Impact of the COVID-19 pandemic on the academic training and psychosocial well-being of undergraduate dental students in Nigeria.

Background: Most educational institutions in Nigeria were shut down for a long while at the onset of the COVID-19 pandemic as a preventive measure, and this affected dental students' academic and clinical training. Aim: To determine the influence of the pandemic on the academic, clinical training, and psychosocial well-being of dental students in Nigeria. Subjects and Methods: This cross-sectional survey was conducted among undergraduate dental students in clinical years in Nigerian dental schools. Participants received the questionnaire through an online platform, it had four sections; socio-demographics, impact on academic training, psychosocial well-being, and an open-ended segment for participants' suggestions to challenges. A mixed method was utilized to analyze the data. The statistical significance level was P < 0.05. Results: One hundred two dental students from nine dental schools participated, with a mean age of 25.3 ± 2.4 years. There were 56 (54.9%) males. Most students, 80 (78.4%) reported that their stay-at-home had not been rewarding academically. The majority, 90 (88.2%) were worried about contracting COVID-19 on school resumption. Participants' psychosocial well-being had significant associations with gender (P = 0.001) and self-directed learning during their stay-at-home (P = 0.001). More female students, 33 (71.7%) were severely worried compared to males 20 (35.7%). Their major suggestions were to commence online teaching and examinations (40.1%) and be provided with adequate personal protective equipment (18.6%). Conclusion: Most undergraduate students in Nigeria were anxious about COVID-19, and females were more affected. This negatively impacted their academic and clinical training. This underscores the importance of adequate psychological support for undergraduate dental students by school authorities.

Periodontal status and its association with self-reported hypertension in non-medical staff in a university teaching hospital in Nigeria.

BACKGROUND: A growing body of evidence suggests a relationship between periodontal disease and non-communicable systemic diseases with rising prevalence in developing countries, Nigeria inclusive. OBJECTIVES: To determine the periodontal status and its association with self-reported hypertension among non-medical staff in a university teaching hospital in Nigeria. METHODS: A cross-sectional study was conducted among non-medical staff using self-administered questionnaires and periodontal clinical examination between July and August 2013. Multivariate analysis was explored to determine the independent variables associated with self-reported hypertension. P values < 0.05 were considered statistically significant. RESULTS: A total of 276 subjects were enrolled into the study. Shallow pockets (CPI code 3) constituted the predominant periodontal disease (46.7%), calculus (CPI code 2) 46%, bleeding gingiva (CPI code 1) in 3.3% and deep pockets ≥ 6mm (CPI code 4) in 2.2%. Self-reported hypertension was the most prevalent self-reported medical condition (18.1%) and found to be associated with periodontitis, increasing age, lower education, and a positive family history of hypertension. CONCLUSION: Periodontal disease was highly prevalent in this study. Self-reported hypertension was associated with periodontitis, older age, lower education and a positive family history. Periodic periodontal examination and regular blood pressure assessment for non-medical staff is recommended.

Comparative periodontal status of human immunodeficiency virus-positive patients and controls in a dedicated human immunodeficiency virus clinic in Nigeria.

BACKGROUND: There are diverse reports on the prevalence and severity of chronic periodontitis in human immunodeficiency virus (HIV) positive persons. Few studies have been carried out in developing countries in Sub-Saharan Africa. This study was aimed at comparing the prevalence and severity of chronic periodontitis of HIV-seropositive patients with that of HIV-seronegative persons using the community periodontal index (CPI). METHODOLOGY: This was a comparative study of the periodontal status of 110 HIV-positive subjects and 110 age and gender-matched HIV-negative controls attending a dedicated HIV Clinic in a Teaching Hospital in Lagos, Nigeria. The CPI and simplified oral hygiene index score were used in the periodontal examination. Highest CPI scores and percentages of CPI sextants assessed the prevalence and severity of chronic periodontitis respectively. Logistic regression was used in adjusting demographic differences in the study population. P ≤ 0.05 was considered as significant. RESULTS: A significant proportion of the HIV-positive patients 61 (55.5%) and the HIV-negative controls 53 (48.7%) had shallow pockets (4-5 mm) (CPI code 3). The prevalence of deep pockets (≥ 6mm) (CPI code 4) was higher among HIV-positive patients 9 (8.2%) than the controls 4 (3.5%) (P = 0.079). HIV-positive patients had a greater percentage of CPI codes 3, 4 and fewer CPI code 0 sextants than controls (P = 0.000). Both groups had comparable oral hygiene status (P = 0.209). Using a logistic regression analysis, HIV-positive status and lower education accounted for the greater severity of chronic periodontitis. CONCLUSION: HIV-seropositive patients had more severe chronic periodontitis than the HIV-seronegative controls, which was independent of lower education.

