Oral Disorders and Serum Oestrogen Levels in Postmenopausal Women in Lagos, Nigeria.

BACKGROUND: Changes in hormonal levels during puberty, pregnancy, menstruation, and menopause have varying effects on the oral cavity. Several mucosal disorders manifest in the oral cavity of postmenopausal women partly due to a decrease in oestrogen and progesterone level which are significant. The aim of this study was to determine the oral disorders associated with serum blood oestrogen levels in Nigerian postmenopausal women. MATERIALS AND METHODS: A cross-sectional analytical study at the Oral Diagnosis and Oral Medicine clinics in a large tertiary hospital in Lagos, Nigeria between June 2019 and December 2019 involving 35 postmenopausal and 35 premenopausal women within the ages of 40 to 60 years. The prevalence of oral disorders such as hyposalivation, burning mouth sensation, and periodontitis in pre and postmenopausal women was determined, likewise the association between oral disorders and blood oestrogen levels. RESULTS: The mean age of the postmenopausal women was 53.2 ± 5.6 years and premenopausal women was 46.4 ± 4.0 years. Chronic periodontitis was the most prevalent oral disorder in 19(54.3%) postmenopausal women followed by hyposalivation 5(14.3%) compared with 13(37.1%) and 2(5.7%) respectively in premenopausal women. All postmenopausal women who had chronic periodontitis 19(100%) had relatively high oestradiol levels compared with 5(38.5%) premenopausal women. CONCLUSION: There was no statistically significant association between oral disorders and blood oestrogen levels.

CONTEXTE: Les changements des niveaux hormonaux pendant lapuberté, la grossesse, la menstruation et la ménopause ont des effets variables sur la cavité buccale. Plusieurs troubles des muqueuses se manifestent dans la cavité buccale des femmes ménopausées, en partie à cause d'une baisse significative des taux d'œstrogènes et de progestérone. L'objectif de cette étude était de déterminer les troubles bucco-dentaires associés aux niveaux d'œstrogènes dans le sang sérique chez les femmes ménopausées nigérianes. MATÉRIEL ET MÉTHODES: Une étude analytique transversale dans les cliniques de diagnostic oral et de médecine bucco-dentaire d'un grand hôpital tertiaire à Lagos, au Nigeria, entre juin 2019 et décembre 2019, impliquant 35 femmes ménopausées et 35 femmes préménopausées âgées de 40 à 60 ans. La prévalence des troubles bucco-dentaires tels que l'hyposalivation, la sensation de bouche brûlante et la parodontite chez les femmes pré et post-ménopausées a été déterminée, de même que l'association entre les troubles buccodentaires et les niveaux d'œstrogènes dans le sang. RÉSULTATS: L'âge moyen des femmes ménopausées était de 53,2 ± 5,6 ans et celui des femmes préménopausées de 46,4 ± 4,0 ans. La parodontite chronique était le trouble bucco-dentaire le plus répandu chez 19 (54,3 %) femmes ménopausées, suivie par l'hyposalivation 5 (14,3 %), contre 13 (37,1 %) et 2 (5,7 %) respectivement chez les femmes préménopausées. Toutes les femmes ménopausées qui souffraient de parodontite chronique 19(100%) avaient des taux d'œstradiol relativement élevés par rapport à 5(38,5%) femmes préménopausées. CONCLUSION: Il n'y a pas d'association statistiquement significative entre les troubles bucco-dentaires et les taux d'œstrogènes dans le sang.

Periodontal status and its association with self-reported hypertension in non-medical staff in a university teaching hospital in Nigeria.

BACKGROUND: A growing body of evidence suggests a relationship between periodontal disease and non-communicable systemic diseases with rising prevalence in developing countries, Nigeria inclusive. OBJECTIVES: To determine the periodontal status and its association with self-reported hypertension among non-medical staff in a university teaching hospital in Nigeria. METHODS: A cross-sectional study was conducted among non-medical staff using self-administered questionnaires and periodontal clinical examination between July and August 2013. Multivariate analysis was explored to determine the independent variables associated with self-reported hypertension. P values < 0.05 were considered statistically significant. RESULTS: A total of 276 subjects were enrolled into the study. Shallow pockets (CPI code 3) constituted the predominant periodontal disease (46.7%), calculus (CPI code 2) 46%, bleeding gingiva (CPI code 1) in 3.3% and deep pockets ≥ 6mm (CPI code 4) in 2.2%. Self-reported hypertension was the most prevalent self-reported medical condition (18.1%) and found to be associated with periodontitis, increasing age, lower education, and a positive family history of hypertension. CONCLUSION: Periodontal disease was highly prevalent in this study. Self-reported hypertension was associated with periodontitis, older age, lower education and a positive family history. Periodic periodontal examination and regular blood pressure assessment for non-medical staff is recommended.

