Developing the teledentistry acceptance survey for dentists - TAS-D: a Delphi study.

INTRODUCTION: The increasing interest in teledentistry since the COVID-19 pandemic warrants an evaluation of dentists' willingness to adopt it. This study aimed to develop a questionnaire to assess dentist's intention to use teledentistry and the associated factors. METHODS: A literature search was used to identify items for the questionnaire. The Unified Theory of Acceptance and Use of Technology (UTAUT2) was adopted as framework. A Delphi panel was constituted of researchers with relevant publications and the International Association of Dental Research e-Oral Health Network members. Three Delphi consultations were conducted to establish consensus on items. Consensus was set at 80% agreement and content validity ratio (CVR), reaffirmed iteratively. RESULTS: Nineteen out of 25 (76%) invited experts participated in the first round, 17 in the second and 15 in the third. The preliminary questionnaire had 81 items in three sections, reduced to 66, 45 and 33 items in the first, second and third rounds. After revision, the final version comprised eight items assessing dentists' backgrounds in Sect. 1, seven items identifying teledentistry uses in Sect. 2, and 17 items assessing intention to use teledentistry and its determinants in seven dimensions in Sect. 3. The initial CVR was 0.45, which increased to 0.80 at the end of the third round. CONCLUSION: A survey tool was developed to assess the acceptance of teledentistry, and its determinants based on the UTAUT2 framework through consensus among teledentistry experts. The tool had excellent validity and needs further evaluation of its psychometric properties.

Tooth loss among the elders in an inner city area of Ibadan, Nigeria.

OBJECTIVE: To determine the prevalence and factors associated with tooth loss among elders in an inner city area of Ibadan, Nigeria. BACKGROUND: Tooth loss is an indication of the oral health of a population, and the possible effects of oral health on general health of the elders has been reported. MATERIAL AND METHODS: A cross-sectional study was undertaken among 392 consenting elders in Idikan, Ibadan, Nigeria. Information on socio-demographic characteristics, causes and effects of tooth loss was obtained using a pretested semistructured questionnaire. After the interview, the elders were examined for the presence of tooth loss by a trained examiner. RESULT: Mean (SD) age of the elders was 73.0 (9.2) years. One hundred and eighty-seven (47.7%) participants had ≥1 missing tooth, and 20 (5.1%) participants had complete edentulousness. The mean SD number of missing teeth was 5.9 (4.7) teeth. Age, level of education, monthly income and physical impairment were associated with mean (SD) number of missing teeth (P˂.05). Speech difficulty, appearance problems, chewing difficulty, feeling bereaved, mobility of adjacent teeth, halitosis and premature ageing were reported more by participants who had ˃16 missing teeth compared to those who had ≤16 teeth (P˂.05). CONCLUSION: The mouth prevalence of tooth loss was 47.7%, and mean (SD) number of missing teeth was 5.9 (4.7) teeth. Age, level of education, monthly income and physical impairment were associated with number of missing teeth (P˂.05). Speech difficulty, appearance problem, chewing difficulty, feeling of bereavement, mobility of adjacent teeth, halitosis and premature ageing were associated with increasing number of missing teeth (P˂.05).

A short report on tooth replacement in an older suburban population in Nigeria.

OBJECTIVES: To determine: the knowledge of the participants about removable dentures, importance of tooth replacement; prevalence of tooth loss and denture use; and factors associated with its non-use among an elderly population in Nigeria. BACKGROUND: Tooth loss without replacement can impact negatively on the quality of life of the elders, thus making use of denture a basic requirement for those with partial or complete edentulous arches in developed countries. It is, however, not known if this is the case among elders in suburban Nigeria. MATERIAL AND METHODS: A cross-section of 392 consenting elderly participants aged ≥65 years residing at Idikan, Ibadan, Nigeria, were interviewed on their biodata, knowledge of removable denture and importance of tooth replacement, history of use of denture and reasons for non-use where applicable. Oral examinations for the presence of missing teeth and denture were conducted by an examiner. Data were analysed with SPSS and P value set at ˂.05. RESULTS: The mean age of the participants was 73 (SD = 9.2) years. About 39% of the participants believed that it was important to replace missing teeth, 56.0% had poor knowledge about tooth replacement options, and 47.7% had at least a missing tooth. Only 7.1% of those with missing teeth had them replaced and all were using removable acrylic partial dentures. Financial constraint was the main reason for non-replacement of missing teeth (80.1%). Age, gender, occupation before retirement, income, level of education and presence of physical impairment were associated with non-use of denture (P Ë‚ .05). CONCLUSION: Many elderly individuals had poor knowledge about removable dentures and the importance of tooth replacement. About half of the participants had full complement of teeth and only 7.1% of those with tooth loss reported denture wear. Major reasons for non-use of dentures were due to economic reasons.

