Oral health-related quality of life: acrylic versus flexible partial dentures.

BACKGROUND: Teeth lost are usually replaced by all-acrylic removable partial dentures (RPD) because of its affordability and ease of fabrication. The all-acrylic RPD is said to cause significant periodontal injury and consequently affect the oral health related quality of life (OHRQoL) of denture wearers. OBJECTIVE: To determine and compare OHRQoL of all-acrylic and flexible RPD wearers at baseline and after use of dentures. DESIGN AND SETTING: Study was quasi-experimental using a cross-over design, involving 30 patients with Kennedy class IV and anterior class III arches. Patient recruitment and review were done over an eight-month period in the Prosthetic Unit of a tertiary health facility. OHRQoL was assessed with the oral health impact profile-14 questionnaire. Data were analysed using descriptive and multivariate analysis at asignificant level of p <.05. RESULTS: Mean age of patients was 33.8 ±10.0 years; at baseline, patient reported occasionally, fairly often or very often for 11(78.6%) OHIP items. However, after using the acrylic and flexible partial dentures, 11(36.6%) patients reported having trouble pronouncing words and 9(30.0%) found it uncomfortable to eat respectively. At baseline, there was a difference in mean OHIP scores with age (p=.02); scores reduced from 12.4 ± 9.8 to 4.8±5.3 (CI= 3.3-12.0, p=.001) after using the all-acrylic denture and 3.8±5.6 (CI= 4.3-13.0, p<.001) with the flexible denture. CONCLUSION: There was improvement in the OHRQoL of patients with use of flexible partial dentures. Therefore, thermoplastic materials are possible alternative RPD base materials in patient management. FUNDING: None declared.

Oral health-related quality of life: acrylic versus flexible partial dentures

Background: Teeth lost are usually replaced by all-acrylic removable partial dentures (RPD) because of its affordability and ease of fabrication. The all-acrylic RPD is said to cause significant periodontal injury and consequently affect the oral health related quality of life (OHRQoL) of denture wearers. Objective: To determine and compare OHRQoL of all-acrylic and flexible RPD wearers at baseline and after use of dentures. Design and setting: Study was quasi-experimental using a cross-over design, involving 30 patients with Kennedy class IV and anterior class III arches. Patient recruitment and review were done over an eight-month period in the Prosthetic Unit of a tertiary health facility. OHRQoL was assessed with the oral health impact profile-14 questionnaire. Data were analysed using descriptive and multivariate analysis at asignificant level of p <.05. Results: Mean age of patients was 33.8 ±10.0 years; at baseline, patient reported occasionally, fairly often or very often for 11(78.6%) OHIP items. However, after using the acrylic and flexible partial dentures, 11(36.6%) patients reported having trouble pronouncing words and 9(30.0%) found it uncomfortable to eat respectively. At baseline, there was a difference in mean OHIP scores with age (p=.02); scores reduced from 12.4 ± 9.8 to 4.8±5.3 (CI= 3.3­ 12.0, p=.001) after using the all-acrylic denture and 3.8±5.6 (CI= 4.3­13.0, p<.001) with the flexible denture. Conclusion: There was improvement in the OHRQoL of patients with use of flexible partial dentures. Therefore, thermoplastic materials are possible alternative RPD base materials in patient management

Making a Case for Formal School-Based Oral Health Promotion: Oral Health Knowledge, Attitude and Practices of Pupils in Ibadan, Nigeria.

Background Providing evidence for institution of school-based oral health promotion programs is paramount in developing countries, due to increasing unmet dental needs impacting on quality of life of children. Aim To evaluate oral health knowledge, attitude and practices (KAP) of pupils in a country lacking formal school oral health promotion. Methods A cross-sectional study was conducted among 1,297 pupils in randomly selected primary schools in one city. Information on oral health KAP were obtained using interviewer-administered questionnaire. Responses to questions were graded, standardized, and data analyzed using SPSS. Results The mean age was 10.6 (±1.7) years. Mean KAP percentage scores were 18.1 (±5.0)%, 18.3 (±4.9)%, and 17.3 (±12.8)%, respectively. Older age, male gender, and previous dental consultations were significantly associated with higher KAP scores. Those who had been educated informally about oral health had higher mean KAP scores ( p = .013, p < .001, and p < .001, respectively). Previous oral health education and consultation with dentists were significant predictors of higher oral health practice scores. Conclusion Poor oral health KAP exists among the pupils. Those who had consulted the dentist or had oral health education had better KAP. These findings reinforce the need for formal school-based oral health promotion.

Impact of Oral Health on The Quality of Life of Elementary School Teachers.

