Compound Odontoma of the Anterior Maxilla Associated with Displaced Lateral Incisor: A Case Report.

INTRODUCTION: Odontomas are the most common odontogenic tumors worldwide and are usually chance findings seen on routine dental examinations. However, on progression, they may be associated with adjacent tooth displacement. CASE DESCRIPTION: We report a case of an 11-year-old girl who presented at the Lagos University Teaching Hospital (LUTH) pediatric dental clinic with a complaint of painless enlargement of the left anterior maxilla of 2-years duration. The swelling was located between teeth 21 and 22 and was associated with distal displacement and mesial angulation of tooth 22. Clinical, radiographic and histopathologic investigations revealed a compound odontoma. Surgical exposure and enucleation was done to remove the tumor. The patient's postoperative course and 6 months follow-up were uneventful. CONCLUSION: This report elucidates the importance of routine dental check-ups and minimally traumatic management of odontomas in pediatric dental patients to prevent adverse effects of odontomas, thereby, minimizing the interventions needed after surgical enucleation.

INTRODUCTION: Les odontomes sont les tumeurs odontogènes les plus courantes dans le monde et sont habituellement des découvertes fortuites observées lors des examens dentaires de routine. Cependant, lors de leur progression, ils peuvent être associés à un déplacement des dents adjacentes. DESCRIPTION DU CAS: Nous rapportons le cas d'une jeune fille de 11 ans qui s'est présentée à la clinique dentaire pédiatrique du Lagos University Teaching Hospital (LUTH) pour se plaindre d'un élargissement indolore du maxillaire antérieur gauche depuis deux ans. Le gonflement était situé entre les dents 21 et 22 et était associé à un déplacement distal et à une angulation mésiale de la dent 22. Les examens cliniques, radiographiques et histopathologiques ont révélé un odontome composé. Une exposition chirurgicale et une énucléation ont été effectuées pour retirer la tumeur. L'évolution postopératoire du patient et son suivi à 6 mois se sont déroulés sans incident. CONCLUSION: Ce rapport met en évidence l'importance des contrôles dentaires de routine et de la prise en charge des odontomes par des moyens peu traumatisants chez les patients pédiatriques afin de prévenir les effets indésirables des odontomes et de minimiser ainsi les interventions nécessaires après l'énucléation chirurgicale. Mots clés: Odontome composé, maxillaire antérieur, incisive latérale déplacée.

Prevalence and Associated Factors of Dental Caries among Primary School Children in South-East Nigeria.

OBJECTIVES: The study aimed to identify the prevalence and associated factors of dental caries in primary school children. MATERIALS AND METHODS: This was a cross-sectional study of 657 primary school children from South East, Nigeria. Data on age, sex, birth rank, dental visits, oral hygiene status, and enamel defects were collected. The presence of dental caries was recorded by using the World Health Organization criteria. Mean DMFT/dmft scores were determined and SPSS version 21 was used for analysis. Chi-square test and multivariate logistic regression were conducted and P ≤ 0.05 was considered significant. RESULTS: The study participants were 316 (48.1%) males and 341 (51.9%) females, and their mean age was 8.41 ± 2.18 years. The prevalence of caries was 22.7% while the mean DMFT and dmft scores were 0.10 and 0.45, respectively. Bivariate analysis showed a significant association between birth rank (P = 0.04), oral hygiene status (P = 0.05), enamel defects (P < 0.001), and dental caries. Multivariate regression analysis showed that good oral hygiene (OR = 0.180, CI: 0.036-1.003, P = 0.04), fair oral hygiene (OR = 0.576, CI: 0.345-0.993, P = 0.04) and enamel defects (OR = 4.939, CI = 2.406-10.137, P < 0.001) were significant predictors of caries in this study. CONCLUSION: The prevalence of dental caries in this study was high. Oral hygiene and enamel defects were predictors of dental caries in the study population.

Effect of mineral trioxide aggregate and formocresol pulpotomy on vital primary teeth: a clinical and radiographic study.

BACKGROUND: Pulpotomy is the common therapy for cariously exposed pulps in symptom-free primary molar teeth. Formocresol (FC) is considered the gold standard dressing agent for pulpotomy, but concerns have been raised over the years about its safety. Other alternative pulpotomy agents have been investigated and suggested. OBJECTIVE: The objective was to evaluate and compare the clinical and radiographic response of FC and white mineral trioxide aggregate (MTA) as pulpotomy materials on primary molars. MATERIALS AND METHODS: Fifty primary molars, with deep carious lesion that exposed a vital but asymptomatic pulp, in 37 children aged 4-7 years were treated with conventional pulpotomy procedure. The teeth were divided randomly into two groups. Group I (FC) and group II (MTA). The treated teeth were evaluated clinically and radiographically and were followed-up for 12 months. RESULTS: At the end of the 12 months follow-up, the clinical success rates for FC and MTA were 81% and 100%, respectively. There was a statistically significant difference ( P = 0.04) between the clinical success rates of FC and MTA. While the radiographic success rates for FC and MTA were 81% and 96%, respectively, there was no statistically significant difference between the radiographic success of MTA and FC. CONCLUSION: White MTA showed a higher clinical and radiographic success rate when compared to FC as a pulpotomy agent in vital primary molars, and it has a potential to become a replacement for FC in primary molars.