Dental education in the rural community: a Nigerian experience.

At the University of Ibadan, Ibadan, Nigeria, dental students are prepared not only to provide skilled care to individual patients, but also to assume responsibility for the community as a whole. In establishing the rural posting program for dental students, it was planned that all fifth year dental students would undertake a rural posting at Igboora, approximately 80 km from Ibadan, the capital of Oyo State. During this 6 week immersion experience students learn about living in a rural area where they provide community oral health services. This report provides recommendations for initiating, sustaining and expanding rural dental education programs.

Using traditional rhyme (folk song) as a tool for oral hygiene promotion (UTRATOHP) among children in rural communities in Nigeria: A protocol for a randomised controlled trial.

BACKGROUND: Most oral diseases are caused by poor oral hygiene, and with adequate oral hygiene measures, they are easily preventable. The use of folk songs to deliver oral health education may likely hold a huge potential for success and an increased likelihood of acceptability and sustainability among school children. Therefore, an investigation into the effectiveness of methods that would be culturally appropriate and sustainable, such as folk songs, is essential. AIM: To determine the effect of traditional rhyme (folk song) as a tool for oral hygiene education among children in rural communities in Nigeria. MATERIALS AND METHODS: This is a school-based, assessor-blinded, two-arm cluster-randomised controlled trial that will assess the effectiveness of oral hygiene messages delivered through traditional rhyme (folk song) on children's oral hygiene knowledge, attitude, practices, and oral hygiene status in two rural communities (Igboora and Idere) in Nigeria. The study will involve a minimum of 424 participants (aged 7-9 years) selected from eight primary schools using the cluster sampling technique. Four schools will be randomised into the test group to receive oral hygiene messages through folk songs, and the participants will sing the song for two weeks. The other four schools will be assigned to the control group, and the participants will receive the usual oral health talk on oral hygiene practices by a dentist. The participants' oral hygiene knowledge, attitude, practice and status will be assessed at baseline, immediate, six, and twelve-month post-intervention. A modified World Health Organization (WHO) Children's oral health survey questionnaire will be utilised for data collection. Oral examinations will be conducted to assess the participants' dental caries experience and oral hygiene status using the dmft/DMFT and simplified oral hygiene indices, respectively. DISCUSSION: Folk songs are popular means of conveying messages in Nigeria, and using them to deliver oral health messages may be an effective, acceptable, and sustainable method among children. This study will provide empirical information about this innovative intervention to guide policy development, dental public health practice, and future studies. TRIAL REGISTRATION: Pan African Clinical Trial Registry-PACTR202010863892797 (October 2020).

Quality and contents of referral letters from peripheral health centers to the dental centre of a teaching hospital, southwestern Nigeria.

OBJECTIVE: Referral letters are deficient in quality and content, which may prevent ideal treatment of patients. Therefore, this study assessed the quality and contents of referral letters from peripheral health centers to the dental center of a teaching hospital in southwestern Nigeria. MATERIALS AND METHODS: All consecutive referral letters received at the dental center of a teaching hospital in southwestern Nigeria from various peripheral health centers over a period of 1 year were prospectively reviewed using a structured questionnaire. The information extracted were patient's demographic data, addresses of referral persons, dates of referral, reasons for referral, medical and dental history, examination findings, investigations done, diagnosis and treatment given. Descriptive analyses of frequencies were done for all variables. RESULTS: One hundred and thirty-four referral letters were received and reviewed, comprising letters from 75 (60.0%) males and 59 (40.0%) females. The patient's age ranged from 2-74 years, with a median age of 25 years. The majority, 91 (85.4%), of the letters were written by medical doctors. An appreciable number of referral letters had no name or signature of the referring health care worker. Information on reasons for referral were not available in 27 (20.1%) of the letters. A significant proportion of referral letters lacked vital information on the patient age, past medical history, past dental history, investigations done and treatment given. CONCLUSION: This study has shown that referral letters written from various peripheral healthcare centers to the dental centre of a teaching hospital is generally of unacceptable quality and the content could be improved upon.

Improvised source of water coolant for ultrasonic scaler: an appropriate technology in underserved communities.

