Prevalence of oral mucosal lesions and oral health related quality of life among adolescents in a rural Nigerian population

Background: Oral mucosal lesions affect people of all age groups, and vary in presentation; from asymptomatic to severely debilitating. Studies reporting the prevalence and effects of these lesions in adolescents are generally few compared to those describing the demography of dental caries and other oral diseases. Objective: To determine the prevalence of oral mucosal lesions, factors that contribute to the prevalence, and the association with the oral-health related quality of life (OHRQoL) of adolescents in the population. Methods: A cross-sectional survey was done on 240 secondary school students aged 10-19 from three secondary schools selected using multi-stage cluster random sampling. A pre-designed questionnaire was used to collect demographic information, presence of systemic illness, and oral habits. Oral-health related quality of life was assessed using the oral-health impact profile (OHIP-14), and intraoral examination was performed within the school premises by a single trained investigator. Results: A total of 33 participants (13.7%) had oral mucosal lesions. Overall, commissural lip pits (5.0%) were the most prevalent, while geographic tongue and irritation fibroma (0.4% each) were the least prevalent lesions. The mean OHIP-14 score of the participants in this study was 7.17+8.64. Participants with systemic diseases and cheek biting habits had statistically significant worse scores than those without either. Conclusion: The most prevalent oral mucosal lesions in the adolescent age group are those of developmental origin. Quality of life was negatively impacted by the presence of systemic diseases as well as cheek biting habit.

Dental esthetics and oral health-related quality of life in young adults.

INTRODUCTION: Dental esthetics affects how people are perceived by society and how they perceive themselves, and this may also affect their oral health-related quality of life (OHRQoL). The aim of this study was to compare the impacts of self-perceived and normatively assessed dental esthetics on the OHRQoL of a young adult population. METHODS: This was a cross-sectional descriptive study involving 375 undergraduate university students, aged 18 to 30 years old. Data collection was carried out through oral examinations and self-administered questionnaires. Dental esthetics of the students was assessed using the esthetic component of the Index of Orthodontic Treatment Need. Two OHRQoL instruments were used: the shortened version of the Oral Health Impact Profile and the Psychosocial Impact of Dental Aesthetics Questionnaire. RESULTS: Statistically significant relationships (P <0.05) were recorded between both self-perceived and normatively assessed dental esthetics of the students, respectively, and 3 of the 4 Psychosocial Impact of Dental Aesthetics Questionnaire subscales: dental self-confidence (Kruskall-Wallis, P = 0.000; P = 0.000), psychological impact (P = 0.003, P = 0.047), and esthetic concern (P = 0.006, P = 0.003). The only exception was the social impact subscale, in which a significant relationship was recorded only with self-perceived dental esthetics (P = 0.040). For the shortened version of the Oral Health Impact Profile scale, marked differences were also observed between the impacts recorded for both self-assessments and normative assessments, respectively, particularly for the psychological disability domain (Fisher exact test, P = 0.021, P = 0.000; P = 0.064, P = 0.096). CONCLUSIONS: Differences exist between the impacts of self-perceived and normatively assessed dental esthetics on the OHRQoL of young adults, particularly in the psychosocial domains. These differences should be considered in orthodontic treatment planning for young adult populations.

Programme guidelines for promoting good oral health for children in Nigeria: a position paper.

BACKGROUND: The objective of this paper is to draw attention to the oral health needs of children in Nigeria, and promote the use of appropriate interventions for disease prevention in the population. It also evaluates the value of the ongoing twice-daily tooth brushing campaign, which focuses on promoting good periodontal health and its relevance for children in Nigeria. DISCUSSION: The main oral health burden for children in Nigeria is untreated dental caries, attributable to low utilization of oral health facilities. While there is a strong association between oral hygiene status and caries occurrence, no research had established an association between frequency of tooth brushing and caries in children in Nigeria. Prevalence of caries and gingivitis is low, despite the fact that a majority of children brush once a day and most of them have fair oral hygiene. Campaigns that promote twice daily brushing to prevent chronic periodontitis in children are not driven by evidences supporting the local epidemic, and therefore cannot be considered as efficient use of the limited resources available. SUMMARY: Existing evidences show that the main oral health need of children in Nigeria is the management of untreated caries. Promoting the treatment of caries should be the primary focus of oral health programmes for children in Nigeria, as this would reduce further risks of developing new carious lesions. Public health campaigns should focus efforts at creating demand for oral health care services, for both preventive and curative purposes.

Study motives, career choices and interest in paediatric dentistry among final year dental students in Nigeria.

