Hematological parameters, obesity, stress and oxidant - antioxidant indicators in patients with or without recurrent aphthous stomatitis: A case control study.

INTRODUCTION: Recurrent Aphthous Stomatitis (RAS) is a frequent chronic disease of the oral cavity that affects 5-25 % of the population with a plethora of predisposing factors. Despite its equivocal etiology, immune alterations, hematologic deficiencies and oxidative stress has been reported to be significant etiologic factors. Stress and obesity are other environmental factors that have been studied to understand associations with RAS. OBJECTIVES: This study investigated the association of stress, hematologic parameters, oxidative indices and other selected salivary factors in a case control study on RAS Methods: Twenty-two participants each in both case and control groups were recruited with saliva and serum samples collected from them after a self-administered Recent Life Changing Questionnaire (RLCQ). OHI-S and salivary flow rate (SFR) were calculated with selected hematologic parameters and oxidative indices such as Total oxidant (TOS) and anti-oxidant (TAS) levels and their ratio - Oxidative Stress Index (OSI). Anti-oxidative indices of Ferric-Reducing Antioxidant Power (FRAP) and Glutathione Peroxidase Activity (GsPHx) were also estimated. RESULTS: The RAS group had a significantly higher RLCQ scores at a median of 145 more than the control (57.5). There was no significant in their obesity indices, however there was a significant higher mean in the ESR (p< 0.0001) and Vit B12 (p = 0.0001); OHI-S was also significantly higher in the RAS group with a median of 1.65. Both the salivary and serum TOS were significantly higher in the RAS (10.0 ± 3.8, 15.4 ± 8.9) compared to the control group (7.92 ± 1.49, 9.56 ± 3.5). GsPHx activity was significantly higher in both the saliva and serum in the control group (0.08 ± 0.08, 0.19 ± 0.11) while nil significant difference was found in the FRAP activity. Regression showed most important variables to be the salivary GsPHx activity, followed by serum OSI and GsPHx activity. CONCLUSION: The oxidative indices of TOS, TAS and GsPHx can serve as significant biomarkers in detecting RAS. This further corroborates the role of immune dysregulation in the etiology and predisposition to RAS.

Relationship between CD4+ count, serum inflammatory cytokines, and oral melanotic hyperpigmentation in newly diagnosed HIV-seropositive patients: a nested case-control study.

OBJECTIVE: Oral melanotic hyperpigmentation (OMH) in patients with human immunodeficiency virus (HIV) infection has been attributed to the use of antifungal or antiretroviral drugs, as well as HIV-induced cytokine dysregulation. This research aimed to determine the relationship between immunosuppression and cytokine dysregulation in newly diagnosed HIV-seropositive subjects with OMH. STUDY DESIGN: The study was conducted among newly diagnosed HIV-seropositive patients at the Infectious Disease Clinic, Ibadan, Nigeria. The cases were patients with OMH matched for age and sex with control subjects without OMH. CD4+ count and cytokine levels (interleukin-6 and tumor necrosis factor-α) were compared between the cases and control subjects. SPSS version 21 software was used for data analysis. RESULTS: Seventy newly diagnosed HIV-seropositive patients were studied, which comprised of 35 cases and 35 control subjects. The median CD4+ counts for cases and control subjects were 174 cells/mm3 (interquartile range [IQR], 57-250) and 324 cells/mm3 (IQR, 107-424), respectively. Severe immunosuppression (CD4+ count, ≤200 cells/mm3) was found in over half of the study participants, being more prevalent among the cases than among the control group (P = .019). Serum cytokine levels did not significantly vary between the cases and control subjects. CONCLUSIONS: There was a significant association between HIV-OMH and severe immunosuppression in the newly diagnosed HIV-seropositive patients.

Salivary inflammatory biomarkers and glycated haemoglobin among patients with type 2 diabetic mellitus.

