Assessment of Basic Knowledge on Orofacial Pain amongst Undergraduate Dental Students.

INTRODUCTION: With pain being the major cause of visits to the dental clinic, the basic knowledge of causes for adequate management is paramount for dentists and dentists-in-training to improve the quality of life of patients. OBJECTIVE: The study was conducted to assess the knowledge of undergraduate dental students regarding orofacial pain (OFP) and how comfortable they are understanding, identifying, and diagnosing different categories of OFP. DESIGN: A cross-sectional study was carried out amongst penultimate and final year dental students of two dental schools. A modified questionnaire on basic knowledge of OFP which contained 16 questions was adopted to evaluate students' knowledge. Questions also assessed how comfortable the students were diagnosing the different categories of OFP. P value was set at ≤0.05 (exact). RESULTS: One hundred and four undergraduates participated in the study. The age range was 23-33 years while the mean was 24.3 ± 2.1years. Only 31% got the basic questions correctly. About 51% in both levels claimed they had moderate knowledge (scale 5-7) of pain education, while 64% of final year students felt their knowledge was adequate for their clinical needs, 50% of the penultimate year felt otherwise (p=0.02). All students however believed they needed more teaching on orofacial pain, with the most preferred form of learning being clinic-based teaching (40.4%). CONCLUSION: The study showed moderate self-assessed knowledge but low general basic knowledge of OFP by the undergraduate students; possibly a reflection of the curriculum. Therefore, there is a need to improve the curriculum for orofacial pain teachings in dental schools.

CONTEXTE: La douleur étant la principale raison des visites chez le dentiste, la connaissance de base des causes pour une gestion adéquate est primordiale pour les dentistes et les étudiants en odontologie afin d'améliorer la qualité de vie des patients. OBJECTIF: L'étude avait pour but d'évaluer les connaissances des étudiants en odontologie sur les douleurs orofaciales (DOF) et dans quelle mesure ils se sentent à l'aise pour comprendre, identifier et diagnostiquer les différentes catégories de DOF. CONCEPTION: Une étude transversale a été menée auprès des étudiants en odontologie de deux écoles dentaires en avant-dernière et dernière année. Un questionnaire modifié sur les connaissances de base en DOF, comprenant 16 questions, a été adopté pour évaluer les connaissances des étudiants. Les questions ont également évalué dans quelle mesure les étudiants se sentaient à l'aise pour diagnostiquer les différentes catégories de DOF. La valeur Pa été fixée à ≤0,05 (exacte). RÉSULTATS: Cent quatre étudiants ont participé à l'étude. La tranche d'âge était de 23 à 33 ans, avec une moyenne de 24,3 ± 2,1 ans. Seuls 31 % ont répondu correctement aux questions de base. Environ 51 % des étudiants des deux niveaux ont affirmé qu'ils avaient des connaissances modérées (échelle de 5 à 7) en éducation sur la douleur, tandis que 64 % des étudiants en dernière année estimaient que leurs connaissances étaient adéquates pour leurs besoins cliniques, 50 % des étudiants en avantdernière année pensaient le contraire (p=0,02). Cependant, tous les étudiants estimaient avoir besoin d'un enseignement supplémentaire sur les douleurs orofaciales, la forme d'apprentissage préférée étant l'enseignement en clinique (40,4 %). CONCLUSION: L'étude a montré une connaissance auto-évaluée modérée mais des connaissances de base générales faibles sur les DOF parmi les étudiants en odontologie, ce qui pourrait être le reflet du programme d'études. Par conséquent, il est nécessaire d'améliorer le programme d'enseignement sur les douleurs orofaciales dans les écoles de dentisterie. Mots-clés: Douleurs orofaciales, connaissances, étudiants, éducation dentaire, Nigéria.

Dental Caries, Traumatic Dental Injuries and Gingivitis among Street-Children in Kano, Nigeria.

