Associations between oral habits, dental anxiety, dental service utilization, and maternal mental health status among 6- to 12-year-old children in Ile-Ife, Nigeria.

PURPOSE: The current study sought to determine the associations between maternal mental health and oral habits, dental anxiety, and dental service utilization of 6- to 12-year-old children in Ile-Ife, Nigeria. METHODS: Data were obtained from a household survey involving 1411 mothers and their 6- to 12-year-old children. Data collected were the confounding (maternal age, child's age at last birthday, sex at birth and socioeconomic status), independent (maternal psychological distress, and depression status) and dependent (child's non-nutritive oral habits, dental anxiety level, and most recent dental visit) variables. Bivariate analyses were conducted to test the associations between the dependent and independent variables. After controlling for confounding variables, the associations between the dependent and independent variables were determined using multivariable linear and logistic regression analyses. RESULTS: Overall, 479 (33.9%) reported one oral habit, 189 (13.4%) reported two and 99 (7.0%) children reported three or more oral habits. Only 25 (1.7%) children reported a dental visit in the year preceding the study. Higher maternal psychological distress was associated with higher dental anxiety in children (AOR: 0.094; 95% CI - 0.080 to - 0.293; p < 0.001). There was no significant association between maternal psychological distress, child's non-nutritive oral habits, and the child's most recent dental visit. There was also no association between maternal depression and the child's non-nutritive oral habits, dental anxiety level, and most recent dental visit. CONCLUSION: Maternal psychological distress was a significant risk indicator for dental anxiety, but not for dental service utilization or non-nutritive oral habits among children in Ile-Ife, Nigeria. Maternal educational status was also associated with dental anxiety. Further research is needed to elucidate the study's findings.

Perception and Concerns about the Use of Gloves, Facemask, and HIV Discriminatory Attitude of Children attending Dental Clinics in Southern Nigeria.

INTRODUCTION: The use of face masks and gloves can prevent possible cross infection between dental patients and health care practitioners. AIM: The study identified the perception of paediatric dental patients on the need for dentists to use face masks and gloves; and their attitude towards using the same clinic with paediatric dental patients living with HIV. METHODS: This was a cross sectional study that recruited 438 children aged 8-15 years attending three paediatric dental clinics located in Southern Nigeria. STATISTICAL ANALYSIS: The dependent variables were perception of cross infection control and attitude towards children living with HIV. The independent variables were age, sex, socioeconomic status and location of clinic. Chi-square analysis was conducted to determine the associations between the dependent and independent variables. Logistic regression analysis was also conducted to assess the effect size of the associations between the dependent and independent variables. The level of statistical significance was inferred at P < 0.05. RESULTS: Majority of the respondents agreed that it was necessary to wear gloves (98.6%) and facemasks (88.1%) during patients' management. More females 62(28.2%) than males 38(17.4%) assumed gloves were used by dentists to protect themselves from patients' bad breath (p=0.007). More children from Benin 97(64.2%) were aware that face masks protect the dentists and the patients (p=0.004), and a few believed that it is embarrassing to patients for dentists to wear facemasks (p=0.001). More children 102(70.8%) from Ile-Ife perceived that face masks protects from bad breath (p=0.004).Children less than 10 years (AOR: 0.85; 95% CI: 0.42-1.70; p=0.64), with high socioeconomic status (AOR: 0.90; 95% CI:0.53-1.52; p=0.70) and children aged 10 to 14 years (AOR: 0.85; 95% CI: 0.44-1.63; p=0.62), in the middle socioeconomic status (AOR: 0.72; 95% CI: 0.39-1.33; p=0.30) were less willing to use the dental clinic alongside children living with HIV. CONCLUSION: There were sex, and clinic location disparity in the perception and attitude of children towards the use of Personal Protective Equipment and the use of the dental clinic alongside children living with HIV.