Undergraduate dental education in Nigeria: perceptions of dental students and recent dental graduates.

Background: Students' perception of their education is a subject that has received very little attention by those providing dental school education. This is more so in the Nigerian environment, where limited research has been carried out in dental education, particularly with respect to the students' perspectives on the quality of training received. Objective: Thus, the aim of this study was to determine the perceptions of dental students and recent dental graduates in Nigeria on their level of satisfaction with the quality of academic and clinical training received in their respective dental schools and the challenges faced in receiving this training. Methods: This was a cross-sectional descriptive study carried out amongst 271 dental students and recent dental graduates from eight dental schools in the country. Ethical approval for the study was obtained from the Institutional Review Board of the Lagos University Teaching Hospital (LUTH). Data collection was via self-administered questionnaires. Statistical analysis was carried out using SPSS 17. Results: The final study sample was made up of 239 students, with a mean age of 24.57 (2.21) years. The two dental specialties in which the least level of satisfaction was recorded with regard to the quality of academic training received were Conservative Dentistry and Orthodontics, while for clinical training they were Conservative Dentistry and Oral Biology/Pathology. The three most common factors which were adversely affecting the quality of clinical training received were, poor electricity supply, insufficient dental chairs and quality of training received. Conclusion: Dental students and recent graduates of Nigerian Dental schools are not satisfied with the quality of undergraduate training received in some dental specialties at their respective dental schools.

PERIODONTAL SYSTEMIC INTERACTION: PERCEPTION, ATTITUDES AND PRACTICES AMONG MEDICAL DOCTORS IN NIGERIA.

BACKGROUND: Periodontal diseases (PD) impact the outcome of some systemic illnesses. Medical doctors' knowledge and practices regarding this association may influence the effective management of their patients. This has been understudied among Nigerian doctors. AIM: The study aimed to determine the knowledge, attitudes and practices regarding periodontal-systemic disease interactions among medical doctors in Nigeria. METHODOLOGY: This was a descriptive, cross sectional study by design, while the study setting was at the National Postgraduate Medical College of Nigeria (NPMCN), Ijanikin, Lagos. The study participants were senior resident doctors attending compulsory Research Methodology and Management courses organized by the NPMCN in 2014. Self-administered questionnaires were distributed among the participants to obtain information on their socio-demography, PD knowledge, association between PD and systemic illnesses, attitudes to periodontal health and oral hygiene practices questionnaires. Student t test and ANOVA were used to test associations between variables. The level of significance was set at p < 0.05. RESULTS: A total of 236 doctors participated in the study with a mean age of 35.8 (± 4.5) years, males being predominant (62.7%). Few doctors (42.1%) knew dental plaque as the main cause of PD, while 16.5% were aware of gum bleeding as earliest sign. Female doctors displayed better knowledge than males (p= 0.044). Majority were aware of an association between PD and chronic kidney disease (88.6%) and diabetes (86.5%). Knowledge of PD as a risk factor for stroke was 33.1%, poor glycemic control (25.4%), and pre-term low birthweight (14.8%). Most doctors had positive attitudes towards patients' periodontal health, while 33.5% assessed their patients' oral cavity regularly. All the doctors used tooth brush and paste to clean their teeth, while 43.2% cleaned twice daily. Only 16.5% used dental floss frequently and was associated with higher PD knowledge (p<0.001) and higher attitude scores (p=0.005). CONCLUSION: Senior resident doctors in Nigeria have positive attitudes regarding periodontal health. However, poor knowledge of PD and PD as risk factor for some systemic illnesses, coupled with unsatisfactory oral hygiene and dental examination practices are evident among the doctors.

PERIODONTAL SYSTEMIC INTERACTION: PERCEPTION, ATTITUDES AND PRACTICES AMONG MEDICAL DOCTORS IN NIGERIA.

