Association between periodontal inflamed surface area and systemic inflammatory biomarkers among pre-dialysis chronic kidney disease patients.

Background: Several studies have shown an association between chronic kidney disease (CKD) and periodontitis. However, only few studies have quantified the burden of periodontal inflammation in pre-dialysis CKD patients. The aim of this study was to determine the association between periodontal inflamed surface area (PISA) and systemic inflammatory biomarkers among pre-dialysis CKD patients. Materials and Methods: 120 pre-dialysis CKD participants were recruited into this study. 60 participants constituted Group A (those with periodontitis) while 60 participants constituted Group B (those without periodontitis). Full periodontal examination was carried out in the participants for the estimation of PISA. Blood samples also collected to determine levels of high sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) in all participants. Independent t-test was used to compare means of PISA, hsCRP and IL-6 levels in the two groups. Pearson correlation analysis was used to determine association between PISA and (hsCRP and IL-6). Results: The mean value of hsCRP was significantly higher in Group A compared to Group B (3.41 mg/L vs. 2.18 mg/L). PISA moderately correlated with hsCRP (r = 0.4, P < 0.01) in both groups. hsCRP also moderately correlated with IL-6 (r = 0.6, P < 0.001) in both groups. Conclusion: This study demonstrates that there was an association between PISA and hsCRP. Increased hsCRP level in Group A revealed the inflammatory burden imposed by periodontitis.

aMMP-8 Oral Fluid PoC Test in Relation to Oral and Systemic Diseases.

The manuscript uses the previously published literature and highlights the benefits of active-matrix metalloproteinase (aMMP)-8 chairside/point-of-care (PoC) diagnostic tools as adjunctive measures in oral and systemic diseases. Previous studies suggest that as a biomarker, aMMP-8 is more precise than total MMP-8, MMP-9, MMP-2, MMP-3, MMP-13, MMP-7, MMP-1, calprotectin, myeloperoxidase (MPO), human neutrophil elastase (HNE), tissue inhibitor of matrix metalloproteinase (TIMP)-1, and bleeding of probing (BOP). Therefore, aMMP-8 could be implemented as the needed key biomarker for the new disease classification for both periodontitis and peri-implantitis. With a sensitivity to the tune of 75-85% and specificity in the range of 80-90%, lateral flow aMMP-8 PoC testing is comparable to catalytic protease activity assays for aMMP-8. The test can be further applied to estimate the glycemic status of an individual, to ascertain whether a person is at risk for COVID-19, in managing the oral side effects of radiotherapy carried in head and neck cancers, and in selected cases pertaining to reproductive health. In the future, aMMP-8 could find application as a potential systemic biomarker in diseases affecting the cardiovascular system, cancers, bacteremia, sepsis, diabetes, obesity, meningitis, as well as pancreatitis. The aMMP-8 PoCT is the first practical test in the emerging new dental clinical field, that is, oral clinical chemistry representing oral medicine, clinical chemistry, peri-implantology, and periodontology.

Nigeria's street children, epitome of oral health disparity and inequality.

INTRODUCTION: it has been close to four years since the authors highlighted the total neglect of the oral health of street children in the Journal of Public Health Policy. Since then, the authorities appear to have simply turned the blind eye making this follow-up imperative. This follow-up report specifically examines the resultant oral health disparity between Nigeria's street children and Private, fee-paying secondary school students in Northern Nigeria. METHODS: we conducted a cross-sectional comparative survey of randomly selected 12-14 years old street children (children of Quranic informal educational institutions) in Northern Nigeria while fee paying, private secondary school children served as controls. A simple close-ended questionnaire translated into Hausa language was used to assess oral health knowledge and the Simplified Oral Hygiene Index used to categorize oral hygiene status of the participants. RESULTS: the mean age (SD) of the participating street children was 12.7 (0.86) while that of the private secondary school students (PSSS) was 13.05 (0.96). The majority (89%) of parents of street children compared with that (7%) of parents of students of private secondary schools had no western education. Only 6% of street children compared with 90% of PSSS cleaned their teeth for the right reasons. Only 5% of street children compared with 90% of private secondary school students used a fluoride-containing toothpaste. Though both groups of children have poor knowledge (street children 3%, private secondary school students 16%) on the use of dental floss, the mean oral hygiene score (SD) for street children was 4.42 (0.85) compared with 1.90 (0.09) for private secondary school students. There were striking differences in knowledge and practice with only 4% of street children compared with 69% of PSSS with knowledge about fluoride and its use (p < 0.0005). Also, 2% of street children compared with 40% of PSSS were aware of the benefits of regular dental visits. Sixty five (65%) of street children used finger and water only for tooth cleaning, none of the secondary school students practiced this (p = 0.0005). CONCLUSION: there is disparity in oral health practice between Nigeria's street children and private secondary school children. This disparity may be attributed to lack of western education and socio-economic status.

Oral health knowledge and practice of 12 to 14-year-old Almajaris in Nigeria: A problem of definition and a call to action.

