The effect of chewing stick use on oral hygiene and gingival health of young adults in Nigeria

Objective: The maintenance of good oral hygiene contributes to gingiva health. Several items have been used for mechanical removal of plague, examples of which are the chewing stick and toothbrush. The objective of this study was to assess the effect of using chewing stick to maintain gingival health. Methods: A randomised, single blind, (clinical investigator) experimental study was conducted among 40 persons (20 chewing stick group and 20 toothbrush and toothpaste group). Data was collected through the use of interviewer-administered questionnaire and clinical examination. Evaluation of the effect on gingival health were done 3weeks and 6weeks after the baseline treatment (Scaling and polishing and oral hygiene instruction with emphasis on the use of toothbrush or chewing stick depending on which group . Results: The mean age of participants in the study was 21.58±2.43years. Participants in chewing stick group had significantly higher oral hygiene score than toothbrush group at 3 weeks post intervention only (P=0.03). The chewing stick group and toothbrush group did not have any significant difference in mean gingival index score at both 3 weeks and 6weeks post intervention stages. Conclusion: Chewing stick use resulted in poorer oral hygiene in the initial assessment but improved at second assessment. Chewing stick use resulted in lower non-significant positive effect on gingival health in comparison with toothbrush/toothpaste use. Dentists in resource poor economy should not discourage the use of chewing stick but rather educate users on the proper use of it, since it is cost effective

Reasons for Seeking Dental Healthcare Services in a Nigerian Missionary Hospital

Objective: To determine the reasons for seeking dental healthcare services in a missionary hospital in Benin City; Nigeria. Materials and Methods: This 14-month retrospective study was conducted in a Pentecostal missionary hospital in Benin City. Data of interest which included age; gender; occupation; primary presenting complaints; and primary diagnosis were collected from the case notes with self-designed proforma. Cases with incomplete data were excluded from this study. The obtained data were subjected to descriptive statistics in the form of frequencies; cross tabulations; and percentages using Statistical Package for the Social Sciences version 17.0. Results: A total of 613 cases were retrieved with the complete information. The majority (56.3) of the patients were young adults (18-40 years). About one-fifth (21.2) of the patients were middle-aged adults. Children and elderly constituted 15.8 and 6.7 of the patients; respectively. A total of 332 (54.2) patients were females. There was diversity in the occupation of the patients with about one-third (37.7) of the patients being students. The majority of the patients had toothache as their primary presenting complaint (71.1). Others were tooth deposits (6.0); fractured teeth (3.8); hole in teeth (3.1); missing teeth for replacement (2.3); routine dental check-up (2.3); and mouth odor (2.0). Diagnosis of dental caries and its complications was made in more than half (58.6) of the patients while one-fifth (20.4) of the patients were diagnosed with gingivitis. Conclusion: Data from this study revealed that these enormous diverse patients of a Nigerian missionary hospital had toothache as their main primary presenting complaint and dental caries and its complication as their main primary diagnosis

Herpes labialis and Nigerian dental health care providers: knowledge, attitudes, behaviors, and refusal to treat.

BACKGROUND: The few existing studies on herpes labialis among health care workers have been predominantly among non-dental health care workers. The purpose of this study was to determine Nigerian dental health care providers' knowledge of, attitudes toward, preventive behaviors for, and refusal to treat patients with herpes labialis. METHODS: This cross-sectional study was conducted among final-year dental students at the University of Benin, dental house officers, and residents at the University of Benin Teaching Hospital, Benin City, Nigeria. Data collection was via a self-administered questionnaire. Bivariate statistics and logistic regression were used to relate the dependent and independent variables. RESULTS: Of the 120 questionnaires distributed, 110 were completed and returned, giving a 91.7% retrieval rate. However, 15 of the returned questionnaires were discarded because they were improperly completed, leaving a total of 95 questionnaires for final analysis in this study. The majority of participants were over 28 years old (54.7%), male (67.4%), unmarried (66.3%), and postgraduate dental health care providers (51.6%). Less than half (43.2%) of participants demonstrated adequate overall knowledge of herpes labialis. About one-tenth (10.5%) and more than three-quarters (87.4%) of participants reported a positive attitude and performance of adequate preventive behaviors, respectively. A total of 16.8% of participants reported a high tendency to refuse treatment to patients with herpes labialis. Although not statistically significant, young, unmarried, male undergraduate participants reported a greater likelihood to refuse treatment to herpes labialis patients. We found a statistically significant positive correlation between attitude and refusal to treat patients with herpes labialis. However, marital status and the attitude of participants toward these patients emerged as the determinants for refusal to treat patients with herpes labialis. CONCLUSIONS: Data from this study revealed a high level of inadequate knowledge, negative attitudes, and reasonably adequate preventive behaviors with respect to herpes labialis. One out of every six dental health care workers studied reported having refused to treat patients with herpes labialis. Unmarried dental health care providers and those with negative attitudes toward herpes labialis patients were more prone to refuse treatment to these patients.