The prevalence of early childhood caries and its associated risk factors among preschool children referred to a tertiary care institution.

OBJECTIVE: The aim was to determine the prevalence of early childhood caries (ECC) and its association with infant feeding and oral health-related behavior among preschool children aged 6-71 months in Lagos. MATERIALS AND METHODS: This was a descriptive cross-sectional study in which 302 children aged 6-71 months were selected from four pediatric outpatient clinics in Lagos, Nigeria. A structured questionnaire was used to obtain information regarding oral hygiene practices, dietary habits, breast and bottle feeding, birth weight of child and socioeconomic status of the family, from mothers of the children. The status of dental caries was recorded according to the World Health Organization criteria. RESULTS: The prevalence of ECC among 302 children aged 6-71 months was 21.2% while the mean deft was 0.735. Multivariate logistic regression analysis showed the correlation of ECC with the associated risk factors. ECC was significantly higher in children who were bottle-fed at night. Method of tooth cleaning other than using fluoridated toothpaste significantly increased the prevalence of ECC. Breastfeeding for duration of 3-6 months showed significantly lesser caries prevalence. Caries significantly increased with age. CONCLUSION: Early childhood caries is a multifactorial disease in which prolonged duration of breastfeeding, nocturnal bottle feeding, and use of cleaning methods other than fluoridated toothpaste are risk factors for ECC. Oral health promotion programs should be targeted at mothers, pediatricians, nurses, caretakers at day care centers and primary care health workers.

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.

Dental Caries Severity and Nutritional Status of Nigerian Preschool Children.

INTRODUCTION: Malnutrition in children is one of the most prevalent global health challenges, and malnourished children have a higher risk of death from childhood diseases. Early childhood caries (ECC) is the most common chronic disease of childhood. Complications from ECC such as pain, loss of tooth/teeth, and infection can undermine a child's nutrition and growth. AIM: This study aims to evaluate the severity of decay, missing, and filled tooth (dmft) by nutritional status using the z scores of the anthropometric measurements: height for age (HFA), weight for age (WFA), weight for height (WFH), and body mass index for age (BMIA) among children with ECC in Nigeria. STUDY DESIGN: This is a cross-sectional study conducted in 5 local government areas (LGAs) in Lagos State, Nigeria. A multistage sampling technique was used. RESULTS: A total of 273 cases of ECC were included in the analyses (mean age 4.19 ± 0.96 y). Overall, the mean dmft was 3.04 ± 2.28, and most (96%) were accounted for by untreated decay. The distribution of dmft within the different z score categories of BMIA (<-3 = severely wasted, -2 to -3 = wasted, -2 to +2 = normal, +2 to +3 = overweight and >+3 = obese) showed the highest dmft scores among the combined severely wasted and wasted groups, lowest among children with normal z scores, and intermediate in the overweight and obese groups. There was a significant negative correlation between BMIA z score, WFH z score, and dmft (r = -0.181, P < 0.05 and r = -0.143, P < 0.05, respectively). However, the correlations between HFA z score, WFA z score, and dmft were positive but not significant (r = 0.048, P = 0.44 and r = 0.022, P = 0.77, respectively). CONCLUSION: Our study showed an increased severity of dental caries among severely wasted or wasted children with ECC compared to those of normal or overweight. KNOWLEDGE TRANSFER STATEMENT: The results from this study will raise awareness among clinicians and policy makers on the need for a primary prevention program for early childhood caries in countries with high burden of malnutrition and limited resources. Also, it will help draw the attention of clinicians to the caries status of malnourished children that can be managed to improve the nutritional outcomes.

ASSOCIATION OF EARLY CHILDHOOD CARIES WITH BREASTFEEDING AND BOTTLE FEEDING IN SOUTHWESTERN NIGERIAN CHILDREN OF PRESCHOOL AGE.

BACKGROUND: Early childhood caries constitute one of the most prevalent chronic diseases among children which have been found to be related to infant feeding practices. OBJECTIVE: to determine the association of early childhood caries with breastfeeding and bottle-feeding practices among children of preschool age. PATIENTS & METHODS: Information about oral health, infant feeding and other child and family characteristics were obtained through structured interviewer administered questionnaire from mothers of preschool children. Intra-oral examination of the children was done and dental caries status was recorded according to the World Health Organization (WHO) criteria. The data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0. Statistical analyses of association of early childhood caries with various categorical variables were performed using chi-square. A logistic regression analysis was also performed with factors that were significant. P-value ≤ 0.05 was considered statistically significant. RESULTS: Of the 302 children in this study, 44% were solely breastfed, 2% were solely bottle-fed while 54% were both breastfed and bottle-fed. Statistical analysis showed that ECC significantly increased with night time bottle feeding (OR=4.5, p=0.001, CI=1.8-11.1), whereas it was significantly lower in children who were breastfed for 3 to 6 months (OR= 0.1, p<0.001, CI=0.03-0.18) as compared to those who were breastfed greater than 12 months duration. CONCLUSION: . This study has shown that breastfeeding for the first 3 - 6 months of life is associated with low incidence of dental caries while babies solely bottle-fed and night time bottle feeding are associated with high incidence of childhood dental caries.