INTRODUCTION: L'utilisation de masques faciaux et de gants peut prévenir une éventuelle infection croisée entre les patients dentaires et les praticiens de santé. OBJECTIF: L'étude a identifié la perception des patients dentaires pédiatriques sur la nécessité pour les dentistes d'utiliser des masques et des gants ; et leur attitude vis-à-vis de l'utilisation de la même clinique avec des patients dentaires pédiatriques vivant avec le VIH. MÉTHODES: Il s'agit d'une étude transversale qui a recruté 438 enfants âgés de 8 à 15 ans fréquentant trois cliniques dentaires pédiatriques situées dans le sud du Nigeria. ANALYSE STATISTIQUE: Les variables dépendantes étaient la perception du contrôle des infections croisées et l'attitude envers les enfants vivant avec le VIH. Les variables indépendantes étaient l'âge, le sexe, le statut socio-économique et le lieu de la clinique. Une analyse du chi carré a été réalisée pour déterminer les associations entre les variables dépendantes et indépendantes. Une analyse de régression logistique a également été réalisée pour évaluer la taille de l'effet des associations entre les variables dépendantes et indépendantes. Le niveau de signification statistique a été déduit à P < 0,05. RÉSULTATS: La majorité des répondants étaient d'accord pour dire qu'il était nécessaire de porter des gants (98,6 %) et des masques (88,1 %) pendant la prise en charge des patients. Plus de femmes 62(28,2%) que d'hommes 38(17,4%) ont supposé que les gants étaient utilisés par les dentistes pour se protéger de la mauvaise haleine des patients (p=0,007). Plus d'enfants béninois 97(64,2%) savaient que les masques faciaux protègent les dentistes et les patients (p=0,004), et quelques-uns pensaient que le port de masques faciaux par les dentistes était gênant pour les patients (p=0,001). Les enfants de moins de 10 ans (AOR : 0.85 ; 95% CI : 0.42-1.70 ; p=0.64), avec un statut socio-économique élevé (AOR : 0.90 ; 95% CI:0.53-1.52 ; p=0.70) et les enfants âgés de 10 à 14 ans (AOR : 0,85 ; IC 95% : 0,44-1,63; p=0,62), au statut socio-économique moyen (AOR : 0,72 ; IC 95% : 0,39-1,33 ; p=0,30) étaient moins disposés à utiliser la clinique dentaire aux côtés des enfants vivant avec le VIH. CONCLUSION: Il y avait une disparités de sexe et de lieu de clinique dans la perception et l'attitude des enfants vis-à-vis de l'utilisation des équipements de protection individuelle et de l'utilisation de la clinique dentaire avec les enfants vivant avec le VIH. Mots clés: Masque, Gants, VIH, Discriminatoire, Enfants.

Oral habits and malocclusion in children resident in Ile-Ife Nigeria.

AIM: To determine the: prevalence of oral habits in children aged 1-12 years in Ife Central Local Government Area of Osun State Nigeria; association between oral habits and malocclusion in children aged 6-12 years; differences in orthodontic treatment needs of children with and without oral habits and the effect of digit sucking severity on occlusal profile. METHODS: This was a cross-sectional study that collected data through a household survey. Information collected included the age, gender, and oral habits of study participants. Intra-oral examination was conducted. The Dental Aesthetic Index (DAI) was used to assess orthodontic treatment needs for 6-12-year-old participants. Independent sample t test was used to compare mean DAI scores of participants with and without oral habits. A digit sucking severity index was developed and digit sucking severity was determined. RESULTS: One hundred and thirty (13.1%) study participants had 142 oral habits. The most common oral habit was digit sucking. The most common malocclusion traits were spacing (29.9%), crowding (21.7%) and increased overjet (16.4%). DAI scores were significantly higher in participants with tongue thrusting (p < 0.001) and bruxism (p = 0.01) habits compared with participants without the habits. Among the 67 participants with oral habits, 54 (80.6%) had no need for treatment, 9 (13.4%) needed elective treatment and treatment was mandatory for 4 (6.0%) participants. CONCLUSIONS: Digit sucking was the most frequently practiced oral habit in the study population. Tongue thrusting and bruxism were significantly associated with greater severity of malocclusion in children 6-12 years old when compared with peers who had no habits. Most children with oral habits had no need for treatment.

ISOLATION, CHARACTERIZATION AND IMMUNOCHEMICAL STUDIES ON FIBROUS PROTEINS FROM COWRY SHELL (CYPRAEA MONETA, LINNAEUS).