Gingival health and oral hygiene practices of schoolchildren in the North West Region of Cameroon.

BACKGROUND: Optimal oral hygiene practices are instrumental to achieving good dental and gingival health. The purpose of this study was to determine the gingival health and oral hygiene practices of schoolchildren in the North West region of Cameroon. METHODS: This cross-sectional survey among 12-13 years old rural and urban schoolchildren in the North West region of Cameroon was conducted between March and November, 2010. RESULTS: A total of 2295 schoolchildren were interviewed but only 2287 of them had oral examination giving a 99.7% participation rate. Out of 2287 school children examined, 1676 (73.3%) had normal gingiva while 26.7% had gingivitis of varying severity. The gingivitis was found significantly more in rural dwellers (P = 0.001). In terms of the severity of the recorded gingivitis, mild gingivitis constituted 549 (89.9 %), moderate gingivitis 49 (8.0%) and severe gingivitis 13 (2.1%). The majority-1929 (85.4%) of the participants had received instruction on how to care for their teeth and the predominant source of this instruction was from their parents. Irregular teeth cleaning were marked 1137 (49.7%) among the children. The dominant teeth cleaning materials were toothbrush and toothpaste. The other oral hygiene aid utilized by the participants include dental floss-25 (1.1%), stick-759 (33.6%), dental floss-25 (1.1%) and other unorthodox agents. The reasons for teeth cleaning among the participants in descending order were to make the teeth clean, to prevent halitosis, to make teeth stronger, to prevent pain and dental diseases. CONCLUSION: The prevalence of gingivitis among Cameroonian schoolchildren in the Northwest region was 26.7% with majority being of mild gingivitis category. Parents, dental professionals and teachers were the main sources of instruction on oral care.

Tobacco use, Alcohol Consumption and Self-rated Oral Health among Nigerian Prison Officials.

BACKGROUND: The oral health condition and lifestyle in term of tobacco use and alcohol consumption of custodian of prisons have been left unstudied. The purpose of this study was to determine the prevalence of tobacco use, alcohol consumption and self-rated oral health among Nigerian prison officials. METHODS: This cross-sectional study was conducted among prison officials working in Abuja, Nassarawa and Kano prison yards between March and June 2011 using 28-item self-administered questionnaire as a tool of data collection. The questionnaire elicited information on demography, self-rated oral health, oral health behaviors, oral health conditions, tobacco use, pattern and quit attempts, alcohol consumption, type and pattern. RESULTS: The participants were aged between 20 and 51 years, with a mean age of 32.25 ± 6.13 years. The majority of the participants were males (66.4%), Christians (76.7%), junior officials (78.1%) and of Northern origin (50.7%). A total of 50 (34.2%) of the participants indicated that they were tobacco users and 39 (78.0%) indulged in cigarette smoking only. Of the study participants, 67 (45.9%) indicated they consume alcohol, beer majorly and gin rarely with 23 (34.3%) consuming it excessively. The dominant tooth cleaning device utilized by the participants was toothbrush and toothpaste, and 65 (44.5%) had visited the dentists with the majority of the visit done >5 years ago. About one-third 57 (39.0%) reported experiencing one or more forms of oral disease. However, it was only 17 (11.6%) of them that rated their oral health poor/fair, and the determinants of self-rated oral health were age, rank, and oral health condition. CONCLUSIONS: Data from this survey revealed that the majority of the participants rated their oral health as good/excellent. The prevalence of tobacco use and alcohol consumption among prison officials was higher than reported values among the general population in Nigeria. This indicates that more surveillance and intervention studies are needed to evaluate the best way to control tobacco use and alcohol consumption among prison officials in Nigeria.

