aesthetics on self-esteem among adolescents.

BACKGROUND: The psychological impact of malocclusion, social acceptance, self-esteem, and the development of personality traits are considerations that can affect the demand for orthodontic treatment. The aim of this study was to assess the effect of malocclusion severity and self-perceived smile and dental aesthetics on self-esteem among adolescents in Lagos, Nigeria. METHODS: This analytical cross-sectional study was performed among 393 adolescents (210 females and 183 males) at a university teaching hospital in Nigeria. The need for orthodontic treatment was assessed using the Dental Aesthetic Index, whereas self-esteem was measured using the Rosenberg Self-Esteem Scale. Smile analysis was performed on photographs of posed smiles, whereas photographs of posed smiles and intraoral frontal view with teeth in centric occlusion were rated with the Visual Analog Scale for self-perception of smile and dental aesthetics. A comparison of variables among self-esteem groups was made using the ANOVA and Tukey post hoc tests, whereas an association among all variables was examined using the correlation coefficient. Stepwise regression analysis examined the effects of independent variables on self-esteem. RESULTS: A significant correlation was found between self-esteem and self-perceived smile (r = 0.294; P < 0.001) and dental aesthetics (r = 0.212; P < 0.001). Adolescents with high self-perceived smile (mean ± standard deviation, 7.66 ± 2.20) and dental aesthetics (6.68 ± 2.58) had higher self-esteem than participants with low self-perceived smile (4.75 ± 2.73) and dental aesthetics (4.36 ± 2.29). Self-perceived smile aesthetics had the most predictive impact on self-esteem. CONCLUSIONS: The results showed that self-perception of smile and dental aesthetics is a significant factor that influences self-esteem among adolescents.

Pattern and prevalence of dental anomalies among a paediatric population in Lagos, Nigeria.

Background: Dental anomalies are craniofacial abnormalities in the size, structure or number of the teeth. This study was conducted to assess the prevalence of dental anomalies among children aged 0-16 years attending the Paediatric Dental Clinic at the Lagos University Teaching Hospital, Lagos, Nigeria. Methods: A cross-sectional design was used and data were obtained from the dental records of the Dental Clinic from January 2014 to August 2019 by two calibrated examiners, who are co-authors of the manuscript. To test for statistical differences, Chi-squared test was utilised for the categorical variables. The prevalence of the different dental anomalies was estimated and presented with frequencies. P < 0.05 was considered statistically significant. Results: Among the 6175 patients' dental records reviewed, 50.85% (n = 3150) were male and the highest proportion of 45.4% (n = 2807) were aged between 6 and 10 years, with a mean age of 8.62 ± 3.85 years. A total of 1090 (17.52%) had dental anomalies; 465 (7.53) anomalies were in the maxilla, 263 (4.6) were in the mandible while 360 (5.83) were in both. The most common anomaly was hypoplasia 550 (9.06%), followed by retained primary tooth 546 (8.84%) and hypodontia 84 (1.36%). Dentinogenesis imperfecta 1 (0.02) and transposition 1 (0.02) were the least prevalent anomalies. Retained primary teeth (5.8%) and the cusp of Carabelli (0.4%) were slightly more prevalent among males. However, females had a higher prevalence of natal/neonatal teeth (0.4%), fusion/germination (0.4%), hypodontia (1.5%) and peg-shaped lateral incisors (0.9%). Conclusion: Dental anomalies' prevalence in this study was 17.52%, with a higher occurrence of anomalies in the maxilla. Hypoplasia was the most prevalent anomaly, after which was retained primary tooth, then hypodontia. Prompt diagnosis and preventive interventions are crucial for the appropriate management of these dental anomalies.

Salivary Cortisol as a Stress Monitor During Third Molar Surgery.