BACKGROUND: Biomaterials are non-drug substances used to treat, enhance or replace functions of body tissues or organs. Natural sources of biomaterials have recently become the focus of several research activities. Cowry shell constitutes one of the most promising natural sources of biomaterials because of its chemical stability, biodegradability and biocompatibility in the body. However, its applications may be limited due to immunogenic and toxic responses that may occur following implantation, hence this study. MATERIALS AND METHODS: Crude fibrous protein extracted with citrate buffer from pulverised cowry shells (Cypraea moneta (L)), was resolved into two components (CSP1 and CSP2) by gel filtration. Immunological studies were performed with antisera obtained from rabbits by double immunodiffusion and immunoelectrophoresis techniques. Mice treated with the proteins were observed for signs of toxicity and their liver, kidney, lungs and spleen were processed histologically. RESULTS: The native molecular weight of CSP1 and CSP2 determined by gel filtration were 91kDa and 33kDa respectively. CSP1 and CSP2 displayed single bands on SDS-PAGE with subunit molecular weight values of 19kDa and 19.5kDa respectively. Antisera obtained from rabbits immunised with the crude citrate buffer extracts precipitated the antigen in double immunodiffusion tests. Histopathological examinations revealed a dose-dependent damaging effect of the shell proteins on liver, kidney, lung and spleen tissues of the treated mice. CONCLUSION: This study showed that cowry shells contain fibrous proteins which are immunogenic and toxic in mice at relatively high concentrations, causing visible organ damage without concurrent physical manifestations.

Hypomineralised second primary molars: prevalence, pattern and associated co morbidities in 8- to 10-year-old children in Ile-Ife, Nigeria.

BACKGROUND: This study tries to determine the prevalence and co-morbidities associated with hypomineralised second primary molars (HSPM) in 8- to 10- year-old children in Ile-Ife, Nigeria; and the co-existence of HSPM and Molar Incisor Hypomineralisation (MIH) in the study population. METHODS: This was a cross sectional study involving 8- to 10- year-old children in schooling in suburban Nigeria. Information was collected on the child's age, sex and socioeconomic status. Intraoral examination was conducted to determine the presence of HSPM, MIH, caries and the oral hygiene status of study participants. The severity of HSPM was also determined. The prevalence of HSPM, the association between HSPM, sex and socioeconomic status of study participants, the difference in the prevalence of caries and poor oral hygiene in children with and without HSPM, and the prevalence of HSPM and MIH co-morbidity were determined. RESULTS: Twenty seven of the 469 children examined (5.8 %) had HSPM. The tooth prevalence of HSPM was 3.9 %. There was no significant sex (p = 0.06), age (p = 0.41), and socioeconomic status (p = 0.67) differences between children with HSPM and without HSPM. More children with HSPM had caries (p ≤ 0.001) and poor oral hygiene (p = 0.01). Children with HSPM have increased odds having dental caries (AOR: 6.34; CI: 2.78-14.46; p = <0.001) and reduced odds of having good oral hygiene (AOR: 0.32; CI: 0.13-0.78; p = 0.01) when compare with children without HSPM. Also 77.8 % of children with HSPM also had MIH. CONCLUSION: The prevalence of HSPM in the study population is significantly high. The large number of children with HSPM and MIH also suggests that HSPM is a predisposing factor for MIH. The significantly higher proportion of children with HSPM who had caries and poor oral hygiene makes it imperative to institute screening programmes for HSPM/MIH in the study population.

Use of caries prevention tools and associated caries risk in a suburban population of children in Nigeria.

AIMS: To determine the association between use of recommended oral self-care (ROSC) caries prevention tools and presence of dental caries in children resident in suburban Nigeria. METHODOLOGY: Secondary analysis was conducted for a dataset generated for 1-12 years old children recruited through a household survey. Information on use of ROSC caries prevention tools (brushing more than once a day, use of fluoridated toothpaste always, and eating sugary snacks between main meals less than once a day), use of oral health adjuncts (dental floss, mouth rinses, other tooth cleansing agents) and presence of caries were extracted. The odds of having caries when ROSC caries prevention tools were used singly or in combination, were determined using multivariate logistic regression adjusted for age and sex. RESULTS: The single or combined use of ROSC caries prevention tools had no statistically significant association with presence of caries. Brushing more than once a day reduced the odds of having caries while consumption of sugar between meals once a day or more increased the odds of having caries after adjusting for age and gender. The use of two ROSC caries prevention tools reduced the risk for caries (AOR 0.28; 95 % CI 0.05-1.53) when adjusted for age. The converse was observed when adjusted for gender (AOR 1.15; 95 % CI 0.38-3.45). The largest effect size was observed when sugary snacks were taken once a day or more between meals after adjusting for age (AOR 5.74; 95 % CI 0.34-96.11). CONCLUSION: The use of a combination of fluoridated toothpaste and twice-daily tooth brushing had the largest effect on reducing the chance for caries in children resident in Ile-Ife, Nigeria.

