Burnout: A predictor of oral health impact profile among Nigerian early career doctors.

There have been reported association of oral health disorders with burnout, stress, and mental health. Arguably, with these reported associations, and the current prevalence of burnout amongst Nigerian doctors, exploring the role of burnout on oral health amongst Nigerian doctors is timely. This study aims to determine the relationship between burnout and oral health-related quality of life amongst Early Career Doctors (ECDs) in Nigeria, while also identifying the role other possible predictors plays in this relationship. This was a cross-sectional study conducted amongst Nigerian ECDs as part of Challenges of Residency Training in Nigeria (CHARTING) II project. A total of 632 ECDs were recruited across thirty-one tertiary hospitals in the 6 geopolitical zones of the country using a multistage cluster sampling technique. A self-administered paper-based semi-structured questionnaire was given to each participant that consented. The tools used to assess burnout and Oral health-related quality of life (OHRQoL) were Copenhagen Burnout Inventory (CBI) and Oral Health Impact Profile (OHIP-14) respectively. Independent samples T-test, ANOVA and Multiple linear regression were used to draw inferences from the data collected. Overall mean OHIP-14 score of all participants was 11.12 (±9.23). The scores for the 3 dimensions of burnout were below 50% with CBI-Personal Burnout having the highest score of 49.96 (±19.15). Significant positive correlations (p < 0.001) were found between OHIP-14 and all the dimensions of burnout, as the burnout scores were increasing, there was a corresponding increase in the OHIP scores thus poorer OHRQoL. The regression model shows that the predictors of OHIP were CBI-PB (p = 0.003), use of fluoride paste (p = 0.039), use of tobacco (p = 0.005) and being a denture user (p = 0.047). This study shows a positive correlation between burnout and OHIP of ECDs. We found that as burnout was increasing, OHIP increased thus implying poorer oral health related quality of life amongst ECDs. The use of fluoride toothpaste, tobacco and denture are other factors we found that could affect the OHIP of ECDs.

Health, well-being, and burnout amongst Early Career Doctors in Nigeria.

BACKGROUND: Early Career Doctors (ECDs) in Nigeria are faced with many individual and systemic problems, which consequently adversely affect their health, well-being, patient care and safety. OBJECTIVE: This study, the second phase of the Challenges of Residency Training and Early Career Doctors in Nigeria (CHARTING II) Study, sought to examine the risk factors and contributors to the health, well-being and burnout amongst Nigerian ECDs. METHODS: This was a study of health, well-being and burnout amongst Nigerian ECDs. Outcome variables included burnout, depression, and anxiety, which were respectively assessed using the Copenhagen Burnout Inventory (CBI) and Oldenburg Burnout Inventory (OLBI), Patient Health Questionnaire (PHQ-9) depression scale, and Generalized Anxiety Disorder (GAD-7) scale. The quantitative data obtained was analysed using the IBM SPSS, version 24. Associations between categorical outcome and independent variables were assessed using chi square, with level of significance set at < 0.05. RESULTS: The mean body mass index (BMI), durations of smoking and alcohol consumption of the ECDs were 25.64 ± 4.43 kg/m2 (overweight range), 5.33 ± 5.65 years and 8.44 ± 6.43 years respectively. Less than a third (157, 26.9%) of the ECDs exercised regularly. The most common disease conditions affecting the ECDs were musculoskeletal (65/470, 13.8%) and cardiovascular diseases (39/548, 7.1%). Almost a third (192, 30.6%) of the ECDs reported experiencing anxiety. Male and lower cadre ECDs were more likely than female and higher cadre ECDs to report anxiety, burnout and depression. CONCLUSION: There is an urgent need to prioritize the health and well-being of Nigerian ECDs, so as to optimize patient care and improve Nigeria's healthcare indices.

Aggressive periodontitis: experience in a Nigerian teaching hospital

Objective: Aggressive periodontitis is a disease entity that can be classified as Stages III & IV and Grade C chronic periodontitis based on the 2017 classification of the American Association of Periodontology for periodontal diseases. It is a class of chronic periodontal disease that features clinically severe periodontal tissue destruction. The diagnosis of aggressive periodontitis in this environment is delayed because of some influencing factors such as lack of dental awareness, patients' poor attitude towards this disease entity and their low socio-economic status. The objective of this case series is to highlight the factors that influence the time of presentation and severity of periodontal tissue destruction of Stages III & IV and Grade C chronic periodontitis (aggressive periodontitis) in this environment. Cases Description: We present the summary of the history, clinical features and radiological findings of four (4) cases of early and delayed presentation of aggressive periodontitis patients aged 19-27 years and factors that influenced their time of presentation. Severe periodontal tissue destruction was a common feature in these four cases with eventual tooth/teeth loss in delayed presenters. They were all treated using standard periodontal debridement with normal saline and 0.2%chlorhexidine gluconate, scaling, root planning and systemic antibiotics therapy. The patients provided informed consents, ethical approval was obtained from the institutional ethical committee and the study was conducted in accordance with the Helsinki declaration of 1975 as revised in 2000.Results: The factors that influenced the time of presentation included dental awareness through dental education, missing and mobile teeth, fear of further loss of teeth in the future, replacement of missing teeth, social marginalization, believe in some traditional 'taboos' and socio-economic status. Conclusion: There is a need for aggressive dental education/enlightenment of the people in this environment especially on periodontal disease. Clinical Significance: Dental awareness through dental education generally influenced time of presentation which prevents severe destruction of the periodontium