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.

The Nigerian Dentist: Emerging Trends in Caries Management.

BACKGROUND: Fundamental to effective caries management, are measures that eliminate caries risk factors and increase caries protective factors. These include the use of appropriate and effective caries assessment, diagnostic and teaching methods. OBJECTIVES: To assess the use of current caries management protocols and teaching methods/techniques among Nigerian Dentists. METHODS: A pre-tested self-administered questionnaire was used. Only dentists of Nigerian descent and practicing in Nigeria were assessed. The questionnaire inquired about diagnostic tools, assessment and teaching methods used by the Dentists in caries management. RESULTS: More than half of the participants reported use of visual (86.3%), tactile method (76.2%) and periapical radiographs (66.2%) at all times for caries diagnosis. More than three quarters had never used electrical conductance, fibre-optic, CAMBRA, ICDAS, laser fluorescence or bacteria count in caries assessment and diagnosis. Among the 38.4% of the respondents who taught courses on cariology, didactic method and demonstration were the commonest methods used, while use of games was the least used. Didactic method was used more by those that had practiced for 10 years and more. This relationship was statistically significant (p= 0.05). CONCLUSION: Majority of Nigerian Dentists still depend solely on traditional methods of teaching, assessment and diagnosis of dental caries. Modern caries assessment, diagnostic techniques and teaching methods are needed to improve caries management in order to promote early treatment, which is often preventive.

CONTEXTE: Les mesures visant à éliminer les facteurs de risque de carie et à augmenter les facteurs de protection de la carie sont fondamentales pour une gestion efficace de la carie. Ces mesures comprennent l'utilisation de méthodes appropriées et efficaces d'évaluation, de diagnostic et d'enseignement des caries. OBJECTIFS: Évaluer l'utilisation des protocoles actuels de gestion des caries et des méthodes/techniques d'enseignement chez les dentistes nigérians. MÉTHODES: Un questionnaire autoadministré pré-testé a été utilisé. Seuls les dentistes d'origine nigériane et exerçant au Nigeria ont été évalués. Le questionnaire portait sur les outils de diagnostic, l'évaluation et les méthodes d'enseignement utilisés par les dentistes pour la gestion des caries. RÉSULTATS: Plus de la moitié des participants ont déclaré utiliser la méthode visuelle (86,3 %), la méthode tactile (76,2 %) et les radiographies périapicales (66,2 %) à tout moment pour le diagnostic des caries. Plus des trois quarts n'avaient jamais utilisé la conductivité électrique, la fibre optique, la CAMBRA, l'ICDAS, la fluorescence laser ou la numération bactérienne pour évaluer et diagnostiquer les caries. Parmi les 38,4 % des personnes interrogées ayant donné des cours de cariologie, la méthode didactique et la démonstration étaient les méthodes les plus utilisées, tandis que l'utilisation de jeux était la moins utilisée. La méthode didactique était plus utilisée par ceux qui avaient pratiqué pendant 10 ans et plus. Cette relation était statistiquement significative (p= 0,05). CONCLUSION: La majorité des dentistes nigérians dépendent encore uniquement des méthodes traditionnelles d'enseignement, d'évaluation et de diagnostic des caries dentaires. Des techniques modernes d'évaluation et de diagnostic des caries ainsi que des méthodes d'enseignement sont nécessaires pour améliorer la gestion des caries afin de promouvoir un traitement précoce, qui est souvent préventif. Mots clés: Gestion des caries, cariologie, dentistes nigérians.

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.

Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study.