Comparative periodontal status of human immunodeficiency virus-positive patients and controls in a dedicated human immunodeficiency virus clinic in Nigeria.

BACKGROUND: There are diverse reports on the prevalence and severity of chronic periodontitis in human immunodeficiency virus (HIV) positive persons. Few studies have been carried out in developing countries in Sub-Saharan Africa. This study was aimed at comparing the prevalence and severity of chronic periodontitis of HIV-seropositive patients with that of HIV-seronegative persons using the community periodontal index (CPI). METHODOLOGY: This was a comparative study of the periodontal status of 110 HIV-positive subjects and 110 age and gender-matched HIV-negative controls attending a dedicated HIV Clinic in a Teaching Hospital in Lagos, Nigeria. The CPI and simplified oral hygiene index score were used in the periodontal examination. Highest CPI scores and percentages of CPI sextants assessed the prevalence and severity of chronic periodontitis respectively. Logistic regression was used in adjusting demographic differences in the study population. P ≤ 0.05 was considered as significant. RESULTS: A significant proportion of the HIV-positive patients 61 (55.5%) and the HIV-negative controls 53 (48.7%) had shallow pockets (4-5 mm) (CPI code 3). The prevalence of deep pockets (≥ 6mm) (CPI code 4) was higher among HIV-positive patients 9 (8.2%) than the controls 4 (3.5%) (P = 0.079). HIV-positive patients had a greater percentage of CPI codes 3, 4 and fewer CPI code 0 sextants than controls (P = 0.000). Both groups had comparable oral hygiene status (P = 0.209). Using a logistic regression analysis, HIV-positive status and lower education accounted for the greater severity of chronic periodontitis. CONCLUSION: HIV-seropositive patients had more severe chronic periodontitis than the HIV-seronegative controls, which was independent of lower education.

Clinical correlates of a lateral-flow immunoassay oral risk indicator.

BACKGROUND: The aim of the present study is to investigate the clinical correlates of a novel lateral-flow immunoassay with bleeding on probing (BOP), oral hygiene, and periodontal probing depth. This report offers a simple, rapid, and highly sensitive tool that addresses two issues important to periodontists: 1) detecting active periodontitis, and 2) predicting chronic periodontitis. METHODS: Seventy-six of 86 males requiring seminal fluid analysis as part of a separate study were serially recruited into the study. After basic dental and periodontal examination under natural light and with the use of the community periodontal index of treatment needs (CPITN) probe, debris and calculus indices were recorded per participant. Participants were subsequently grouped into "good," "fair," and "poor" oral hygiene categories based on a simplified oral hygiene index. BOP was assessed with the ball-ended tip of the probe, and periodontitis was assessed with pocket probing as well as a lateral flow of neutrophil collagenase-2 immunoassay, which measures levels of matrix metalloproteinase-8. RESULTS: Neutrophil collagenase-2 immunoassay was 96% sensitive for poor oral hygiene, 95% sensitive for chronic periodontitis (defined as at least two sites with periodontal pockets), and 82.6% sensitive for at least two sites with BOP. CONCLUSION: Neutrophil collagenase-2 immunoassay had a high sensitivity for at least two sites with BOP and two sites with periodontal pockets but a lower relationship for single-site pockets and BOP.

Self-Reported Medical Conditions and Oral Health Status of Patients seen in a Nigerian Dental Clinic.

