Tooth Loss: The Nigerian Experience - A Narrative Review.

BACKGROUND: Tooth loss is an irreversible condition and it is an indicator of overall dental health. Tooth loss impairs speech, aesthetics, mastication, and deglutition, affecting an individual's oral health related quality of life. This study aimed to review the pattern of tooth loss in Nigerians over a forty-one-year period. MATERIALS AND METHODS: A literature search for articles on tooth loss and related subjects was performed on databases (NICB PubMed, Medline and Cochrane). Keywords used for the search included "tooth loss" and "Nigeria' as well as partial edentulousness, partial denture, implant and prosthodontics. The articles included were studies published between 1972 and 2019, written in English language and involving human subjects. A self-developed proforma was used to extract clinical and demographic data from the articles. RESULTS: All the studies assessed were observational. Most studies were conducted in tertiary hospitals. There was a marginal difference in the prevalence of tooth loss between males and females. The mean age of persons presenting in hospitals across Nigeria for extraction of their teeth was identical across several studies. Most of the studies reported the molars as the teeth most frequently lost. CONCLUSION: In younger adults, tooth loss was more common in 20-29-year-old subjects, while among the elderly it peaked in the 60-70-year-old group. Dental caries was the predominant cause of tooth loss over the years. Community based studies may provide more accurate information on the extent of tooth loss in Nigerians.

CONTEXTE: La perte de dents est un état irréversible et un indicateur de la santé dentaire globale. La perte de dents nuit à l'élocution, à l'esthétique, à la mastication et à la déglutition, affectant ainsi la qualité de vie d'un individu liée à sa santé bucco-dentaire. Cette étude avait pour but d'examiner le profil de la perte de dents chez les Nigérians sur une période de quarante et un ans. MATÉRIEL ET MÉTHODES: Une recherche documentaire d'articles sur la perte de dents et les sujets connexes a été effectuée sur des bases de données (NICB PubMed, Medline et Cochrane). Les motsclés utilisés pour la recherche comprenaient "perte de dents" et "Nigeria" ainsi que édentation partielle, prothèse partielle, implant et prosthodontie. Les articles inclus étaient des études publiées entre 1972 et 2019, rédigées en langue anglaise et impliquant des sujets humains. Un proforma auto-développé a été utilisé pour extraire les données cliniques et démographiques des articles. RÉSULTATS: Toutes les études évaluées étaient observationnelles. La plupart des études ont été menées dans des hôpitaux tertiaires. Il y avait une différence marginale dans la prévalence de la perte de dents entre les hommes et les femmes. L'âge moyen des personnes se présentant dans les hôpitaux du Nigeria pour l'extraction de leurs dents était identique dans plusieurs études. La plupart des études ont indiqué que les molaires étaient les dents les plus fréquemment perdues. CONCLUSION: Chez les jeunes adultes, la perte de dents était plus fréquente chez les sujets âgés de 20 à 29 ans, tandis que chez les personnes âgées, elle atteignait un pic dans le groupe des 60-70 ans. Les caries dentaires étaient la cause prédominante de la perte de dents au fil des ans. Des études communautaires pourraient fournir des informations plus précises sur l'étendue de la perte de dents chez les Nigérians. Mots clés: Perte de dents, Édentation, Prévalence, Nigeria.

MANAGEMENT OF DENTAL CARIES WITH ATRAUMATIC RESTORATIVE TREATMENT UNDER FIELD CONDITION IN PRIMARY SCHOOLS IN OYO STATE, NIGERIA.

Background: Dental caries is a common disease in children, which results in tooth loss if not treated. Children in suburban Nigerian communities have a high unmet treatment need index for caries, due to limited access to dental services. Objective: To provide atraumatic restorative treatment (ART) as a field treatment for dental caries and assess the acceptability of this approach to pupils. Methods: This is a report of the treatment of dental caries under field conditions among 432 pupils in six primary schools around the Primary Oral Health Clinics (POHC) at Idikan and Igboora, Oyo state, Nigeria. ART restorations were placed on asymptomatic class 1 cavitated carious teeth, were evaluated at six and twelve weeks for intactness and symptoms. Acceptability was assessed by asking the pupils immediately after treatment if they experienced pain/ discomfort while receiving the treatment. Data were analysed using descriptive statistics. Results: The mean (SD) age of the participants was 9.2(1.8) years; 222(51.4%) were males. The mean (SD) DMFT/ dmft score were 0.06(0.36) [median (Range): 0.0(6)] and 0.07(0.41) [median (Range): 0.0(4)] respectively. Forty (71.4%) decayed teeth were eligible for ART. At six weeks 27(96.4%) fillings were intact while 1(3.6%) had a defective margin, at twelve weeks 23(82.1%) fillings were retained and 1(3.6%) had dislodged. All participants reported no pain during treatment and found the approach acceptable. Conclusion: ART fillings were intact in 27(96.4%) and 23(82.1%) at 6 and 12weeks respectively. The provision of ART within a familiar environment is an acceptable method of caries treatment in underserved schoolchildren.

