PREVALENCE AND PREDICTORS OF CIGARETTE SMOKING AND ALCOHOL USE AMONG SECONDARY SCHOOL STUDENTS IN NIGERIA.

Background: Cigarette and alcohol use are the most common causes of noncommunicable diseases. Studies related to cigarette and alcohol use among Nigerian adolescents have shown increases in the habits and require urgent intervention. Nationally representative data is needed to develop effective national policies and interventions, but this is lacking. Hence, this study aimed to provide nationally representative empiric information about cigarette and alcohol use prevalence and predictors among Nigerian secondary school students. Methods: This study included 2,530 Nigerian students in Nigeria from five of the six geopolitical zones in Nigeria. A self-administered questionnaire was used to obtain information about the participants' sociodemographic and school-based characteristics, cigarette and alcohol use status, and harm perception of tobacco and alcohol use. Data were analysed with SPSS version 25 at p<0.05. Results: Participants' mean age (±SD) was 16.34 (±2.0) years. The prevalences (95%CI) for ever-cigarette and current-cigarette smoking were 11.1% (95%CI:9.9-12.4) and 8.4% (95%CI:7.3-9.5), respectively. While 21.0% (95%CI:19.4-22.7) and 15.6% (14.2-17.1) were the prevalences for lifetime and current alcohol use, respectively. The predictors of current cigarette smoking were studying in northern-Nigeria (aOR:1.94;95%CI:1.10-3.44), attending private-schools (aOR:1.56;95%CI:1.03-2.38), boarding-student (aOR:1.75;95% CI:1.15-2.69), male-gender (aOR:3.03; 95%CI:1.80-5.10), current alcohol use (aOR:12.50;95%CI:8.70-18.18), having no (aOR:2.59;95%CI:1.58-4.26) or low tobacco harm perception (aOR:2.04;95%CI:1.18-3.53). The predictors of current alcohol use were male (aOR:1.32; 95%CI:1.01-1.72) and current cigarette smoking (aOR:12.5;95%CI:8.77-17.86). Conclusion: The prevalences of cigarette and alcohol use were high among Nigerian secondary school students, and both habits were strongly associated. Their predictors were school-related factors, sociocultural characteristics, and tobacco harm perception.

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.

A PILOT TRIAL OF THE IMPACT OF FINANCIAL INCENTIVE ON THE UTILIZATION OF DENTAL SERVICES AMONG CIVIL SERVANTS IN IBADAN, NIGERIA.

BACKGROUND: Financial constraints have been reported as major barriers to utilization of dental services in developing countries. It is however unknown if financial incentives will improve dental service utilization among civil servants in Nigeria. OBJECTIVE: To evaluate the effect of financial incentive on the utilization of dental services among civil servants in Ibadan, Nigeria. METHODS: This was a pilot trial among two clusters of civil servants in Ibadan, Nigeria. In both groups, the civil servants participated in an oral health education programme, a dental screening exercise and referral for dental treatment. In addition to this, the experimental group got a financial incentive to present for treatment. The two groups were followed up for a period of twelve weeks. Data were analysed using SPSS. RESULTS: A total of 109 civil servants participated in the study. There were 62 in the control group and 47 in the experimental group. The mean age of the study participants in the control group was 42.1 ± 8.75 years, mean DMFT was 0.95 ± 1.87 and 94% of them had an unmet dental need. Similarly, in the experimental group the mean age was 44.7 ± 11.68 years, mean DMFT was 0.45 ± 0.95 and 98% of them had an unmet need. There was no significant difference between the two groups at baseline. At twelve weeks, none of those referred for treatment in the control group presented for treatment while only 3 (6.4%) experimental group presented for dental treatment. No statistical difference was observed (p=0.077). CONCLUSION: In this study financial incentive did not result in significant increased utilization of dental care services among adults.

DEVELOPMENT OF A TOOL FOR DISPELLING MYTHS ASSOCIATED WITH NATAL/NEONATAL TEETH: "ADUNNI" A HEALTH EDUCATION VIDEO IN A NATIVE NIGERIAN LANGUAGE.