BACKGROUND: Periodontal diseases (PD) impact the outcome of some systemic illnesses. Medical doctors' knowledge and practices regarding this association may influence the effective management of their patients. This has been understudied among Nigerian doctors. AIM AND OBJECTIVES: To determine the knowledge, attitudes and practices regarding periodontal-systemic disease interactions among medical doctors in Nigeria. METHODOLOGY: This was a descriptive, cross sectional study by design, while the study setting was at the National Postgraduate Medical College of Nigeria (NPMCN), Ijanikin, Lagos. The study participants were senior resident doctors attending compulsory Research Methodology and Management courses organized by the NPMCN in 2014. Self-administered questionnaires were distributed among the participants to obtain information on their socio-demography, PD knowledge, association between PD and systemic illnesses, attitudes to periodontal health and oral hygiene practices questionnaires. Student t test and ANOVA were used to test associations between variables. The level of significance was set at p < 0.05. RESULTS: A total of 236 doctors participated in the study with a mean age of 35.8 (± 4.5) years, males being predominant (62.7%). Few doctors (42.1%) knew dental plaque as the main cause of PD, while 16.5% were aware of gum bleeding as earliest sign. Female doctors displayed better knowledge than males (p= 0.044). Majority were aware of an association between PD and chronic kidney disease (88.6%) and diabetes (86.5%). Knowledge of PD as a risk factor for stroke was 33.1%, poor glycemic control (25.4%), and pre-term low birthweight (14.8%). Most doctors had positive attitudes towards patients' periodontal health, while 33.5% assessed their patients' oral cavity regularly. All the doctors used tooth brush and paste to clean their teeth, while 43.2% cleaned twice daily. Only 16.5% used dental floss frequently and was associated with higher PD knowledge (p<0.001) and higher attitude scores (p=0.005). CONCLUSION: Senior resident doctors in Nigeria have positive attitudes regarding periodontal health. However, poor knowledge of periodontal disease, and periodontal disease as risk factor for some systemic illnesses, coupled with unsatisfactory oral hygiene and dental examination practices are evident among the doctors.

Clinical correlates of a lateral-flow immunoassay oral risk indicator.

BACKGROUND: The aim of the present study is to investigate the clinical correlates of a novel lateral-flow immunoassay with bleeding on probing (BOP), oral hygiene, and periodontal probing depth. This report offers a simple, rapid, and highly sensitive tool that addresses two issues important to periodontists: 1) detecting active periodontitis, and 2) predicting chronic periodontitis. METHODS: Seventy-six of 86 males requiring seminal fluid analysis as part of a separate study were serially recruited into the study. After basic dental and periodontal examination under natural light and with the use of the community periodontal index of treatment needs (CPITN) probe, debris and calculus indices were recorded per participant. Participants were subsequently grouped into "good," "fair," and "poor" oral hygiene categories based on a simplified oral hygiene index. BOP was assessed with the ball-ended tip of the probe, and periodontitis was assessed with pocket probing as well as a lateral flow of neutrophil collagenase-2 immunoassay, which measures levels of matrix metalloproteinase-8. RESULTS: Neutrophil collagenase-2 immunoassay was 96% sensitive for poor oral hygiene, 95% sensitive for chronic periodontitis (defined as at least two sites with periodontal pockets), and 82.6% sensitive for at least two sites with BOP. CONCLUSION: Neutrophil collagenase-2 immunoassay had a high sensitivity for at least two sites with BOP and two sites with periodontal pockets but a lower relationship for single-site pockets and BOP.

Self-Reported Medical Conditions and Oral Health Status of Patients seen in a Nigerian Dental Clinic.

OBJECTIVE: To assess the prevalence of self-reported medical conditions among patients attending a dental clinic in Nigeria. SUBJECTS AND METHODS: This was a cross-sectional study conducted at the Oral Diagnosis Clinic of the Lagos University Teaching Hospital. A self-administered questionnaire was used to collect bio-data and history of medical conditions. Oral examination was carried out on all the patients. Teeth present, carious teeth, mobile teeth and the oral hygiene status were recorded. Data entry and analysis was done using SPSS statistical software. RESULTS: The prevalence of self-reported medical conditions in this study was 22.1%. Hypertension was the most prevalent (10.3%), followed by allergies (4.4%), diabetes mellitus (4%) and gastrointestinal disorders (3%). Hypertension (p=0.000) and diabetes (p=0.000) had a statistically significant association with increasing age. The prevalence of medical conditions increased significantly with the increased number of mobile teeth (p=0.033). There was no statistically significant association between the self-reported medical conditions and the number of carious teeth (p=0.619), the oral hygiene status (p=0.765) and the educational level (p=0.712). CONCLUSION: The prevalence of medical conditions among the dental patients was moderate.