Government and nongovernmental organizations need national and global estimates on the descriptive epidemiology of common oral conditions for policy planning and evaluation. The aim of this component of the Global Burden of Disease study was to produce estimates on prevalence, incidence, and years lived with disability for oral conditions from 1990 to 2017 by sex, age, and countries. In addition, this study reports the global socioeconomic pattern in burden of oral conditions by the standard World Bank classification of economies as well as the Global Burden of Disease Socio-demographic Index. The findings show that oral conditions remain a substantial population health challenge. Globally, there were 3.5 billion cases (95% uncertainty interval [95% UI], 3.2 to 3.7 billion) of oral conditions, of which 2.3 billion (95% UI, 2.1 to 2.5 billion) had untreated caries in permanent teeth, 796 million (95% UI, 671 to 930 million) had severe periodontitis, 532 million (95% UI, 443 to 622 million) had untreated caries in deciduous teeth, 267 million (95% UI, 235 to 300 million) had total tooth loss, and 139 million (95% UI, 133 to 146 million) had other oral conditions in 2017. Several patterns emerged when the World Bank's classification of economies and the Socio-demographic Index were used as indicators of economic development. In general, more economically developed countries have the lowest burden of untreated dental caries and severe periodontitis and the highest burden of total tooth loss. The findings offer an opportunity for policy makers to identify successful oral health strategies and strengthen them; introduce and monitor different approaches where oral diseases are increasing; plan integration of oral health in the agenda for prevention of noncommunicable diseases; and estimate the cost of providing universal coverage for dental care.

Community perspectives on barriers and challenges to HIV pre-exposure prophylaxis access by men who have sex with men and female sex workers access in Nigeria.

BACKGROUND: Men who have sex with men (MSM), female sex workers (FSW) have critical needs for effective HIV prevention tools. This study identified perspectives of MSM, FSW and policy makers on the needs for, barriers to, and challenges with pre-exposure HIV prophylaxis (PrEP); and the logistics required to support roll-out of PrEP for MSM and FSW in Nigeria. METHODS: Qualitative and quantitative data were collected through a cross-sectional study. The quantitative data were collected through an online survey administered to 519 MSM, FSW and transgender respondents. The qualitative data were collected through 22 focus group discussions with 140 MSM and 80 FSW, and a two-day consultative workshop with 65 participants. Two open-ended questions in the online survey were also a source of qualitative data. Results of the quantitative data were reported descriptively; the qualitative data were inductively examined with a content analytic approach to construct descriptive categories. The findings from the quantitative and qualitative responses were triangulated. RESULTS: Four hundred and ninety-four (95.2%) online respondents had heard about PrEP through community dialogue (71.3%), and 439 (84.6%) supported its use by MSM and FSW. Fewer than half of the respondents were aware of the clinical care required for PrEP, and misconceptions about PrEP were common. Stated barriers to PrEP uptake were stigma, cost, frequency of HIV counseling and treatment services required, and possible drug-drug interactions. Concerns included possible condom migration, increased risk for sexually transmitted infections and pregnancy for FSW, and poor adherence to medication and hospital schedules. Participants felt that trained peer educators and HIV-test counselors could provide information and refer clients to clinics that provide PrEP. PrEP can be provided through peer-led facilities for MSM and FSW, though its access should be expanded to all persons who are at substantial risk for HIV to prevent negative labeling of PrEP. Public awareness about the use of antiretrovirals for HIV prevention is needed to prevent labeling of PrEP users as being HIV positive. CONCLUSION: Although MSM and FSW are interested in the use of PrEP, numerous individual and structural barriers need to be addressed to facilitate access to it in Nigeria.

Orthodontic treatment need of children and adolescents with special healthcare needs resident in Ile-Ife, Nigeria.

OBJECTIVES: This study determined differences in the orthodontic treatment need of children and adolescents with and without special healthcare needs (SHCN) resident in Ile-Ife. METHODS: Participants were children and adolescents aged 6 to 19 years with and without SHCN recruited from regular and special schools in Ile-Ife, Nigeria, respectively. SHCN were categorised as hearing impairment (HI), visual impairment (VI), physical impairment (PI) or intellectual disability (ID). The orthodontic treatment need was determined using the aesthetic component (AC) and dental health component (DHC) of the index of orthodontic treatment need (IOTN) and the dental aesthetic index (DAI). Chi-squared tests were used to determine differences in orthodontic treatment need; one-way analysis of variance was used to compare participants' mean DAI scores. Statistical significance was inferred at p < 0.05. RESULTS: The data of 164 participants with SHCN and 208 participants without SHCN were analysed. Significantly more children and adolescents with SHCN than those without SHCN had great need for treatment on the AC (15.2% vs. 4.3%; p<0.001) and the DHC (28.0% vs. 18.3%; p = 0.005) of IOTN and mandatory need for treatment using the DAI (28.0% vs. 12.0%; p < 0.001). The orthodontic treatment need of participants with intellectual disability, visual impairments and multiple SHCN differed significantly from the control group, those with intellectual disability also had greater need for orthodontic treatment compared with those with physical and hearing impairments (p < 0.05) CONCLUSION: Children and adolescents with SHCN, resident in Ile-Ife, are at greater risk of having malocclusion traits that require orthodontic treatment when compared with their peers without SHCN, especially those with intellectual disability.