BACKGROUND: Type 2 diabetes mellitus has reached epidemic proportions worldwide and improved detection techniques and biomarkers are urgently needed across the spectrum of diabetes initiation and progression. Inflammatory biomarkers play a role in the development of the condition and blood is the gold standard body fluid for the diagnosis of diabetes mellitus. Serum glycated haemoglobin is a widely used marker of chronic hyperglycemia, and it is currently used to diagnose type 2 diabetes mellitus and it is the standard biomarker for the adequacy of management. However, saliva offers an alternative to serum as a biological fluid for diagnostic purposes. Non-invasive measures of inflammatory biomarkers (such as saliva diagnostics) are increasingly being investigated due to significant similarities between salivary and serum proteome. The role of saliva diagnostics in diabetes mellitus has not been explored in our study population. OBJECTIVES: This study investigated the association of selected salivary inflammatory biomarkers (Interleukin 6 [IL-6], C-reactive protein [CRP], and Tumour necrosis factor α [TNF-α]) to glycated haemoglobin (HbA1C) in type 2 diabetics. MATERIALS AND METHODS: Seventy-five participants, 39 type 2 diabetics (52%) and 36 (48%) healthy controls were recruited. Saliva and blood samples were collected for each participant. The levels of selected salivary inflammatory biomarkers (IL-6, CRP and TNF-α) were estimated by Enzyme Linked Immunosorbent Assay (ELISA) method and glycated haemogloin (HbA1C) was estimated using the liquid chromatography method. Periodontal status of the participants were determined using the Basic Periodontal Examination (BPE). RESULTS: The mean salivary levels of CRP was significantly higher in diabetics, 0.05 ± 0.04 µg/ml than in controls, 0.02 ± 0.02 µg/ml (p < 0.001). Mean TNF-α was also significantly higher in diabetics, 5.39 ± 12.10 pg/ml than in controls, 1.51 ± 3.66 pg/ml (p = 0.036). Mean salivary IL-6 was also higher in diabetics compared with controls (47.20 ± 18.49 versus 41.94 ± 16.88 pg/ml), but the difference was not statistically significant, p = 0.204. In the multivariate analysis adjusting for age and periodontal status, only the mean salivary CRP was significantly higher in diabetics, 0.034 higher than controls (95% CI 0.009, 0.059 and p = 0.01). There was a positive correlation between salivary CRP and HbA1C levels, which was moderate with r-value 0.4929 and p-value < 0.0001. CONCLUSIONS: Salivary inflammatory biomarkers especially CRP are higher in diabetics compared with controls and CRP is positively correlated with serum HbA1C levels. The biomarkers show potentials as non-invasive alternative method to evaluate glycaemic control in diabetes.

Awareness of COVID-19 and the Dental Implications of its Oral Manifestations among Dental Health Practitioners in Nigeria.

Background: There are many aspects of COVID-19 that are related to dental practice. Hence, this study aimed to assess the level of awareness of COVID-19 concerning its symptoms, transmission and prevention and the dental implications of its oral manifestations among dentists in Nigeria. Methodology: This is a cross-sectional study that sampled dentists who work in Nigeria regardless of their place of work with an online questionnaire using Google forms to collect the data. The questionnaire was anonymous to maintain the privacy and confidentiality of all information collected in the study. The survey was a structured questionnaire divided into three sections: Dentists' demographics, knowledge of the disease and dental implications of COVID-19. Results: This study included 206 dentists practising in Nigeria, with 126 (61.2%) males and 80 (38.8%) females. A total of 191 (92.7%) dentists perceived COVID-19 as highly contagious and deadly. Almost all the participants (n=205, 99.5%) were knowledgeable about the mode of transmission of the disease through respiratory droplets. A total of 204 (99.0%) affirmed that dental practitioners were at risk of becoming infected with COVID-19. About 84.5% reported that salivary glands can serve as a potential reservoir for COVID-19. Conclusion: The awareness of COVID-19 concerning the mode of transmission, symptoms and prevention among the dental professionals was encouraging. This would lead to enhanced infection control in dental settings. The majority of the participants reported that saliva can be used as a promising non-invasive specimen for diagnosis, monitoring and infection control in patients with COVID-19.

Histologic assessment of extraction sockets following tooth extraction: suitability of a rabbit model

This study was aimed at determining the suitability of rabbits for assessment of alveolar bone healing following tooth extraction. Methods: Six (6) adult female New Zealand rabbits were used for this study. They were acclimatized under stand ard laboratory conditions for two weeks before the commencement of the study. Tooth extraction wascarried out in all the rabbits and this was followed by histologic assessment of alveolar bone healing and osteocyte count at week 2 and week 4 post extraction. Results: All the rabbits tolerated the extraction procedure and no complication was recorded. Histo-architecture of alveolar bone was characterized by marked osteoblastic activity at week 2 post extraction and increased osteocyte presence at week 4 post extraction. Average value of osteocyte count (cells/µm2) was 20 ± 4.58 at week 2 post extraction and 32.33 ± 2.08 at week 4 post extraction. Conclusion: The result obtained from this study shows that the rabbit could well serve as an experimental anima l for assessment of alveolar bone healing following tooth extraction

Comparative Analgesic Effects of Ibuprofen, Celecoxib and Tramadol after third Molar Surgery: A Randomized Double Blind Controlled Trial.

