Malocclusion and its impact on quality of life of school children in Nigeria

BACKGROUND: Malocclusion, though not life-threatening,is an important public health issue, which has a large impacton the individual, causing discomfort, social and functionallimitations.OBJECTIVE: To evaluate objectively orthodontic treatment needsin Nigerian schoolchildren and the impact of malocclusion ontheir quality of life.METHODS: This cross-sectional study involved schoolchildrenaged 12 to 16 years from four randomly selected secondaryschools in Lagos, Nigeria. A prestructured questionnaire wasadministered and a clinical examination was conducted.Occlusal status was assessed for each subject using the DentalAesthetic Index (DAI). Oral Health Impact Profile-14 (OHIP-14) was also evaluated.RESULTS: There were 410 (50.9%) females and 395 (49.1%)males aged 12 to 16 years. Mean age was 14.5 ± 1.3 years.Irregularity of teeth was the most prevalent malocclusion.Generalised spacing and midline diastema were seen in 59%and 31% respectively; crowding in 43% of the schoolchildren.Other occlusal anomalies were recorded. There was nostatistically significant difference between the sexes. Over onethird of the study population did not need treatment, treatmentwas mandatory in 24.3%, elective in 21% and highly desirablein 17%. More females than males did not need orthodontictreatment. Oral conditions had no effect on the quality of life of85.3% of the study sample.CONCLUSION: Most Nigerian schoolchildren were found tohave a dental appearance that needed orthodontic treatment.However, components of the oral conditions impacted on thequality of life of a few subjects. Psycho-social need is veryimportant in orthodontic diagnosis. WAJM 2010; 29(6): 417­424

Dental Spacing in Primary Dentition of Nigerian Children and its Relationship to Arch and Crown Dimensions

Objectives: The aims of this study were to compare mesiodistal and buccolingual crown widths; as well as dental arch dimensions between children with spaced and normal dental arches; and to determine which of the parameters mostly influence dental spacing. Methods: Crown and dental arch dimensions of dental casts of 125 children; grouped into spaced and normal primary dental arches; based on the tooth size-arch length discrepancy; were measured using electronic digital caliper. The data were statistically analyzed using t-test and stepwise multiple regression analysis. Results: Maxillary and mandibular spaced arches had statistically significant larger intercanine widths than the normal arches. The total mesiodistal tooth size in both arches; and mean buccolingual width of the mandibular first and second primary molars of the spaced arches were significantly smaller than those of the normal arches. However; there were no significant differences between spaced and normal arches in arch length; arch depth and intermolar arch width. The most important predictor of spacing in both arches is the intercanine width; followed by total mesiodistal tooth size. Conclusions: The parameter that mostly influences dental spacing is the intercanine width

Behavior management techniques employed by nigerian dentists for their child patients / Técnicas de manejo do comportamento utilizadas por dentistas nigerianos em pacientes infantis

Objective: To determine the different behavior management techniques employed by dentists in Nigeria for their child patients. Method: One hundred and fifty questi onnaires were hand delivered to dentists in different locations in Nigeria. Information required include respondent's bio data, years post graduation, behavior management techniques employed, and reasons for choice of technique. Results: A total of 128 (85.3%) were returned completed, comprising 53.2% females and 46.8% males, in age groups, < 30 years (25%), 30-39 years (48.4%), 40-49 years (19.5%) and 50 years and above (7.1%). Thirty five (27.3%) practiced in health centers, 88 (68.8%) in teaching hospitals and 5 (3.9%) in private hospitals. Majority (98.4%) attended to child patients and 29.6% rated their patients as uncooperative. The most frequently used behavior management technique was 'tell-show-do'. (73.4%) followed by positive reinforcements (35.9%), modeling (31.2%), desensitization (18.7%), restraints (13.2%), sedation (11.7%) and 'hand over mouth' (4.6%). Only 3.2% used general anesthesia. The major factors influencing choice of behavior management technique was age of child (78%), convenience to dentists (28%), availability of facilities (25.8%), and acceptability by parents/child (18.8%). Only 25.8% rated their facilities as adequate. Conclusion: The 'tell-show-do' technique was practiced by majority of respondents in this study. Improvements of facilities may increase the number of dentists employing pharmacological methods of management.

Objetivo: Determinar as diferentes técnicas de manejo do comportamento utilizadas por cirurgiões-dentistas nigerianos em seus pacientes infantis. Método: Cento e cinquenta questionários foram enviados a cirurgiões-dentistas em diferentes regiões da Nigéria. As informações requisitadas incluíam dados do respondente, pós-graduação, técnicas de manejo do comportamento utilizadas e motivos para a escolha da técnica. Resultados: Um total de 128 (85,3%) questionários foram devolvidos preenchidos, dos quais 53,2% eram de mulheres e 46,8% de homens, em relação à faixa etária, < 30 anos (25%), 30-39 anos (48,4%), 40-49 anos (19,5%) and 50 anos ou mais (7,1%). Trinta e cinco profissionais (27,3%) exercia a profissão em centros de saúde, 88 (68,8%) em hospitais escola e 5 (3,9%) em hospitais privados. A maioria (98,4%) atendia crianças e 29,6% classificaram seus pacientes como não cooperadores. A técnica mais utilizada foi a do 'falar-mostrar-fazer' (73,4%) seguida pelo regorço positivo (35,9%), modelagem (31,2%), desensibilização (18,7%), contenção (13,2%), sedação (11,7%) e ?mão sobre a boca? (4,6%). Somente 3,2% utilizam anestesia geral. Os principais fatores influenciadores quando da escolha da técnica foram a idade da criança (78%), a conveniência do profissional (28%), disponibilidade de instalações (25,8%), e aceitação pelos pais/criança (18,8%). Apenas 25,8% avaliaram suas instalações como adequadas. Conclusão: A técnica 'falar-mostrar-fazer' é utilizada pela maioria dos profissionais. A melhoria das instalações poderia aumentar o número de cirurgiões-dentistas que utilizam técnicas farmacológicas de manejo comportamental.