Amalgam phase down: baseline data preceding implementation in Nigeria.

OBJECTIVE: The Minimata Convention on mercury includes amalgam phase-down and eventual phase-out from dentistry. To aid its subsequent evaluation it is important to have baseline data of amalgam use in a locality prior to implementing a phase-down. METHODOLOGY: Records of patients spanning 5 years from January 2011 to January 2016 were analysed to determine and the compare frequency of amalgam usage with other dental materials for carious teeth restorations in a Nigerian university teaching hospital. Classes of cavities restored and cadres of operators who employed the different materials were included. Institutional ethics committee approval was obtained prior to commencing the study. RESULTS: 2,058 patients' records were retrieved, 59% females and 41% males. Their ages ranged 19-80 years, mean 33.5 ± 12.7 years, young adults 20-39 years old were the majority (62.9%). Filling materials included 57.5% amalgam, 17.6% glass ionomer cement (GIC) and 24.9% resin composite. Class I restorations constituted 70.5% of amalgam restorations, while Class II restorations made up 29.4% and Class V restorations accounted for 0.1%. Undergraduate dental students placed most of the amalgam restorations (60.5%), and 78.9% of all their restorations were amalgam. Less experienced dentists used all materials equally; the more experienced dentists placed more composite resin and GIC (43.3%). CONCLUSION: Amalgam fillings constituted nearly 60% of the restorations of carious teeth. Training of dental students in placement of non-mercury alternatives to amalgam and Minimum Intervention Dentistry needs to be emphasized in dental schools. Phase-down of amalgam should be intensified in Nigeria with the ultimate aim of a phase-out in line with the Minamata Convention.

Shade selection practices amongst clinical dental students in South Western Nigeria

Objective: Shade selection is crucial in satisfying aesthetic demands of patients during cosmetic dental treatment. It is important to nurture and evaluate this act in students as future dental professionals. This study aimed to evaluate the understanding and practice of tooth shade matching amongst dental students. Methods: A descriptive cross-sectional study was carried out in South-Western Nigeria. A structured, self-administered questionnaire was given to clinical dental students to garner information on socio-demographics, knowledge and practice of shade selection. The resulting data were statistically tested using chi-square with p-value ≤ 0.05 indicating significant level. Results: There was 76.5% response rate to the questionnaires with the male subjects accounting for 52.3%. The mean age of participants was 24.2 ± 2.4 years. Majority (40.9%) did not know the ideal time required for shade selection. Most (57.9%) students used visual/manual method in shade selection but 63.6% of these did not know the name of the shade guide used. Majority (80.8%) select the shade before commencing restorative procedure. Less than half (36.4%) of participants performed tooth shade matching in 3 segments (from incisal-third to cervical-third) while 54.5% considered tooth shade as a single uniform colour. Most students, 67.4% had a fair knowledge of shade matching while 13.6% practiced good shade matching technique for restorations/prosthesis. There was a statistically significant difference (p=0.022) between shade selection practice and the clinical training levels of students. Conclusion: The dental students had a fair knowledge about the principles of shade selection but lack the clinical know-how