BACKGROUND: This study compared the effects of ibuprofen, celecoxib and tramadol on pain after surgical extraction of impacted mandibular third molars. PATIENTS AND METHODS: This double blind randomized controlled trial recruited 135 healthy subjects who required surgical extraction of impacted mandibular third molars, with a mean age of 26.51 ± SD 6.29 years. The subjects were randomized into three equal groups and given appropriate doses of each drug immediately after extraction. They continued the drugs up to 48 hours after extraction. Postoperative pain intensity was self-recorded by subjects at 4, 8, 16, 24 and 48 hours after extraction, using visual analogue scale (VAS). Data analysis involved descriptive statistics, 2-sample Wilcoxon Mann-Whitney U test and Kruskal Wallis rank test. Statistical analysis was done using intention-to-treat analysis. The mean VAS at each point of postoperative pain assessment was compared using one way analysis of variance (ANOVA) among the three groups. Statistical significance was inferred at p < 0.05. RESULTS: The mean VAS score of the celecoxib group (32.35± SD 23.96) at 4 hours was the lowest among the three groups. This was followed by the ibuprofen group with mean VAS score of 38.96 ± SD 22.30. Whereas, the subjects in tramadol group experienced the highest VAS score (53.31 ± SD 23.30) at 4 hours. There was statistically significant difference in the mean VAS scores at 4 hours after extraction when the three groups were compared (p = 0.0039). Celecoxib group also had the lowest mean VAS scores at 8 hours, 24 hours and 48 hours after the extraction. None of the subjects in the ibuprofen and celecoxib groups reported any adverse effect of the analgesics, whereas 47.61% of the tramadol group did. CONCLUSION: Celecoxib was the most effective analgesic of the three studied drugs in controlling postoperative pain after mandibular third molar extraction in our subjects. It was closely followed by ibuprofen while tramadol was found to be the least effective. CLINICAL SIGNIFICANCE: The outcomes of this study suggest that celecoxib can be prescribed for effective control of postoperative pain after third molar surgery especially in patients with peptic ulcer disease who will not tolerate the adverse effect of traditional nonsteroidal anti-inflammatory drugs. It also shows that ibuprofen can be an analgesic of choice for patients who are not at risk of gastrointestinal complications of nonsteroidal anti-inflammatory drugs (NSAIDs). Tramadol could be considered for patients with milder postoperative pain after third molar surgery.

Pattern of presentation and outcome of routine dental interventions in patients with halitosis.

AIMS: The aims of this study were to describe the pattern of presentation of halitosis and to evaluate the success rate following routine dental intervention irrespective of the type of halitosis. PATIENTS AND METHODS: This cross-sectional study was conducted among sixty consecutive patients who presented in our Oral Diagnosis and Oral Medicine Clinic, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, on account of halitosis from May 2015 to April 2016. Diagnosis of halitosis was made using the organoleptic method from a whole mouth breath test as described by Miyazaki et al., 1999. Halitosis was assessed before treatment, 2 and 6 weeks after treatment. The results were analysed with STATA statistical software version 11. RESULTS: Sixty out of 305 patients seen in the clinics during the study period had halitosis, with a prevalence of 19.5%. Fourteen (23%) patients had pseudohalitosis while 46 (77%) had genuine halitosis; no case of halitophobia was seen. Majority (71.6%) brush their teeth once daily. The predominant extra-oral etiologic factors were respiratory 2 (3.3%) and ear, nose and throat disorders 1 (1.6%). Twenty-nine (63%) patients with genuine halitosis who had organoleptic scores of ≥4 had no perceivable odour, following routine dental interventions (P < 0.001); the remaining 17 (37%) patients only had slight malodour. Similarly, all the 14 (100%) patients with pseudohalitosis had complete remission after the treatment. CONCLUSIONS: The prevalence of halitosis was 19.5%, with male predilection. Routine dental interventions achieved >90% success rate. Preventive oral care is recommended for all halitosis patients.

Oral health related quality of life (OHRQoL) following third molar surgery in Sub-Saharan Africans: an observational study.