Studies have revealed that Nigerians irrespective of social class have negative attitudes and practices towards children born with natal teeth and those who erupt teeth within the first 30 days of life. This has been associated with the strong cultural myths and beliefs that exist among the populace. Children with natal teeth and their families have been stigmatized and are believed to be cursed. This stigmatization affects their social life and consequently impacts on their quality of life. Therefore, there is a need to develop an intervention such as a video to help dispel these myths. Videotapes have been shown as an intriguing means of communication and valuable tool in health education. To help dispel the myths associated with natal teeth, and neonatal teeth a twenty-eight-minute culturally appropriate video in the a local Nigerian language (Yoruba) titled "Adunni" targeted for people from the low social class was developed. This film has been sent to primary health care centers in suburban and rural areas and will be shown to mothers, pregnant women, nursing mothers and traditional birth attendants with a view to appropriately inform them and the entire communities that eruption of natal or neonatal teeth is not a curse.

THE COST MINIMIZATION ANALYSIS OF AN OUTREACH DENTAL SERVICE: A PILOT STUDY AT AKINYELE LOCAL GOVERNMENT AREA IN NIGERIA.

BACKGROUND: Access to dental services improves oral health and thereby, overall general health. For people with limited or no access to oral health care services, outreach dental services may be used to reduce oral health inequality. There is however paucity of information on the economic analysis of outreach dental services in sub Saharan Africa. OBJECTIVE: To report a cost minimization analysis of an outreach dental service as compared with a primary oral health clinic. METHOD: A comparative analysis of the costs expended in the treatment of patients at an outreach dental service of the University College Hospital, Ibadan was done versus the costs that would have been incurred if the patients had been treated at a Primary Oral Health Clinic of the same institution. RESULTS: A total of three hundred and forty two (342) participants were attended to at the outreach dental service. More than 80% of the 123 participants examined had an unmet oral health need. The procedures carried out were in keeping with the basic package of oral care. The average cost of the outreach per participant was ₦530 (~$2.50) only versus an estimate of ₦868 (~$4.13) per participant if the programme had been clinic based. The total cost savings was ₦115,344 (~$549.26). CONCLUSION: Outreach dental services provide similar dental treatment to services in a primary oral health clinic at a reduced cost.

Dental care seeking behaviour of children in a rural Nigerian community.

BACKGROUND: There is sparse information about oral health seeking behaviour of children in rural areas of developing countries. The aim of the Study was to determine the dental care seeking-behaviour of children attending the first rural based community oral health centre in Nigeria. METHODS: A retrospective review of records of patients aged 16 years or younger treated at the Primary Oral Health Care Centre in Ibarapa, Nigeria over six years was conducted. Data on sociodemographic characteristics of the patients, pattern of presentation and their oral hygiene practices were collected and processed using SPSS. RESULTS: A total of 239 paediatric patients were seen during the period with a mean age of 9.7 ± 4.4 years and 132 (55.2%) were males. The majority, 225 (94.1%), were presenting for the first time. All the children sought dental care for one problem or the other and the most common reasons for seeking care were: tooth ache in 105 (43.9%), trauma in 30 (12.6%) and perceived unclean mouth in 20 (8.4%) patients. Older children were more likely to seek dental care because of pain (p < 0.00 1), while younger children sought care principally on account of trauma (p < 0.001) and the under 5 years were seen more often for gum ache (p =0.006). The majority, 175 (73.2%), used toothbrush and 182 (76.2%) cleaned their teeth once daily. CONCLUSION: None of the children presented for routine check-up, rather, consultation was as a result of dental problems with toothache being the most common reason.

Smokers and Non Smokers: A Comparison of Oral Health Practices and Effect of Non Surgical Periodontal Therapy on their Periodontium.

AIMS AND OBJECTIVES: To assess the oral hygiene measures and self report oral symptoms of smokers and non smokers, as well as evaluate and compare the effect of non-surgical periodontal therapy on their periodontium. MATERIALS AND METHODS: This was a quasi experimental study conducted on smokers and non smokers. Adult patient smokers were recruited into the study group and matched with age and sex controls (non-smokers). Data was collected on oral hygiene measures and self reported oral symptoms. The patients were examined and evaluated using oral indices. Each patient had scaling and root planing done and was re-examined after six weeks. Data was analysed using SPSS. RESULTS: Seventy-two patients completed the study with age ranging from 20 to 65 years and a mean age of 43.7 (± 17.8) years. Twenty-one percent (21%) of smokers and 42% of the non smokers reported experiencing gum bleeding, p = 0.041. Sixty percent of the smokers reported stains on their teeth compared to 29.7% of non smokers, p = 0.028. The baseline gingival and calculus indices were lower in smokers compared to non smokers while the plaque index was higher among the smokers. The response to scaling and root planing was worse among smokers comparing their gingival and calculus indices but better in terms of the plaque indices, however, these were not statistically significant. CONCLUSION: There were no significant differences between the response of smokers and non smokers to non surgical periodontal therapy although smokers experienced gingival bleeding less often and have lower gingival index.

