Geriatric dentistry education and context in a selection of countries in 5 continents.

PURPOSE/AIM: To summarize and discuss how geriatric dentistry has been addressed in dental schools of different countries regarding to (1) teaching students at the predoctoral level; (2) advanced training, and (3) research. METHOD AND MATERIALS: A convenience sample of faculty members from a selection of high, upper-middle and lower-middle income countries were recruited to complete the survey. The survey had 5 open-ended main topics, and asked about (1) the size of their elderly population, (2) general information about dental education; (3) the number of dental schools teaching geriatric dentistry, and their teaching methods; (4) advanced training in geriatric dentistry; (5) scholarship/research in geriatric dentistry. RESULTS AND CONCLUSION: (1) There is great variation in the size of elderly population; (2) duration of training and content of dental education curriculum varies; (3) geriatric dentistry has not been established as a standalone course in dental schools in the majority of the countries, (4) most countries, with the exception of Japan, lack adequate number of dentists trained in geriatric dentistry as well as training programs, and (5) geriatric dentistry-related research has increased in recent years in scope and content, although the majority of these papers are not in English.

Management of dental anxiety: a survey of Nigerian dentists

Background: Dental anxiety is a major issue with respect to provisions of and access to dental care. We evaluated the knowledge and management of anxiety among Nigerian dentists. Materials and Methods: The study population included 192 Nigerian dentists recruited during an annual national dental conference in Abuja. The conference was a meeting point for dentists with post graduation experience ranging between 1 and 32 years and from different part of the country. They completed a structured questionnaire on dental anxiolysis. Data analysis was performed using SPSS version 16. Results: Of the interviewed dentists; 122 (55.1) practiced in teaching hospitals and 24 had their specialization in child dental health. A total of 34 (19.8) dentists had been exposed to formal trainings on the practice of dental anxiolysis. Of this number; 66 had basic life support training and only 11.8 had refresher training programs. The most preferred route of administration of anxiolytic drugs was oral (57.3). Most of the respondents were of the view that dental anxiolysis should not be instituted for all dental patients. Conclusion: The interviewed Nigerian dentists were knowledgeable and managed dental anxiety. Although some of them had no formal training on dental anxiolysis; the major consensus is that dental anxiolysis should not be instituted for all dental patients

Implant restoration of partially edentulous ridges: a review of 121 Nigerian patients.

OBJECTIVE: Because of increasing health awareness, many Nigerian patients are demanding that their lost tooth/teeth be replaced with dental implants. This study reports the pattern and distribution of implant replacement of lost tooth/teeth in a private dental practice in Lagos, Nigeria. METHODS: A retrospective review of implant replacement of lost tooth/teeth over a period of 6 years at Schubbs Private Dental Clinic, Lagos, was carried out. Data analysis included age, sex, occupation, habits and medical condition of patients, augmentation procedure, technique of implant placement (immediate vs conventional loading) tooth/teeth replaced, and follow-up period. RESULTS: A total of 227 implants (Bicon, Boston, MA) with complete superstructure were placed in 121 patients(males = 68, females = 53; age range: 15-74 years). Majority of the patients were of high socioeconomic class. Ten (8.3%) patients had immediate implants and 111 (91.7%) undergone 2-stage implant procedures. The highest number (39.2%) of implants was placed in the molar region, and the replacement of the canines was the lowest (3.1%). Success rate over a period of 6 years was 96%. Of the 9 (4%) implants that failed, 2 were repeated and remained functional till date. CONCLUSIONS: Dental implant therapy as a means of tooth replacement is gaining popularity among Nigerian social upper class. Success rate in this series is comparable with previous reports from Europe and America.

Systematic approach for the propagation of postgraduate dental implant education in developing countries.