INTRODUCTION: Surgical extraction of the impacted third molar is one of the commonest minor oral surgical procedures carried out in oral surgery. Problems created by the disturbances in post-extraction wound healing and physiologic sequelae of third molar surgery can significantly affect the patient's quality of life. METHODS: The study population consisted of 135 subjects that required surgical extraction of mandibular third molar under local anesthesia and met the inclusion criteria. Patients were assessed pre-operatively and post-operatively on days 1,3,5,7, and 14 using the United Kingdom Oral Health related Quality of Life questionnaire (UK-OHRQoL). RESULTS: This study also showed that surgical removal of impacted teeth exerted a negative influence on patient's Quality of life (QoL) across various physical, social, psychological aspects of life. UK-OHRQoL-16 mean scores showed that severe difficulty in eating was experienced by 106 (78%) patients on postoperative day (POD) 1. The symptom however improved within the first week with only 16 (11.9%) experiencing this symptom by POD 7 and none by POD 14. CONCLUSION: There was a deterioration in oral health related quality of life in the immediate postoperative period particularly POD 1 and 3 following third molar surgery, which slowly returned to preoperative level by 7th day. Routines such as eating, laughing and smiling, work and speech were also affected. Patients need to be informed of these symptoms after third molar removal so as to enable them prepare very well for the procedure and its sequelae.

Salivary Flow Rates of Nigerian Patients with Chronic Kidney Disease: A Case-control Study.

AIMS AND OBJECTIVES: The study determined the relationship between chronic kidney disease (CKD) and changes in salivary flow and the complications of reduced salivary flow among African subjects with CKD compared with the controls. MATERIALS AND METHODS: One hundred and eighty patients, 90 C KD and 90 controls were recruited, interviewed and examined. Stimulated and unstimulated saliva collection was done with standardized spitting method. Urinalysis and blood creatinine levels were determined and glomerular filtration rate (GFR) of each patient was calculated from the blood creatinine using Cockcroft and Gault formula. Statistical analysis was done using STATA 11 software. RESULTS: The mean stimulated and unstimulated whole salivary flow rate among CKD subjects were 4.07 ± 1.91 and 2.34 ± 0.99 ml/5 min respectively and is significantly lower than that of the controls which were 8.05 ± 3.95 ml/5 min and 3.82 ± 2.27 ml/5 min for stimulated and unstimulated flow rates. Oral signs of reduced salivary flow were found in 80% of CKD patients. The commonest oral finding was taste abnormalities others are burning sensation, halitosis and difficulty in mastication. CONCLUSION: Patients with CKD had reduced stimulated and unstimulated salivary flow rate. Reduced salivary flow was associated with oral lesions in majority (80%) of CKD patients, the commonest finding being taste abnormalities.

Oral findings in chronic kidney disease: implications for management in developing countries.

BACKGROUND: The importance of oral health care in the management of patients with systemic diseases including chronic kidney disease (CKD) has been affirmed. Many CKD patients have related oral lesions, however, attention to oral health care has been lacking, especially in the developing countries with higher burden of renal diseases. METHODS: One hundred and eighty patients, 90 cases and 90 controls were recruited, interviewed and examined. Oral mucosa assessment was based on the WHO Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases. Urinalysis and blood creatinine levels were determined. Glomerular filtration rate (GFR) of each patient was calculated from the blood creatinine using Cockcroft and Gault formula. RESULTS: Oral lesions were present in 86 out of 90 (96.5%) CKD patients compared with 15 out of 90 (16.7%) controls (p < 0.001). Abnormal lip hyperpigmentation was the most frequently seen lesion in 81 out of 90 (90%) CKD patients. Other significant findings were gum bleeding, xerostomia, candidiasis, burning mouth and abnormal taste. In the controls (without CKD), the mean GFR was lower in subjects with oral lesions compared with those without oral lesions p < 0.001. CONCLUSIONS: CKD and reduced GFR in subjects without CKD are risk factors for oral lesions. The higher prevalence of oral lesions in CKD patients necessitates mandatory oral screening to identify patients with deteriorating renal function. The management of such lesions will enhance the overall well-being of CKD patients in developing countries.

Reconstruction of mandibular defects using nonvascularized autogenous bone graft in nigerians.

OBJECTIVES: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile-Ife, Nigeria. PATIENTS AND METHODS: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife constituted the study sample. Relevant information was retrieved from the patients' records. This information include patients' demographics (age and sex) as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. RESULT: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD) 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%). Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients) and postoperative wound infection (eight patients) were the most common complications recorded. CONCLUSION: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care contributed to the good outcome.

Virulence of oral Candida isolated from HIV-positive women with oral candidiasis and asymptomatic carriers.