Sociodemographic Status of Patients Seeking Routine Scaling and Polishing in a Resource Challenged Environment.

OBJECTIVES: To assess the sociodemographic profile of patients seeking routine scaling and polishing in a resource challenged setting in Ibadan, Nigeria Study design: A retrospective review of dental records of patients presenting for scaling and polishing at the Periodontology Clinic of a tertiary hospital in Ibadan, Nigeria over a period of one year was done. Two groups were identified; those seeking routine scaling and polishing and those referred as a result of periodontal disease or from other clinics. The age, gender, religion, marital status and socioeconomic status were obtained from the records of each patient. Analysis was done using SPSS version 16. The level of statistical significance was set at 5%. RESULTS: A total of 295 patients with a mean age of 42.5 (±17.7) years had scaling and polishing done over the period; 100 (33.9%) came routinely and 195 (66.1%) were referred. There were 151 (51.2%) males and 144 (48.8%) females. The majority (83.2%) were Christians. Their socioeconomic class ranged from skilled workers (21.4%), through unskilled workers (22.7%) to dependants (55.9%). A higher proportion of Christians than Muslims presented routinely for the procedure, 35.8% vs. 20.4% (p = 0.037). The proportion of skilled workers, unskilled workers and dependants who came for routine scaling and polishing were 46.0%, 25.4% and 32.7% respectively (p = 0.038). Socioeconomic status was found, on multivariate analysis, to significantly predict seeking for routine scaling and polishing. CONCLUSION: Socioeconomic status is a determinant of seeking for routine scaling and polishing in a resource poor country.

ORAL HEALTH AWARENESS AND PRACTICES OF PRIMARY SCHOOL TEACHERS IN IBADAN, NIGERIA.

BACKGROUND: The school is an important avenue for promoting oral health most especially in developing countries with low resources. However, the success of any school based preventive oral health programme is dependent on the teachers about whom there is little information on their present state of oral health awareness and practices in Ibadan, South-western Nigeria. AIM & OBJECTIVES: To investigate the oral health awareness and practices of primary school teachers in Ibadan, Nigeria. MATERIALS & METHODS: A cross sectional study of randomly selected public primary school teachers in Ibadan was performed. Data were collected using structured self-administered questionnaire, which assessed their socio-demographic characteristics, oral health awareness, oral hygiene measures and utilization of dental services. Data were analysed using SPSS version 21. Chi square statistics was used to test for association between variables and p value set at < 0.05. RESULTS: A representative sample of 309 teachers participated in the study with a mean age of 48.7 (± 5.94) years. The majority, 284 (91.9%), were females. A few, 39 (12.6%), of the teachers knew what dental caries and its causes were, while 1 (0.3%) knew the cause of oral cancer. Only 149 (48.2%) knew that oral diseases could be prevented. If the teachers had problems with their teeth; 154 (49.8%) would go to the hospital, 115 (37.2%) would self-medicate, 20 (6.5%) would visit the drug shop (chemist), 1 (0.3%) would visit the traditional healer and 19 (6.2%) were not sure of what to do. About a third of participants, 99 (32.0%) have had previous consultations with the dentist, with many 72 (72.0%) doing so because of pain. Many of the teachers 183 (59.2%) cleaned their teeth twice or more daily before eating. Male teachers (84.0%) and those with less teaching experience (60.6%) were found spending longer time in cleaning their teeth (p = 0.035 and p = 0.002). CONCLUSION: Poor oral health awareness and practices still exists among the teachers. There is a need for urgent intervention to promote oral health amongst them.

Oral health practices of adult inhabitants of a traditional community in Ibadan, Nigeria.

