A 2-arm randomized controlled study to improve the oral health of children living with HIV in Nigeria: Protocol and study design.

Background: Good oral health is an integral part of overall child health. However, immune-deficient states like the presence of Human Immunodeficiency Virus (HIV) will compromise oral health and salivary bacterial composition, leading to adverse oral conditions. Nigeria has 1.9 million HIV-positive residents, and 0.2% of incident HIV infections occur among children below 15 years. Aim: This study aims to determine through a randomized control study, the effect of an educational intervention on the oral health status and oral health-related quality of life (OHRQoL) of HIV-positive children presenting to five pediatric HIV clinics in Kano, Nigeria. Methods/Design: This 2-arm randomized control study will be conducted in five pediatric HIV outpatient clinics in Kano State, Nigeria over a period of 6 months. Eligible participants will include 172 HIV-infected frequency matched children aged 8-16 years (they can self-implement the oral health intervention with minimal supervision from the caregivers) who will be randomized and allocated into control and intervention groups. The evaluation and oral health assessment will be carried out by five examiners who will be trained and calibrated. Discussion: Our findings will help inform policies to improve the oral health and OHRQoL of HIV-positive Nigerian children and inform the need to integrate oral health care services into HIV programs in similar settings. Trial registration: ClinicalTrails.gov ID: National Clinical Trial (NCT) NCT05540171. Registered on 12th September 2022.

Viability of periodontal ligament cells in selected transport media for avulsed teeth: an in vitro study

To compare the viability of periodontal ligament (PDL) cells stored in Hanks Balanced Salt Solution (HBSS) with those in readily available transport media over a variable period of time. Methods: Periodontal ligament cells harvested from premolars freshly extracted for orthodontic reasons were cultured for exponential growth. The cells were exposed to egg white, evaporated milk, water and Hanks Balanced Salt Solution (HBSS) at room temperature. Their viability was evaluated after 30 minutes, 1 hour and 3 hours with the tetrazolium salt-based colorimetric assay (MTT assay). Statistical analysis was done using the IBM® SPSS version 23.0 software. Comparison between the Mean Optical Densities (MODs) of the cells stored in HBSS and other media at each time interval was done using the independent t test. Repeated measure ANOVA and Tukey post-hoc test were also carried out to compare the MOD of cells within each medium over time. The level of significance was set at p <0.05. Result: The PDL cells stored in egg white had higher MODs than those in HBSS at 30 minutes and 1 hour. Conversely, the MODs of the cells stored in milk and water were lower than those in HBSS at all the studied points. There was a significant difference in the viability of the cells stored in HBSS and water at all the time points (p<0.05). Conclusion: For up to an hour, egg white was found to perform better than HBSS in supporting the viability of PDL cell

The risk factors and pattern of traumatic dental injuries in 10-12-year olds in Kano, Nigeria.

Background: Traumatic dental injuries (TDIs) rank among the most common conditions in children and adolescents. Nigerian dental trauma data are largely based on studies that were conducted in the southern parts of Nigeria. This study was designed to identify the risk factors and the pattern of TDIs among school-age children in northern Nigeria. Objectives: The objective of the study was to identify the risk factors for and to determine the pattern of dental injuries among 10-12-year-old males in Kano, northern Nigeria. Materials and Methods: Six hundred and ninety-six 10-12-year olds were selected through a multistage sampling of school children, street children and rehabilitated children in Kano and examined for TDIs using the WHO protocols. Data analysis was carried out using SPSS version 20. Statistical significance was considered when P < 0.05. Results: Six hundred and ninety-four 10-12-year olds participated in the study; The prevalence of TDIs was 6.6%. Being a street-child was associated with 30% higher risk for dental injuries (adjusted odds ratio [aOR] = 1.3; 95% confidence interval [CI] = 0.60 - 3.1; P = 0.48), whereas living as a rehabilitated street child (aOR = 0.41; 95% CI = 0.19 - 0.88; P = 0.02) and older age were associated with a reduced risk (aOR = 0.63; 95% CI = 0.39 - 1.01; P = 0.06) to injuries. The most common type of trauma was enamel-dentine injuries or Ellis II, and the most common cause was falls. Street children and low-age groups had more single-tooth injuries (85.7% and 85.0%, respectively). The commonly injured teeth were the maxillary right and left central incisors. Conclusion: Living on the street and young age were associated with the likelihood for injuries in male adolescents in Kano. The maxillary central incisors were the commonly affected teeth.