Traditionally dental plaque, calculus and stains have been removed by scaling and polishing manually with hand instruments such as curettes, chisels, hoes and scalers. However, ultrasonic scaling is becoming the preferred method of initial periodontal treatment and maintenance, due to improved patient and operator comfort. Ultrasonic scaling can be performed effectively using pipe-borne water as coolant. However, such a water supply is unavailable in many rural dental clinics, especially in underserved communities in Nigeria. This article reports on an improvised source of water coolant, designed and fabricated to make modern, easy and effective plaque control available to people in communities where there is no pipe-borne water. The device will improve operator efficiency in tooth cleaning and patient compliance with treatment. Due to its simple design but effective function, the device is ideal for use in Nigeria's primary healthcare delivery program, offering enhanced preventive and curative services to remote, rural and semi-urban populations. In doing so oral health can be improved with a reduction in the incidence of oral diseases.

Developing an Oral Hygiene Education Song for Children and Teenagers in Nigeria.

BACKGROUND: Oral diseases mainly caused by poor oral hygiene are a major public health problem affecting over half of the world's population. Oral hygiene education targeted at children and teenagers in schools is an important approach in addressing this problem. Folk songs in the language and cultural context children and teenagers are familiar with appears to be a promising tool and alternative to traditional oral hygiene education. OBJECTIVES: This paper aims to report how a local traditional song on oral hygiene education amongst children and teenagers in southwestern Nigeria was developed with a view to providing information on how the song can be developed in other languages as well as how other oral health education songs can be developed. METHOD: Oral health professionals from the University College Hospital, Ibadan, and music experts from the University of Ibadan, in collaboration with traditional/local musicians, parents/guardians, schoolteachers, and community heads, took part in the development of the song over a period of 6 months. Developing the tool involved certain processes which were validated and evaluated. These processes included developing the lyrics, choosing the type of song, creating the melody, and producing and finishing the song as an oral hygiene education tool. Written and audio documentations of the processes were done. RESULTS: A 90-second oral hygiene education song was developed in English and later translated into Yoruba. The numerous steps, collaborations, and meetings required in the development of the song were associated with many learning opportunities including team-building, understanding cultural contexts, effective collaboration, leadership, and communication skills. CONCLUSIONS: Creating new and effective oral hygiene education tool requires various processes and multiple steps and resources. However, it is a necessary and worthy exercise in ensuring sustainable and adequate oral hygiene, especially amongst children and teenagers in underserved populations, as we move into the future.

Assessment of Atraumatic Restorative Treatment (ART) on the permanent dentition in a primary care setting in Nigeria.

OBJECTIVES: To assess the acceptability of ART and to evaluate on a longitudinal basis the survival rate of single surface occlusal ART restorations in the permanent dentition. DESIGN: Longitudinal Study of ART restorations. SETTING: Primary Oral Health Care Setting. PARTICIPANTS: Aged 8-19 years in a low socioeconomic community, Southwestern Nigeria. INTERVENTIONS/METHODS: Ninety-three ART restorations were applied on single surface occlusal caries by a dentist who had undergone training on ART. MAIN OUTCOME MEASURES: Six monthly follow-up of patients to evaluate restoration retention and marginal defect was conducted by an independent evaluator. RESULTS: Over 90.0% of the subjects had never undergone dental treatment, yet 63.0% perceived dental treatment as painful. After undergoing the treatment as many as 98.0% admitted that ART was not painful. On the question of their willingness to make recall visits, about 95.0% responded in the affirmative and about 96.0% reported that they would encourage others to come for treatment. The cumulative survival rate of single surface occlusal ART restorations after 2 years was 93.5% (SE=2.3%). CONCLUSIONS: ART was shown to be acceptable and effective in the management of single surface occlusal caries in the permanent dentition in these Nigerian children and adolescents outside the traditional clinical setting.

Prevention of Dental Caries in Nigeria: A Narrative Review of Strategies and Recommendations from 1999 to 2019.

OBJECTIVES: This narrative review aimed to show the approaches recommended for the prevention of dental caries in Nigeria by epidemiological surveys (P), primary preventive methods and strategies,( I) comparison preferred by experts (C) in the prevention of dental caries (O). METHODS: An electronic literature search of some databases such as Pubmed, Pubmed Central, Google Scholar, African Journal Online (AJOL) and Medline was conducted using these keywords delimited by Boolean operators AND, OR and NOT: "dental caries" "prevention" "Nigeria. Epidemiological studies using WHO criteria published in English between 1999 and 2019 were included in this study. RESULTS: All studies that met the inclusion criteria were epidemiological cross-sectional studies, non-clinic -based. The approaches recommended include need for continuous caries surveillance, preventive and restorative programmes, primary prevention, use fluorides, oral health education and atraumatic restorative treatment. CONCLUSIONS: The recommended approaches should include continuous caries monitoring, comprehensive preventive and restorative programmes, primary prevention, use fluorides, oral health education and atraumatic restorative treatments in public schools and primary health care (PHC) centres. It is necessary to augment these approaches with undergraduate cariology curriculum review of dental schools, public-private partnership and oral health policy implementation with emphasis on prevention.

