Replication of GWAS significant loci in a sub-Saharan African Cohort with early childhood caries: a pilot study.

BACKGROUND: Early childhood caries (ECC) is a rapidly progressing form of dental infection and a significant public health problem, especially among socially and economically disadvantaged populations. This study aimed to assess the risk factors for ECC among a cohort of Sub-Saharan African children and to determine the role of genetics in the etiology of ECC. METHODS: A sample of 691 children (338 with ECC, 353 without ECC, age < 6 years) was recruited from schools in Lagos, Nigeria. Socio-demographic, dental services utilization and infant dietary data were obtained with interviewer-administered questionnaire. Oral examination was conducted using the WHO oral health diagnostic criteria. Saliva samples were collected from the children for genetic analysis. Single nucleotide polymorphisms were selected from previous study for genotyping. Genetic association analyses to investigate the role of genetics in the etiology of ECC was done. Bivariate comparisons and Multivariate logistic regression analyses were conducted to assess associations between ECC and predictor variables, p < 0.05. RESULTS: Of the 338 children with ECC, 64 (18.9%) had Severe-Early Childhood Caries (S-ECC). Children aged 48-59 months comprised the highest proportion of subjects with ECC (165; 48.8%) and S-ECC (24; 37.5%) while female subjects had higher dt (3.13 ± 2.56) and dmft values 3.27 ± 2.64. ECC was significantly more prevalent among children who were breastfed at night ≥ 12 months (OR 3.30; CI 0.39, 4.75), those with no previous dental visit (OR 1.71; CI 0.24, 2.77), those who used sweetened pacifiers (OR 1.85; CI 0.91, 3.79) and those who daily consumed sugar-sweetened drinks/snacks (OR 1.35; CI 0.09, 18.51). A suggestive increased risk for ECC (OR 1.26, p = 0. 0.0397) was observed for the genetic variant rs11239282 on chromosome 10. We also observed a suggestive reduced risk for ECC (OR 0.80, p = 0.03) for the rs131777 on chromosome 22. None of the genetic variants were significant after correction for multiple testing (Bonferroni p value p = 0.004). CONCLUSIONS: Prolonged night-time breastfeeding, poor utilization of dental services and daily consumption of sugar were risk factors for ECC. Larger sample size is needed to confirm the results of the genetic analysis and to conduct genome wide studies in order to discover new risk loci for ECC.

Experience and knowledge of child abuse and neglect: A survey among a group of resident doctors in Nigeria.

BACKGROUND: Child abuse and neglect (CAN) is a significant public health problem. Dentists are in good position to identify and report cases of CAN. AIM: The aim of this study was to determine the experience and knowledge of CAN among a group of Nigerian dental residents. MATERIALS AND METHODS: This was a cross-sectional study carried out among dentists attending a postgraduate update course. Data were collected to assess the knowledge of respondents on the forms of CAN, indicators and risk factors. Respondents' professional experiences were also assessed as well as actions taken and possible barriers to reporting suspected cases. RESULTS: Data were collected from 179 respondents, with a mean age of 33.1 ± 5.2 years. The respondents demonstrated good knowledge of the forms of child abuse, with an average score of 95.2%. The risk factors for CAN were correctly identified by 153 (85.5%) respondents as children with physical/mental disabilities, 151 (84.4%) as products of unwanted pregnancies, 128 (71.5%) as children from polygamous families and 122 (68.2%) as children from low socioeconomic families. Physical, sexual and emotional abuse and neglect were majorly identified as bruises behind the ears, 162 (90.5%); oral warts, 114 (63.7%); poor self-esteem, 158 (88.3%) and untreated rampant caries, 137 (76.5%), respectively. Seventy-four (46.5%) of the respondents did not evaluate children for CAN and only 12 (14.1%) of those who observed suspected cases of CAN reported to the social service. Lack of knowledge of referral procedures and concerns about confidentiality were the major barriers to reporting cases of CAN. CONCLUSION: The dentists had good theoretical knowledge of the indicators, risk factors and signs of CAN but lagged in clinical detection and reporting of such suspected cases. There is a need for continuing education and advancement of the postgraduate dental curriculum to improve the educational experiences with regard to CAN.

Pattern of tooth extraction in children attending tertiary health care centers in Nigeria: a prospective study.