Dental Caries Prevalence, Severity, and Pattern Among Male Adolescents in Kano, Nigeria.

Background: Dental caries is the most common oral disease of mankind; however, there are limited data on the oral status of adolescents in northern Nigeria. Recently, the World Health Organization set the global caries goal as significant caries (SiC) index score of <3. This study was designed to appraise the magnitude of the disease among adolescents in northern Nigeria. Objectives: The objective of the study was to determine the prevalence, pattern, and severity of caries among 10-12-year-old adolescents in Kano, Nigeria. Materials and Methods: Six hundred and ninety-four school-aged children were selected through a multi-stage sampling of 10-12-year-old children in Kano and examined for dental caries using the WHO protocols. Data analysis was carried out using the Statistical Package for the Social Sciences (SPSS version 20 Inc. Chicago IL, USA). Results: The prevalence of caries was 22.9% with mean DMFT and SiC scores of 0.5 (±1.2) and 3.7 respectively. DMFT >0 ranged from 1 to 8. Tooth 85 (the right mandibular second primary molar) and tooth 36 (left mandibular permanent first molar) had the highest caries count for primary and permanent teeth respectively. More lesions occurred on the left mandible in primary and permanent teeth. The second primary molars and the first permanent molars were most affected by the disease. Conclusion: The prevalence of dental caries was low among male adolescents in Kano as evidenced by the low mean DMFT/dmft scores; however, the condition exceeded the recommended WHO thresholds. Caries occurred more frequently on teeth 85 and 36.

Effect of Dental Treatment on the Quality of Life of Children with Traumatic Dental Injuries in Ibadan, Nigeria.

Background: Anterior dental trauma is known to be common in our environment as well as the complications that come with it. These injuries have been seen to impact the quality of life (QoL) of children significantly due to the fact that they compromise their dental health. This leads to aesthetic, psychological, social, and therapeutic problems impacting both the children and their parents. Treatment of these injuries has also been severely neglected possibly due to lack of awareness of where or how to access treatment as well as fear of dental treatment. However, treatment may on the other hand bring about a substantial improvement on the QoL of children in terms of their daily living. Aim: To assess the effect of dental treatment on the QoL of 12- to 15-year-old Nigerian school children previously identified as having had traumatized anterior teeth. Design: This is a follow-up study where secondary data were extracted from a cross-sectional study involving 1575 children attending public and private secondary schools in Ibadan, Nigeria. One hundred and ninety-six adolescents with evidence of dental trauma, previously identified as having their QoL negatively affected as a result of dental trauma, were called to take part in the follow-up study. The Child Perception Questionnaire (CPQ11-14) was used in assessing the QoL of participants with dental trauma before and after treatment. Data were analysed using the IBM® SPSS® Statistics version 20.0, and the effect of dental treatment on the QoL of the participants was assessed using the McNemar's test. Statistical significance was set at P < 0.05. Results: Fifty-one (26.0%) out of the 196 invited children participated; there were 31 males and 20 females. The mean age was 13.4 years (standard deviation 1.1 years). Eighty traumatized anterior teeth were involved, with the maxillary centrals being the commonest (68, 85%). Twenty-three (45.1%) participants had more than one traumatized tooth. The commonest dental trauma was enamel fracture, which involved the dentine (39, 48.8%). The main treatments given were composite build-up (36, 45%) and root canal treatment (42, 52.5%). With the CPQ11-14, in the oral symptoms domain, the number adversely affected before treatment fell from 30 (58.8%) to 3 (5.9%) (P < 0.001); in the emotional well-being domain, the number dropped from 35 (68.6%) to 10 (19.6%) (P < 0.001); and in the social well-being domain, the number fell from 34 (66.7%) to 22 (43.1%) (P = 0.004). However, in the functional limitation domain, the number adversely affected increased from 24 (47.1%) before to 46 (90.2%) after treatment (P < 0.001). Conclusion: Treatment resulted in a significant improvement in the QoL of participants, especially regarding their oral symptoms, and emotional and social well-being. However, there was worsening in the functional limitation domain. There is the need to introduce oral health into the school curriculum in order to encourage early reporting and prompt treatment of traumatic dental injuries.