OBJECTIVE: To assess the prevalence of self-reported medical conditions among patients attending a dental clinic in Nigeria. SUBJECTS AND METHODS: This was a cross-sectional study conducted at the Oral Diagnosis Clinic of the Lagos University Teaching Hospital. A self-administered questionnaire was used to collect bio-data and history of medical conditions. Oral examination was carried out on all the patients. Teeth present, carious teeth, mobile teeth and the oral hygiene status were recorded. Data entry and analysis was done using SPSS statistical software. RESULTS: The prevalence of self-reported medical conditions in this study was 22.1%. Hypertension was the most prevalent (10.3%), followed by allergies (4.4%), diabetes mellitus (4%) and gastrointestinal disorders (3%). Hypertension (p=0.000) and diabetes (p=0.000) had a statistically significant association with increasing age. The prevalence of medical conditions increased significantly with the increased number of mobile teeth (p=0.033). There was no statistically significant association between the self-reported medical conditions and the number of carious teeth (p=0.619), the oral hygiene status (p=0.765) and the educational level (p=0.712). CONCLUSION: The prevalence of medical conditions among the dental patients was moderate.

Pattern of periodontal treatments performed at the periodontology clinic of the Lagos University Teaching Hospital: 22 months review.

BACKGROUND: A critical evaluation of the pattern of periodontal procedures performed is important in providing useful data to the administrator for proper planning and budgeting for dental health service. OBJECTIVE: To assess the pattern of periodontal treatments performed over a given period of time at the Periodontology clinic of the Lagos University Teaching Hospital, Lagos, Nigeria. METHODS: This was a twenty two months retrospective study of all periodontal procedures performed on patients seen at the periodontology clinic of the Lagos University Teaching Hospital between January 2006 and October 2007. The periodontology treatment record was used to retrieve information which included the patient's age, gender, diagnosis and periodontal procedures given. The procedures were further categorized into surgical and nonsurgical groups. The information obtained was then analyzed using Epi Info 2007 statistical software. RESULTS: A total of 1,938 patients were seen during this period. Females were 1009 (52.1%) and males were 929 (47.9%). (F/M, 1.1:1). A total of 2,110 periodontal treatments were performed. Majority of the patients received non-surgical periodontal therapy which constituted the bulk (96.3%) of the therapies. Scaling and polishing was the most frequently performed non-surgical procedure accounting for 1261 (62.1%) with slightly more males receiving the treatment. Of the surgical treatment modalities, operculectomy accounted for 65.4% and was carried out on more females than males. Regenerative procedures were the least performed surgical treatments. CONCLUSION: This study highlighted that non-surgical periodontal therapy, particularly scaling and polishing was the most frequently utilized periodontal procedure. Operculectomy was the predominant surgical procedure performed. The low percentage of regenerative surgical procedures was however below the desired expectation.

Isolation and molecular identification of Fusobacterium nucleatum from Nigerian patients with oro-facial infections.

BACKGROUND: Fusobacterium nucleatum is one of the most common anaerobic bacteria present in the oral cavity and is often isolated from infections involving other body sites. OBJECTIVE: To characterise F. nucleatum strains from patients attending a teaching hospital in Nigeria in order to provide information on the methods for accurate identification of anaerobes in clinical specimen. METHODS: Fusobacterium nucleatum specie from 50 patients presenting with oro-facial infections were studied by culture on Fusobacterium selective agar and fastidious anaerobe agar. The isolates were characterised based on colonial morphology, microscopy, lipase production, susceptibility to kanamycin and colistin and resistance to vancomycin. Biochemical tests were performed using a commercial test kit. The identity of the isolates was confirmed based on molecular characterization performed using polymerase chain reaction (PCR) analysis. RESULTS: Forty-eight (96%) F. nucleatum isolates were obtained from the 50 patients by culture and all the isolates were identified by colonial appearance and microscopy based on their unique spindle shape with tapered ends. Only 26 (54.2%) of the 48 isolates were identified by commercial API 20A test kit while PCR confirmed the identity of all the isolates. CONCLUSION: Anaerobes are involved in human infections and their study is quite cumbersome due to tedious nature and high cost of the techniques involved. Cultural method is reliable in the isolation and identification of F. nucleatum species. PCR is a rapid and simple method that can complement the phenotypic identification of anaerobes and would assist in their full identification.

Pattern of tooth mobility and missing teeth types among juvenile periodontitis patients in Lagos University Teaching Hospital Dental Centre.