BACKGROUND: Although, the association between oral health care practices and sociodemographic characteristics of populations have been documented, information is sparse on sociodemographic indices influencing oral health practices of residents of traditional communities. The study aimed to describe the oral health practices of adult inhabitants of a traditional community in Nigeria. METHODS: A descriptive, cross-sectional study involving adult residents in randomly selected houses in Idikan, Ibadan, Nigeria. Data on their oral health care practices was obtained with the use of structured interviewer administered questionnaires. Data was analysed with SPSS and test of association carried out using Chi square. RESULTS: A total of 390 adult residents participated in the study, of which 56.2% were males. A total of 196 (50.3%) participants used toothbrush solely to clean their teeth, 72 (18.5%) used chewing sticks alone while 119 (30.5%) used both tooth brush and chewing stick. Older residents of the community, those with no formal education and in lower occupational classes were more likely to use chewing stick (p < 0.05). The majority (68.7%) cleaned their teeth once daily, 30% cleaned twice while 1.3% cleaned infrequently. Educational level attained and occupational class were significantly related to frequency of oral hygiene. Nearly all (95.4%) of the participants knew that oral health services are available in most hospitals, yet only 35.9% had ever visited a dental centre with a significantly higher proportion being males (p < 0.05). CONCLUSION: The study showed that the oral health practices of a typical traditional community in Nigeria are highly influenced by socioeconomic considerations.

The effectiveness of oral health education conducted at a rural community market setting.

BACKGROUND: The workplace is one of the avenues for educating the public about their oral health in developing countries; particularly in rural communities where the workplace plays a major role in communal living. It is therefore necessary to find out if the market is appropriate for achieving the set aim of improving oral health awareness among the populace in rural communities. AIM AND OBJECTIVES: The aim of this study was to determine the effectiveness of oral health education conducted in a market in a rural community by comparing the oral health practices of market women involved in the oral health education programme to those not involved in the programme. DESIGN: A prospective study. SETTING: A rural community in South-western Nigeria. MATERIALS AND METHODS: A prospective interventional study was conducted among market women in Igboora, a rural community in South-western Nigeria. The intervention was oral health education differentiating between the intervention group and the control group. Structured interviewer administered questionnaires were used to obtain information from the participants on their oral hygiene measures, fluoride use, dental attendance and the demographics of the participants. Data collected was analyzed using SPSS and p-value set at <0.05. RESULTS: Two hundred market women participated in the study with a mean age of 45.2 ± 17 years. The interventional group was made up of 106 market women while the control group was made up of 94 market women. There were no significant differences in the sociodemographic characteristics of women in both the intervention and control groups. Women in the intervention group engaged in more frequent cleaning of their teeth and tongue than those in the control group (p < 0.001). Market women who had participated in the oral health education subsequently visited the dentist more often than those in the control group (p = 0.010). CONCLUSION: The study showed that oral health education conducted at a market was effective in improving some oral health practices of participants. It is recommended that oral health practices be extended to major markets in our communities.

Validation of the oral impact on daily performance frequency scale in Ibadan, Nigeria.

BACKGROUND: Oral health related quality of life measures provide alternative ways to evaluate oral health status in a way that prioritises impact on lifestyle. These measures are, however, hardly used in our setting. Before the measures can be used effectively, validity of the tool needs to be evaluated. The aim of the study was to validate the Oral Impact on Daily Performance (OIDP) frequency scale in an adult Nigerian patient population. METHODOLOGY: This was a descriptive cross sectional study in which consecutive patients attending the Primary Oral Health Care Centre, Idikan and the Oral Diagnosis Clinic of the University College Hospital, Ibadan were recruited. Data was collected with OIDP structured interviewer administered questionnaires, global self-rating and perceived treatment need questions and by oral examination. The frequency scale of the OIDP index was used to compute the impact scores. Data collected was subjected to statistical analysis using SPSS version 19. RESULTS: A total of 204 patients participated in the study. The OIDP score ranged from 0 to 40; 78.9% of the participants reported an impact on daily performance with eating and enjoying food being the most reported activity impacted upon. The Cronbach's alpha coefficient was 0.811; the OIDP index was significantly associated with global self-ratings of oral health, perceived need for dental treatment and was able to discriminate between patients with or without dental caries. CONCLUSION: The OIDP frequency scale exhibited satisfactory psychometric properties amongst adult dental patients in Ibadan, Nigeria.

Self rating of oral health status by student dental surgeon assistants in ibadan, Nigeria - a pilot survey.