Contexte: Les traumatismes dentaires antérieurs sont connus pour être fréquents dans notre environnement ainsi que les complications qui en découlent. Ces blessures ont un impact significatif sur la qualité de vie des enfants en raison du fait qu'elles compromettent leur santé dentaire. Cela conduit à des problèmes esthétiques, psychologiques, sociaux et thérapeutiques affectant à la fois les enfants et leurs parents. Le traitement de ces blessures a également été gravement négligé, peut-être en raison du manque de connaissance de l'endroit et de la manière d'accéder au traitement ainsi que de la peur des soins dentaires. Cependant, le traitement peut en revanche apporter une amélioration substantielle de la qualité de vie des enfants au niveau de leur vie quotidienne. Objectif: Évaluer l'effet d'un traitement dentaire sur la qualité de vie d'écoliers nigérians âgés de 12 à 15 ans précédemment identifiés comme ayant eu des dents antérieures traumatisées. Conception: Une étude de suivi où les données secondaires ont été extraites d'une étude transversale portant sur 1575 enfants fréquentant des écoles secondaires publiques et privées à Ibadan, au Nigéria. Cent quatre-vingt-seize adolescents présentant des signes de traumatisme dentaire, précédemment identifiés comme ayant une qualité de vie affectée négativement à la suite d'un traumatisme dentaire, ont été appelés à participer à l'étude de suivi. Le Questionnaire de perception de l'enfant (CPQ11-14) a été utilisé pour évaluer la qualité de vie des participants ayant subi un traumatisme dentaire avant et après le traitement. Les données ont été analysées à l'aide d'IBM® SPSS® Statistics version 20.0 et l'effet du traitement dentaire sur la qualité de vie des participants a été évalué à l'aide du test de McNemar. La signification statistique a été fixée à P < 0,05. Résultats: Cinquante et un (26,0%) des 196 enfants invités ont participé; il y avait 31 hommes et 20 femmes. L'âge moyen était de 13,4 (SD 1.1) ans. Quatre- vingt dents antérieures traumatisées ont atteinte, les centrales maxillaires étant les plus fréquentes (68, 85%). Vingt-trois (45,1%) participants avaient plus d'une dent traumatisée. Le traumatisme dentaire le plus fréquent était la fracture de l'émail impliquant la dentine (39, 48,8%). Les principaux traitements administrés étaient la reconstitution de composite (36, 45%) et le traitement canalaire (42, 52,5%). Avec le CPQ11-14, dans le domaine des symptômes oraux, le nombre de patients atteints avant le traitement est passé de 30 (58,8%) à 3 (5,9%) (P < 0,001); dans le domaine du bien-être émotionnel, le nombre est passé de 35 (68,6%) à 10 (19,6%) (P < 0,001) et dans le domaine du bien-être social, le nombre est passé de 34 (66,7%) à 22 (43,1%) (P = 0,004). Cependant, dans le domaine de la limitation fonctionnelle, le nombre de personnes atteintes est passé de 24 (47,1%) avant à 46 (90,2%) après traitement (P < 0,001). Conclusion: Le traitement a entraîné une amélioration significative de la qualité de vie des participants, en particulier en ce qui concerne leurs symptômes buccaux et leur bien-être émotionnel et social. Cependant, il y avait une aggravation dans le domaine de la limitation fonctionnelle. Il est nécessaire d'introduire la santé bucco-dentaire dans le programme scolaire afin d'encourager le signalement précoce et le traitement rapide des blessures dentaires traumatiques.

