Oral health in an urban slum, Nigeria: residents' perceptions, practices and care-seeking experiences.

BACKGROUND/INTRODUCTION: One of the key recommendations for the new WHO global strategy for oral health is inclusion of disadvantaged populations and their engagement in policy dialogues such that their needs and views are addressed in policy decisions. OBJECTIVES: This study explored oral health perceptions, practices and care-seeking experiences of slum residents in Ibadan, Nigeria. METHOD: Focus group discussions (FGD) were conducted with family health-decision makers in an urban slum site. Oral health perceptions, practices, and care-seeking experiences were discussed. FGDs were recorded, transcribed, and translated. ATLAS.ti qualitative research software was deployed for analysis using thematic analysis. RESULTS: Six FGD sessions, divided by gender and age, were conducted between September-October 2019, (N = total 58 participants, aged 25 to 59 years). Common dental ailments mentioned were dental pain, tooth sensitivity, bleeding gums, tooth decay, mouth odor, gum disease, and tooth fracture. Perceived causes of dental conditions included poor dental hygiene and habits, sugary diets, ignorance, and supernatural forces. Mouth cleaning was mostly done once daily using toothbrush and paste. Other cleaning tools were ground glass, wood ash, charcoal, "epa Ijebu" (a dentrifice), and "orin ata" (a type of chewing stick). Remedies for relieving dental pain included over-the-counter medicines, warm salted water, gin, tobacco (snuff/powdered), cow urine/dung, battery fluid, and various mixtures/ concoctions. Visits to the dentists were mentioned by a few but this was usually as last resort. Main barriers to accessing care from dental care facilities were unaffordability of service charges and fear of extreme treatment measures (extraction). Suggested measures to improve timely access to dental health care included reducing/subsidizing costs of treatments and medications, offering non-extraction treatment options, and oral health education programmes. CONCLUSION: The slum residents experience various forms of dental ailments mostly pain-related. The residents perceived formal dental clinics as unaffordable, thereby engaging in self-care remedies and harmful oral health practices before seeking professional help. Policymakers and decision-makers may leverage this empirical evidence for the people's education on early dental care and address challenges to affordable, available, and acceptable oral healthcare services among slum residents to improve access to care facilities.

A 5-year retrospective study of rampant dental caries among adult patients in a Nigerian Teaching Hospital.

BACKGROUND: Rampant caries in adults has not been a focus of many researches unlike the childhood form of the disease. The disease is an interesting finding in an adult patient. When the condition occurs in children, it has been described as nursing bottle caries, baby bottle tooth decay, and the most recently adopted term, "early childhood caries". AIM: The aim was to determine the prevalence of rampant caries among adult patients. MATERIALS AND METHODS: Cases of rampant caries were identified from the records of all the patients treated during a 5-year period. Variables considered included the socio-demographic data, frequency of consumption of cariogenic diet, social habits, decayed, missing, filled teeth (DMFT), socioeconomic status (SES), and oral hygiene (OH), etc. Data were analyzed using student's t-test and one-way ANOVA for continuous variables, while Fishers exact test was adopted for categorical variables. Level of significance was set at P < 0.05. RESULT: Less than 1% (21 out of 3458) of patients treated during the period had adult rampant caries, but only 17 patients with complete data were analyzed. The age range of the patients was 22-61 years with a median of 36 years. The number of teeth with open carious cavities ranged from 8 to 18, with a mean of 11.6 ± 3.3 teeth. A statistically significant difference was found in the number of open carious cavities and gender (P = 0.03), and between the SES and OH (P = 0.001). Patients in low SES had the poorest OH, The number of open carious lesion was higher in those that consumed refined sugar regularly. CONCLUSION: Occurrence of rampant caries was low and related to low socioeconomic status and regular consumption of cariogenic diet.

SELF REPORTED TOOTH DISCOLORATIONS AMONG PATIENTS SEEN AT DENTAL CENTER UNIVERSITY COLLEGE HOSPITAL IBADAN.

BACKGROUND: Tooth discoloration is an aesthetic problem that is linked to a variety of causes and it could be a source of embarrassment, leading to reduced self-esteem. AIM: To determine the prevalence of self reported tooth discoloration and the distribution of the different intrinsic tooth discolorations. METHODOLOGY: A retrospective study that reviewed the distribution of tooth discoloration reported by patients that presented for treatment of tooth discoloration at conservation clinic of the dental centre University College Hospital, Ibadan between December 2011 and December 2014. Data collected from patients' case files included patients' demographics, type of tooth discoloration as diagnosed by attending consultant and treatment offered. Data were analyzed using SPSS version 20. Frequencies and means were used for continuous variables while chi square was used to compare the categorical variables. P value was set at ≤ 0.05. RESULTS: One hundred and thirty six patients reported tooth discoloration as their major reason for presentation at the clinic. The patients were between age 16-75 years with mean age of 35.62±14.31 years and male to female ratio of 1:1.13. Prevalence of reported tooth discolouration during the study period was 9.8%. Pulpal necrosis was the most reported cause of (86.8%) tooth discolouration, while fluorosis was the least (0.7%) reported. Non vital tooth bleaching was the most common treatment (72.1%) offered for tooth discoloration. No significant comparison was observed between gender and type of tooth discoloration, p=0.088. CONCLUSION: Pulpal necrosis is a major cause of discoloration which leads to reduced self esteem. There is need to improve on dental awareness on causes of tooth discoloration for prevention and early presentation for management.