Prevalence of periodontitis and oral hygiene practices among diabetic and non-diabetic patients in a tertiary hospital in Lagos: a cross-sectional study.

Introduction: periodontitis is the sixth leading long-term complication of diabetes mellitus which can impair diabetic patients' metabolic control. Patients with both diabetes mellitus and periodontal disease present with the challenge of managing these two chronic diseases, each of which may impact the other. The aim of this study was to determine and compare the prevalence of periodontitis and oral hygiene practices among diabetic and non-diabetic patients attending a large tertiary hospital in Lagos, Nigeria. Methods: this was a cross-sectional comparative study involving 110 diabetics and 110 non-diabetic patients aged 40 years and above. They were recruited from the diabetes and general medical out-patient clinics respectively in a large tertiary hospital in Lagos using a systematic sampling method. Data was collected using an interviewer-administered questionnaire. In addition, blood tests for glycated haemoglobin and oral examination using a simplified periodontal examination were conducted. The prevalence and severity of periodontitis and oral hygiene practices were compared between both groups. Data were analyzed with IBM SPSS version 21 Software. Results: the prevalence of periodontitis was higher among the diabetics 100 (90.9%) compared to the non-diabetic patients 79 (71.8%), and this was statistically significant (p<0.001). Severity of periodontitis among both groups was also statistically high 54 (49.1%) vs. 35 (31.8%) p<0.001. Conclusion: the prevalence of periodontitis was higher and more severe among diabetics compared to non-diabetics. Oral hygiene practices in both groups are not statistically significant p>0.05. Oral health education programs targeted at diabetic patients should be carried out to prevent and control periodontitis.

Association of Elevated C-Reactive Protein with Severe Periodontitis in Hypertensive Patients in Lagos, Nigeria: A Pilot Study.

BACKGROUND: Epidemiological studies have shown that individuals with chronic periodontitis have a significantly higher risk of developing cardiovascular complications, which might be attributed to the increased production of inflammatory cytokines initiated by the complex microbiota in dental biofilm. AIM: The study aims to evaluate the association between chronic periodontitis and C-reactive protein (CRP) levels in a group of hypertensive individuals in Nigeria. MATERIALS AND METHODS: The investigator enrolled 50 hypertensive patients with chronic periodontitis into the study from the medical outpatient clinic of a teaching hospital in Lagos, Nigeria. Full-mouth periodontal examination was done to assess the participant's periodontal status, with probing depths and clinical attachment levels of six sites on all teeth. The investigator defined periodontitis as at least one interproximal site with probing depth ≥4 mm. Classification of participants into three groups was done based on their severity of periodontitis; mild (n = 16), moderate (n = 27), and severe (n = 7) periodontitis. Their CRP serum levels were measured, and the association with the severity of periodontitis was determined. P was found to be ≤ 0.05. RESULTS: The median CRP levels were 1.0 (0.6, 2.2), 2.4 (1.1, 4.8), and 4.1 mg/L (3.3, 9.4) for mild, moderate, and severe chronic periodontitis, respectively. The association between the serum CRP levels and severity of periodontitis was statistically significant (P = 0.006). CONCLUSION: There was an association of elevated serum CRP level with increased severity of chronic periodontitis in hypertensive individuals. This preliminary finding among Nigerians suggests that chronic periodontal inflammation may contribute to systemic inflammatory burden in hypertensive patients.

Relevance of routine blood pressure assessment among dental patients in Lagos, Nigeria.

AIM: To determine the relevance of routine blood pressure (BP) measurement in patients attending the dental clinic. MATERIALS AND METHODS: This was a retrospective survey of patients who attended the dental clinic in the Preventive Dentistry Department of a tertiary Hospital in Lagos, Nigeria over an eighteen month period. Data retrieved from the patient's hospital records included age, sex, BP and history of hypertension. Data was analyzed using Epi info 2011 package. p-value <0.05 was considered statistically significant. RESULTS: A total of 1910 patients' records were assessed. Females represented 53.4% (n = 1020) of the study population. The mean age was 37.1 ± 15.0 years (range 18-88 years). The prevalence of hypertension was 39.9% (n = 763). Hypertension was stage 1 in 25.5%, stage 2 in 9.8% and severe in 4.6% of the dental patients. Past medical history of hypertension was obtained for 952 patients (49.8%). Of the 763 patients with high blood pressure, 14.8% had a known history of hypertension, while 42.1% were previously undiagnosed (p < 0.0001). Systolic and diastolic BP increased with increasing age (p < 0.05) and was significantly higher in males than females (p < 0.05). CONCLUSION: The high prevalence of hypertension noted among the study population with its potential consequence during dental procedures makes the measurement of blood pressure a valuable assessment in a dental clinic. CLINICAL SIGNIFICANCE: The high prevalence of hypertension particularly the previously undiagnosed cases among the dental patients highlights the relevance of routine blood pressure assessment prior to dental procedures in contemporary dental practice, so as to minimize the potential complications that could occur.

Severe presentation of necrotizing ulcerative periodontitis in a Nigerian HIV-positive patient: a case report.

OBJECTIVE: To report a case of severe necrotizing ulcerative periodontitis (NUP) with a rarely associated sequestrum formation in a Nigerian HIV-positive patient. CLINICAL PRESENTATION AND INTERVENTION: A 47-year-old HIV-positive male patient with no history of previous dental visits presented with a severe toothache in his lower jaw of 4 weeks' duration, which had affected his ability to chew properly. Clinical examination revealed marked gingival inflammation, moderate gingival recession and mobility of some of his lower anterior teeth: 31, 32, and 33. There was also a sequestrum present associated with the affected teeth. His CD4 cell count was 226 cells/mm(3). His viral load was very high (360,082 copies/ml). The intervention included thorough debridement of the necrotic lesion and sequestrectomy. The patient responded well to treatment after 1 week of follow-up. Unfortunately, the CD4 count was not assessed further because the patient was lost to follow-up. CONCLUSION: This case showed that a high CD4 cell count does not necessarily prevent the occurrence of NUP in HIV-positive patients. Intervention might have enhanced a rapid positive response to the treatment within a short time.