Transferability of clinical skills acquired on simulator to real life clinical practice.

AIM: The aims of this study were to determine the relationship between performances of students in clinical skills laboratory and real life clinical practice and to determine the experiences and views of instructors as it relates to teaching in skills laboratory. METHODS: The performances of two randomly selected sets of graduates in the operative examinations conducted in skills laboratory were compared with the performances of the same sets of graduates in the operative examinations conducted on life patients two years later using Spearman's rank test. Experiences and views of two teachers from each of the six dental schools in southern Nigeria as it relates to teaching in clinical skills laboratory were obtained using a structured questionnaire. RESULTS: There was an insignificant correlation between the outcomes at both examinations (p value was 0.18). Most of the respondents (62.5%) agreed that teaching in skills laboratory was tiresome and most (75.0%) strongly agreed that the number of students constitutes a serious challenge to learning. Most of the respondents regarded their role in skills laboratory as that of an expert as against that of a facilitator. CONCLUSION: There was a weak correlation between performances in skills laboratory and real life environment. Students' number appears to make teaching in skills laboratory unpleasant and teachers had a wrong perception of their role.

Changing pattern of pediatric maxillofacial injuries at the Accident and Emergency Department of the University Teaching Hospital, Ibadan--a four-year experience.

INTRODUCTION: Maxillofacial injuries are common among polytraumatized patients, and in Nigeria, the incidence seems to be on the increase. This probably is related to the drive of industrialization and the increase in the number of road traffic accidents. Delays in attending to severe maxillofacial injuries can be grave because of concomitant injuries that can be life threatening. METHODS: This is a prospective review of maxillofacial injuries in patients less than or equal to 16 years of age who were seen at the Accident and Emergency Department between October 2002 and December 2006. In all the patients, the accident and emergency physicians carried out initial resuscitation, and thereafter, they were referred to the maxillofacial unit on call. RESULTS: A total of 611 patients with maxillofacial injuries were seen during the study period and of this, 134 (22%) were less than or equal to 16 years old. The male:female ratio was 1.1:1.0. Road traffic accident (RTA) was the most common etiological factor in 73 (54.5%) cases, while gunshot injuries accounted for 6 (4.4%) cases. Soft tissue lacerations were the most common maxillofacial injuries occurring in 90 (55.9%) cases; mandibular fractures were the most common bony injury in 17 (13.4%). CONCLUSIONS: The upsurge in maxillofacial gunshot injuries in the pediatric age group is alarming and this may be a reflection of the global changes (westernization and drug-related offenses like armed robberies) and the harsh economic conditions in this community.

Occupational exposure to bloodborne pathogens and management of exposure incidents in Nigerian dental schools.

The goal of this study was to determine the frequency of occupational exposures to bloodborne pathogens amongst Nigerian clinical dental students, their HBV vaccination status, and reporting practices. A cross-sectional study of all clinical dental students in the four Nigerian dental schools was carried out by means of an anonymous self-administered questionnaire that asked questions on demography, number and type of exposure, management of the exposures, personal protection against cross infection, and the reporting of such exposures. One hundred and fifty-three students responded (response rate of 84.5 percent). Only thirty-three (37.9 percent) were fully vaccinated against HBV. Ninety (58.8 percent) of the students have had at least one occupational exposure. There was no significantly associated difference between sex, age, location of school, and exposure. Most of the exposures (44.4 percent) occurred in association with manual tooth cleaning. There was inadequate protection of the eyes. None of the exposures were formally reported. It is the responsibility of training institutions to ensure the safety of the students by mandatory HBV vaccination prior to exposure and adequate training in work safety. Written policies and procedures should be developed and made easily accessible to all workers to facilitate prompt reporting and management of all occupational exposures.