PERCEPTION AND EXPERIENCE AND OF NIGERIAN PAEDIATRICIANS TO DENTAL REFERRAL FOR CHILDREN WITH CHRONIC ILLNESSES.

BACKGROUND: Interdisciplinary collaboration in the management of patients offers several advantages especially for children with chronic illnesses who are often at risk for other health conditions. Diseases in other parts of the body can be detected by a physician and lead to subsequent referral to the appropriate managing team. This study assessed the perception and experience of dental referral among Nigerian paediatricians as well as factors that may influence their decision to refer to a dentist. METHODS: Self administered questionnaires were used to obtain socio-demographic data, history of exposure to dental teachings as well as experience with dental referral. Two hundred and sixty nine paediatricians and paediatric practitioners were involved in the study. Descriptive statistics and measures of central tendencies generated. Associations were tested with Chi Squares and Statistical significance was set at P <0.05. RESULTS: A total of 269 respondents participated in the study out of whom 142(52.8%) trained at institutions where there was a sister dental school, but 243(90.3%) of them had no official dentistry postings. Majority of the respondents 259(96.3%) were in favour of routine professional oral check-up for children but only 83(30.9%) endorsed the recommended bi annual oral checks. A referral rate of 0.76-1.9% was obtained. CONCLUSION: Although paediatricians are a known source of dental referral for children globally, a lot needs to be done to equip the physicians with the necessary knowledge and skill that will enable them participate more actively in the promotion of oral health for Nigerian children.

The wits appraisal using three reference planes and its interaction with the ANB angle among a sub-set of Nigerians".

AIMS: Conjoint analysis of orthodontic patients using the Subspinale (A-point) Nasion-Supramentale (B point) (ANB) angle and the Wits appraisal is popular in many practices. This study aimed to present reference values for the Wits appraisal among Nigerians using three horizontal reference planes namely the bisected occlusal plane (BOP), the functional occlusal plane (FOP) and the maxillomandibular angle bisector (MM° bisector) plane. It also assessed the relationship of the Wits appraisal with the ANB angle and its interaction with clinical measures of sagittal skeletal relations among subjects with malocclusion. METHODOLOGY: One hundred participants with normal occlusion and 120 with malocclusion were recruited in the study. Cephalometric radiographs were taken for all participants. Each radiograph was manually traced on a 0.003 matted cellulose acetate tracing paper using a sharpened 2H pencil. The Wits appraisal and ANB angle were determined. Data was analyzed using SPSS version 19. RESULTS: The mean age was 20.7 ± 4.9 years for those with normal occlusion and 18.8 ± 6.5 years in the malocclusion group. There were 91 (41.4%) males and 129 (58.6%) females. Mean values for the Wits appraisal using the BOP as reference, was--1.27 ± 2.91mm, with the FOP, it was -3.54 ± 3.24mm, while with the MM° bisector plane, it was--.75? ± .94mm. The ANB angle showed highest correlation with the MM'°bisector plane Wits value(P< 0 .001). CCONCLUSION: hen the clinical and angular cephalometric findings are at variance, the ANB angle is best moderated by the MM'° isector plane Wits appraisal.

Accuracy of age estimation using Demirjian method among Nigerian children.

INTRODUCTION: Accurate age determination is important in paediatric dentistry, orthodontics, forensic identification of deceased persons, among other reasons. In developing countries where accurate birth records are lacking, scientific methods of accurately assessing patients' ages are relevant. Many methods for age determination using the dentition exist but the most widely used is that proposed by Demirjian in 1973. This study aimed to determine the accuracy of age determination using the Demirjian method among Nigerian children. METHODOLOGY: Orthopanthomograms of children seen at the orthodontic clinic of the University College Hospital, Ibadan were reviewed. Chronological age was calculated from date of birth recorded at registration to the nearest decimal. Dental age was calculated using the Demirjian criteria (1973). Boys and girls were analysed separately to allow for gender related variations in dental development. The paired t-test and correlation analysis were used to compare the chronological age and calculated dental age. RESULTS: Ninety-three children (41 boys and 52 girls) with ages ranging from 4.42 to 16.75 years (mean 10.69 years for boys and 10.50 years for girls) were assessed using the Demirjian method. There was a significant difference between the chronological and dental age among the boys (p = 0.009); the converse was the case among the girls (p = 0.051). The chronological and dental age of the children showed high correlation (p < 0.01). CONCLUSION: There are variations between chronological age and dental development among Nigerian children. Other methods of age determination should be explored for this population.

Dentists' knowledge and attitude towards informed consent taking in a Nigerian teaching hospital.

BACKGROUND AND AIM: There has been an increase in medical and dental knowledge in the world today. More and more people are getting to know their rights and cases of medical and dental liability is on the increase. Hence a proper approach towards obtaining informed consent in dental practice has become necessary. This study assessed dentists' perception on informed consent taking for dental procedures. METHODOLOGY: Self administered questionnaires were given to all dentists working in one of the teaching hospitals in the south west region of Nigeria. The questionnaires assessed the doctors' ability to properly define informed consent, knowledge of aspects relevant to informed consent taking and procedures for which they felt informed consent should be taking routinely. RESULTS: The result revealed 10 out of 56 dentists (17.5%) were able to rightly and fully define informed consent. Almost all the dentists (98.4%) claimed to have taken informed consent at one time or the other, out of which 31 dentists (59.6%) claim that they always take verbal informed consent on routine dental treatment. However 21 (42%) of the dentists believed that informed consent scares patients, while 31 (54.5%) believed informed consent prepares patients better for the procedure. Generally the dentists agreed that the more invasive the dental treatment procedure was the more they felt informed consent should be taken. CONCLUSION: Dentists knowledge about informed consent seems to be inadequate as only few of them were able to define informed consent. However their attitude towards informed consent seems to be more positive as almost all claimed to have taken informed consent from patients at one time or the other. Therefore regular update about knowledge and significance of informed consent should be encouraged.

MANDIBULAR AND MAXILLARY DISTOMOLARS IN THE ORTHODONTIC CHILD PATIENT: A REPORT OF 3 CASES.

Multiple supernumerary molars are rare and are usually detected on routine radiological investigations. Supernumerary molars could occur as paramolars or distomolars. Occurrence of distomolars in children is reported to be a rare occurrence. In this report of 3 cases, bilateral maxillary and mandibular impacted fourth molars were observed as incidental findings on orthopanthomograms in children between the ages of 12 and 15 years.