Background: Procedures in oral surgery, especially surgical extraction of the impacted mandibular third molar is often considered anxiety-producing and stressful. This study evaluated the effect of oral sedation (5 mg diazepam) on the physiological stress level in subjects that underwent surgical extraction of the mandibular third molar by measuring the change in salivary cortisol concentration. Subjects and methods: 204 salivary samples were collected from 102 subjects between 9.00 am and 12.00 pm to standardise the diurnal variations of cortisol secretion. Saliva samples were collected 45 min before and 15 min after surgical extraction from each subject in either group. The samples were stored in the freezer (- 20 °C) until analysis was done in the laboratory using salivary cortisol ELISA kits (DiaMetra S.r.l., Eagle Biosciences, Italy), and the cortisol concentration was measured with a microplate reader. Results: There was a statistically significant change (p = <0.001 between the pre-surgical extraction salivary cortisol concentration of all subjects with a median of 7 ng/ml and post-surgical extraction salivary cortisol concentration of both the study and the control groups with a median of 17 ng/ml and 15 ng/ml, respectively. Only 11.8% of subjects in the study group had a reduction in post-surgical salivary cortisol concentration, while in the control group, 3.9% of subjects had a reduction in post-surgical salivary cortisol concentration. There was no statistically significant difference between the two groups (p = 0.135). Conclusions: Hence, oral sedation has no significant impact on physiological stress during the surgical extraction of the mandibular third molar. However, salivary cortisol concentration can adequately reflect the stress induced by surgical extraction in subjects and its usefulness as a biomarker in stress research. Furthermore, the type of disimpaction of mandibular third molar affects salivary cortisol concentration, with distoangular disimpaction having the highest cortisol concentration and more stressful to subjects when compared to other types of disimpaction.

Patients' Management Patterns for Restorative Treatment Procedures: A 4-Year Overview at the Restorative Clinic of a Tertiary Hospital in Nigeria

Abstract Objective: To determine the patients' management pattern for restorative treatment procedures at the Restorative Dentistry Clinic at the Lagos State University Teaching Hospital (LASUTH). Material and Methods: A descriptive and retrospective study design was employed to determine patients' management patterns for the restorative treatment procedures at the Restorative Dentistry Clinic at LASUTH. Treatment records of patients who attended the Restorative Clinic at the Lagos State University Hospital, Ikeja, Lagos, Nigeria, from 2011 to 2014 were reviewed; the effective treatments during the period under review were recorded as treatment procedures and were recorded as operative, endodontic, fixed prosthodontics, and removable procedures. Results: A total of 14,437 (75%) operative; 1,353 (7.0%) endodontic; and 559 (2.9%) fixed prosthodontics and 2,852 (14.9%) removable prosthodontic procedures were carried out during the period under review. This study showed that operative procedures were the most performed restorative procedures, whereas removable prosthodontics and endodontic procedures ranked second and third, respectively, to operative procedures. Fixed prosthodontics procedures were the least performed restorative procedures. Conclusion: This study showed that more efforts were being expended by dentists on operative services compared to endodontic, removable, and fixed prosthodontics services combined. Comprehensive studies, embracing all disciplines of dentistry, should be carried out to determine the level of demand and clinical relevance of procedures in clinical dental practice and hence to set specific and general objectives of dental education for the populace. Access to dental health Insurance services should also be increased in the country.

Self-Reported Periodontal Disease and its Association with Dental Anxiety in Lagos, Nigeria

ABSTRACT Objective To determine the relationship between dental anxiety and self-reported periodontal status. Material and Methods The study was conducted among 263 patients at the Family Medicine Clinic of the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria. Self-assessed gingival and periodontal disease was measured using the validated periodontal disease self-report surveillance questionnaire. The Modified Dental Anxiety Scale (MDAS) was used for evaluating dental anxiety. Student's t-test was used to test for association between categorical variables. P-value < 0.05 was considered to be statistically significant. Results Seventy-seven (29.3%) participants had high dental anxiety, while 49 (18.6%) had very high dental anxiety. The prevalence of periodontal disease was higher among those with very high dental anxiety (77.6%), while female respondents had a significantly higher proportion of self-reported periodontitis (34.1%). There was a significantly higher prevalence of very high dental anxiety among respondents who had never visited the dentist (23.2%). Similarly, females (19.4%), middle-class respondents (30.8%), and those with a primary level of school education (23.5%) had a higher prevalence of high dental anxiety, even though the association was not significant. Conclusion The prevalence of self-reported periodontal disease among the respondents with very high dental anxiety was higher than in those with high dental anxiety and those without dental anxiety, but the difference was not significant.

