Assessment of oral health status in a Ghanaian population: rationale, methods, and population characteristics.

BACKGROUND: Oral health surveys aid in estimating the oral health of a population and provide a projection for future oral health care needs. We report the procedures and rationale of a survey carried out to assess the oral health status and risk factors for oral disease among adults in the Greater Accra Region (GAR) of Ghana. The objective was to provide prevalence estimates on dental diseases, oral health behaviour and risk factors, and to establish baseline epidemiological data on the population's oral health for further research. METHODS: This was a population-based cross-sectional study of adults aged 25 years and above. A random, stratified two-stage sampling method was used to select participants from rural and urban communities in three types of districts (Metropolitan, Municipal, Ordinary). A semi- structured questionnaire was used to collect data on socio-demographic characteristics, oral health behaviours and risk factors for oral disease. Anthropometric data and a full-mouth clinical examination was carried out including: soft tissue assessment, tooth count, prosthodontic status, dental caries assessment and periodontal assessment. RESULTS: A total of 729 participants were included in the study with a mean age of 43.9 years (SD 14.6). Majority 425 (61.0%) were females. Though the metropolitan districts had more dental clinics and personnel, along with better health insurance coverage, they had a higher prevalence of missing teeth, retained roots, severe periodontitis and poorer oral health coverage. The findings also show some significant differences in disease prevalence, within the different localities and districts. CONCLUSIONS: Availability and access to oral health services is not the most important determinant of good oral health outcomes in this region. We recommend exploring socio-behavioral and cultural factors as well. This study provides district level data to inform policy and guide further research.

Accuracy of the electronic apex locator, tactile, and radiographic methods in working length determination.

Background: Determination of working length (WL) is necessary for the successful outcome of root canal treatment (RCT). Common methods in WL determination include tactile, radiographic, and electronic apex locators (EAL). Aim: The aim of this study was to compare three methods of WL determination to the actual visualization of the apical constriction (AC). Materials and Methods: Consecutive patients with indications for extraction of single-rooted single canal teeth at the University of Ghana Dental School clinic were randomly assigned to three groups. In-vivo root canal WL was determined by tactile sensation, digital radiography, and a 5th generation EAL (Sendoline S5). Files were cemented in the canals after the in-vivo measurements. The apical 4-5 mm of the roots was trimmed to expose the inserted files and the AC. Actual WL, as determined by visualization of the AC, was done using a digital microscope. Different WLs were then compared for the various groups, and the mean actual canal lengths were reported. Results: EAL accurately predicted the AC in 31 (96.9%) teeth, while the digital radiographic and tactile sensation methods accurately predicted the constriction in 19 (59.4%) and 8 (25%) teeth, respectively, in the study population. The mean working canal lengths for single-rooted teeth showed no observable difference among sexes, age categories, and side of the jaw. Conclusion: The EAL provided more reliable and accurate WL measurements for single-rooted teeth among Ghanaians, compared to digital radiography and tactile methods.

Periodontitis prevalence and severity in an African population: A cross-sectional study in the Greater Accra Region of Ghana.

BACKGROUND: Periodontitis is a major public health problem affecting many adults, with considerable variation in its prevalence and severity worldwide. There is little data on its prevalence or associated risk factors in Ghana making development of evidence based preventive programs challenging. This study assessed the prevalence, severity, extent, and associated risk factors of periodontitis in an adult Ghanaian population. METHODS: A population based cross-sectional study involving adults aged ≥25 years in the Greater Accra Region (GAR) of Ghana. A random stratified two-stage sampling method was used to select participants from rural and urban communities. Data on sociodemographic and risk factors were collected using a semi-structured questionnaire. A full-mouth periodontal examination was performed to diagnose and describe the severity of periodontitis following the CDC-AAP case definition. RESULTS: A total of 729 participants were included in the study, with a mean age of 43.9 ± 14.6 years and 61% being female. Majority (84.8%) presented with gingivitis, 46.7% had periodontitis with 41.8% having both, and 13.9% had severe periodontitis. The mean clinical attachment loss (AL) was 1.36 ± 0.67 mm and 1.41 ± 0.57 mm for probing depth (PD). Factors associated with periodontitis included, increasing age, smoking, and alcohol use; being Muslim provided lower odds of disease. Older people, former smoking, being underweight and not having health insurance were associated with severe periodontitis. CONCLUSIONS: This study shows a high burden of periodontitis with comparatively more severe disease. Existing sociodemographic disparities in disease burden highlights the need of developing targeted population based preventive programs.