UNLABELLED: The objective of this study was to determine the degree of tooth mobility and missing teeth according to tooth type of juvenile periodontitis patients attending the Lagos University Teaching Hospital Dental Centre from January 2004 to March 2004. METHODOLOGY: Eighteen juvenile periodontitis patients were identified with an age range of 18 years to 36 years. There were 9 males and 9 females. RESULT: In this study, the most common tooth mobility exhibited was grade 2 (46%), followed by grade 3 (37%) and grade 1 (17%). The most mobile tooth type were the upper incisors (23%) when considering all degrees of tooth mobility. The least mobile teeth were the lower cuspid/bicuspins (7.5%). Within the jaws, the most commonly missing tooth type were the upper incisors (28%), more females exhibited grade 2 tooth mobility than males, while more males exhibited grade 3 tooth mobility. CONCLUSION: Mild or moderately mobile teeth particularly of 1st molars and incisors should be considered a risk factor for aggressive periodontitis and should require further periodontal examination at routine dental visits particularly amongst adolescents and young adults. Regular prophylactic scaling and polishing with frequent recalls should result in early diagnosis and in preventing the rapid progression of this condition.

Oral hygiene practices among adolescents in Surulere, Lagos State, Nigeria.

OBJECTIVE: To determine the oral hygiene practices of adolescents attending schools within Surulere, a Local Government Area in Lagos, Nigeria. METHOD: A questionnaire enquiring about oral hygiene practices such as method of oral cleansing and frequency, and attitude to professional prophylaxis was administered to 600 adolescents. Demographic data such as sex, age, social class and ethnic group was also obtained. RESULTS: The majority (96.3%) of the subjects used toothbrush and paste only for oral hygiene. The use of the chewing stick combined with toothbrush/paste was practiced by nearly 4% of the subjects seen. A significant difference in the method of oral hygiene was observed among the social classes, with the use of chewing stick in combination with toothbrush/paste being more prevalent among the lower social classes than the higher social classes. Oral hygiene was carried out at least once a day by 97% of the subjects. Nearly all subjects (95.5%) had never been to the dental clinic for professional prophylaxis (scale and polish), with less than 1% routinely visiting the dental clinic for professional prophylaxis once or twice yearly. CONCLUSION: The use of toothbrush and paste appears to have increased slightly when compared to previous studies among this group. There is need for oral health education on the frequency of use of the toothbrush and the importance of routine dental visits and professional prophylaxis among the population especially the lower social classes.

Dental caries trend among adolescents in Lagos, South-West Nigeria.

BACKGROUND: The past few decades have witnessed a changing trend in dental caries prevalence among Nigerians; thus the need to investigate the current trend of caries among adolescents Nigerians. OBJECTIVE: To determine the prevalence and severity of dental caries among adolescents in Lagos, South-west of Nigeria. METHODS: The World Health Organization (WHO) methodology for basic oral health surveys was employed. The study population was 11 to 16 year-old adolescents from primary and secondary schools in Surulere, Lagos, Nigeria. Surulere local government area (LGA) of Lagos State, South-West Nigeria was selected as the location of this study as the LGA is quite cosmopolitan having Nigerians of all walks of life. Information on sex, age, socioeconomic status and ethnicity was obtained. The dentition of subjects was examined for dental caries, fillings and missing teeth. RESULTS: Six hundred adolescents of age 11 to 16 years were studied. A high caries-free prevalence of 457 (76.2%) was found among the subjects. Mean(SD) DMFT (decayed, missing, filled teeth) of 0.72 (1.67) and mean DMF% (decayed, missing, filled per cent) of 2.62 (6.17) were recorded among the study population. Older adolescents had higher caries erates than the younger ones. More females than males had caries while the socioeconomic status did not seem to influence caries experience. DT (decayed teeth) was the major contributor of the DMFT index. Among the ethnic groups the Igbo and Edo/Delta had the highest caries experience while the Efik/Ibibio, Yoruba and Hausa had the lowest. A restorative index of 1% was recorded, showing poor utilization of dental health care services by the population. CONCLUSION: This study shows an increasing caries trend when compared to previous Nigerian studies despite the mean DMFT of 0.72 being better than the WHO target of 1.5DMFT. Ready availability of sweets and confectionaries to all classes of people in the country compounded by poor knowledge of and utilization of preventive and restorative oral health care services may be contributory to the current trend.

A retrospective study of some socio-demograhic factors associated with pericoronitis in Nigerians.