A community survey on maternal perception about the initiation of dental home for infants in Lagos, Nigeria.

INTRODUCTION: because efforts directed toward oral health promotion and disease prevention are fundamentally superior to dental rehabilitation after disease development, early preventive dental visits are widely encouraged by dental professional and academic stakeholders. Aim: this study aimed to determine the perceptions and practices of mothers with regards to the establishment of dental home at four local government areas (LGAs) in Lagos, Nigeria. METHODS: was a community-based descriptive household survey conducted amongst mothers in Alimosho, Ikorodu, Surulere and Epe LGAs of Lagos State. Socio-demographic data, information about the importance of primary teeth, knowledge about dental home as well as their child´s age at first dental visit and reasons for attending was obtained with a validated, structured interviewer administered questionnaire. Descriptive statistics, Chi-square and multivariable regression analysis were conducted, and the level of significance was set at P<0.05. RESULTS: the highest proportion of the mothers were aged between 26-30 years (27.4%; mean age: 34.58±7.8 years) and had a tertiary level of education (n=206, 59.9%); most respondents (n=80, 51.4%) did not know the age a child should be taken to the dental clinic for the first time and had not taken their child for any dental visit (n=229, 65.4%). Out of those who had previously taken their child for dental visits, the greater proportion (n=115, 95.0%) took the child when he/she was older than one year of age. Overall, only 126 (36.0%) respondents had a good perception about oral health and the need for a dental home while 224 (64.0%) respondents had poor knowledge. Logistic regression analysis of predictor variables that showed mothers with a tertiary level of education (OR=0.108; CI=0.0023-0.495) and those with 2-3 children (OR=0.482; CI=0.253-0.920) had significant lower odds of poor perception about the importance of a dental home. CONCLUSION: maternal knowledge and practices with regards to dental home were poor and inadequate. It is necessary to create more awareness among parents/caregivers, especially through antenatal and immunization clinics to establish the concept of dental home.

Electronic cigarette use among adolescents and young adults in Nigeria: Prevalence, associated factors and patterns of use.

BACKGROUND: Electronic cigarettes (e-cigarettes) have emerged in the Nigerian market, and if used without supervision, may have damaging effects on the physical and mental health of users. Therefore, there is a need to determine the patterns of use, especially among adolescents and young adults. This study aims to assess the prevalence and factors associated with electronic cigarette use, as well as the relationship between their use and anxiety among adolescents and young adults in Lagos, Nigeria. METHOD: An online cross-sectional study among participants aged between 15-35 years. The survey had three sections: sociodemographic information, the pattern of e-cigarette use, and a 7-item Generalized Anxiety Disorder (GAD-7) scale. Bivariate and multivariable logistic regression analysis was used to identify factors associated with e-cigarette use. P-values <0.05 were considered significant. Statistical analysis was done using STATA-15.0 software. RESULTS: Data from a total of 949 respondents was analysed. Participants had a mean age of 23.36 years (±3.97) and were predominantly female (55.64%). The prevalence of e-cigarette ever-use was 7.9% (95% CI: 5.8,10.0). Older age and being male were independently associated with higher odds of e-cigarette use. After adjusting for age and sex, alcohol use (p<0.001), friend's use (p<0.001), and other tobacco product or substance use (p:0.05) remained significantly associated with higher odds of e-cigarette use. There was no association between anxiety levels and e-cigarette use. CONCLUSION: These findings suggest a higher likelihood of e-cigarette use among alcohol consumers, poly-tobacco or substance users and individuals with friends who use e-cigarettes. Health providers and policy makers in Nigeria might consider preventive measures aimed at young adults with the identified risk factors, as well as close monitoring of trends in e-cigarette use in the coming years.

Association between anxiety, alcohol, poly-tobacco use and waterpipe smoking: A cross-sectional study in Lagos, Nigeria.

