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.

an evaluation of the possible relationship between chronic periodontitis and hypertension.

BACKGROUND: Periodontal diseases have been reported to have a form of reciprocal relationship with the general systemic health, in which case those with some systemic diseases such as hypertension have poorer periodontal health and vice versa. The issue of causal or casual relationship is however yet to be finally resolved. AIM: The aim of this study was to determine any possible relationship between chronic periodontitis and cardiovascular risk factors. METHODOLOGY: A cross-sectional assessment of cardiovascular risk factors such as blood pressure, body mass index, waist circumference and the carotid artery intima media thickness (CIMT) was done among 100 consecutive subjects in the echocardiogram unit of the University College Hospital, Ibadan, Nigeria over a period of six months. These cardiovascular risk factors were compared with periodontal parameters such as Simplified Oral Hygiene index (OHI-S), Gingival index (GI) and Community Periodontal Index (CPI). RESULTS: The systolic blood pressure (SBP) of the respondents ranged from 98 - 210 mm Hg with a mean of 133.1 ± 15 mm Hg, diastolic blood pressure (DBP) 60 - 136 mm Hg with a mean of 84.6 ± 6.4 mm Hg. There was a statistically significant relationship between the systolic blood pressure and oral hygiene index (P< 0.000), diastolic blood pressure and oral hygiene index (P < 0.010) and mean carotid artery intima media thickness and oral hygiene index (P< 0.012) among the respondents. CONCLUSION: In view of the significant relationship between the blood pressure and the mean carotid artery intima media thickness, when compared with the oral hygiene status of respondents in this study, more emphasis should be laid on regular preventive dental visit as a way of decreasing cardiovascular health risk.

Bad-breath: Perceptions and misconceptions of Nigerian adults.

OBJECTIVE: To provide baseline data about bad-breath perception and misconceptions among Nigerian adults. METHODS: Multi-center cross-sectional study of individuals aged 18-64 years using examiner-administered questionnaires. Age comparisons were based on the model of emerging adults versus full adults. Data were recoded for statistical analyses and univariate and secondary log-linear statistics applied. RESULTS: Participants had lopsided perceptions about bad-breath. While 730 (90.8%) identified the dentist as the expert on halitosis and 719 (89.4%) knew that bad-breath is not contagious, only 4.4% and 2.5% associated bad-breath with tooth decay and gum disease respectively. There were no significant sex differences but the older adults showed better knowledge in a few instances. Most respondents (747, 92.9%) would tell a spouse about their bad-breath and 683 (85%) would tell a friend. CONCLUSIONS: Participants had lop-sided knowledge and perceptions about bad-breath. Most Nigerian adults are their "brothers' keepers" who would tell a spouse or friend about their halitosis so they could seek treatment.

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-ASSESSED DENTAL HEALTH KNOWLEDGE OF NIGERIAN DOCTORS.

OBJECTIVES: To assess medical doctors' knowledge of common dental diseases and the need to include dental education in the Nigerian undergraduate medical curriculum. DESIGN: Cross-sectional multicentre non-random survey using a convenience sample. SETTING: Tertiary hospitals across two geo-political zones of Nigeria. Participants were mostly recruited while attending seminars and other departmental events which brought doctors together. SUBJECTS: Medical doctors in tertiary hospitals across two geo-political zones of Nigeria. MAIN OUTCOME MEASURES: Knowledge of common dental diseases namely, dental caries, gingivitis and periodontitis was evaluated using an open-ended questionnaire. The definition, etiology, treatment and age-related risk were assessed. Exposure to dental education during undergraduate training was assessed. Opinion on desirability and suggested length of future training were also assessed. RESULTS: A total of 127 doctors (35 interns, 30 residents, 34 senior residents and 28 consultants) participated in the study. Overall, knowledge of definition, etiology, treatment and relative prevalence were recorded. About 69 doctors (54.3%) correctly defined dental caries, 120 (94.5%) correctly defined gingivitis while only only 29 (22.8%) correctly defined chronic periodontitis. The proportions of respondents who correctly identified disease etiology were 26 (20.5%) for caries, 31(24.4%) for gingivitis and 12 (9.4%) for chronic periodontitis. The proportions of respondents who correctly identified appropriate treatment modalities were 39 (30.7%) for caries, 18 (14.2%) for gingivitis and 6 (4.7%) for periodontitis. Those who correctly identified the relative, age-related prevalence of the three diseases were 81 (63.8%) for caries, 51 (40.2%) for gingivitis and 47 (37%) for periodontitis. CONCLUSION: Most of the medical doctors who participated in the study demonstrated inadequate knowledge of common dental diseases and about 97% of respondents supported the idea of including dental education into the current Nigerian undergraduate medical curriculum.