BACKGROUND: Pericoronitis is an infectious disease of the operculum overlying an erupting or semi-impacted tooth particularly the lower third molars. It is a painful, sometimes debilitating and common periodontal emergency commonly found in young adults. OBJECTIVE: The purpose of this study was to determine the socio-demographic factors related to pericoronitis among Nigerians and compare these factors to other similar studies. METHODS: The patients included in this retrospective study were those who with a diagnosis of pericoronitis from January 2000 to December 2006. Socio-demographic and clinical data such as sex, age, tooth/teeth affected by pericoronitis and date of presentation were retrieved from the records of the Oral Diagnosis Clinic. RESULTS: During the study period, 373 patients presented with pericoronitis, 222 (59.5%) were female and 151 (40.5%) were male. The peak age of occurrence of pericoronitis was 19-23 years, accounting for 170 (45%) of the patients. The occurrence of pericoronitis was highest in the month of February, 67 (18%), followed by January (14.5%). The lower left third molar 169 (453%) was more affected than the lower right third molar 138 (37.1%) or combination of either lower third molars 66 (17.7%). More females 136 (68.1%) than males 64 (32.3%) were affected particularly in the younger age groups 14-23 years. CONCLUSION: Pericoronitis occurs more often in adult female Nigerians while the lower left third molar is the commonest tooth associated with this condition. Further studies are required to elicit the predisposing factors in this group of Nigerians.

Periodontal Status of Adolescents in Surulere; Lagos State; Nigeria

Objective : The objective of this study was to assess the periodontal status; treatment needs and dental visit practice of adolescents in Lagos; Nigeria. Methods : 600 subjects were selected by stratified random sampling from 6 schools; 3 secondary and 3 primary schools in Surulere Local Government Area of Lagos state; Nigeria. About one hundred subjects in each age category of 11 to 16 years were selected. A questionnaire was designed seeking biographic data such as age; sex; occupation of parent; and dental visit attendance and a section for recording periodontal clinical examination using the Community Periodontal Index of Treatment Needs (CPITN) was included. The periodontal status; treatment needs and dental visit practices of adolescents were determined. Results: Only 3 were found to be healthy periodontally. 83 of the subjects presented predominately with the worst condition recorded; code 2 (i.e. calculus); which is a reversible condition. A mean of 0.6 healthy sextants; 2.3 bleeding sextants and 3.1 calculus-accumulated sextants was calculated. A statistical difference in periodontal status was noted with age; the younger adolescents (11-13 years) presenting predominately with bleeding sextants when compared to the older adolescents (14-16 years) who presented more calculus-accumulated sextants. Nearly all subjects required periodontal treatment. 83 needed professional prophylaxis (TN2). Conclusion: There is a need for a school oral health education programme within the LGA with a focus on periodontal disease prevention and provision of oral prophylaxis by dental surgeons; therapists and volunteer dental students

Awareness of periodontal diseases amongst Nigerian diabetics.

This prospective study sample consisted of 261 Nigerians made up of 155 diabetics seen at the medical outpatient clinic of Lagos University Teaching Hospital, Lagos and general hospital, Ikeja, Lagos, Nigeria and 106 health controls randomly selected. The subjects were required to complete a questionnaire containing the biographic data and occupation, and assessment of their knowledge, attitude and practice towards periodontal health and utilisation of appropriate professional care. They were then examined and assessed using the CPITN code. Their ages ranged from 5 to 65 years. Close to three-quarters of the subjects (73.5% for diabetics and 74.5% for controls) were 45 years or older. Furthermore, 6% of the low skilled diabetics new about periodontal disease while only 27.2% of those in the medium and highly skilled group had some knowledge of periodontal disease. This relationship was found to be statistically significant (X2 = 12-22 ; df = 2, p < 0.05). Similarly, statistically significant relationship was demonstrated between diabetics and controls with regards to knowledge about the demonstrated between diabetic and controls with regards to knowledge about the cause/s of periodontal disease and awareness of gum bleeding. 73.6% of the controls had never been to the dentist before unlike 62.1% of diabetics. All subjects in either group who claimed not to bleed scored at least the minimum on the CPITN code. While 52.3% of diabetics and 22.5% of control had a CPITN score of 2,54% of those in the control group and 30% of diabetics recorded a score of 3 on the CPITN code. In conclusion, the level of awareness of periodontal disease is quite low amongst both groups, hence there is a need to promote periodontal health awareness in the general populace as well as clinics.