BACKGROUND: Waterpipe smoking (WPS) has been reported to have a wide range of damaging health effects on pulmonary and cardiovascular systems. Studies suggest that waterpipe tobacco smoking is associated with reduced harm perceptions, mental health problems and the use of psychoactive substances. We investigate the patterns of use and the association of WPS with anxiety, poly-tobacco and alcohol use in Lagos, Nigeria. MATERIALS AND METHODS: A cross-sectional study design was used to assess the data from 818 adolescents and adults in Lagos State, Nigeria. An online questionnaire obtained demographic information, waterpipe, e-cigarette, alcohol and other tobacco product use from respondents. Anxiety was assessed using the validated Generalised Anxiety Disorder 7-point scale. Bivariate and multivariate logistic regression analysis was used to identify the factors associated with waterpipe ever-use. P < 0.05 was considered statistically significant. RESULTS: The mean (standard deviation) age of respondents was 23.43 (±3.96), over half were female (55.2%) and a majority had a college diploma or more (88.59%). Among study participants, 18.58% reported waterpipe ever-use. Among ever waterpipe users, 17.33% reported current use (past 30-days), with a majority having smoked waterpipe in a bar or pub. Alcohol use (P < 0.001), e-cigarette ever-use (P: 0.010) and poly-tobacco ever-use (P: 0.030) were significantly associated with higher odds of waterpipe use in the multivariate regression model. Further, there was a lower likelihood of waterpipe ever-use in the bivariate regression model among respondents with mild and moderate to severe anxiety levels than those with normal anxiety levels (P: 0.030); however, this association was no longer significant in the adjusted model. CONCLUSIONS: Our findings suggest a relatively high prevalence of WPS in Lagos, Nigeria. Concurrent alcohol consumption, e-cigarette and poly-tobacco use are associated with WPS, and most waterpipe smokers have normal anxiety levels. The Nigerian Government should consider surveillance measures for WPS and a more comprehensive smoke-free policy.

Replication of GWAS significant loci in a sub-Saharan African Cohort with early childhood caries: a pilot study.

BACKGROUND: Early childhood caries (ECC) is a rapidly progressing form of dental infection and a significant public health problem, especially among socially and economically disadvantaged populations. This study aimed to assess the risk factors for ECC among a cohort of Sub-Saharan African children and to determine the role of genetics in the etiology of ECC. METHODS: A sample of 691 children (338 with ECC, 353 without ECC, age < 6 years) was recruited from schools in Lagos, Nigeria. Socio-demographic, dental services utilization and infant dietary data were obtained with interviewer-administered questionnaire. Oral examination was conducted using the WHO oral health diagnostic criteria. Saliva samples were collected from the children for genetic analysis. Single nucleotide polymorphisms were selected from previous study for genotyping. Genetic association analyses to investigate the role of genetics in the etiology of ECC was done. Bivariate comparisons and Multivariate logistic regression analyses were conducted to assess associations between ECC and predictor variables, p < 0.05. RESULTS: Of the 338 children with ECC, 64 (18.9%) had Severe-Early Childhood Caries (S-ECC). Children aged 48-59 months comprised the highest proportion of subjects with ECC (165; 48.8%) and S-ECC (24; 37.5%) while female subjects had higher dt (3.13 ± 2.56) and dmft values 3.27 ± 2.64. ECC was significantly more prevalent among children who were breastfed at night ≥ 12 months (OR 3.30; CI 0.39, 4.75), those with no previous dental visit (OR 1.71; CI 0.24, 2.77), those who used sweetened pacifiers (OR 1.85; CI 0.91, 3.79) and those who daily consumed sugar-sweetened drinks/snacks (OR 1.35; CI 0.09, 18.51). A suggestive increased risk for ECC (OR 1.26, p = 0. 0.0397) was observed for the genetic variant rs11239282 on chromosome 10. We also observed a suggestive reduced risk for ECC (OR 0.80, p = 0.03) for the rs131777 on chromosome 22. None of the genetic variants were significant after correction for multiple testing (Bonferroni p value p = 0.004). CONCLUSIONS: Prolonged night-time breastfeeding, poor utilization of dental services and daily consumption of sugar were risk factors for ECC. Larger sample size is needed to confirm the results of the genetic analysis and to conduct genome wide studies in order to discover new risk loci for ECC.