BACKGROUND: Individuals, generally, in this environment are known to rate their oral health status favourably despite the presence of oral diseases and conditions, probably due to sub optimal awareness level about oral health, however it is not known if this is the case with members of the dental team especially those who assist the dentist in day to day procedures. OBJECTIVE: This study assessed the self ratings of oral health status amongst student dental surgeon assistants on clinical rotation at the Dental Centre, UCH, Ibadan. METHOD: This was a descriptive cross sectional study in which data was obtained with the use of self administered questionnaire and by clinical oral examination. Data obtained included sociodemographic data of respondents, questions assessing self rating of oral health status and evaluation of presence or absence of clinical oral conditions. RESULTS: A total of 54 students with a mean age of 23.9years on clinical posting participated in the study. Nearly all (98.1%) rated their oral health as very good or good and 55.6% perceived a need for oral health care. About 60% had consulted a dentist previously. The mean DMFT was 0.28 and 14.8% of the respondents had a DMFT score > 0. Significant association was found between the global self rating of oral health and perceived need for dental treatment. CONCLUSION: The perceived need for dental treatment is an important factor in global rating of oral health amongst student dental surgeon assistants.

Effectiveness of an oral health care training workshop for school teachers: a pilot study.

BACKGROUND: School teachers play key roles in imparting appropriate and up-to-date knowledge to pupils and students. However, most teachers in developing countries like Nigeria have poor knowledge and motivation about oral health which may be due to inadequate training in the area of oral health. This might be one of the reasons for the poor oral hygiene among them and their students. OBJECTIVES: To evaluate the effectiveness of an oral health care training programme organized for teachers in Eruwa, Oyo state, Nigeria. METHODS: An intervention study was conducted among 40 school teachers who attended a two day oral health training workshop at Eruwa, headquarters of Ibarapa East Local Government Area. Training methods included lectures and demonstrations on aetiology, clinical features, treatment and prevention of common oral diseases. Pre- and post- evaluation written tests were administered to the participants to assess the effectiveness of the training. The knowledge scores were rated as poor, fair and good knowledge scoring <50.0%, 50.0-60.0% and > 60.0% respectively. Frequencies, percentages and means of relevant variables were generated. Paired t-test was used to compare means at P<0.05. RESULT: The mean age of the teachers was 40.13 ±7.24 years. There were 16 (40.0%) males and 24 (60.0%) females. Twenty (50.0%) of the participants had poor pre-training knowledge as compared to 7 (17.5%) after the training. Thirteen (32.5%) had fair pre-training knowledge as compared to 17 (42.5%) post training. Only (2.5%) of the participants had good pre-training knowledge as compared to 18 (45.0%) post training. The mean scores of the pre- and post-evaluation tests were 31.70 ±11.31 and 48.20 ±11.16 respectively. There was a statistically significant difference between the mean scores of the pre and post evaluations P<0.05. CONCLUSIONS: The training workshop improved the knowledge of school teachers regarding oral health.

Quality of records keeping by undergraduate dental students in ibadan, Nigeria.

BACKGROUND: Recording the interaction between a patient and the dentist is of primary importance in dental practice. The completeness of recordings of undergraduate students, often inadequate, has been found to subsequently impact on the quality of dental care offered by professionals. Once identified, correcting the inadequacies has also been shown to improve the quality of dental practice. OBJECTIVE: We aimed to evaluate the quality of records keeping by dental students in Ibadan, Nigeria. METHOD: A retrospective review of records of patients seen by dental students, at the clinics of the dental school in Ibadan, Nigeria, over a six months period was conducted. The charts were reviewed for: demographic data, medical and dental history, clinical findings, diagnosis, treatment plan and note on informed consent. Assessment of the quality of data obtained was done using a modified CRABEL's scoring system. RESULTS: A total of 318 case files were retrieved for this study. The median modified CRABEL score was 95%, with a range of 65 to 95%. Eighty-two recordings (25.2%) had a score < 90%, while 236 recordings (74.2%) had a score ≥ 90%. The most frequently unrecorded data was written consent in all the charts, followed by procedure done with the documentation absent in 20.4%. All the supervisors signed at the end of the consultation. CONCLUSION: The quality of records keeping by dental undergraduates is fair but there is a need to emphasize deficient areas and improve upon the quality of record keeping.