BACKGROUND: The success of preventive school health programs is largely dependent on teachers who are role models to pupils and pivotal to implementation. It is therefore important to understand the perception of school teachers about the impact of oral health on their daily activities. The aim of this study was to assess oral health related quality of life of elementary school teachers by evaluating the impact of oral conditions like dental caries and periodontal disease on their daily performances and school work. METHODS: This was a descriptive cross sectional study in which 407 teachers were selected through multistage random sampling technique. Data were collected with structured interviewer-administered Oral Impact on Daily Performances (OIDP) questionnaires and by clinical oral examinations. Data were collated and analysed with SPSS. RESULTS: The prevalence of reporting of impacts on daily performances was 39.1% with eating and enjoying food being the most commonly impacted activity. Impacts on daily performances were more likely to be reported by teachers with better education (p = 0.019). Teachers with caries had higher odds of reporting impacts as a result of oral health status (CI: 1.04, 5.64, p = 0.040). The severity of periodontal disease found on clinical examination was not related to reporting of impacts on quality of life (p > 0.05). CONCLUSIONS: The oral health status of school teachers impacted significantly on their daily performance and school work when they experienced pain. Painless but highly prevalent oral lesions were, however, not perceived to influence their quality of life.

Comparison of two oral health-related quality of life measures among adult dental patients.

PURPOSE: The most commonly used oral health related quality of life measures, Oral Health Impact Profile (OHIP) and Oral Impact on Daily Performances (OIDP), are affected by cultural and linguistic factors, which may be intensified in a treatment-need driven society. This study therefore aimed to compare the psychometric properties of the OHIP-14 and OIDP measures in adult patients in Nigeria where patients typically visit the dentist when dental problems arise. MATERIALS AND METHODS: This was a cross-sectional study in which 264 patients attending two dental clinics were recruited. Data were collected with OHIP-14 and OIDP structured interviewer-administered questionnaires, global self-report and perceived need for dental treatment questions and by oral examination. Data collected were subjected to statistical analysis using SPSS version 19 and the level of statistical significance was set at a p-value of 0.05. RESULTS: The majority (61.0%) rated their oral health status poorly and 203 (76.9%) perceived a need for treatment. The average OHIP and OIDP scores were 12.0 (range 0 to 56) and 8.9 (range 0 to 40), respectively. Both instruments showed a high index of validity and reliability; both had similar face and content validity, however, OIDP had better criterion validity while OHIP-14 had better construct validity and internal consistency. CONCLUSIONS: Both OHIP-14 and OIDP are precise, valid and reliable for evaluation of OHRQOL where dental care is treatment-need driven. They are able to discriminate between groups according to their perception of oral health status, but with OIDP detecting fewer impacts on daily activities.

An audit of school oral health education program in a developing country.

OBJECTIVE: The increasing prevalence of oral diseases in children in developing countries is a major public health concern and creates the need to review various preventive strategies put in place on oral health promotion. In the absence of formal national programs, tertiary health institutions have adopted low-budget school oral education programs targeted at improving oral health awareness and behavioral changes in school children. The aim of this study was to review the school oral health education programs conducted by the Community Dentistry Unit of a tertiary hospital in a major city in Nigeria. MATERIALS AND METHODS: An evaluation of the school oral health education programs conducted in the city over a 5-year period was done. Data collected included: venue of the program, the number of students and teachers educated in each school, screening and referrals, adequacy of teaching aids, desire for revisit, and barriers noted in its conduct. RESULTS: A total of 104 oral health education programs were conducted during this period involving 16,248 participants. The majority (80%) of the schools visited were primary schools and 54% were privately owned. Over half of the programs was conducted on assembly grounds, 21% in classrooms, and 13% in school halls. Challenges encountered included: lack of audiovisual aids, transportation problems, inadequacy of screening tools, and insufficient promotional materials. All the schools visited requested for (subsequent) regular visitation. CONCLUSION: The study showed the feasibility of low-budget oral health education and willingness of schools to benefit from such programs. There are barriers to effective communication, which can be mitigated in order to achieve an optimal school oral health education program in a low resource setting.

How valid are the psychometric properties of the oral health impact profile-14 measure in adult dental patients in Ibadan, Nigeria?

BACKGROUND: The Oral Health Impact Profile (OHIP) is the most widely used quality of life (QoL) measure to evaluate the influence of oral diseases on individuals. QoL measures have been noted to be context and environment specific, and there is a need to cross-culturally adapt a scale before its introduction into any community. This study aimed to evaluate the psychometric properties, validity and internal consistency of the OHIP-14 measure in an adult patient population in Ibadan, Nigeria. METHODS: A cross-sectional study was conducted over a four-month period on 204 adult patients using OHIP-14 structured questionnaire, global self-report indicator of oral conditions and perceived treatment need. Oral examinations were performed to assess periodontal status, caries experience and attachment loss. Data were analyzed using SPSS and p-value for statistical significance was set at < 0.05. RESULTS: A total of 204 patients participated in the study with a mean OHIP score of 11.2 (± 9.8). OHIP scores were not related to the sociodemographic characteristics. Perception of need for treatment was greater among those who reported impacts on their QoL (89.3% vs. 14.3%, p < 0.001). The OHIP scores correlated negatively with global self rating of oral health status (rho = -0.23, p < 0.01). Higher OHIP scores were associated with having carious teeth (p = 0.023). The Cronbach's alpha for the 14 inventory items ranged from 0.857 to 0.871. CONCLUSION: The OHIP-14 measure showed good psychometric properties with satisfactory validity and internal consistency in adult patients in Ibadan, Nigeria.