Ocular health practices by dental surgeons in Southern Nigeria.

BACKGROUND: Dental professionals are among the occupational groups that experience ocular injuries and problems as they perform their daily dental works. The purpose of the study was to determine the ocular health practices by dental surgeons in Southern Nigeria. METHODS: This cross-sectional study was conducted on dental surgeons working in Southern Nigerian tertiary oral healthcare centers using self-developed validated questionnaire as the tool of data collection. RESULTS: Of the 148 respondents, 27 (18.2%) rated their ocular health as poor/fair. More than half 82 (55.4%) of the respondents have undergone professional eye examination with a quarter 20 (24.3%) of them having received it, in the last 6 months. Symptomatic care was the major reason for the last visit. Medicated glasses use was found to be significantly associated with perception of ocular health and receipt of professional eye examination. A total of 32 (21.6%) and 2 (1.4%) of the respondents reported non-use of eye goggles and face mask respectively. Non-availability and associated visual clarity with goggle use were the main inhibitor to the regular safety eye goggles use among the respondents. The main suggested ways among the respondents of improving goggle use were training and provision of goggles free of charge for dental surgeons. Only 32 (21.6%) of the respondents would be uncomfortable reminding their colleagues on need to use safety eye goggle while attending to patients. CONCLUSION: Data from this study revealed that a significant proportion of the respondents rated the ocular health as excellent/good and do not regularly indulge in eye safety practices. Implementation of recommendation by the respondents may improve occupational eye safety among dental surgeons in Southern Nigeria.

Analysis of split tooth as an unstudied reason for tooth extraction.

BACKGROUND: Split tooth is an unstudied reason for tooth extraction. The purpose of this study was to determine and analyze split tooth as a reason for extraction in a dental clinic in Benin City. METHODS: The prospective study was carried out on 669 patients having tooth extraction between May, 2005 and December, 2012. Over the period of the study, diagnosis and tooth extraction were done by three dentists of more five years practice experience. The indications for tooth extraction were noted with specific interest on those diagnosed as split tooth without restoration. Data was entered into Microsoft excel, sorted and transported into SPSS (SPSS version 16.0, Chicago, IL, USA). RESULTS: Split teeth constituted for 39 (5%) of extracted teeth. This 39 extractions were done in 38 patients meaning that two split teeth were extracted on separate occasions from same patient. The majority 23 (61%) of extracted split tooth were done in patients in the fifth decade of life. More of the split tooth extraction were performed in males 28 (72%) than females 11 (28%). Overall mandibular teeth were more affected than the maxillary teeth and the most affected teeth were mandibular second molars 23 (59%) while the least affected were the mandibular first premolars 1 (3%) and the third molars 1 (3%). The reported masticatory accident as aetiology, were biting on stone 21 (53%) or piece of bone 10 (26%) while eating. A few 3 (8%) were suspected bruxists. The majority 25 (65%) visited the dental clinic 3-6 months after the incident and onset of symptoms. CONCLUSION: Split tooth constitute a reasonable common reason for tooth extraction and this was most common in the fifth decade of life. It is therefore important to improve early diagnosis of a cracked tooth in order to prevent the progression of the crack tooth to split tooth.

Dentofacial injuries in commercial motorcycle accidents in Cameroon: pattern and cost implication of care.

