Prevalence, pattern and severity of molar incisor hypomineralisation in 8- to 10-year-old school children in Ile-Ife, Nigeria.

AIM: This study aimed to determine the prevalence, pattern and severity of MIH in school children resident in a suburban population in Nigeria. METHODS: This was a cross-sectional study involving pupils aged 8-10 years resident in suburban Nigeria. Details of each pupil's socio-demographic variables were collected. Intra-oral examination was conducted to determine the presence of MIH, the affected tooth and the severity of the lesion. The association between the prevalence of MIH and socio-demographic variables of each child was determined. The predictors of MIH were also determined using a binomial regression analysis. RESULT: Eighty-three of the 469 children examined (17.7 %) had MIH. There was no significant association between sex (p = 0.58), socio-economic status (p = 0.09), age (p = 0.26) and MIH. There was also no significant difference in the number of teeth affected by MIH in the maxilla and mandible, and on the right and left side of the face. The most commonly affected teeth were the left mandibular molars. The occlusal surfaces of the first molars were mostly affected by MIH and the severity of MIH on the teeth examined varied from mild (80.8 %), moderate (14.0 %) to severe (5.2 %). CONCLUSION: The prevalence of MIH in this study population is consistent with previous reports. The non-association between sex and MIH prevalence, the varied severity of the lesion and association between MIH affectation of the first permanent molars and central incisors give more weight to the possible role of environmental factors in the aetiology of the lesion. The non-association between MIH and socio-economic status may serve as a distinctive feature of MIH and chronological enamel hypoplasia.

Natal and neonatal teeth: a review.

The presence of teeth in newborn is uncommon. Sometimes it occurs, appearing in about one in every 2,000 to 3,000 live births. Natal teeth are teeth already present at time of birth, neonatal teeth erupt during the first 30 days after birth. The normal eruption of the first teeth is quite exciting but their occurrence at birth or few days after birth is quite disturbing because of societal unpleasant reaction towards it in some communities and calls for concern. The majority of natal and neonatal teeth represent the early eruption of normal primary teeth. Less than 10% of natal teeth are supernumerary. Although the majority of natal teeth are isolated incidents, their presence may be associated with some syndromes. Complications include discomfort during suckling causing irritation and trauma to infants tongue, sublingual ulceration, laceration of the mother's breasts and aspiration of the teeth. The objective of the present study was to present a review of the literature on the current information on this topic and give treatment options if necessary.

Signs and symptoms of temporomandibular disorders in Nigerian adult patients with and without occlusal tooth wear.

OBJECTIVES: The purpose of this study was to investigate the prevalence of signs and symptoms of temporomandibular disorders in Nigerian patients with and without occlusal tooth wear, and to relate the signs and symptoms with the severity of occlusal tooth wear. METHODS: One hundred and fifty patients with occlusal tooth wear, and 100 control subjects participated in this study (mean age 40.8 +/- 12.2 years, range 18-65 years). Exclusion criteria included patients and subjects with more than one missing opposing pair of premolars or molars, restorations covering the entire incisal edge, canine cusps and occlusal surfaces of premolars and molars. The severity of occlusal wear was assessed using the tooth wear index (TWI) designed by Smith and Knight (1984). Chi-square test was used to compare the differences in signs and symptoms of TMD. P < 0.05 was defined as significant. RESULTS: Although more females reported pain than males the difference was not statistically significant (p = 0.05). Except for impaired range of movement, tooth wear patients and controls differ significantly with respect to the variables; pain report, pain on palpation, TMJ sound and deviation on opening (p < 0.001). Patients with mean occlusal TWI score of > or =3 differ significantly from those with TWI score < or =2 with respect to pain on palpation and TMJ sound (p < 0.001). CONCLUSIONS: Posterior occlusal wear (mean TWI scores of 3 or 4) was significantly associated with pain on palpation and TMJ sound. Hence there may be a clinically relevant risk of TMD among Nigerian patients with occlusal tooth wear.

Bacterial infections of the head and neck fascial spaces in Nigerians.