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.

Comparative evaluation of perceptions of dental students to three methods of teaching in Ile-Ife, Nigeria.

BACKGROUND: The World Health Organization in 1994 recommended that dental education should be problem based, socially and culturally relevant, and community oriented. OBJECTIVES: To explore the perceptions of Pre-phase II (pre-clinical II) dental students on three methods of teaching used during two academic sessions. METHODS: All part IV dental students in two consecutive sessions undergoing pre phase II course in the Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife were recruited into the study. Three different modes of teaching that is, Problem based learning (PBL), hybrid PBL and traditional teaching were used to teach the students. A twenty two itemed anonymous questionnaire on a five point Likert scale was administered to the students at the end of the course. Six perceived factors were extracted from the questionnaire using factor analysis. RESULTS: There was a statistically significant difference (p < 0.01) between the overall mean of PBL method compared to the other methods of teaching. The perceived factor "communication with peers" had the highest mean score for PBL in both sessions (4.57 ± 0.58 and 4.09 ± 0.93 respectively). However, PBL method was very helpful in all the six perceived factors while the students perceived that the traditional method of teaching was not helpful in "interaction with tutors" and "challenge to critical thinking". CONCLUSIONS: The findings showed that students preferred the PBL method to other forms of teaching. PBL enhanced the students' communication skill, was very useful as pedagogic tool and improved their critical thinking.

A prospective study on the effectiveness of ketamine and diazepam used for conscious sedation in paediatric dental patients' management.

AIM: The need to manage children using safe, effective and inexpensive conscious sedation materials and techniques in paediatric dentistry is high. This study evaluated the safety and effectiveness of a combination of low dose ketamine (5 mg/kg) and diazepam (0.2 mg/kg) used for conscious sedation in healthy children undergoing paediatric dental procedures at a paediatric dental outpatient clinic over a 3-year period. MATERIALS AND METHODS: All children who were scheduled for conscious sedation between 2009 and 2012 were included in the study. All children received ketamine 5 mg/kg body weight in combination with diazepam 0.2 mg/kg body weight in a single oral dose for use as conscious sedation. Patients were considered sedated when the Ramsey Score was 2 or 3. Time of onset and duration of surgical procedures were recorded. Side effects during and after discharge were recorded. RESULTS: Twenty five patients participated in the study. The effectiveness of the sedation was 84.0%. The mean time of onset of action was 10.5 ± 7.2 minutes. All cases that needed additional sedation needed this after 35?36 minutes. Three cases (12.0%) developed high temperature in the night of the day of the procedure. There was a case (4.0%) of hallucination. CONCLUSION: Ketamine and diazepam as medication for conscious sedation was considered effective. The duration of effectiveness appears to be 35 minutes. The combination is considered safe for use for conscious sedation in healthy paediatric dental outpatients undergoing minor oral surgical procedures.

Prevalence and clinical consequences of untreated dental caries using PUFA index in suburban Nigerian school children.

BACKGROUND: Dental caries is the most common childhood disease and the most frequent non-communicable disease worldwide. In developing countries, a vast majority of the caries remains unrestored. However, the severity and consequences of untreated dental caries among Nigerian children is unknown. OBJECTIVES: To determine the prevalence using the DMFT/dmft index and severity of oral conditions related to dental caries using the PUFA/pufa index in suburban Nigerian children. METHODS: The study population consisted of 1,266 randomly selected school children in Ile-Ife, Nigeria. Dental caries status was assessed using the DMFT/dmft index, described by WHO for epidemiological studies. The PUFA/pufa index was used to assess the clinical consequences of untreated dental caries. RESULTS: The mean dmft was 0.58 for the 4-6 years age group while the mean pufa score was 0.16 for the same age group. The mean DMFT score (0.16) was highest for the 13-16 years age group, while the mean PUFA score was 0.05 for the same age group. The prevalence of dmft > 0 was highest in the 4-6 years age group (16.9 %) while the prevalence of DMFT > 0 was highest in the 13-16 years age group (7.2 %). The mean pufa > 0 was highest in the 4-6 years age group (9.2 %). The overall caries prevalence was highest in the 4-6 years age group (17.4 %). Thirty-three percent of decayed teeth in the permanent dentition and 28.2 % of the primary dentition had signs of odontogenic infections. CONCLUSIONS: Despite the increase in the consumption of westernised diets by Nigerian children coupled with limited access to dental care, the prevalence was low but the clinical consequences of untreated dental caries was still high.