BACKGROUND: To identify the causes of tooth extraction in a tertiary pediatric center in an urban centre in Nigeria. METHOD: Data was collected prospectively from 400 children attending one of the four tertiary dental clinics. The demographic profile, the indications for tooth extraction, and the tooth extracted were noted. Data was compared with result of study conducted 21 years back in the same center, and data from two other tertiary health centers in the region. RESULTS: The prevalence of tooth extraction was 58.8% in the study population. This occurred in significantly more male patients. Tooth loss was commonest amongst the 7-10 age group. Dental caries was the main cause of tooth loss for all age groups. Most patients (66.0%) lost a single tooth. The lower molars were the most frequently lost teeth (47%). Indications for tooth extraction were similar in the region. CONCLUSION: Dental caries remains the most common cause of tooth extraction. The indications for tooth extraction remain the same but the prevalence of tooth loss per cause of tooth loss had not changed over the last 21 years, and across institutions in Southwestern Nigeria.

Prevalence of dental fluorosis among 12-15-year-old students in Enugu Metropolis, Nigeria.

BACKGROUND: Excessive ingestion of fluoride during tooth development, particularly at the maturation stage, may result in dental fluorosis, with clinical implications. Literature is scarce on dental fluorosis in Enugu, Nigeria. PURPOSE: The aim of this study was to assess the prevalence of dental fluorosis in Enugu, a major city in South East Nigeria. MATERIALS AND METHODS: A multistage sampling technique was used to select a calculated sample of 400 students. A pretested interviewer-administered questionnaire was used to ascertain student's sociodemographic and related variables. The student participants were examined for dental fluorosis using Dean's index criteria according to the World Health Organization guidelines. Data were analyzed using SPSS version 16, and Chi-square test of association was used to compare proportions and ratios with significant level set at P < 0.05 and 95% confidence level. RESULTS: Among the 400 students analyzed, 231 (57.8%) and 169 (42.2%) were male and female, respectively. Mean age was 13.43 ± 1.021 years. The prevalence of dental fluorosis was 11.3%, with the preponderance of very mild score (82.2%), and no observed severe dental fluorosis. The difference in the distribution of the scores of fluorosis among the children was highly statistically significant (χ2 = 72.80, P = 0.000). Dental fluorosis was found present in 39 (10.3%) of 378 users of fluoridated toothpaste and in 6 (27.7%) of the 22 users of nonfluoridated toothpaste. The differences in the presence and absence of dental fluorosis were statistically significant among users of fluoridated toothpaste. CONCLUSION: This study shows the prevalence of dental fluorosis to be low among secondary school students of Enugu metropolis.

A Preexperimental Study to Assess the Impact of an Interdisciplinary Educational Intervention on Nurses' Knowledge of Perinatal and Infant Oral Health Care.

OBJECTIVE: The objective of this study was to assess the impact of an interdisciplinary educational intervention on the knowledge of nursing practitioners regarding perinatal and infant oral health (PIOH) care. MATERIALS AND METHODS: This was a preexperimental study conducted among nursing practitioners in Lagos, Nigeria. Participants received hands-on training and didactic lectures, which included dental caries etiology and risk factors; oral hygiene and dietary education; teething and its management; dental trauma and its prevention; nonnutritive habits; screening, referrals, and counseling; and fluoride varnish application. Knowledge of the trainees was assessed using pre- and posttest questionnaires. Level of statistical significance was set at P < 0.05. RESULTS: Overall, 110 nurses participated in the study with a mean age of 40.9 ± 10.8 years; 106 (96.4%) were females. Approximately 88% of the participants had not received formal training on PIOH. The baseline mean scores of the participants' knowledge on oral hygiene, teething, trauma, caries, and oral habits were 4.31 ± 1.9, 9.84 ± 2.6, 2.59 ± 1.7, 4.24 ± 1.8, and 1.45 ± 0.6, respectively; this increased significantly (P < 0.001) following the educational intervention with posttest mean scores as 7.58 ± 0.8, 11.79 ± 1.3, 4.34 ± 1.9, 6.19 ± 1.8, and 1.82 ± 0.4 and six-month evaluation scores as 6.21 ± 1.8,7 10.27 ± 3.1, 4.39 ± 1.5, 5.91 ± 1.8, and 1.79 ± 0.5, respectively. Overall posttest (31.4 ± 4.2) and six-month (28.6 ± 6.2) knowledge scores were significantly higher than the pretest values (22.4 ± 4.8, P < 0.001). At the six-month post-intervention survey, 84% of the nurses reported inclusion of PIOH education in their routine general health education sessions. CONCLUSION: There was a positive impact of the educational intervention as evidenced by an increase in the knowledge of the nurses on PIOH care and the inclusion of PIOH education in their general health education. A slight decline between posttest and six-month evaluation scores indicates a need for continuous education and evaluation.