Maxillectomy and Quality of Life: Experience from a Nigerian Tertiary Institution.

INTRODUCTION: Maxillectomy is a surgical procedure for managing tumors affecting the maxilla; the goal of maxillectomy however should not be limited to tumor extirpation but should include restoration of oronasal function and facial contours, as failure to do these may give rise to psychosocial and functional challenges. This study aimed to appraise the pattern of maxillectomies, challenges of management, and quality of life (QOL) of a proportion of the study population. MATERIALS AND METHODS: This was a cross-sectional study carried out at the Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan. Patients' case files from year 2000 to 2016 were retrieved and reviewed. Data extracted for analysis included age, gender, site of lesion, and histologic diagnosis; lesions were grouped as benign or malignant. Contacts were made with patients or their next of kin for a clinic review appointment where QOL was assessed with the University of Washington Quality of Life version 4 Questionnaire. Data were analyzed and result presented as means and frequencies. RESULTS: Out of the 78 cases of maxillectomy recorded in the department within the study period, records were available and adequate in 67 cases. There were 37 (55.2%) females with a mean age of 35.88 ± 14.9 years. Swelling was the most common reason for presentation (63, 94%). The mean period between onset of disease and presentation for treatment was 3.66 ± 3.35 years. Distribution of lesions was benign 35 (52.2%) and malignant 32 (47.8%). Hemi-maxillectomy was the commonest surgical procedure (23, 34.8%). While majority had some prosthetic rehabilitation, 31 participants (48.5%) obtained no prosthesis. Eight participants gave scores of ≥75% when comparing their present health-related QOL (HR-QOL) with a month before surgery; the overall QOL was ≥60%. However, HR-QOL and overall QOL in the last 7 days before assessment were rated as good in 55.6% and 66.7%, respectively. Chewing was the most important domain to participants. CONCLUSION: The pattern of presentation and indications for maxillectomy in this series are similar to that from previous studies. The uptake of prosthetic rehabilitation was low and overall QOL was rated as fair. QOL should be considered as part of treatment outcome measure for maxillectomy.

ORAL HEALTH KNOWLEDGE AND PRACTICE AMONG TRADERS IN IBADAN.

BACKGROUND: Adopting good oral health practices such as regular tooth brushing and flossing; healthy nutritional habits and regular visits to the dentist, play a vital role in the wellbeing of an individual by preventing oral diseases such as dental caries and periodontal disease. Adequate knowledge of factors related to oral health may influence oral health practices leading to improved oral health. OBJECTIVE: The objective of this study was to assess the oral health knowledge and practice of a group of adults in Ibadan, Nigeria to enable planning of oral health services. METHODOS: A cross sectional survey involving 400 randomly selected traders at the Bola Ige Modern Market, Gbagi, Ibadan. A semi-structured interviewer-administered questionnaire was used to obtain information on socio-demographics, oral health knowledge and practice. Data was analyzed using descriptive statistics at p < 0. 05. RESULTS: The mean age of participants was 36.9 ±1.2, 37.0% had adequate knowledge that tooth decay was related to sweet food substances, but the majority (61.9%) consumed carbonated drinks at least once a week. Only 22.8% had ever visited a dentist in their life time and 5.8% in the last six months. Knowledge of who a dentist was associated with their level of education, with more participants who had tertiary education (83%) having greater knowledge (χ2= 38.3, p < 0. 001). About 70.3% of the study participants used a toothbrush and toothpaste to clean their teeth. CONCLUSION: There is poor oral health knowledge amongst adult Nigerians and they utilize oral health practices that do not engender good oral health.

PERCEPTION AND UTILIZATION OF ORAL HISTOPATHOLOGY SERVICES BY GENERAL PRACTICE DENTIST IN SOUTHWEST NIGERIA.

BACKGROUND: Oral histopathology services are oral diagnostic procedures. General Dental Practitioners (GDPs) are routinely exposed to oral lesions that require biopsies. Hence, the study's objective of assessing the perception and the utilization of oral histopathology services by GDPs. METHOD: This was a cross-sectional study conducted at dental clinics distributed across Southwest Nigeria. A self-administered questionnaire consisting of sections addressing the socio-demographic/professional aspects; the beliefs of GDPs and their utilization of oral histopathology services was used to collect data. A modified 5-point Likert rating scale was used to indicate the extent of agreement or disagreement with statement constructs. Analysis was done using SPSS for windows version 20.0. Significance was assessed at 5%. RESULTS: There were 56.1% males and 43.9% females. The peak age range was 30-39 years (35.4%), while 58.5% had ≤ 10 years of practice and 79.3% work in government dental centres. Many of the respondents (61.0%) thought suspicious lesions should be biopsied, 47.6% thought that specialists' skills were not required for biopsy. Furthermore, 53.7% had poor perception scores while 81.1% of those who had seen oral lesions that required biopsies, had poor utilization scores. CONCLUSION: The GDPs had a poor perception and utilization of oral histopathology services. Continuous medical education is needed to increase awareness amongst dentists.