OBJECTIVE: To assess the pattern of dentofacial injuries in commercial motorcycle accidents among riders and passengers in Cameroon. METHODS: This was a hospital based study conducted in 6 out of 10 regional capitals in the months of December 2011 to September 2012. Analyzed information included age, gender, residence, role on the motorcycle (rider or passenger), type, pattern and month of injury, cost, duration and patient's perception about the cost of treatment. RESULTS: A total of 387 patients were studied with majority of the patients being 21-30 years (39.8%), males (63.8%), passengers (57.3%) and urban dwellers (85.8%). Most of the injuries occurred in December (20.7%), January (19.4%) and February (20.2%). Soft tissue injuries were most frequent (91.2%) followed by trauma to the teeth (83.5%), of which 62.3% were tooth loss. Mandibular fracture was commoner than maxillary fracture; (45% versus 25.3%). A total of 44.2% of patients received their treatment as in-patients. The treatment of the dentofacial injuries among 64.3% of the patients lasted for more than a month. A total of 51.9% of the patients spent 100,000 francs ($200) or more for their treatment. More than half (51.4%) of the patients perceived the cost of treatment as expensive. CONCLUSION: Dentofacial injuries in commercial motorcycle accidents necessitated hospital admission and lengthy treatment time with high attendant cost. Preventing these injuries will serves as a form of poverty reduction as money that will be used by the victim to better their life is not used to correct deformities or treat injuries.

Nigerian dental therapy students' knowledge, attitude, and willingness to care for patients with HIV.

The objective of this study was to assess Nigerian dental therapy students' knowledge, attitudes, and willingness to care for patients with HIV. A twenty-six-item questionnaire was used to conduct a cross-sectional study of the dental therapy students of Federal School of Dental Therapy and Technology, Enugu State, Nigeria. The level of knowledge of HIV transmission and prevention among the respondents was high. However, misconceptions about the transmission of HIV through blood donation, mosquito bite, and sharing cups and plates were noted. Erroneous descriptions of HIV as harmless, self-limiting, antibiotic sensitive infection, punishment virus, and contagious infection were also reported. More than half (56.2 percent) and 25.2 percent of the respondents, respectively, expressed feelings of empathy and sympathy towards individuals with HIV. About three-quarters (74.3 percent) expressed willingness to treat patients with HIV, and 87.6 percent expressed confidence in their ability to prevent occupational HIV acquisition. This expressed confidence was significantly associated with their willingness to treat patients with HIV. More than half (55.7 percent) of the respondents reported they can adequately deliver HIV-related information to patients. A total of 86.2 percent said there is a need for training dental therapists in the clinical care of patients with HIV, and 89.0 percent said that dental therapists can play a significant role in the dissemination of HIV-related information. The vast majority (90.0 percent) expressed willingness to disseminate HIV-related information, and the majority (70.5 percent) considered the dental therapist the most suitable dental professional to give HIV-related information to patients.

Stem cells in dentistry: knowledge and attitude of Nigerian dentists.

BACKGROUND: Several controversies exist about the methods of harvesting and eventual utilization of stem cells in Medicine and Dentistry. The objective of the study was to investigate the awareness, attitude and knowledge of the use of stem cells in Dentistry among Nigerian Dentists. METHODS: This descriptive, cross-sectional study was conducted among dentists selected from both private and public health sectors, in some of the major cities in Nigeria. RESULTS: The majority of the participants were ≤35 years in age, male, Pentecostal Christians, possessed a postgraduate qualification, had practiced for ≤5 years and were specialists or specializing. In this study, 153(81.0%) of the participants reported awareness about the use of stem cells in dentistry which was significantly associated with qualification and type of practice. Most of the respondents 114 (60.3%) had a poor knowledge of the use of stem cells in Dentistry. This was significantly associated with type of practice and awareness about stem cell use in dentistry but binary logistic regression showed awareness as the only determinant of knowledge. About three-quarters 142 (75.1%) of the participants exhibited positive attitude towards stem cell use. This had a positive non-significant association with knowledge and reported awareness. CONCLUSION: Data from this study revealed a high level of awareness, positive attitude to and poor knowledge of the use of stem cells in Dentistry among a cross section of Nigerian Dentists.

Toothache among dental patients attending a Nigerian secondary healthcare setting.

