DENTAL AGE ESTIMATION USING THE RADIOGRAPHIC VISIBILITY OF PERIODONTAL LIGAMENT AROUND LOWER THIRD MOLARS AMONG SELECTED NIGERIANS.

Background: Age estimation for sporting activities, legal age determination and migration purpose is oftentimes essential, which makes the need for a scientifically proven method of age estimation an important aspect of medical practice. Forensic odontology is an essential aspect of forensic practice and may be a veritable tool in age estimation. Aim and Objective: The objective of this study was to evaluate the usefulness of orthopantomograms (OPG) in age estimation among selected Nigerians. Methodology: A retrospective assessment of 202 OPGs was done to review the visibility of the periodontal ligament of third molars with completed root formation according to the methods described by Olze et al (2010). Individual ages were then calculated by deducting date of exposure from the date of birth recorded in years. Mean age with standard deviation were calculated for each group. Results: Assessing the minimum and maximum age at which each of the stages of the radiographic visibility of the periodontal ligament as seen on the OPGs revealed that there was a gradual increase in the age at which the stage increment occurred, with a few exceptions. Comparison of the radiographic visibility of the periodontal ligament revealed that males tend to achieve early periodontal visibility stages compared to females, but the reverse was observed in later stages. Age 17 is more than likely attained in any person found within stages 1 to 3 as the minimum age found in these stages were above 17 years. Conclusion: With a few exceptions, the assessment of periodontal ligament visibility on OPGs can adequately predict the age of individuals. Thus, the use of this method may need to be combined with other methods in accurate determination of dental age in instances of forensic age estimation.

FACTORS INFLUENCING CHOICE OF ORAL HYGIENE PRODUCTS BY DENTAL PATIENTS IN A NIGERIAN TEACHING HOSPITAL.

BACKGROUND: Several factors, such as cost, branding, packaging and family influence, had been implicated as influencing the choice of toothpastes and toothbrushes by individuals. Media advertisement is also considered a very strong factor influencing consumer's choice. AIM: To assess the extent to which some factors influenced the choice of toothpastes and toothbrushes among dental patients in a Nigerian teaching hospital. MATERIALS AND METHODS: Two-hundred and two patients were interviewed on factors that influenced their choice of toothbrush and toothpaste. Some of the factors considered include the cost, packaging, brand, media advertisement and their previous experience. RESULTS: Factors that affected choice of toothbrush by respondents included texture (89.6%), brand (62.9%), previous experience (64.4%) and for toothpaste, fluoride content (62.4%), previous experience (69.3%), and advice by a dentist (55.0%). Media advertisement was the least influential in their choice of toothpaste (29.2%) and toothbrush (24.3%). Consideration for fluoride was a stronger factor than herbal contents in the choice of toothpaste (P<0.001). CONCLUSION: Previous experience seems to be a very strong factor in the choice of both the toothbrush and toothpaste in this study, which suggest that for as long as the respondents are satisfied with a particular product, they will stick to it.

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.

Periodontal Condition and Treatment Needs of Some Pregnant Women in Ibadan, Nigeria.

BACKGROUND: Periodontal diseases had been reported to be worse in the presence of hormonal imbalance as seen during pregnancy, which if that is the case, should resolve following childbirth when the hormonal level of the women should have reverted to normal. SUBJECTS AND METHODS: Periodontal health of 345 pregnant women was assessed once during pregnancy and at 14(th) week following their childbirth. The clinical variant of community periodontal index of treatment needs probe was used in the assessment. RESULTS: During pregnancy, 167/345 (48.4%) of the women had deep pockets, 178/345 (51.6%) had shallow pockets. After childbirth, 5/345 (1.5%) had healthy periodontium, 25/345 (7.2%) had calculus and 7/345 (2.0%) had deep pockets. All of the respondents required oral hygiene instructions (OHI) and prophylaxis and 167/345 (48.4%) required complex treatment during pregnancy. After childbirth, 340/345 (98.5%) of the women required OHI and prophylaxis. Despite the great need for dental treatment among the respondents, majority never sought any treatment as 308/345 (89.3%) of the respondents had never visited a dentist before the study. CONCLUSION: The fact that the deep pocket reduced drastically following childbirth shows that it was not a true pocket. The high unmet treatment needs among the respondents require a concerted effort from dentists and policy makers in order to enlighten the women, especially those of child bearing age concerning the need for preventive dental visitation.