Orbito-ocular soft tissue measurements in young adults--an indigenous Negro population study.

AIM: This study was named at determining normal orbital soft tissue parameters in young adults in an indigenous black population. METHODOLOGY: Prospective study on consentimg young adults in a Nigerian University with no previous orbito-facial trauma/surgery, strabismus, ptosis, telecanthus, and history of neurological diseases or previous ocular trauma were excluded. The age, sex and height of each participant were recorded. With the aid of a manual Sliding Vernier Caliper, the inner canthal distance (ICD), outer canthal distance (OCD), right horizontal palpebrae fissure length (RHPFL), left horizontal palpebrae fissure length (LHPFL). The results were imputed, analyzed and reported as simple frequency, means and standard deviations using the SPSS version 11 and statistical significant accepted at P < 0.05. RESULTS: Two hundred and four of participants of which 136 (66.7%) were males constituted the study population. Their ages ranged between 17-38 years with a mean and standard deviation of 23.6 ± 3.2 years. Their height ranged from 1.43-1.94 m with a mean and standard deviation of 1.70 ± 0.81 m. The mean and standard deviation for OCD, ICD, RHPFL and LHPFL were 99.6 ± 5.5 mm, 36.5 ± 3.3 mm, 32.5 ± 1.8 mm and 31.7 ± 1.9 mm, respectively. The range and mean ICD (28.2-45.4 mm and 36.5 mm) is greater than the range and mean palpebrae fissure lengths in either eye. Statistcally significant gender based differences were recorded in the mean OCD and ICD with higher values in in males. CONCLUSION: Normal soft tissue orbit-ocular parameters are presented for young adults in the population showing statistically significant mean larger values for males compared with female subjects.

Oral hygiene measures and the periodontal status of school children.

BACKGROUND: Tooth brushing and other mechanical cleaning procedures are considered the most reliable methods of effective plaque removal, which is essential for prevention of periodontal diseases. OBJECTIVE: To investigate the relationship between oral hygiene practices, socioeconomic status and gingival health in a group of Nigerian children. METHODS: Our study population consisted of 242 randomly selected school children in Ile-Ife, Nigeria. Participants completed a questionnaire on oral hygiene measures, their gingival health was assessed using oral hygiene index (OHI), plaque index (PI) and index of gingival inflammation (GI). RESULTS: Toothbrushing once daily was the most common practice (52.1%). Toothbrush with a fluoride-containing toothpaste was the most common tooth cleaning aid, while the up and down brushing technique was predominantly used. There was no statistically significant gender difference in toothbrushing frequency; however, significant gender differences were observed in PI and OHI scores (P<0.05). Gingivitis was absent in 28.9% of the children,, while 50.8% had mild, 13.6% moderate and 6.6% severe gingivitis. There was a weak but significant negative correlation between oral hygiene frequency and GI (P<0.05). Socioeconomic status had no relationship with oral hygiene frequency, however it had low but significant correlation with OHI and GI (P<0.05). A logistic regression analysis of the predictors on gingivitis showed that male gender and medium textured toothbrush had significant association with gingival health. CONCLUSIONS: Gingival health was influenced by gender, socioeconomic status, oral hygiene frequency and toothbrush texture. Motivation to apply instructions given on oral health care and regular reinforcement are essential.

Breastfeeding, timing and number of erupted teeth in first twelve months of life in Nigerian children.

AIM: This was to assess the possible impact of breastfeeding on the timing of eruption of the primary central incisors and the number of teeth erupted within the first 12 months of life. METHODS: 1,016 children aged 3 to 12 months were recruited from the immunisation and out patients clinics, Ile- Ife, Southwest Nigeria. Mothers of the children were asked about the form of breastfeeding they had practised for their child. An intra-oral examination on each child was conducted to assess number of erupted teeth. The impact of the form of breastfeeding (exclusive or non exclusive) on the timing of eruption of the primary central incisors and the number of teeth that had erupted within the first 12 months was assessed. RESULT: There was no significant difference in the eruption timing of the primary central incisors in children who were exclusively breastfed when compared with children who were not exclusively breastfed, neither did the form of breastfeeding impact on the number of teeth erupted at 12 months. CONCLUSION: The form of breast-feeding had no impact on the timing of eruption of the primary central incisors and the number of teeth erupted within the first 12 months of life in this Nigerian child population.