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.

Early Childhood Caries - A diagnostic enigma.

Early childhood caries (ECC) is the most common chronic infectious childhood disease. It is also a major public health problem worldwide [Gomez, 2013]. Although it is not life-threatening, early childhood caries impacts negatively the quality of life when associated with pain. It affects the function, social interactions and cognitive and neurodevelopment of affected children, whose parents also suffer financial and emotional stress [Folayan and Alade, 2018]. Early childhood caries is defined as the presence of one or more cavitated or non-cavitated lesion, missing or filled tooth due to caries in any primary tooth in a child 71 months of age or younger [AAPD, 2008]. The two key parameters here are the age of the child and involvement of the primary dentition. Here is a scenerio. How to classify a case of a child that has had symptoms of pain from a carious primary tooth at age 4 years but only came for treatment at age 6 years? Is this a case of early childhood caries because of the onset at age 4, or it cannot be considered early childhood caries because of late diagnosis? This highlights the challenges posed by the age-related definition of early childhood caries and the timing of diagnosis of this clinical entity. The age bracket used for the definition of early childhood caries entails the assumption that the majority of children of this age group will have only primary teeth in the oral cavity. However, there is growing evidence to suggest an increasing number of children erupt their first permanent teeth at a younger age due to improved nutrition: cases of eruption of the first permanent incisor by age 4 years had been reported [Ilieva, 2002]. Therefore, if a five-year-old child has a single caries lesion on a permanent tooth, what is the diagnosis for this child? Finally, it is difficult to develop a treatment plan for the lesion with the current definition of ECC. While caries can be divided into mild, moderate and severe with corresponding treatment protocol for each lesion, the age-related categorisation of early childhood caries - severe or non-severe [AAPD, 2008] - makes the development of a treatment protocol challenging and difficult. These scenarios highlight the diagnostic challenges that the current definition of early childhood caries poses. It also underscores the challenges associated with identifying early childhood caries as a distinct lesion from caries in general - it has no distinct diagnostic feature from caries. Defining a lesion by the age of the patient and including a diagnostic criteria that is not restrictive to the age group - caries in the primary dentition - encumbers the attempt to make early childhood caries a distinct clinical entity.

A radiographic study of the mandibular third molar root development in different ethnic groups.

BACKGROUND: The nature of differences in the timing of tooth formation between ethnic groups is important when estimating age. AIM: To calculate age of transition of the mandibular third (M3) molar tooth stages from archived dental radiographs from sub-Saharan Africa, Malaysia, Japan and two groups from London UK (Whites and Bangladeshi). MATERIALS AND METHODS: The number of radiographs was 4555 (2028 males, 2527 females) with an age range 10-25 years. The left M3 was staged into Moorrees stages. A probit model was fitted to calculate mean ages for transitions between stages for males and females and each ethnic group separately. The estimated age distributions given each M3 stage was calculated. To assess differences in timing of M3 between ethnic groups, three models were proposed: a separate model for each ethnic group, a joint model and a third model combining some aspects across groups. The best model fit was tested using Bayesian and Akaikes information criteria (BIC and AIC) and log likelihood ratio test. RESULTS: Differences in mean ages of M3 root stages were found between ethnic groups, however all groups showed large standard deviation values. The AIC and log likelihood ratio test indicated that a separate model for each ethnic group was best. Small differences were also noted between timing of M3 between males and females, with the exception of the Malaysian group. These findings suggests that features of a reference data set (wide age range and uniform age distribution) and a Bayesian statistical approach are more important than population specific convenience samples to estimate age of an individual using M3. CONCLUSION: Some group differences were evident in M3 timing, however, this has some impact on the confidence interval of estimated age in females and little impact in males because of the large variation in age.