MODE OF TRANSMISSION OF HIV/AIDS: PERCEPTION OF DENTAL PATIENTS IN A NIGERIAN TEACHING HOSPITAL.

BACKGROUND: Despite the fact that the possible modes of transmission of Human Immunodeficiency Virus (HIV) are well established, there still abound many misconceptions, which contribute to the persistence of social stigmatization of those living with the virus. AIM: To assess the perception of some dental patients on the possible modes of transmission of HIV in order to identify areas of misconceptions. DESIGN OF THE STUDY: A prospective study. SETTING: A dental centre located within a teaching hospital in Nigeria. MATERIALS & METHODS: A prospective study of 212 dental patients was undertaken using a structured questionnaire to assess the perception of respondents on possible mode of transmission of HIV. RESULTS: Majority of the respondents agreed that HIV could be transmitted through sexual means (96.2%), blood transfusion (96.7%) and sharing of sharp objects (92.5%). A few of the respondents believed that HIV can be transmitted through sharing of drinking cups (9.4%) and mosquito bites (13.6%). A greater percentage of those with higher educational qualifications agreed that the use of unsterilized dental instruments may transmit the virus, which was statistically significant (p< .002) and a lower percentage of the more educated respondents agreed that sharing of drinking cup can transmit the virus (p<.000). CONCLUSION: Despite the generally good knowledge of the possible modes of transmission of HIV, there are still some misconceptions, which may encourage stigmatization of those living with HIV, which could lead to people unwilling to consent and go for voluntary counseling and testing.

PREVALENCE OF COEXISTING DIABETES MELLITUS AND HYPERTENSION AMONG DENTAL PATIENTS IN A TERTIARY CARE HOSPITAL.

BACKGROUND: Diabetes mellitus and hypertension are quite important in dental settings as may present as an emergency during dental treatment or may necessitate a modification in the patient's management. OBJECTIVES: To determine the prevalence of coexistence of diabetes mellitus and hypertension among a group of dental outpatients and to assess the relationship between these medical conditions and a cross-section of factors. METHODOLOGY: A cross sectional survey of 203 outpatients presenting in a Dental Clinic within a Tertiary hospital was undertaken. The capillary blood glucose of respondents was measured using a glucometer. Patients with a random blood glucose (RBS) ≥ 200 mg/dl were considered diabetic. Their blood pressure (BP) was assessed using a digital sphygmomanometer and a systolic BP of <120-139 and diastolic BP of <80-89 mmHg was taken as normal. Relationship between the two parameters was tested using Chi-square and p-value <0.05 was taken as statistically significant. RESULTS: The age range of respondents was 16-75 years with a mean of 40.4 ±13.1 years and most (56.2%) of them were females. Their mean blood glucose was 108.7± 43.1 mg/dl, mean systolic blood pressure was 121.2 ± 14.9 mm Hg and mean diastolic blood pressure was 76.8 ± 13.3 mm Hg. Twenty-seven (13.3%) had high systolic BP, while 37 (18.2%) had high diastolic BP. Nine (4.4%) had their blood glucose in the range of diabetes. There was a co-existence of high blood glucose and diastolic blood pressure in 6 (3.0%) of the respondents and statistically significant association (p = .000) between the blood glucose and diastolic blood pressure. CONCLUSION: Dentists should note that co-existence of diabetes mellitus and diabetes in a dental patient is an index of increased morbidity and mortality and should always screen for these medical conditions.

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.

A comparative study of the oral hygiene status of smokers and non-smokers in Ibadan, Oyo state.