Awareness and Preferred Mode of Getting Information on First Aid Management of Avulsed Permanent Teeth: Survey of Nigerian Mothers

ABSTRACT Objective: To determine the awareness and sources of information on first aid management of avulsed permanent teeth in a group of South-western Nigerian mothers. Material and Methods: An 18-item interviewer-administered questionnaire was used to survey 385 mothers attending the antenatal and immunization clinics on their perception towards dental avulsion, its management, sources, and preferred mode of receiving information on first aid. The effect of all significant factors was inferred at p<0.05. Results: Mothers who had previous information on the first aid management of dental avulsion had significantly higher knowledge (p=0.000). Majority (80.8%) of the mothers did not know that an avulsed permanent tooth could be replanted, though mothers whose children had not experienced dental trauma had significantly higher knowledge (p=0.003). The knowledge of first aid management of avulsed permanent tooth was low, regardless of age, education and employment status of the respondents. Conclusion: There was low knowledge among mothers regarding the first aid measures in the management of avulsed permanent teeth. Their main preference for receiving information was through social media and television. There is a need to increase oral health educational campaigns targeted towards mothers.

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.

Advancing oral health policy for mandatory dental screening before admission into public primary and secondary schools in Lagos, Nigeria.

BACKGROUND: The oral health of children is a significant public health issue that considerably affects nutritional intake, growth and development, daily learning activities, sleep pattern, self-esteem, and quality of life. In Nigeria, limited progress has been made in reducing the prevalence and burden of oral health problems such as dental caries, Noma, and oral cancer due to absence of national data, inadequate budgetary allocation, dearth of personnel, poor policy framework/implementation, and challenges of care access. Lagos state has a large, diverse population, hampered by illiteracy and poverty, and school-based dental screening is a strategy that can potentially reduce the prevalence of oral diseases among a vulnerable population in resource-poor settings. This document proposes secondary prevention through screening for a significant proportion of children in Lagos State and will be a veritable source of Data for oral Health planning. PROPOSED INTERVENTIONS: A draft policy document is proposed for the Ministry of health for legislation mandating a low-cost comprehensive oral health examination to screen every child admitted into Primary or Secondary School in any of the State Government-owned Schools in Lagos State. Each child will receive an oral health education leaflet and a duplicated annual dental screening form in addition to all the other requirements he will provide before being cleared for resumption when the academic year commences. The parents of the child will then be expected to present the form at any of the Lagos State-owned General hospitals for dental screening. The children will receive expedited attention and will not be kept waiting unnecessarily before being attended to. Students who have any form of dental disease will however be required to open a dental card at the clinic and have their treatments done as soon as possible. Except the dental treatment is found to be very expensive, the parents would be firmly encouraged to have the treatment done before the academic year commences and the form can be filled and signed. The school authorities would be notified if the parents cannot bear the cost and the ministry of health would be duly informed. Once the child is examined and found to be free of dental disease, the form can be filled and signed by the attending dental practitioner and duly stamped. A duplicate would be retained in a dedicated file in the dental clinic while the main form will be returned to the school. The schools will keep the forms in a dedicated file and at the end of each admission cycle, a report on the oral health status of the children for each school must be submitted to the Ministries of Education and Health. The preferred format for submission should be an excel spreadsheet containing the biodata and the summary of dental findings and treatment provided as applicable for each child. EVALUATION: Short and long term evaluation will be done to assess coverage rate, the number of dental diseases identified, number of treatments done, the satisfaction of parents and children with the services while the cost-benefit analysis of the services will be determined using a combination of qualitative and quantitative methods. The results of these analyses will be utilized to justify further government commitment of resources to this program. CONCLUSION: Strategies to reduce the burden of disease in developing countries must focus on policy design/implementation and preventive interventions. This proposed policy can help to decrease or eliminate barriers to access. It can also increase the number of children who will receive both preventive and curative oral care and also improve their knowledge of oral health.

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