Prevalence and Associated Factors of Dental Caries among Primary School Children in South-East Nigeria.

OBJECTIVES: The study aimed to identify the prevalence and associated factors of dental caries in primary school children. MATERIALS AND METHODS: This was a cross-sectional study of 657 primary school children from South East, Nigeria. Data on age, sex, birth rank, dental visits, oral hygiene status, and enamel defects were collected. The presence of dental caries was recorded by using the World Health Organization criteria. Mean DMFT/dmft scores were determined and SPSS version 21 was used for analysis. Chi-square test and multivariate logistic regression were conducted and P ≤ 0.05 was considered significant. RESULTS: The study participants were 316 (48.1%) males and 341 (51.9%) females, and their mean age was 8.41 ± 2.18 years. The prevalence of caries was 22.7% while the mean DMFT and dmft scores were 0.10 and 0.45, respectively. Bivariate analysis showed a significant association between birth rank (P = 0.04), oral hygiene status (P = 0.05), enamel defects (P < 0.001), and dental caries. Multivariate regression analysis showed that good oral hygiene (OR = 0.180, CI: 0.036-1.003, P = 0.04), fair oral hygiene (OR = 0.576, CI: 0.345-0.993, P = 0.04) and enamel defects (OR = 4.939, CI = 2.406-10.137, P < 0.001) were significant predictors of caries in this study. CONCLUSION: The prevalence of dental caries in this study was high. Oral hygiene and enamel defects were predictors of dental caries in the study population.

Investigation of the esthetic outcomes of white spot lesion treatments.

OBJECTIVE: The present study compared the ability of bleaching, resin infiltration and microabrasion to restore the appearance of existing white spot lesions (WSL) on tooth surfaces as close as possible to that of the original healthy enamel. MATERIALS AND METHODS: Sixty extracted human teeth with WSL were randomly assigned to three treatment groups (20/group). Prior to treatment, the colour of the surrounding healthy enamel and the WSL were measured as the baseline and pre-treatment (PreRX) colours respectively using spectrophotometer based on CIE L*A*B. The L-value was used for the statistical comparison. WSLs in each group were treated respectively by bleaching, infiltration or microabrasion following the manufacturer's instructions. Colour measurement was repeated after treatment. Both intragroup and intergroup comparisons were performed using ANOVA followed by Tukey's multiple comparison test (α=0.05). RESULT: In all groups the mean L-values were significantly higher in PreRX WSL (P < 0.01; Tukey) compared to baseline (sound enamel). After treatment the difference in mean L-value between baseline and WSL increased significantly (P < 0.01, Tukey) in Bleaching and Microabrasion groups by 1.4% and 1% respectively, but decreased in Infiltration group by 3.4%. Thus resin infiltration decreased the L-value of the WSL, bringing it closer to the L-value of the sound enamel while bleaching and microabrasion increased the L-value. CONCLUSIONS: Among the three treatment modalities investigated in this study, resin infiltration was the most effective in masking the WSLs.

Pattern of malocclusion and caries experience in unrepaired cleft lip and palate patients in Enugu.

BACKGROUND: Clefts are common birth defects, usually accompanied by various malformations that include malocclusions, and may be associated with tooth decay. The aim of this study was to assess the malocclusion and caries status of the patients with unrepaired clefts who presented at the National Orthopaedic Hospital Enugu. SUBJECTS AND METHODS: A cross-sectional, descriptive study was conducted among patients with unrepaired cleft lip and/or palate that presented at the National Orthopaedic Hospital, Enugu between January 2009 and December 2011. Detailed records of 140 patients with cleft deformities who presented to the hospital within the study period were analyzed for the cleft pattern, whereas those patients above 6 years of age (52 patients) were analyzed for malocclusion using the Angle's classification of malocclusion. Assessment for dental caries according to WHO guidelines was made for all the patients. RESULT: There were 74 males and 66 females. Cleft lip with or without alveolus involvement had equal prevalence (47.1%) (66 patients) with combined cleft lip and palate; eight patients had isolated cleft palate (4.71%). Angle's class 1 malocclusion was statistically significantly higher than other classes (P = 0.000). Class I malocclusion was seen in 38 patients (73.1%), whereas class 111 was seen in 8 patients (15.4%) and class 11 in 6 patients (11.5%). Eight patients (100%) who developed class 111 malocclusion all had a hard palatal defect. Proclining of maxillary anterior teeth (increased overjet) was the most common orthodontic anomalies, reported in 25 patients (48.1%) (P = 0.002). Caries prevalence of 12.9% was observed in this study. Caries experience was statistically significantly higher in deciduous than permanent teeth (P = 0.002). CONCLUSION: The high prevalence of malocclusion in these cleft patients emphasizes the need for an interdisciplinary team approach and early inclusion of dental care especially oral hygiene to prevent tooth decays.

Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations.

A Survey of the Knowledge of Dental Implants as a Choice in Treatment of Edentulous Jaws among Health Workers in Government Dental Clinics in Enugu.

BACKGROUND: Dental implantology is fast becoming a specialty in the field of dentistry. Within the last five decades, dentistry appears to have recorded its most significant advancement in the field of dental implantology. With dental implants, missing teeth can now be replaced with stable, comfortable and natural-looking and feeling artificial replacements. Inspite of this lenght of time associated with the innovation, the awareness and practice of dental implantology in the government dental clinics in Enugu is still aground. OBJECTIVES: To determine if health workers in these hospitals were aware of dental implants as a choice for replacing missing teeth. METHODS: The survey was conducted using a random sampling with self-administered questionnaires among health workers in the three health institutions in Enugu between January and February, 2009. RESULTS: Out of 320 respondents in the study, only 31 (9.7%) were aware of dental implant, while 23( 7.2% ) recognised it as a choice in tooth replacement. CONCLUSION: The knowledge of dental implants as a replacement choice for missing dentitions is low among health workers in Enugu.