Prevalence and extent of enamel defects in the permanent teeth of 8-year-old Nigerian children.

OBJECTIVES: Enamel formation is a vulnerable developmental process, susceptible to environmental influences such as excessive systemic fluoride (F) exposure and infant/childhood disease. This study determined prevalence and extent of developmental enamel defects (DDE) and dental fluorosis in 8-year-old Nigerians and explored associations with key predictors. METHODS: A sample of 322 healthy 8-year-olds (155 males, 167 females) from primary schools in lower and higher water F areas of (i) rural and (ii) urban parts of Oyo State in south-west Nigeria (n = 4 areas) (in which the mean (SD) F concentration of community water supplies ranged from 0.07 (0.02) to 2.13 (0.64) mg F/L) were dentally examined using modified DDE (mDDE) and Thylstrup and Fejerskov (TF) indices. Drinking waters, cooking waters and toothpaste samples were analysed for F concentration using a F ion-selective electrode (F-ISE). Information on infant/childhood diseases, infant feeding and tooth cleaning practices was obtained from parents/legal guardians. Data were analysed using ANOVA, chi-square tests, Spearman correlation and binary logistic regression as appropriate. RESULTS: Mean (SD) F concentration of actual drinking and actual cooking waters consumed by participants was 0.25 (0.20) and 0.24 (0.14) mg F/L respectively in the urban higher F area; 1.11 (1.00) and 1.16 (1.02) mg F/L, respectively in the rural higher F area (P < .05). Overall, mouth prevalence of DDE in the permanent dentition was 61.2% with a mean (SD) of 2.4 (2.2) index teeth affected. Dental fluorosis mouth prevalence was 29.8% with a mean of 2.1 (3.7) teeth affected. Prevalence and extent of DDE and dental fluorosis were greater in higher F than lower water F areas (P < .001). A weak positive correlation was seen between extent of dental fluorosis and drinking water F concentration (ρ = 0.28). The absence of infant/childhood disease was associated with a lower risk of DDE being present (P = .001), with an odds ratio of 0.43 (95% CI = 0.26, 0.71). Gender was a statistically significant (P = .014) predictor for dental fluorosis with females having a higher risk OR 1.94 (95% CI = 1.14, 3.28) of dental fluorosis than males. CONCLUSIONS: In these Nigerian 8-year-olds (n = 322), mouth prevalence of DDE was 61.2% (mean (SD) teeth affected = 2.4 (2.2)), and a key positive predictor was a history of infant/childhood disease. With 29.8% of these children exhibiting dental fluorosis (mean (SD) teeth affected = 2.1(3.7)), drinking water F concentration was identified as a positive predictor, along with gender, with females more at risk of dental fluorosis than males.

Some socio-demographic attributes as covariates in tooth wear among males in a rural community in Nigeria.

BACKGROUND: Association between some socio-demographic attributes and tooth wear among adult male population in a rural community of Igbo-ora, Southwestern Nigeria was investigated in this cross-sectional study. METHODS: Cross-sectional study among 200 consenting adult males in Igbo-ora was carried out using a 10-item semi-structured questionnaire to obtain data on socio-demographics. Oral examination to establish the presence of tooth wear lesions was carried out by two examiners. Frequencies and percentages of relevant variables were generated. Multivariate analysis was used to test associations between categorical variables at P<0.05. RESULTS: The mean age of participants was 35.6±11.7 years. One hundred and six (53.0%) subjects had one form of tooth wear lesion. Sixty eight (34.0%) of the subjects had attrition only and 96 (48.0%) had multiple tooth wear lesions. There was an association between age group, marital status, level of education and tooth wear (p<0.05). However, the association between occupation and tooth wear was not statistically significant (p>0.05). After adjusting for marital status, occupation and level of education, the association between age group and tooth wear was still significant. Though marital status was found to be associated with tooth wear, this association was not significant after adjusting for age, occupation and level of education. The association between some of the socio-demographic factors studied and the types of tooth wear was statistically significant (p<0.05). CONCLUSION: Age group was the only independent predictor of tooth wear.