BACKGROUND: Bacterial infections of the head and neck region remain a major public health concern in Nigeria despite the availability and widespread use of antibiotics in the country. OBJECTIVE: This study was conducted to determine the pattern, aetiology, management and outcome of head and neck fascial space infections at Ife. METHODS: All consecutive patients who presented with fascial space infections between January 1995 and July 2004 at the Maxillofacial Unit of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria were admitted into the study. A structured questionnaire was completed for each patient and analyzed in respect of patients' demographics, source of infection, predisposing factors, location of infection; treatment and outcome. RESULTS: One hundred and three patients were managed during the study period. There were 55(53.4%) males and 48(46.6%) females with age ranging from 1-85 years. Submandibular space was the most common single space involved followed by the buccal space. The fascial spaces around the mandible were more involved those around the maxillae and scalp for all age groups. Four patients presented with Ludwigs' angina. Odontogenic infections arising from pulpitis, periodontitis and pericoronitis caused over 70% of the space infections. Microbial cultures showed mixed aerobic and anaerobic bacteriology. Management was by incision and drainage/decompression, removal of the source, use of antibiotics and supportive care. Two deaths were recorded in the course of this study. CONCLUSION: Bacterial infections of the head and neck region remain a major health hazard among Nigerians with spread of infection commonly involving the submandibular and the buccal spaces.

Dental caries in 12-year-old suburban Nigerian school children.

BACKGROUND: Dental caries is one of the commonest oral diseases in children. Despite this fact, not much attention has been given to studies on this issue among suburban Nigerian children. OBJECTIVE: To investigate the prevalence of dental caries, dental attendance and oral health behaviours among the 12- year-old suburban Nigerian children. SUBJECTS AND METHODS: Four hundred and two schoolchildren (349 boys, 153 girls) from both private and public schools age 12-year-old participated in the study in 2003. One examiner was calibrated and performed the screening procedures using standard method of WHO diagnostic criteria. RESULTS: The prevalence of caries was 13.9 % and mean DMFT was 0.14. The decayed component accounted for 77.2 % of the DMFT while filling and missing teeth accounted for 15.8% and 7% respectively. Over 85 % of the children examined were caries free. Seventy seven per cent of the teeth affected by caries were untreated. The probability of having caries experience DMFT> 0 was significantly associated with the type of school and regular sweet consumption p < 0.05. The children who had not visited the dentist had higher caries prevalence than other children. This was statistically significant p < 0.05. Dental attendance was generally poor in both public (90.6%) and private (83.1%) school children. CONCLUSION: The findings in this study for the caries prevalence in 12 year-old suburban Nigerian schoolchildren was as low as in developed countries of central Europe and lower than the global standard according to WHO references for the year 2000.

Rampant caries experience in a Nigerian teaching hospital population.

OBJECTIVES: A prospective study to find out the prevalence, pattern of distribution of rampant caries in patients treated at the outpatient clinic of the Dental Hospital, Obafemi Awolowo University Teaching Hospital Complex ( OAUTHC) Ile - Ife, Nigeria. METHOD: A total of 403 child patients aged 1 to 5 years who attended the hospital from January 1998 to December 2002 were examined by the authors. Questionaires were given to the parents or guardians to complete. RESULTS: The sample consisted of 213 males (52.8% ) and 190 females (47.2% ). Twenty two children (15males, 7 females) presented with rampant caries which was not statistically significant P >0.5. The prevalence of rampant caries was 5.5% . The peak age incidence was 4 years. More boys suffered rampant caries than girls with boy to girl ratio of 2:1. The pattern of distribution showed that the labial surfaces of the maxillary incisors were affected in all the patients. Five patients had proximal caries out of which mandibular primary incisors of 3 children were involved and one child presented with palatal caries of the maxillary primary incisors. CONCLUSION: The Dental Hospital, OAUTHC has experienced increased in number of rampant caries patients. Therefore emphasis on prevention of caries in suburban Nigerian children in Ile-Ife should be stepped up before it constitutes a significant oral health problem.

The effect of psychological management on dental anxiety in children.

The aim of this study was to determine the effect of using of psychological management techniques on the level of anxiety in Nigerian children during dental management. The Short Form of the Dental Anxiety Survey Schedule was administered to 81 children who were attending a suburban dental clinic for the first time. This schedule was re-administered again two weeks later when they came for a follow up visit. The age of the patients was recorded. The types as well as number of psychological techniques employed during treatment were also noted. The overall mean dental anxiety level of the children decrease from an average of 15.23 +/- 5.03 before treatment to 13.40 + 4.13 after treatment (p < 0.001). However, the mean dental anxiety score in children in whom no psychological technique was employed during treatment increased after treatment. On the other hand, there was also a statistically significant decrease in the mean dental anxiety level of children treated using either a single psychological technique or combined psychological techniques after treatment. Better results were obtained when combined psychological techniques where used than when only a single technique was used. It was concluded that psychological techniques used in the management of dental anxiety in children are highly effective in decreasing dental anxiety levels. Better results are obtained when a number of techniques are combined effectively.