We studied oral health knowledge and practices of 12 to 14-year-old Almajiri boys in northern Nigeria because we found few studies on their health, and none on their oral health. We present our study after explaining the desperate life circumstances and context of Nigeria's approximately 10 million Almajiri youth. Our results, when compared with those of previously studied populations (those most similar in terms of environment, age range, and oral health characteristics) show that the Almajiris fare poorly. Although the international community has paid some attention to the Nigerian Almajiri children's educational needs, there has been little support for health, and none for oral health. We argue that the World Health Organization could better assist Nigeria and these children by assuring that the Almajiris are not excluded from programs targeting children classified as 'street children', and make specific recommendations.

Another reason for impeccable oral hygiene: oral hygiene-sperm count link.

OBJECTIVES: 1. To investigate the relationship between periodontitis and infertility. 2. To evaluate the importance of oral hygiene to general health. MATERIALS AND METHODS: Eighty-six men requiring seminal fluid analysis as part of an on-going investigation for infertility in their spouses were serially recruited into the study. Basic dental and periodontal examination were performed. Each participant was also screened for periodontitis using a lateral flow immunoassay kit which detected levels of active membrane metalloproteinase-8. RESULTS were read-off as a color change. Due to some incomplete entries, only 76 participants were involved in the final data analysis. RESULTS: There were 55 subjects with subnormal counts (of which ten were found to be azoospermic, 41 oligospermic) and 25 normospermic controls. A positive association was found between periodontitis and subnormal sperm count in only one age group but statistically significant association was found between poor oral hygiene and subnormal sperm count across all age groups. CONCLUSION: For the first time, there appears to be a significant association between poor oral and subnormal sperm count. There also appears to an association between chronic periodontitis and subnormal sperm count. These relationships warrant further investigation. PRINCIPAL FINDINGS: There appears to be a link between poor oral hygiene and low sperm count.

Nigerian dentists' knowledge of aggressive periodontitis.

OBJECTIVE: To assess the general knowledge of Nigerian dentists on aggressive periodontitis (AgP) and specific knowledge of distinguishing between the clinical features of localized aggressive periodontitis (LAP) and generalized aggressive periodontitis (GAP). MATERIALS AND METHODS: A cross-sectional, non-random convenience survey was done on 200 dentists, in three geopolitical zones of Nigeria, using pre-tested, closed question- type questionnaires. Eventually, only 133 questionnaires were analyzed. Relationships between six outcome variables namely clinical features of LAP, clinical features of GAP, LAP oral hygiene, GAP oral hygiene, laser therapy option and type of laser therapy, and the explanatory variables of gender and experience were analyzed. RESULTS: A total of 33.8% of the dentists had poor general knowledge, 16.5% had fair knowledge, 31.9% had good knowledge, while 10.5% had excellent knowledge. Gender- and experience-related differences were found, but they were not statistically significant. CONCLUSION: Both the general and specific knowledge of aggressive periodontitis among Nigerian dentists is less than expected and needs improvement through targeted, continuing dental education.

Aggressive periodontitis in a Nigerian teaching hospital.

AIM: These case series were aimed at highlighting late presentations of aggressive periodontitis (AP) in a teaching hospital as well as proffering possible reasons for such presentations which would serve as part of the solution to prevent such presentations in the future. BACKGROUND: Aggressive periodontitis is a severe form of destructive periodontitis traditionally believed to present around puberty. However, many cases seen in a teaching hospital presented much later for yet-to-be explained reasons. CASE DESCRIPTION: Seven patients referred to the specialist periodontal clinic of a Nigerian teaching hospital presented with clinical features consistent with AP. Most of the patients were over twenty and some over thirty years of age. CONCLUSION: Aggressive periodontitis patients seen in our center were often outside the traditional age brackets. The range of treatment options available to the patients were under-utilized due to serious financial constraints. CLINICAL SIGNIFICANCE: Aggressive periodontitis comes with serious psychological challenges and severe morbidity. Prompt diagnosis and effective management hold the key to success It is important to investigate why many of the cases seen in our center presented that late. Could be due to ignorance and poverty or could be due to failure of dentists recognize these cases and consequent misdiagnosis? Further studies are needed to answer these questions.

Emerging trends in dental specialty choice in Nigeria.

Asymmetry in the distribution of dental specialists in Nigeria has the potential to negatively affect dental education at all levels. There is a dearth in Nigerian studies on the trends of influencing factors on the choice of dental specialty in Nigeria. Past efforts have not resulted in policy change thus necessitating the current study. One hundred and twelve (51 male, 61 female) Nigerian dental graduates aged 23-55 years with a mean age of 35.21 ± 8.21 years completed self-administered questionnaires to assess the impact of 16 influencing factors on their choice of dental specialty. The graduation period of respondents, which ranged between 0 and 30 years was recorded into three decades and cross-tabulated against 16 influencing factors to assess their relative impact on specialty choice. Diagnostic challenge, predictable work hours and patient type appeared to have maintained a consistent popularity while affluence and income, although less popular influences three decades ago are becoming increasingly relevant while length of programme, prestige and level of crowding exerted less influence on choice of specialty than other factors. The potential influence of incentives such as career counselling and grants for overseas training to encourage enrollment in less popular programmes was assessed based on recommendations from previous studies. However, these measures appeared to be unpopular among Nigerian dental graduates. Diagnostic challenges and predictable work hours remain popular as influencing factors on choice of dental specialty among Nigerian dental graduates. Affluence and income, although previously unpopular are now gaining popularity among Nigerian dental graduates.