INTRODUCTION. Pain intensity and oral health practices among patients with toothache, a major dental public health problem is necessary information for the formulation of preventive and interventional oral health policies. OBJECTIVE. To assess the pain intensity and oral health practices among dental patients attending a Nigerian secondary healthcare setting with toothache. MATERIALS AND METHODS. This study was a prospective study of adult patients attending the dental clinic of Rasheed Shekoni Specialist Hospital, Dutse, Jigawa State, Nigeria. Interviewer-administered questionnaire which elicited information include demography, pain intensity using visual analogue, tooth brushing behaviour and previous dental treatment was the tool of data collection. RESULTS. The majority of the respondents were males and young adults. More than half (60.5%) of the respondents reported pain of moderate to severe intensity and 42.6% have engaged in self medication for the toothache. More than one-third (34.2%) had experienced the pain for ≥ four weeks and the major factor that prompted the decision to visit dentist were unbearable nature of the pain and sleep disturbances. Almost half (46.2%) of the respondents had previously visited the dentist and the common received treatment was tooth extraction. A total of 57.9% of the respondents indulge in twice-daily tooth cleaning. CONCLUSION. Data from this study revealed that respondents with toothache had history of dental visit and visited dental clinic when the pain is unbearable and disturbed sleep. There is a need for proper patient education at any encounter with dentist.

Nigerian Dentists and Oral Health-Care of Pregnant Women: Knowledge; Attitude and Belief

Background: Pregnant women seek preventive; interventional and rehabilitative oral health-care for their oral health and protection of their fetus and babies after delivery. The objective of the study was to determine the Nigerian Dentist's knowledge; attitude and belief pertaining to the oral health-care of pregnant women. Materials and Methods: This cross-sectional of Nigerian dentist was conducted between June and December; 2011 using Huebner et al.; modified dentist's attitude to the pregnant women questionnaire Results: The overall response rate of 92.5 (149/160). Receipt of continuing medical education (CME) was reported among the participants on periodontal disease of pregnant patients (22.1); oral hygiene of pregnant patients (20.1); early childhood caries (35.6) and general dental problem (51.0). The majority (92.6) agreed that Dentists have the skill to counsel pregnant patients; But only 73.8 of them provided oral hygiene instruction frequently to pregnant patients and even fewer (6.0) were involved in educational advice on oral health for young women. Many of the participants agreed that counseling pregnant patients about periodontal disease and its effect on the developing baby is of utmost importance. Participants also dominantly agreed that dental treatment should be part of prenatal care and 97.3 of them opined that physician recommendation will increase the likelihood of pregnant seeking dental care. More than half (56.4) of the participants reported that Dentists should be concerned about being sued if something goes wrong with the pregnancy. The recommended ways to improve oral health-care of pregnant women among the participants were through CME (92.6); provision of educational materials on oral health-care of pregnant women (93.3) and information on ways to counsel pregnant women (98.0). Conclusion: Data from this study revealed high preparedness; positive attitude and favorable disposition in dental care provision for pregnant women among the studied Nigerian Dentists

A survey of orofacial injuries among basketball players.

OBJECTIVE: To determine the prevalence of orofacial injuries among basketball players in Benin City, Nigeria and to survey the athletes' awareness, attitude and use of mouthguards. METHODS: A cross-sectional survey of basketball players in the standard basketball arena in Benin City was conducted between November 2009 and January 2010. A self-administered questionnaire elicited information on demography, the prevalence of oral and facial injuries, distribution of site and cause of orofacial injuries, athletes' knowledge, attitudes and usage of mouthguards. Data were subjected to descriptive statistics and Chi square test. RESULTS: The response rate was 78%. Of the 156 respondents, 79.5% were male and 20.5% female, with a mean age of 23.1 years. The distributions was amateurs (61.5%) professionals (38.5%). The mean number of injuries in previous 12 months was 3.7 ± 1.8. The prevalence of both facial and oral injuries among the respondents was 62.8% with the lip and gingiva most commonly involved respectively. The common causes of the orofacial injury reported were from elbows of opponents, falling and collisions with other players. The prevalence of injury was not significantly associated with demography, category, competition and duration of participation. More than half had heard and seen mouthguards and the coach was the leading source of information. The reasons for non-use of mouthguard were mostly ignorance, non-availability and non-affordability. CONCLUSION: The high prevalence of orofacial injury among basketball players reported in this study justifies the need for multidisciplinary injury prevention interventional approach with emphasis on the rules of the games.