Parental anxiety as a possible predisposing factor to child dental anxiety in patients seen in a suburban dental hospital in Nigeria.

INTRODUCTION: The aim of this study was to determine the relationship between parents' anxiety level and that of the child patient. METHODS: The Short Form of the Dental Anxiety Survey Schedule was administered to 81 children who were attending the dental clinic for the first time. The Dental Anxiety Scale was also used to collect relevant information from the parents. RESULTS: There was no statistically significant correlation between the anxiety level of the mother (r = -0.02, P = 0.82) or the father (r = -0.59, P = 0.62) and that of their child. However, bivariate analysis showed a closer association between the anxiety levels of the mother and the child (P = 0.055) compared to that between the father and the child (P = 0.475) although this was again found not to be statistically significant. CONCLUSION: Assessment and management of the anxiety level of the mother may be needed in some cases, both to manage the child effectively and to break the cycle of dental care anxiety in families.

Traumatized anterior teeth in children: a review of the literature.

This article reviews the incidence, predisposing factors, aetiology, classification, clinical features, treatment modalities and complications of traumatic injuries to anterior teeth in children. This review is primarily based on articles selected from Medline concerning traumatic injuries to the anterior teeth of children up to August 2000. The anterior teeth are important both functionally and esthetically. Fracture of such teeth could affect the appearance of an individual and their ability to eat properly. Epidemiological studies worldwide on traumatic injuries to anterior teeth in children shows that the prevalence is relatively high with more boys affected than girls. The commonest reported aetiological factor is fall. There is need to review the various aspect of this subject and update the treatment technique. Preventive measures to minimise its occurrence such as early orthodontic treatment of procline incisors and the use of mouth protectors during contact sports were highlighted. In addition it was suggested that children be supervised when they are playing and the public be educated on first aid management of dental trauma.

Unmet orthodontic treatment need in rural Nigerian adolescents.

A survey of orthodontic treatment need was carried out among randomly selected rural Nigerian adolescents using the index of orthodontic treatment need. Altogether, 704 subjects (381 boys and 323 girls) aged 12-18 years (mean 14.8, SD 1.79) were recruited in the study. The results indicated that 12.6% of the population were in objective need of orthodontic treatment. Whilst there was a discrepancy in the proportions of Nigerian adolescents needing orthodontic treatment on aesthetic and dental health grounds, girls were found to have a more attractive dental appearance and less orthodontic treatment need than boys. However, the differences were not statistically significant (P>0.05). The correlation between the orthodontist's and the subject's rating of dental appearance was found to be low (r=0.35). The study also provided reliable baseline data for planning orthodontic services in Nigeria especially in areas where there are no dental services.

Eruption times of third molars in young rural Nigerians.

The eruption pattern of third molar amongst 1071 rural Nigerians (523 males and 548 females) aged 11-21 years was assessed. The earliest age at which the third molar erupted for males and females was 14 and 13 years respectively with females significantly ahead of males (P < 0.01). A full compliment of erupted third molars was recorded at age 14 years in 1.1 per cent of the population. However, the mean age for the eruption of 1, 2, or 3 and all third molars were 16.58 and 17.50 years respectively. Whilst third molar-eruption was significantly earlier in the mandible, no right-left side differences were found. Problems often associated with the erupting third molars are likely to be seen earlier in young rural Nigerians than in the western countries.

Needs for dental information of adolescents from an inner city area of Liverpool.

The aim of this study was to determine the needs for dental information of adolescents and investigate the relationship of their desire for information with their opinion of who decides to make an appointment with the dentist (ie parent or child). In-depth interviews were conducted with 10 adolescents (aged 14 to 16 years) to derive questions for a questionnaire to assess dental information needs. One hundred and fifty-eight adolescents of similar age attending a secondary school in Liverpool were invited to complete the questionnaire. The results showed that adolescents are interested in finding out more information on different aspects of dental health which included especially: how to keep their teeth for life, about the best toothpaste, what to do in case they sustain dental injury and whether they required an orthodontic appliance. Another important finding was that more than half of the adolescents (57%) felt that they were responsible for taking decisions for their dental attendance. These children expressed a desire to know more about certain dental matters. Information needs of young people are important because of evidence derived from this study suggesting that acquisitiveness for dental information in this group, has possible implications for future patterns of seeking dental care.