Periodontitis & sub-fertility; opinions and practices of Nigerian specialists.

BACKGROUND: Increasing evidence in the emerging field of periodontal medicine continues to stimulate research to verify the association between chronic periodontitis and general health. The link between chronic periodontitis and sub-fertility has not been well-investigated except for a handful of reports spanned over several decades. METHODS: As a prelude to a series of observational and interventional studies, 119 specialists and doctors participated in an online survey to ascertain their practices and opinions about this link. Our main exposure variables were dental history taking, periodontal/dental referrals and knowledge of possible link between chronic periodontitis and sub-fertility. RESULTS/FINDINGS: Our findings showed that dental history taking and periodontal/dental referrals were not part of sub-fertility management protocols of Nigerian specialists and doctors. These findings proved true irrespective of basic and postgraduate experience. Specialty was the only explanatory variable that accounted for statistical significance with the main exposure variables but the figures of members of different specialties were too low for any meaningful comparisons. CONCLUSIONS: The findings confirmed our suspicion of an almost complete lack of knowledge of this unlikely yet plausible association which deserves further research.

Pattern of periodontal treatments performed at the periodontology clinic of the Lagos University Teaching Hospital: 22 months review.

BACKGROUND: A critical evaluation of the pattern of periodontal procedures performed is important in providing useful data to the administrator for proper planning and budgeting for dental health service. OBJECTIVE: To assess the pattern of periodontal treatments performed over a given period of time at the Periodontology clinic of the Lagos University Teaching Hospital, Lagos, Nigeria. METHODS: This was a twenty two months retrospective study of all periodontal procedures performed on patients seen at the periodontology clinic of the Lagos University Teaching Hospital between January 2006 and October 2007. The periodontology treatment record was used to retrieve information which included the patient's age, gender, diagnosis and periodontal procedures given. The procedures were further categorized into surgical and nonsurgical groups. The information obtained was then analyzed using Epi Info 2007 statistical software. RESULTS: A total of 1,938 patients were seen during this period. Females were 1009 (52.1%) and males were 929 (47.9%). (F/M, 1.1:1). A total of 2,110 periodontal treatments were performed. Majority of the patients received non-surgical periodontal therapy which constituted the bulk (96.3%) of the therapies. Scaling and polishing was the most frequently performed non-surgical procedure accounting for 1261 (62.1%) with slightly more males receiving the treatment. Of the surgical treatment modalities, operculectomy accounted for 65.4% and was carried out on more females than males. Regenerative procedures were the least performed surgical treatments. CONCLUSION: This study highlighted that non-surgical periodontal therapy, particularly scaling and polishing was the most frequently utilized periodontal procedure. Operculectomy was the predominant surgical procedure performed. The low percentage of regenerative surgical procedures was however below the desired expectation.

Isolation and molecular identification of Fusobacterium nucleatum from Nigerian patients with oro-facial infections.

BACKGROUND: Fusobacterium nucleatum is one of the most common anaerobic bacteria present in the oral cavity and is often isolated from infections involving other body sites. OBJECTIVE: To characterise F. nucleatum strains from patients attending a teaching hospital in Nigeria in order to provide information on the methods for accurate identification of anaerobes in clinical specimen. METHODS: Fusobacterium nucleatum specie from 50 patients presenting with oro-facial infections were studied by culture on Fusobacterium selective agar and fastidious anaerobe agar. The isolates were characterised based on colonial morphology, microscopy, lipase production, susceptibility to kanamycin and colistin and resistance to vancomycin. Biochemical tests were performed using a commercial test kit. The identity of the isolates was confirmed based on molecular characterization performed using polymerase chain reaction (PCR) analysis. RESULTS: Forty-eight (96%) F. nucleatum isolates were obtained from the 50 patients by culture and all the isolates were identified by colonial appearance and microscopy based on their unique spindle shape with tapered ends. Only 26 (54.2%) of the 48 isolates were identified by commercial API 20A test kit while PCR confirmed the identity of all the isolates. CONCLUSION: Anaerobes are involved in human infections and their study is quite cumbersome due to tedious nature and high cost of the techniques involved. Cultural method is reliable in the isolation and identification of F. nucleatum species. PCR is a rapid and simple method that can complement the phenotypic identification of anaerobes and would assist in their full identification.