Dental education in the rural community: a Nigerian experience.

At the University of Ibadan, Ibadan, Nigeria, dental students are prepared not only to provide skilled care to individual patients, but also to assume responsibility for the community as a whole. In establishing the rural posting program for dental students, it was planned that all fifth year dental students would undertake a rural posting at Igboora, approximately 80 km from Ibadan, the capital of Oyo State. During this 6 week immersion experience students learn about living in a rural area where they provide community oral health services. This report provides recommendations for initiating, sustaining and expanding rural dental education programs.

Improvised source of water coolant for ultrasonic scaler: an appropriate technology in underserved communities.

Traditionally dental plaque, calculus and stains have been removed by scaling and polishing manually with hand instruments such as curettes, chisels, hoes and scalers. However, ultrasonic scaling is becoming the preferred method of initial periodontal treatment and maintenance, due to improved patient and operator comfort. Ultrasonic scaling can be performed effectively using pipe-borne water as coolant. However, such a water supply is unavailable in many rural dental clinics, especially in underserved communities in Nigeria. This article reports on an improvised source of water coolant, designed and fabricated to make modern, easy and effective plaque control available to people in communities where there is no pipe-borne water. The device will improve operator efficiency in tooth cleaning and patient compliance with treatment. Due to its simple design but effective function, the device is ideal for use in Nigeria's primary healthcare delivery program, offering enhanced preventive and curative services to remote, rural and semi-urban populations. In doing so oral health can be improved with a reduction in the incidence of oral diseases.

Oral mucosal lesions and temporomandibular joint impairment of elderly people in the South East Local Government Area of Ibadan.

OBJECTIVE: To determine the prevalence of oral mucosal lesions, temporomandibular joint (TMJ) impairment and oral health-related habits in the elderly people in South East Local Government Area (SELGA) in Ibadan. BACKGROUND DATA: SELGA is one of the largest local government areas in Oyo State, Nigeria and has a population of 225,800. DESIGN: A cross-sectional survey. METHODOLOGY: A randomly selected sample of 690 elderly people from 23 wards in SELGA were examined by two trained and calibrated examiners using mirror, probe and natural light. RESULTS: One hundred and fifty-five (22.46%) of the elderly examined had one or more oral pathology lesions, representing infection-related swelling, non-infection-related swelling, pre-malignant lesions, denture stomatitis, non-denture based ulcers, angular cheilitis, geographic tongue, scrotal tongue, lichen planus, hyper-pigmentation and TMJ impairment. Fifty-five (35.5%) of these pathologies were infection-related swellings. Six (3.9%) of the pathologies were denture-related stomatitis, 14(9.03%) were pre-malignant lesions, 14(9.03%) were non-infection-related swelling, while 27 (17.4%) were TMJ impairment. The rest of the lesions constituted the remaining 25.1%. Only 15.9% of the participants had tobacco-related habits, 10.7% drank alcohol, whilst 41.6% chewed kola nuts. CONCLUSION: Oral pathoses prevalence (22.46%) was similar to findings in developed countries (29.9%) but with a reversal of causal factors, infection-related swellings were more common, whereas pre-malignant lesions were less common. The infections were mostly complications from periodontal disease, which culminated in abscess formation. Tobacco-related habits were not highly prevalent among the elderly people in SELGA. However, oral pathoses resulting from nutritional deficiencies were the third most frequent lesions observed.

Pattern of tooth loss in an elderly population from Ibadan, Nigeria.

OBJECTIVES: To determine tooth loss, edentulousness, causes of tooth loss and pattern of tooth loss in the elderly in South East Local Government area (SELGA) in Ibadan. BACKGROUND DATA: SELGA is one of the largest in Oyo State, Nigeria and has a population of 225,800. DESIGN: A cross-sectional survey. METHODOLOGY: A total of 690 elderly individuals who were 65 years and above living in various wards in SELGA were interviewed by two interviewers and examined by two trained and calibrated examiners whilst two record clerks recorded all the findings of the examination. RESULT: Forty-eight per cent of the subjects in the study had not lost any teeth. The mean tooth loss was 4.5+/-7.6. Percentage edentulousness was 1.3% and this was higher in males than in females. This difference was not statistically significant (chi(2)=0.07 p=0.7). The total number of teeth lost was 3,102, 14% of the total number of teeth examined. The study showed that caries was not a major cause of tooth loss. Only 22 (0.7%) teeth were lost as a result of caries, 19 (0.6%) were lost because of trauma and periodontal disease contributed to loss of 3,061 (98.7%) teeth. Mandibular teeth exhibited a higher rate of retention than maxillary teeth. The percentage of elderly individuals with tooth loss increased with age. CONCLUSION: The study highlights the high life expectancy of a tooth among the elderly in SELGA. Despite the different cause of tooth loss in this area, in comparison with developed countries, the pattern of tooth retention appeared similar.