Prevalence and family structures related factors associated with crown trauma in school children resident in suburban Nigeria.

BACKGROUND: Multiple risk factors have been identified for traumatic dental injuries, including crown fractures, in various age groups and various populations. The objective of this study was to determine the prevalence, risk factors and family related factors for crown trauma among 8 to 16 year-old children in a suburban population, Nigeria. METHODS: This is a secondary analysis of a data of 2107 children collected through a school-based survey. Study participants were 8 to 16 year-old resident in suburban Nigeria. The independent variables for the study were age, sex, socioeconomic status, and birth rank, family size and parenting status (one parent, step parent, both parents, and guardians). Details were collected using an interviewer administered questionnaire. Intraoral examination was conducted to identify presence of crown fracture. The independent variables associated with and predictors of crown trauma were determinedusing chi-square and logistic regression analysis respectively. RESULTS: Only 167 (7.9 %) of the 2107 study participants had crown trauma. The teeth level prevalence of crown trauma was 0.33 %. Children with middle socioeconomic status had reduced odds of having crown trauma when compared with children with low socioeconomic status (AOR 0.50; CI 0.32-0.80). The odds of having crown traumawas more than doubled in males when compared with females (AOR 2.41; CI 1.72-3.39) and almost doubled in children living with single parents when compared with children living with both parents (AOR 1.94; CI 1.29-3.05). CONCLUSIONS: The prevalence of crown traumawas low in this study population. Being a female and having lowsocioeconomic status significantly reduced the risk factors for crown traumawhile living with single parents increased risk for crown trauma.

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.

Strategies for Oral Health Research in Africa and the Middle Eastern Region.

The highest burden of diseases worldwide is in low- and middle-income countries, but due to lack of capacity and inadequate infrastructure, research output from these countries is unable to address existing and emerging challenges in health care. Oral health research has particularly been hampered by low prioritization, resulting in insufficient development of this sector. There is an urgent need for research correlating oral health to upstream social and environmental determinants and promoting the common risk factor approach for prevention of noncommunicable diseases. Population-wide preventive measures for oral health care are more effective than purely curative approaches, especially for vulnerable groups who have limited access to information and appropriate health care. This article identifies priorities and proposes strategies for researchers, stakeholders, and policy makers for the initiation and sustenance of appropriate oral health care research. The proposed interventions are intended to promote collaboration, capacity building, and health advocacy. Local ownership in multinational research projects in low- and middle-income countries, complemented by skills transfer from high-income countries, is encouraged to ensure that regional health needs are addressed. Emphasis is placed on a shift toward translational research that has a direct impact on oral health care systems.

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.

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.

Changes in the prevalence of dental caries in primary school children in Lagos State, Nigeria.

OBJECTIVES: To evaluate the changes in the prevalence of dental caries in Lagos State over a 3 years period and the role of age, sex, and playing in the changes observed. MATERIALS AND METHODS: Three primary schools in Lagos State, Nigeria were randomly selected for the study. Six hundred and thirty-three children age 2-12 years, were examined for caries in 2000 while 513 children were examined in 2003. The prevalence of tooth decay and the prevalence of untreated tooth decay were calculated for the two years, that is, 2000 and 2003. Also the degree of unmet treatment need among the population with caries experience was measured. Differences in the prevalence and severity of dental caries in the primary and permanent dentition were assessed. RESULTS: Approximately 18% of children had untreated tooth decay in their primary dentition in 2003: A 26.1% increase from 2000. About 12.0% of the decay, extracted, and filled teeth (deft) index was seen with decayed teeth in 2000 and 16.6% in 2003. Extracted primary teeth decreased from 2.5% in 2000 to 1.5% in 2003. The change in mean deft between 2000 (0.42) and 2003 (0.47) was 11.9%. Over the study period, the overall reduction in the prevalence of dental caries was 34.8% in the permanent dentition. The decline was larger among children aged 5-9 years (62.1%) and among females (75%). CONCLUSION: The study showed no overall changes in caries severity but a decrease in caries prevalence in the permanent dentition over the study period. The largest decline in caries prevalence in the permanent dentition was observed in children aged 5-9 years and females. On the contrary, there was an increase in the caries prevalence in the primary dentition.