BACKGROUND: Students' motives for studying Dentistry have been a subject of interest for years because of the potential for understanding the psychological makeup and subsequent job satisfaction for the dentist. It is also useful in identifying expectations of the profession. This study therefore tried to identify study motives and career preferences of dental students especially with respect to the practice of paediatric dentistry. METHODS: This was a cross-sectional study using a self-administered questionnaire. The final year students in six dental schools in Nigeria were required to fill the questionnaire. Students were asked to rank their motives and career preferences on a Likert like scale with points ranging from 0-5 where 0 represented a factor that had no influence on their decision and 5 represented a very influential factor. The underlying dimensions for study motives, career preference, impression about and motive for interest in the practice of paediatric dentistry were identified using factor analysis. RESULTS: One hundred and seventy nine of 223 students (80.3%) participated in this study. Motives for the practice of dentistry included characteristics of the profession, altruism and intellectual challenges, existence of artistic theme in dentistry and parent's recommendation. Overall, 67.1% of respondents indicated interest in postgraduate studies and 50.8% were interested in paediatric dentistry practice. The main motives for showing interest in the practice of paediatric dentistry were 'personal interest, professional interest and interest of significant others in children', and 'family influence'. Significantly more males than females were interested in the practice of paediatric dentistry though the motives for interest in the practice of paediatric dentistry did not differ significantly by sex or age. CONCLUSION: The non-significant sex difference in the motives for interest in the practice of paediatric dentistry is a possible reflection of changes in strong cultural themes in the motives for career choices in Nigeria.

Determinants of preventive dental practice for children among final-year dental students in Nigeria.

BACKGROUND: This study aims to identify the determinants of caries prevention-oriented practice for children among final-year dental students in Nigeria. METHOD: A questionnaire was distributed to 179 final-year dental students in six dental schools in Nigeria. It requested information on age, gender, knowledge of caries prevention measures, self-perceived competency in providing caries-preventive care for children, and caries prevention-oriented practice for two hypothetical cases with high and low risk of caries. Chi-squares tests and logistic regression analysis were done. RESULTS: Between 24% and 41% of the respondents indicated their inability to determine the appropriate treatment modality for children with high and low caries risk. Majority of the students failed to differentiate between the caries-preventive practice for children with high and low risk of caries: preventive strategies for children with high caries risk were also used for those with low caries risk. Age, gender, knowledge of caries prevention measures, and self-perceived competency in providing caries-preventive care were not associated with student's capacity to provide caries-preventive practice for children. CONCLUSION: Caries-preventive practice among dental students in Nigeria could be improved. It may be important to explore the possible role of problem-based learning approach in addressing this challenge.

Determinants of preventive oral health behaviour among senior dental students in Nigeria.

BACKGROUND: To study the association between oral health behaviour of senior dental students in Nigeria and their gender, age, knowledge of preventive care, and attitudes towards preventive dentistry. METHODS: Questionnaires were administered to 179 senior dental students in the six dental schools in Nigeria. The questionnaire obtained information on age, gender, oral self-care, knowledge of preventive dental care and attitudes towards preventive dentistry. Attending a dental clinic for check-up by a dentist or a classmate within the last year was defined as preventive care use. Students who performed oral self-care and attended dental clinic for check-ups were noted to have complied with recommended oral self-care. Chi-square test and binary logistic regression models were used for statistical analyses. RESULTS: More male respondents agreed that the use of fluoride toothpaste was more important than the tooth brushing technique for caries prevention (P < 0.001). While the use of dental floss was very low (7.3%), more females were more likely to report using dental floss (p=0.03). Older students were also more likely to comply with recommended oral self-care (p<0.001). In binary regression models, respondents who were younger (p=0.04) and those with higher knowledge of preventive dental care (p=0.008) were more likely to consume sugary snacks less than once a day. CONCLUSION: Gender differences in the awareness of the superiority of using fluoridated toothpaste over brushing in caries prevention; and in the use of dental floss were observed. While older students were more likely to comply with recommended oral self-care measures, younger students with good knowledge of preventive dental care were more likely to consume sugary snacks less than once a day.

An appraisal of the oral health care system in Nigeria.

OBJECTIVES: This study aimed to assess the strengths and weaknesses of the oral health care system in Nigeria and to outline broad policy options for strengthening the system. METHODS: A critical appraisal of the oral health care system in Nigeria was conducted. The Maxwell criteria were used to assess performance. RESULTS: There has been some progress and growth in the oral health care system in Nigeria. However, it is clear that the system falls short on many desirable attributes. The system is neither effective nor efficient and the resources available are grossly inadequate and are overstretched in many areas. The oral health care system is unresponsive to the needs of the populace and there is little stewardship of the system. CONCLUSIONS: Urgent action in the Nigerian oral health care system is required on the part of all stakeholders. The first step should involve the provision of adequate resources for the immediate implementation of the national oral health policy. There is also a need for more research on oral health-related issues in the country. Efforts towards improving the system must be properly coordinated by the Federal Ministry of Health and involve all stakeholders in the sector in order to achieve success.