Periodontitis & sub-fertility; opinions and practices of Nigerian specialists.

BACKGROUND: Increasing evidence in the emerging field of periodontal medicine continues to stimulate research to verify the association between chronic periodontitis and general health. The link between chronic periodontitis and sub-fertility has not been well-investigated except for a handful of reports spanned over several decades. METHODS: As a prelude to a series of observational and interventional studies, 119 specialists and doctors participated in an online survey to ascertain their practices and opinions about this link. Our main exposure variables were dental history taking, periodontal/dental referrals and knowledge of possible link between chronic periodontitis and sub-fertility. RESULTS/FINDINGS: Our findings showed that dental history taking and periodontal/dental referrals were not part of sub-fertility management protocols of Nigerian specialists and doctors. These findings proved true irrespective of basic and postgraduate experience. Specialty was the only explanatory variable that accounted for statistical significance with the main exposure variables but the figures of members of different specialties were too low for any meaningful comparisons. CONCLUSIONS: The findings confirmed our suspicion of an almost complete lack of knowledge of this unlikely yet plausible association which deserves further research.

Proposing a novel protocol for halitosis assessment.

AIM: This is a review paper intended to develop a simple protocol for the comprehensive yet rapid assessment of halitosis. MATERIALS AND METHODS: An extensive protocol was developed through a review of literature to identify all possible etiological factors as have been identified by previous workers. The resulting protocol was presented as a form including extensive medical and dental history as well as oral and periodontal examination. Relevant medical aspects, an otolaryngology (ENT) consultation section as well as a gastrointestinal consultation were also included. Every bit of evidence gathered from literature was included in order to develop a list that's as inclusive of all possible contributing factors as possible. Factors discovered from the experience of the authors were also included in the protocol. RESULTS: A long list of factors was identified in literature including medical, dental, periodontal, diet and others. All these were included in the resulting form and a pre-evaluation checklist was also included. CONCLUSION: Halitosis is multifaceted in etiology. A simple easy-to-use protocol helps in an extensive yet rapid evaluation of halitosis.

Do smokers benefit from dental hygiene oral prophylaxis? A Nigerian pilot study.

Smoking is a major, preventable risk factor for periodontitis. This pilot study in Nigeria evaluated the effect of dental oral prophylaxis on oral hygiene and periodontal indices among 13 systemically healthy smokers and 8 non-smokers. All participants received full-mouth scaling and root planing, tooth polishing, demonstration of correct brushing technique and a new toothbrush and toothpaste. After 6 months, debris index, calculus index, oral hygiene index and community periodontal index of treatment needs status code 0 scores showed no improvement in smokers. There was a 50% improvement of all indices among non-smokers. Smokers showed no benefit from dental oral prophylaxis in this study.

Do smokers benefit from dental hygiene oral prophylaxis? A Nigerian pilot study

Smoking is a major, preventable risk factor for periodontitis. This pilot study in Nigeria evaluated the effect of dental oral prophylaxis on oral hygiene and periodontal indices among 13 systemically healthy smokers and 8 non-smokers. All participants received full-mouth scaling and root planing, tooth polishing, demonstration of correct brushing technique and a new toothbrush and toothpaste. After 6 months, debris index, calculus index, oral hygiene index and community periodontal index of treatment needs status code 0 scores showed no improvement in smokers. There was a 50% improvement of all indices among non-smokers. Smokers showed no benefit from dental oral prophylaxis in this study