Dentine hypersensitivity and associated factors: a Nigerian cross-sectional study.

INTRODUCTION: Prevalence of dentine hypersensitivity (DH) may be on the increase as a result of changing lifestyles. This study aimed to assess the prevalence of DH and relative importance of associated factors in 18-35 year old Nigerians and compare to findings from a similar European study. METHODS: Following ethical approval, 1349 subjects from the six geopolitical zones in Nigeria participated in this cross sectional study. DH was clinically evaluated by cold air tooth stimulation, patient pain rating (yes/no) and investigator rated pain using the Schiff ordinal scale (0-3). Erosive tooth wear using the BEWE index was assessed. A questionnaire regarding the nature of the DH, erosive dietary intakes, tooth brushing habits and other factors was completed by patients. Bivariate analysis was conducted. RESULTS: 32.8% of patients reported pain on tooth stimulation and 32.9% scored ≥1 on Schiff scale for at least one tooth. Questionnaire reported sensitivity was 41.2%. There were statistically significant associations between Schiff score and clinically elicited DH (p < 0.001); and BEWE erosive tooth wear score and clinically elicited DH (p < 0.001). There were significant associations between DH and some oral hygiene practices such as brushing frequency, brush movement and brushing after breakfast. Fresh fruit and fruit/vegetable juice intake also showed significant association. CONCLUSION: The most important risk factors of DH for this population in Nigeria appear to be the frequency and characteristics of tooth brushing. This should be considered in its prevention and management.

Knowledge, diagnosis and management of dentine hypersensitivity: a national survey of dentists in Nigeria.

AIM: To assess the knowledge of Nigerian dentists regarding dentine hypersensitivity (DH) and their methods of diagnosis and management. METHODS: A cross-sectional questionnaire-based study of dentists practicing in all six geopolitical zones of Nigeria was conducted. The questionnaire focussed on participant's demography, exposure to patients with DH, knowledge-based questions, diagnosis and management of DH. Data analysis using EPI Info statistical software determined frequencies and proportions. Associations between discrete variables were assessed using the chi-square test (P ≤ 0.05). RESULTS: A total of 1,057 dentists responded; the majority (83.8%) had practiced for up to 15 years, and 92.0% reported that, on average, between one and 10 of their patients each week complained of DH. The majority (92.8%) of dentists described DH as stimulated brief pain from the tooth; 24.2% expressed that DH can be treated by altering the number of dentinal tubules. A diagnosis of DH is made by tapping (20.6%) or scratching (73.4%) the tooth. Although radical treatments, such as extraction (24.7%) and root canal therapy (34.5%), were mentioned by some, the majority identified aetiological and predisposing factors (98.8%) and provided diet (95.1%) and oral hygiene (95%) counselling as part of the management of DH. Evaluation of 36 knowledge-based questions revealed that only 1.8% of the respondents provided at least 25 correct answers. Knowledge was significantly associated with respondent age and number of years in practice (P ≤ 0.05) but was not associated with the number of patients with DH seen per week (P = 0.46). CONCLUSION: Dentists practicing in Nigeria exhibited knowledge gaps concerning DH and its diagnosis and management.

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.