Nigerian dental students' willingness to treat HIV-positive patients.

Dental care of HIV-positive individuals plays a vital role in improving their nutritional intake, medication tolerance and effectiveness, treatment success rate, and quality of life. It is therefore important to ensure optimal dental care of this group of people, especially since more of them, with or without knowledge of their serologic status, are now utilizing dental services. The objective of this study was to assess Nigerian dental students' willingness to treat HIV-positive individuals. A descriptive cross-sectional survey of all seventy-six final-year dental students of the University of Benin, Nigeria, was conducted in December 2007 using a self-administered questionnaire that elicited information on the students' demography, self-rated knowledge on HIV/AIDS, attitude towards homosexuals, infection control practices, occupational risk perception, and willingness to provide care for HIV-positive individuals. The response rate was 76.3 percent. Over 77 percent of the respondents were in the twenty-five to thirty years age group. The male-female ratio was approximately 1.6:1. HIV-related knowledge was reported as high by only 31 percent of the respondents. Eighty-one percent showed great interest in HIV-related information, while about half (53.4 percent) exhibited significant worry about occupational contagion. Forty-eight (82.7 percent) desired more knowledge about safety precautions during treatment of HIV patients. Fifty respondents (86.2 percent) reported good infection control practices. About three-fourths (74.2 percent) rated the risk of HIV contagion from patients high, while only one-fourth (25.8 percent) reported having an unsympathetic attitude towards homosexuals. Almost all respondents (98.3 percent) agreed that oral care for HIV-positive individuals improves their quality of life, but only 58.8 percent expressed a willingness to treat HIV-positive patients and only 46.5 percent said they will render volunteer dental services in HIV centers. HIV prevalence will determine the location of practice of 41.4 percent of the respondents. The result suggests the need to have a comprehensive educational/motivational program for the next generation of dentists in Nigeria in order to ensure adequate care of HIV-positive individuals. The perceived deficiency revealed in this study can also serve as a vital guide for curriculum change on HIV-related issues.

Preventing HIV Transmission in Nigeria: Role of the Dentists.

BACKGROUND: As healthcare providers, dentists are in a unique position to foster behavioural changes that are needed to stem the spread of HIV infection. This study was conducted to assess the role of dentists in the prevention of HIV transmission in Nigeria. METHODS: This descriptive cross-sectional survey was conducted from June 2006 to January 2007. A multi-stage sampling technique was used to select 300 practising dentists from all parts of Nigeria. Data were collected through a self-administered questionnaire that focused on dentist demographic details, attitudes towards treating HIV-infected persons, involvement in public or clinic-based patient education on HIV and infection control. RESULTS: Two hundred and fifty-seven questionnaires were returned completed, constituting an 86% response rate. The majority of respondents (77.8%) had their dental practice in the southern part of Nigeria, and 89% were in the age bracket of 21-40 years. HIV education by dentists was ranked as poor, as less than a quarter of respondents routinely educated patients on HIV in the clinic. Only a few dentists (33.3%) were involved in public enlightenment programme on HIV in the previous 12 months. Most of the respondents (93%) reported a willingness to treat HIV-infected patients while observing universal precautions. Good infection barrier practices were adopted by 89.9% of dentists, and disposable cartridges for local anaesthetic agents and dental needles were not reused by 93.4% of the respondents. Autoclaving was the most widely used sterilization method (73.2%), but less than half of the respondents knew how to ascertain whether sterilization was effective. CONCLUSION: This study revealed that efforts by Nigerian dentists to prevent HIV transmission are presently less than optimal. Therefore, there is a need for sensitisation and motivation through seminars, workshops and lectures.