Non-third molar related pericoronitis in a sub-urban Nigeria population of children.

BACKGROUND: The study will report on the prevalence, clinical presentation, diagnosis, and management of non-third molar related pericoronitis seen in children below the age of 15 years who report at the Pediatric Dental Clinic, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife over a 4½ year period. MATERIALS AND METHODS: This is a prospective study of cases of pericoronitis affecting any tooth exclusive of the third molar diagnosed in the pediatric dentistry out-patient clinic in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife between January 2008 and June 2012. Pericoronitis was diagnosed using the criteria described by Howe. Information on age, sex, history malaria fever, upper respiratory diseases, tonsillitis, and evidence of immunosuppression were taken. Radiographs were taken in all cases to rule out tooth impaction and information on treatment regimen was also collected. RESULTS: The prevalence of non-third molar related pericoronitis was 0.63%. More females (63.6%) were affected. Chronic pericoronitis was the most common presentation (73.3%). No case was reported in the primary dentition and the premolar. No case was associated with tooth impaction and the tooth most affected was the lower right second permanent molar (35.7%). Bilateral presentation was seen in 36.4% patients. Herpetic gingivostomatitis was reported in association with one case. Chronic pericoronitis resolved within 3 days of management with warm saline mouth bath (WSMB) and analgesics, while acute/subacute resolved within 10 days of management with antibiotics, analgesics, and WSMB. CONCLUSIONS: The prevalence of non-third molar related pericoronitis is the low. The most prevalence type is chronic pericoronitis affecting the lower right second permanent molar.

Facial nerve palsy: analysis of cases reported in children in a suburban hospital in Nigeria.

AIM: The study describes the epidemiology, treatment, and treatment outcomes of the 10 cases of facial nerve palsy seen in children managed at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife over a 10 year period. It also compares findings with report from developed countries. METHODOLOGY: This was a retrospective cohort review of pediatric cases of facial nerve palsy encountered in all the clinics run by specialists in the above named hospital. A diagnosis of facial palsy was based on International Classification of Diseases, Ninth Revision, Clinical Modification codes. Information retrieved from the case note included sex, age, number of days with lesion prior to presentation in the clinic, diagnosis, treatment, treatment outcome, and referral clinic. FINDINGS: Only 10 cases of facial nerve palsy were diagnosed in the institution during the study period. Prevalence of facial nerve palsy in this hospital was 0.01%. The lesion more commonly affected males and the right side of the face. All cases were associated with infections: Mainly mumps (70% of cases). Case management include the use of steroids and eye pads for cases that presented within 7 days; and steroids, eye pad, and physical therapy for cases that presented later. All cases of facial nerve palsy associated with mumps and malaria infection fully recovered. The two cases of facial nerve palsy associated with otitis media only partially recovered. CONCLUSION: Facial nerve palsy in pediatric patients is more commonly associated with mumps in the study environment. Successes are recorded with steroid therapy.

Association between breastfeeding and eruption of the first tooth in preschool children in Nigeria.

AIM: This study specifically examines the effect of the form and duration of breastfeeding on the timing of eruption of the first tooth in Nigerian children STUDY DESIGN: The study included 398 children aged 6 months to 71 months. The mothers were asked to provide information on the duration and form of breastfeeding, and the age of eruption of the first deciduous teeth. The socioeconomic status (SES) of the child was calculated using the mother's level of education and the father's occupation. Intraoral examination was conducted to assess the teeth present and dentition status of the child. A tooth was considered present in the mouth when any part of the tooth was visible. RESULTS: There was no association found between the duration of breastfeeding (p=0.48), form of breast feeding (p=0.61), duration of exclusive breast feeding (p=0.41) and timing of eruption of the first tooth. CONCLUSION: The duration of breast feeding does not affect the timing of eruption of the first deciduous tooth, neither does the form of breastfeeding.