Evaluation of the scope and practice of oral and maxillofacial surgery in Nigeria.

BACKGROUND: Oral and maxillofacial surgery is still evolving, with the scope of practice in Nigeria inadequately determined. AIMS AND OBJECTIVES: This study aims to ascertain the level of practice in various parts of the country vis-a-vis the global trend and factors influencing the scope in Nigeria. DESIGN OF THE STUDY: Cross-sectional. SETTING: The study was carried out at the University of Ibadan. Participants included all the maxillofacial surgeons on the mailing list of the Nigerian Association of Oral and Maxillofacial Surgeons and Practicing in Nigeria as at December, 2012. MATERIALS AND METHODS: Structured questionnaires were delivered to all on the mailing list of the Nigerian Association of Oral and Maxillofacial Surgeons. Respondents were asked to provide information about their demographics, years of practice, areas of practice and factors influencing the choice of practice among others. Nonresponders were reminded a month after initial contact. Data were entered into a personal computer and variables analyzed using descriptive statistical analysis. RESULTS: Thirty-two (56%) of the 57 questionnaires were returned. Most respondents were aged 41-45 years ( n = 11, 34.4%). Twenty-six (81.3%) were males, whereas 6 (18.8%) were females. Twenty respondents (62.5%) practiced in the teaching hospitals. Eighteen respondents (56.3%) practiced in the south-west geopolitical region. Twelve respondents (37.5%) were the only maxillofacial surgeons in their centers. 81.3% routinely practiced traumatology against 15.6% for implantology. Seventy-eight percent ( n = 25) had satisfactory facilities for traumatology, dentoalveolar surgery, and cleft repair surgery, while facilities were least satisfactory in implantology and orthognathic surgery (15.6% and 12.5%, respectively). The highest single factor influencing choice/area of practice was financial reward (100% of respondents). Fifty percent ( n = 16) claimed not to have had adequate training in their area of interest. Most respondents (93.8%) believe the greatest challenge facing oncological maxillofacial surgery in Nigeria was late presentation of patients. CONCLUSION: The scope of practice of oral and maxillofacial surgery is largely limited in the country relative to what obtains globally.

Evaluation of the scope and practice of oral and maxillofacial surgery in Nigeria

Background: Oral and maxillofacial surgery is still evolving; with the scope of practice in Nigeria inadequately determined. Aims and Objectives: This study aims to ascertain the level of practice in various parts of the country vis-a-vis the global trend and factors influencing the scope in Nigeria. Design of the Study: Cross-sectional. Setting: The study was carried out at the University of Ibadan. Participants included all the maxillofacial surgeons on the mailing list of the Nigerian Association of Oral and Maxillofacial Surgeons and Practicing in Nigeria as at December; 2012. Materials and Methods: Structured questionnaires were delivered to all on the mailing list of the Nigerian Association of Oral and Maxillofacial Surgeons. Respondents were asked to provide information about their demographics; years of practice; areas of practice and factors influencing the choice of practice among others. Nonresponders were reminded a month after initial contact. Data were entered into a personal computer and variables analyzed using descriptive statistical analysis. Results: Thirty-two (56) of the 57 questionnaires were returned. Most respondents were aged 41-45 years ( n = 11; 34.4). Twenty-six (81.3) were males; whereas 6 (18.8) were females. Twenty respondents (62.5) practiced in the teaching hospitals. Eighteen respondents (56.3) practiced in the south-west geopolitical region. Twelve respondents (37.5) were the only maxillofacial surgeons in their centers. 81.3 routinely practiced traumatology against 15.6 for implantology. Seventy-eight percent ( n = 25) had satisfactory facilities for traumatology; dentoalveolar surgery; and cleft repair surgery; while facilities were least satisfactory in implantology and orthognathic surgery (15.6 and 12.5; respectively). The highest single factor influencing choice/area of practice was financial reward (100 of respondents). Fifty percent ( n = 16) claimed not to have had adequate training in their area of interest. Most respondents (93.8) believe the greatest challenge facing oncological maxillofacial surgery in Nigeria was late presentation of patients. Conclusion: The scope of practice of oral and maxillofacial surgery is largely limited in the country relative to what obtains globally