AIMS: The aim of this study was to assess the effect of tobacco smoking on gingival health and the oral hygiene status of respondents. MATERIALS AND METHODS: A cross-sectional survey of 213 adults from three communities in the Ibadan North local government was carried out. Respondents were divided into two groups comprising of 117 smokers (cases) and 96 non-smokers (control). Intra oral examination was done using the Simplified Oral Hygiene Index (OHI-S) and Gingival index (GI). RESULTS: The mean age of the smokers was 31.2 ± 12.6 years and that of the non-smokers 32.8 ± 9.5 years. The mean Simplified Oral Hygiene Index (OHI-S) was 1.15 ± 0.51 for the non-smokers and 2.19 ± 0.62 for the smokers (P < 0.05). The mean GI was 1.06 ± 0.55 for the non-smokers and 1.62 ± 0.58 for the smokers (P < 0.05). CONCLUSION: The study shows that smoking is associated with increased severity of gingival disease. It is, therefore, recommended that smokers should be encouraged to visit a dentist for preventive procedure more regularly than the non-smokers and better still, smokers should be encouraged to quit smoking as gingival disease is not without consequences if allowed to persist.

Undiagnosed diabetes mellitus: a survey of dental outpatients in a tertiary hospital.

BACKGROUND: Most dentists depend on the history given by the patients when assessing their medical status. However, quite a number of these patients may be unaware of their medical condition, which may be significant in the planning of their dental treatment. OBJECTIVES: To determine the prevalence of undiagnosed diabetes mellitus and the factors associated with hyperglycaemia among patients presenting at a tertiary Dental Clinic in Nigeria. METHODOLOGY: Their blood samples were assessed for glucose by means of a glucometer (Accu-Chek Active, Roche diagnostic). Random blood glucose (RBS) equal to or greater than 200mg/dl was considered diabetic. Statistical significance was set at p < 0.05. RESULTS: Nine (4.4%) of the 203 patients seen were diabetic with a male to females ratio of 1:2. Gender, socioeconomic status, body mass index, family history of diabetes was not significantly associated with abnormal blood glucose. However, there was a statistically significant difference in the mean ages of patients with normal blood glucose (39.2 + 12.4) and diabetes mellitus (55.5 + 16.9) (p = .000). About 51.2% (104) of the subjects have never checked their blood sugar. CONCLUSION: This study showed that patients' account of their systemic status is not always reliable. Thus, it will be of immense benefit if dentist seeks symptom/sign that may aid in identifying those at risk or those that are already diabetic. Furthermore, routine screening for diabetes mellitus amongst patients aged 45 years and above may reduce the morbidity and mortality associated with the disease.

Dental health service utilisation by resident doctors/medical officers in the University College Hospital, Ibadan, Oyo State, Nigeria.

BACKGROUND: Dental disease is still a serious health problem universally possibly because dental health awareness and dental service utilization is still very low. The reported prevalence of dental diseases, especially periodontal disease, is higher among the black race while their rate of dental service utilization is lower in comparison to Caucasians. AIM: The aim of this study was to assess the rate of dental service utilization and identify the factors influencing such utilization by medical doctors and dentists in the University College Hospital, Ibadan. METHODOLOGY: Two hundred 26-item questionnaires were distributed among the resident doctors/medical officers in the University College Hospital, Ibadan, Oyo state. The questionnaire sought to know if there is any previous dental visits, the reason for such visits and any other follow-up visits afterward. One hundred and ninety of the doctors returned the filled questionnaires giving a response rate of 95%. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 14.0. Level of statistical significance was set at p < 0.05. RESULTS: Majority of the respondents (65.3%) had a previous dental visit but only 25.3% was within the last one year of the study. Among those that had visited a dentist before, 59.7% did so for the symptomatic treatment of one ailment or the other and only 13.7% of them went back for the follow-up appointment after the resolution of their symptoms. There was a statistically significant difference between the rate of dental service utilization and the gender of the respondents (p < 0.001). There was no statistical significant relationship between the rate of dental service utilization and age of the respondents. CONCLUSION: The study showed that the rate of dental service utilization is low when compared with that of developed countries. Some factors identified as contributing to the lack of dental service utilization among the participants include prolonged and repeated dental appointments and the demand of their work.