Dental Education With the COVID-19 Pandemic: Ghanaian Dental Students' Experience.

Introduction: Due to the COVID-19 pandemic, all Ghanaian tertiary institutions were closed down and resorted to online teaching. This posed a challenge for dental education due to requirements of clinical tutoring and patient handling. This study explored the experiences of dental students with the change in teaching methods during the pandemic with the aim of assessing their effectiveness and explore measures for their improvement. Materials and Methods: This was an online survey involving undergraduate dental students in the two dental schools in Ghana. An e-questionnaire was sent out to all the students, exploring their knowledge of and response to the pandemic and assessing the impact of measures implemented during the pandemic to assist them complete their education. Results: Two hundred out of 412 students participated in the study giving a response rate of 48.5%; however, completed responses were available for 195 students, 123 (63.1%) from the University of Ghana Dental School and 72 (36.9%) from the Kwame Nkrumah University School of Medicine and Dentistry. There were 106 (54.4%) females;108 participants (54.4%) were pre-clinical students. One hundred and sixty-four (84%) respondents believed dental professionals had a higher risk of contagion because of proximity to patients during treatment and 115(59.0%) reported being fearful of performing clinical procedures. The students demonstrated adequate knowledge of the disease and a positive attitude towards the required changes instituted because of the pandemic. They however, highlighted technical obstacles and distraction as some of their challenges. The quality of internet was acceptable, but the volume of data was inadequate to meet their needs. Also, though both Universities had their own recommended learning management systems, Zoom was the preferred online learning platform. Conclusions: Generally, the students demonstrated a positive attitude towards the required changes. A blended educational approach may continue to be ideal for dental education as we adapt to this pandemic. Innovative ways may need to be sought to improve the online experience and the University approved online learning management systems enhanced to make them more user friendly.

Introduction: En raison de la pandémie de COVID-19, tous les établissements d'enseignement supérieur ghanéens ont été fermés et ont eu recours à l'enseignement en ligne. Cela a posé un défi pour l'enseignement dentaire en raison des exigences de tutorat clinique et de traitement des patients. Cette étude a exploré les expériences des étudiants en médecine dentaire avec le changement des méthodes d'enseignement pendant la pandémie dans le but d'évaluer leur efficacité et d'explorer des mesures pour leur amélioration. Méthodes: Il s'agissait d'une enquête en ligne impliquant des étudiants en médecine dentaire de premier cycle dans les deux écoles dentaires du Ghana. Un questionnaire électronique a été envoyé à tous les étudiants, explorant leurs connaissances et leur réponse à la pandémie et évaluant l'impact des mesures mises en oeuvre pendant la pandémie pour les aider à terminer leurs études. Résultats: 200 étudiants sur 412 ont participé à l'étude, ce qui donne un taux de réponse de 48,5%; cependant, des réponses complètes étaient disponibles pour 195 étudiants, 123 (63,1%) de l'École dentaire de l'Université du Ghana et 72 (36,9%) de l'École de médecine et de dentisterie de l'Université Kwame Nkrumah. Il y avait 106 femmes (54,4%); 108 participants (54,4%) étaient des étudiants précliniques. Cent soixante-quatre (84%) répondants pensaient que les professionnels dentaires avaient un risque plus élevé de contagion en raison de la proximité des patients pendant le traitement et 115 (59,0%) ont déclaré avoir peur d'effectuer des procédures cliniques. Les étudiants ont démontré une connaissance adéquate de la maladie et une attitude positive envers les changements requis institués en raison de la pandémie. Ils ont cependant souligné les obstacles techniques et la distraction comme certains de leurs défis. La qualité d'Internet était acceptable, mais le volume de données était insuffisant pour répondre à leurs besoins. De plus, bien que les deux universités aient leurs propres systèmes de gestion de l'apprentissage recommandés, Zoom était la plate-forme d'apprentissage en ligne préférée. Conclusions: En général, les étudiants ont démontré une attitude positive envers les changements requis. Une approche pédagogique mixte peut continuer à être idéale pour l'enseignement dentaire alors que nous nous adaptons à cette pandémie. Des moyens innovants devront peut-être être recherchés pour améliorer l'expérience en ligne et les systèmes de gestion de l'apprentissage en ligne approuvés par l'Université seront améliorés pour les rendre plus conviviaux.