PURPOSE: To analyze the outcome of the formative feedback and summative assessment in 2 different groups of dentists after a postgraduate dental implant course. This course was conducted with the hope of developing a systematic approach to implant dentistry training. METHODS: A 6-day mini-residency postgraduate dental implant course which was approved for 75 credit hours by the international congress of oral implantologists and approved for fellowship after a satisfactory grade at the end of course examination was conducted at the Faculty of Dentistry of the University of Ibadan in West Africa. This course was organized by the Caribbean affiliate of the International Congress of Oral Implantologists utilizing the syllabus which has been instrumental in training Caribbean Dentist since 2004. The postgraduate course in implantology was delivered to 2 groups of participants: group I comprising mainly of faculty staff from the major dental schools in Nigeria with previous postgraduate qualifications and group II were general dental practitioners in private practice in Nigeria.The outcome of the assessment by the 2 different groups was compared with the outcome of implant postgraduate courses in dentistry that are presently documented in Medline/Pubmed. RESULTS: There was no significant difference in the reason for attending the course when the 2 groups are compared (P value ranged from 0.82 to 0.93). Both groups expressed good and similar response to the overall quality of the presentation (P value = 0.19), comprehensiveness of topics covered (P value = 0.34), organization of presentation (P value = 0.34). The multiple choice question assessment at the end of the course was very difficult for both groups and the performance was below average for both groups. CONCLUSIONS: The 6-days mini-residency course combined with the 1-month distance learning component was adequate for the sustainability stage and this lead to certification of 72% of the delegates via the examination route.

Evaluation of shade matching practices among nigerian dentists / Avaliação dos procedimentos de determinação de cor de restaurações entre dentistas niegerianos

OBJECTIVES: To assess tooth shade matching practices among Nigerian Dentists. MATERIALSAND METHODS: The data was collected by paper questionnaire mailed at random to dentists insome Nigerian Teaching Hospitals and General Hospitals. The questionnaires comprised of two aspectsthat inquired about their biographical data and basic methods of shade selection. About 95% of thequestionnaires were retrieved and analyzed. RESULTS: 160 (83, males; 77 females) dentists participatedin the study. 71% performed tooth shade matching often, with restorative dentists (100%) mostlyinvolved than other specialists. 67% agreed that shade matching should be done in consultation withothers. However, only 40.6% actually consults others during shade selection. Also, 85% of the dentistsresponded correctly that shade matching should be done under natural lights. However in their clinicalpractice, majority (97%) selected their teeth under dental lights. CONCLUSION: The study revealedthat majority of the dentists practicing in the Nigerian Teaching and State Dental Hospitals are involvedin shade matching practices. Majority of the dentists performed tooth matching procedure withoutconcurrence from others and under dental light source. However few dentists reported complaintsfrom their patients. Emphasizing color science in dental curriculum and teaching new shade matchingsystems could be essential for improved restorative outcomes.

OBJETIVOS: Determinar os procedimentos de determinação de cor entre dentistas nigerianos.MATERIAIS E MÉTODOS: Os dados foram coletados por meio de questionários em papel,enviados aleatoriamente a dentistas em alguns hospitais de ensino e hospitais gerais. Osquestionários compreenderam dois aspectos de questões sobre dados biográficos e métodos básicosde seleção de cores. Em torno de 95 % dos questionários foram recuperados e analisados.RESULTADOS: 160 dentistas (83 homens, 77 mulheres) participaram do estudo. 71% executamescolha de cores, sendo que 100% dos dentistas restauradores o fazem, em número bem maior doque as demais especialidades. 67% concordam que escolha da cor deve ser feita em conjunto comoutras pessoas. Entretanto, somente 46,6 % realmente consultam uma segunda opinião durantea seleção de cores. Também 85% dos dentistas responderam que a escolha da cor deve ser feitasob luz natural. Entretanto, em sua prática clínica a maioria seleciona a cor sob luz de refletores.CONCLUSÃO: O estudo revelou que a maioria dos dentistas atuantes nos centros pesquisadospraticam a seleção de cores dentárias. A maioria procede sem consultar segunda opinião e sobluzes de refletores. Entretanto, poucos dentistas relataram queixas de pacientes. A ênfase daciência da cor no currículo dental e ensino de novos sistemas de escolha de cores poderia seressencial para a melhora dos resultados restauradores.