BACKGROUND: Street-children (Almajirai) constitute a significant proportion of the adolescent population in northern Nigeria. They face health challenges, especially oral health, from being inadequately protected, supervised or directed by responsible adults. OBJECTIVES: The objective of the study was to determine the prevalence of dental caries, dental trauma, gingivitis and oral hygiene scores in street-children. METHODOLOGY: Three hundred and sixty-six school-aged children were selected through a multi-stage sampling of 10 to 12-year-old children from four modern and traditional qur'anic schools, and examined for oral conditions using the WHO protocol. The DMFT index, the modified Ellis criteria, the Gingival Bleeding Index and the Oral Hygiene Index-Simplified (OHI-S) were used to assess dental caries, traumatic dental injuries, gingivitis and oral hygiene scores respectively. Chi-squared tests and Odds Ratio were used to compare the difference and test the association between Almajirai groups. Data analysis was carried out using the Statistical Package for the Social Sciences (SPSS version 20). Statistical significance was considered when p < 0.05. RESULTS: One hundred and sixty eight (45.9%) traditional Almajirai and 198 (59.4%) modern-type Almajirai, participated in the study. Their mean age was 10.8(±0.8) years. The prevalence of dental caries was 25.4% with mean DMFT and SiC scores of 0.6 (±1.3) and 1.7 respectively. DMFT scores ranged from 0 to 12. The prevalence of traumatic dental injuries and gingivitis were 8.7% and 82.2% respectively, while the OHI-S score was 3.0. The odds for traumatic dental injuries were 41% less in the modern-type Almajirai (p=0.02); the modern-type Almajirai were twice as likely to develop gingivitis (aOR 95%CI =2.0, p=0.01). OHI-S scores showed poorer oral hygiene levels in the modern Almajirai (p=0.02). CONCLUSION: Dental caries, traumatic dental injuries, gingivitis and poor oral hygiene were prevalent among street-children in Kano. There is a high level of untreated dental disease in the study population.

CONTEXTE: Les enfants des rues constituent une proportion importante de la population adolescente du nord du Nigeria. Ils sont confrontés à des problèmes de santé, notamment de santé bucco-dentaire, du fait qu'ils ne sont pas suffisamment protégés, supervisés ou dirigés par des adultes responsables. OBJECTIFS: L'objectif de cette étude était de déterminer la prévalence des caries dentaires, des traumatismes dentaires, de la gingivite et des scores d'hygiène buccale chez les enfants des rues. MÉTHODOLOGIE: Trois cent soixante-six enfants d'âge scolaire ont été sélectionnés par un échantillonnage à plusieurs degrés d'enfants de 10 à 12 ans dans quatre écoles qur'aniques modernes et traditionnelles, et ont été examinés pour les conditions bucco-dentaires en utilisant le protocole de l'OMS. L'indice CAOD, les critères d'Ellis modifiés, l'indice de saignement gingival et l'indice d'hygiène buccale simplifié (IOB-S) ont été utilisés pour évaluer les caries dentaires, les lésions dentaires traumatiques, la gingivite et les scores d'hygiène buccale, respectivement. Les tests du chi carré et l'Odds Ratio ont été utilisés pour comparer les différences et tester l'association entre les groupes Almajirai. L'analyse des données a été réalisée à l'aide du progiciel statistique pour les sciences sociales (SPSS version 20). La signification statistique a été considérée lorsque p < 0,05. RÉSULTATS: Cent soixante-huit (45,9%) Almajirai traditionnels et 198 (59,4%) Almajirai de type moderne ont participé à l'étude. Leur âge moyen était de 10,8 (±0,8) ans. La prévalence de la carie dentaire était de 25,4 % avec des scores moyens de CAOD et de SiC de 0,6 (±1,3) et 1,7 respectivement. Les scores CAOD variaient de 0 à 12. La prévalence des lésions dentaires traumatiques et de la gingivite était de 8,7 % et 82,2 % respectivement, tandis que le score OHI-S était de 3,0. Les risques de lésions dentaires traumatiques étaient 41 % moins élevés chez les Almajirai de type moderne (p=0,02) ; les Almajirai de type moderne étaient deux fois plus susceptibles de développer une gingivite (aOR 95%CI =2,0, p=0,01). Les scores OHI-S ont montré des niveaux d'hygiène buccale plus faibles chez les Almajirai de type moderne (p=0,02). CONCLUSION: Les caries dentaires, les lésions dentaires traumatiques, les gingivites et une mauvaise hygiène bucco-dentaire étaient prévalentes chez les enfants des rues de Kano. Il existe un niveau élevé de maladies dentaires non traitées dans la population étudiée. Mots clés: Caries, enfants des rues, Almajirai, Adolescents, Hygiène buccale, Gingivite.

Impact of oral hygiene and socio-demographic factors on dental caries in a suburban population in Nigeria.