ORAL HEALTH QUALITY OF LIFE IN A NIGERIAN UNIVERSITY UNDERGRADUATE POPULATION.

INTRODUCTION: Oral health related quality of life is utilized in health services research to examine trends in oral health and population-based needs assessment. OBJECTIVE: To assess both the generic and orthodontic specific aspects of the Oral health-related quality of life of a University undergraduate population. METHODOLOGY: This was a cross-sectional descriptive study carried out among 420 undergraduate students, aged 18-30years old, attending the University of Lagos, Nigeria. The data collection was carried out through oral interviews and self-administered questionnaires. Two Oral health related quality of life instruments were used (1) A generic scale: the Shortened version of the Oral Health Impact Profile (OHIP-14) and (2) A condition specific scale: the Psychosocial impact of dental aesthetics questionnaire (PIDAQ). Data analysis was carried out using the Statistical Package for Social Sciences (SPSS). RESULTS: With respect to the Oral Health Impact Profile (OHIP-14) scale, the overall mean score recorded by the students was 10.43+7.85. The physical pain subscale recorded the highest impact with 93.3%, while the least impact was recorded in the handicap subscale, with 29.9%. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) scales revealed significant gender differences, with the subscales of 'social impact', 'psychological impact' and 'aesthetic concern' recording low mean subscale values. CONCLUSION: . The mean Oral Health Impact Profile (OHIP-14) score of the students (10.43 + 7.85) in this study reflects that the oral health status of most of the students did not significantly affect their Oral health-related quality of life. However, the physical pain domain was the most severely affected aspect of their Oral health-related quality of life. The Psychosocial Impact of Dental Aesthetics (PIDAQ) scale scores recorded significant gender differences.

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.

Causes and pattern of tooth loss in children and adolescents in a Nigerian tertiary hospital.

BACKGROUND: Tooth loss diminishes the quality of life and is also related to poorer general health. Premature tooth loss in children can have devastating effects such as compromised aesthetics and function, mesial and distal drifts of adjacent teeth leading to crowding and impaction of the permanent successors and other forms of malocclusion. OBJECTIVE: To assess the causes and pattern of tooth loss in children and adolescents at the Paedodontic Clinic of the Lagos University Teaching Hospital, Lagos. METHODS: This retrospective study was carried out at the Paedodontic Unit of the Lagos University Teaching Hospital, Lagos using clinical records over a period of time from January 2008 to April 2010. Information obtained included age, gender, missing and extracted teeth, and reasons for extraction/tooth loss. Exfoliated primary teeth and congenitally missing teeth were excluded. Data was analysed using Epi info 2007 statistical software. Chi-square test was used to compare proportions of tooth loss among age groups. The level of significance was set at P < 0.05. RESULTS: A total of 493 patients aged 1-16 years had lost one or more teeth due to various reasons. There were 244 (49.5%) males and 249 (50.5%) females. Majority of the subjects lost their teeth due to caries and its sequelae (64.3%) compared to trauma (10.8%) and orthodontic reasons (23.5%). Seven (1.4%) lost their teeth due to failure of previous treatment such as pulp therapy. CONCLUSION: Extraction largely due to caries and its sequelae was responsible for most of the tooth loss among the study population. There is the need for intensified oral health education and awareness programmes in the populace with emphasis on prevention of dental caries and early presentation for dental treatment in order to avert premature tooth loss in children and adolescents.

Pattern of endodontic treatment in children in a Nigerian tertiary hospital.

OBJECTIVES: The aim of this study was to determine the frequency and reasons for endodontic treatment in patients aged 16 years and below seen at the Paedodontic clinic of the Department of Child Dental Health of the Lagos University Teaching Hospital. METHODS: Dental records of patients aged 16 years and below treated for various dental problems at the Paedodontic clinic of the Lagos University Teaching Hospital between January 2006 and December 2007 were reviewed to select cases that received endodontic treatment. The survey was conducted to determine the frequency of endodontic treatment for each tooth in the maxilla and mandible, the reasons for endodontic treatment and type of endodontic treatment performed in each tooth. Data on age, sex, endodontically treated teeth, reasons for endodontic treatment and date of treatment was retrieved from the patients' dental records. RESULTS: A total of 2376 patients were seen during the period of survey, out of which 260 (11%) patients received endodontic treatment of three hundred teeth comprising 194 mandibular teeth and 106 maxillary teeth. The primary lower second molar (26%) was the most frequently endodontically treated tooth followed by the permanent lower first molar (22%). All the primary and permanent molars were endodontically treated due to caries while 62.5% and 60% of permanent and primary central incisors respectively were endodontically treated due to caries. The other infrequent reasons for endodontic treatment were trauma (5.3%) and failed root canal treatment (1.3%). CONCLUSION: The primary lower second molar was the most frequently (26%) treated endodontically and the major reason (93.3%) for endodontic treatment was caries. Only 5.3% of the endodontically treated teeth were due to trauma.