Knowledge, attitude, and practice of dental implantology in Nigeria.

AIM: The purpose of this study was to assess the knowledge, attitude, and practice of dental implantology among dentists practicing in Nigeria. MATERIALS: Self-administered questionnaires to assess the knowledge, practice, and attitude of dental implantology were sent to dentists practicing in all the 6 geopolitical zones of Nigeria (i.e., all tertiary dental institutions, and selected general and private hospitals within the zones). Data collected were analyzed and presented in descriptive and tabular forms. RESULTS: The response rate was 77%. Only 2 (1.3%) of the respondents claimed to have employed implant(s) for dental restoration in their practice, while 152 respondents (98.7%) have never used implants as a method of tooth/teeth restoration. Of the latter, 46.1% have suggested implants for full/partial denture patients, 31.8% have suggested dental implants to patients needing single-tooth replacement, and 89.6% were ready for dental implant placement if equipment and materials for dental implants backed up with adequate training were provided. Of respondents, 83.1% also believed that implantology is a multidisciplinary approach, and 42.9% rated implants as the best option for dental restoration. CONCLUSIONS: The practice of implant dentistry is presently very low in Nigeria. Clearly, there is a need for dental implant education for Nigerian dentists to increase their knowledge and proficiency in dental implant dentistry. In addition, all efforts should be made to include implant education and practice in dental curricula in undergraduate and postgraduate institutions in Nigeria.

Acceptability of maxillary major connectors in removable partial dentures.

BACKGROUND: The choice of connector lies between plate, a bar or a combination of bars, which may cross the palate in various positions. Many opinions have been expressed concerning the acceptability to the patients of the various forms of palatal connectors but there have been few investigations. OBJECTIVES: The aim of this study is to compare subjective patients' reactions to three maxillary major connectors: metal bar, metal plate, and acrylic connectors and to establish the most acceptable and the least acceptable maxillary major connectors. METHODS: Fifteen consecutive patients attending the prosthetic out-patient clinic of Dental Center, University College Hospital, Ibadan who had never worn dentures were recruited into the study. Three dentures each with a different maxillary major connector design were fabricated for each patient. A questionnaire was administered to ascertain their reactions to each of the three denture designs. RESULTS: Fourteen patients (93.3%) preferred the denture with metal palatal bar major connector whereas only one patient preferred the denture with acrylic plate major connector design. No patient preferred the palatal metal plate connector design. CONCLUSIONS: The metal bar major connector was the most acceptable maxillary major connector while acrylic resin plate was more acceptable than metal plate maxillary major connector. It also confirmed the influence of connector design on patient acceptance of removable partial denture.

Socio-demographic factors and edentulism: the Nigerian experience.

BACKGROUND: The rate of total edentulism is said to be increasing in developing countries and this had been attributed mainly to the high prevalence of periodontal diseases and caries. Several reports have shown that non-disease factors such as attitude, behavior, dental attendance, characteristics of health care systems and socio-demographic factors play important roles in the aetiopathogenesis of edentulism. The aim of this study was to assess the relationship between socio-demographic factors and edentulism. METHODS: A total of 152 patients made up of 80 (52.6%) males and 72 (47.4%) females who presented in two prosthetic clinics located in an urban and a rural area were included in the study. The relationship between gender, age, socio-economic status and edentulism in this study population was established. RESULTS: No significant relationship between gender and denture demand was noted in the study. The demand for complete dentures increased with age while the demand for removable partial dentures also increased with age until the 3rd decade and then started to decline. A significant relationship was found between denture demand and the level of education with a higher demand in lower educational groups (p < 0.001). In addition, the lower socio-economic group had a higher demand more for prostheses than the higher group. CONCLUSIONS: The findings in this study revealed a significant relationship between socio-demographic variables and edentulism with age, educational level and socio-economic status playing vital roles in edentulism and denture demand.