AIM: This was to determine dental caries determinants in the study participants. METHODOLOGY: This was a secondary data study extracted from primary data through a school-based study that recruited students from primary and secondary schools in a suburban population in Nigeria. The variables included age, gender, socio-economic status, oral hygiene status, type of parenting, birth rank, family size and presence of dental caries. The diagnosis of dental caries was based on the World Health Oral Health Survey recommendations while oral hygiene was determined using simplified-oral hygiene index (OHI-S). Data was analysed using STATA version 13, statistical significance was set at P < 0.05. RESULTS: The prevalence of dental caries for the study population was 12.2%, DMFT and dmft were 0.16 and 0.06 respectively. Children within age groups 11-13 and 14-16 years had reduced chances of having dental caries (P = 0.01; P = 0.01); children with fair oral hygiene and poor oral hygiene had increased odds of having dental caries (P ≤ 0.001; P ≤ 0.001), last child of the family also had increased odds of having dental caries while children from large family size had reduced odds of having dental caries. This study also showed that first permanent molars and second primary molars were mostly affected by dental caries but there was no significant difference between distribution of the maxillary or mandibular jaw or between right and left quadrants. CONCLUSION: Age, oral hygiene, birth rank and family size were the significant determinants of dental caries in the study population and the teeth mostly affected were first permanent molars and second primary molars.

ORO-FACIAL FASCIAL SPACE INFECTION IN A PAEDIATRIC GAMBIAN POPULATION: A REVIEW OF 93 CASES.

BACKGROUND: Oro-facial fascial space infection is known to be a clinical presentation of neglected dental care. The proportion of children with dental sepsis has also been known to increase markedly with caries experience. Such fascial space infection in the paediatric age group is known to progress rapidly within a short period and is thus potentially more fatal than in the adult population. AIM: This study aimed to document and evaluate the pattern of oro-facial fascial space infection amongst paediatric Gambian population. PATIENTS AND METHODS: The study was a 4-year descriptive retrospective survey of all patients with oro-facial fascial space infection seen and managed at the dental unit of the polyclinic attached to the Edward Francis Small Teaching Hospital in Banjul, The Gambia from May 2015 to April 2019. The information collated were patients' sociodemographic data as well as clinical features related to their medical and dental condition. The extracted data were analyzed using Statistical Package for Social Sciences (SPSS) version 15.0 (SPSS Inc, Chicago, IL). Absolute numbers and simple percentages were used to describe categorical variables. Quantitative variables were described using mean (with standard deviation), median and range. Categorical variables were compared using chi square test and numeric variables compared using student t-test. Differences were considered significant if p<0.05. RESULTS: A total of 322 patients with oro-facial fascial space infection were managed within the period of the study out of whom 93 patients that met the inclusion criteria were studied. Their ages ranged from 3 months to 16 years, with a mean age of 8.5(SD2.1) years. There were 54 males and 39 females with a gender (M: F) ratio of 1.4: 1. All the patients presented with painful facial swelling and fever. Eighty-one (87.1%) had a history of toothache. The median number of fascial space involvement was 1 space; the submandibular space was involved unilaterally in 43 (46.2%) and bilaterally in 8 patients (8.6%). Eighty-one (87.1%) were odontogenic in origin and 12 (12.9%) were non-odontogenic. Seventy-two (88.89%) of odontogenic cases involved posterior teeth and 45 (62.5%) of these were the first permanent molars. Incision and decompression and teeth extraction were done for all the odontogenic cases. Staphylococci and/or streptococci were cultured from six patients. All the patients had inpatient treatment with a combination of intravenous amoxicillin, metronidazole and gentamicin treatment. Mortality rate was 5.4% (5 out of 93) and the mean age of patients who died, 3.0 (SD0.3) years, was significantly lower than that of those who survived, 8.3 (SD1.4) years, (p<0.0001). CONCLUSION: The commonest symptoms of oro-facial fascial space infection in the Gambian paediatric population were fever, facial swelling and toothache. Most of the infections were odontogenic and affected most commonly the submandibular space. Posterior teeth were more commonly involved than the anterior, with the first permanent molar being the most commonly affected tooth. Incision and decompression were performed in all odontogenic cases, with extraction of all culprit teeth. All patients had in-patient treatment with intravenous amoxicillin, metronidazole and gentamicin. The mortality rate was 5.4%. The burden of dental caries with its complications is huge in the paediatric population of the Gambia. Training of dental surgeons and specialists and their auxiliaries with advocacy on the need for regular dental checkup for children, as well as prompt attention to dental diseases will help to reduce this scourge.