Strengthening the oral health system in Nigeria: A health systems building block approach

Aim: The present study aimed to describe the building blocks of the oral health system, including the role that the community plays in strengthening the oral health system in Nigeria. Methodology: This research was a scoping review of the existing literature retrieved from search engines and databases. Thus, we utilised grey literature, peer-reviewed literature, policy documents and websites. The oral health system was analysed using the World Health Organisation's Health systems framework, and we adapted this framework by introducing a seventh block, community participation. We also inserted the links between the oral health service delivery and oral health workforce blocks of the framework to improve the oral health outcomes. Results: More dental clinics are required to improve the availability and accessibility of oral health services. Dental workforce expansion is imperative. This can be approached by training of junior cadre dental professionals and incorporating community health practitioners to deliver basic oral care. There is an unregulated access to medication to treat dental conditions; hence, oral disease treatments need to be included in the country's treatment guidelines to improve standard of care. The government needs to improve on overall health spending and invariably increase oral health care allocation urgently. Furthermore, the country's stewardship of oral health care is hinged on well disseminated and implemented national policies on oral health. The oral health system can achieve its overall goals with community participation, engagement and ownership. Conclusion: Strengthening the oral health system in Nigeria requires urgent attention on each building block and cross-cutting interventions across the system's building blocks. The role of the community will need to be recognised because it is vital in sustaining any organisational change.

Prevalence of oral mucosal lesions and oral health related quality of life among adolescents in a rural Nigerian population

Background: Oral mucosal lesions affect people of all age groups, and vary in presentation; from asymptomatic to severely debilitating. Studies reporting the prevalence and effects of these lesions in adolescents are generally few compared to those describing the demography of dental caries and other oral diseases. Objective: To determine the prevalence of oral mucosal lesions, factors that contribute to the prevalence, and the association with the oral-health related quality of life (OHRQoL) of adolescents in the population. Methods: A cross-sectional survey was done on 240 secondary school students aged 10-19 from three secondary schools selected using multi-stage cluster random sampling. A pre-designed questionnaire was used to collect demographic information, presence of systemic illness, and oral habits. Oral-health related quality of life was assessed using the oral-health impact profile (OHIP-14), and intraoral examination was performed within the school premises by a single trained investigator. Results: A total of 33 participants (13.7%) had oral mucosal lesions. Overall, commissural lip pits (5.0%) were the most prevalent, while geographic tongue and irritation fibroma (0.4% each) were the least prevalent lesions. The mean OHIP-14 score of the participants in this study was 7.17+8.64. Participants with systemic diseases and cheek biting habits had statistically significant worse scores than those without either. Conclusion: The most prevalent oral mucosal lesions in the adolescent age group are those of developmental origin. Quality of life was negatively impacted by the presence of systemic diseases as well as cheek biting habit.