OBJECTIVE: This study compared the virulence of oral Candida species isolated from human immunodeficiency virus (HIV)-positive women with and without oral candidiasis. STUDY DESIGN: Candida species were isolated from 197 women, and their virulence attributes were measured. RESULTS: Of the 197 women, 117 (59.4%) carried Candida. Of these, 15 (12.8%) had symptoms of oral candidiasis. Among highly active antiretroviral therapy (HAART)-naive patients, 33% were diagnosed with oral candidiasis, whereas 5.9% were asymptomatic carriers (P < .01). C. albicans was the predominant species, with higher virulence attributes than non-albicans Candida. Women diagnosed with oral candidiasis had higher levels of Candida (P = .02) than asymptomatic carriers. There was no difference in the CD4 counts and the virulence attributes of Candida from both the groups. CONCLUSIONS: This study indicates that oral candidiasis is mainly caused by high counts of C. albicans and suggests the importance of therapies targeting Candida counts in the oral cavity even in patients on HAART to reduce the development of infections.

Inhibitory Effect of Dodonaea viscosa var. angustifolia on the Virulence Properties of the Oral Pathogens Streptococcus mutans and Porphyromonas gingivalis.

Aim. This study investigated the effect of Dodonaea viscosa var. angustifolia (DVA) on the virulence properties of cariogenic Streptococcus mutans and Porphyromonas gingivalis implicated in periodontal diseases. Methods. S. mutans was cultured in tryptone broth containing a crude leaf extract of DVA for 16 hours, and the pH was measured after 10, 12, 14, and 16 h. Biofilms of S. mutans were grown on glass slides for 48 hours and exposed to plant extract for 30 minutes; the adherent cells were reincubated and the pH was measured at various time intervals. Minimum bactericidal concentration of the extracts against the four periodontal pathogens was determined. The effect of the subinhibitory concentration of plant extract on the production of proteinases by P. gingivalis was also evaluated. Results. DVA had no effect on acid production by S. mutans biofilms; however, it significantly inhibited acid production in planktonic cells. Periodontal pathogens were completely eliminated at low concentrations ranging from 0.09 to 0.02 mg/mL of crude plant extracts. At subinhibitory concentrations, DVA significantly reduced Arg-gingipain (24%) and Lys-gingipain (53%) production by P. gingivalis (P ≤ 0.01). Conclusions. These results suggest that DVA has the potential to be used to control oral infections including dental caries and periodontal diseases.

Oral Candida colonization in HIV-positive women: associated factors and changes following antiretroviral therapy.

There is a paucity of information about the factors associated with oral colonization with Candida species and the changes associated with antiretroviral (ARV) therapy. This study investigated the role of ARV therapy and other factors in a study population. Relevant clinical and laboratory information was obtained and oral rinse specimens were tested for yeast identification. The findings were compared with previous data from the same clinic before ARV therapy was available. Of 197 patients, 117 (59.4 %) were colonized. Candida albicans was the dominant species (71 %) and Candida dubliniensis was the most frequent non-albicans Candida. The colonized group had a higher rate of concurrent tuberculosis (TB) infection (77.4 % compared with 56 % in the non-colonized patients, P = 0.03) and a lower median CD4(+) count (346.5 cells mm(-3)) compared with the non-colonized group (418 cells mm(-3)). Participants not on ARV therapy and those having oral prosthesis were all colonized (P = 0.003 and P = 0.022, respectively). The oral Candida count was negatively correlated with the CD4(+) count in participants on ARV therapy (P = 0.006). Associated factors using logistic regression were dental caries (odds ratio = 1.30; 95 % confidence interval = 1.07-1.60] and diabetes mellitus (odds ratio = 5.52; 95 % confidence interval = 1.68-18.12). The colonization rate was higher (81.3 %) as well as the yeast count before ARV therapy was available, while the prevalence of C. dubliniensis was found to have increased from 6.3 to 11 %. Dental caries, diabetes mellitus, oral prostheses and TB infection were associated with oral colonization. The colonization rate, variety and yeast counts declined with ARV therapy.

Alveolar Osteitis: Patients' compliance to post-extraction instructions following extraction of molar teeth.

BACKGROUND: To evaluate the effect of various combination of post-extraction regimen administered to patients who had intra-alveolar molar tooth extraction. PATIENTS AND METHODS: One year prospective study involving 76 consenting patients who came for 1-week post-extraction review. The patients were placed on warm saline mouth rinse with (verbal instruction) or without antibiotic and or analgesic therapy (written prescription), after intra-alveolar molar tooth extraction. Information was obtained from the patients through questionnaire and clinical examination. RESULTS: The patients were placed on warm saline mouth rinse (n = 29, 38.2%) only, warm saline rinse, antibiotics (Amoxicillin and metronidazole) and Paracetamol (n = 31, 40.8%), Paracetamol and warm saline rinse (n = 12, 15.8%) and antibiotics (Amoxicillin and metronidazole) and Paracetamol (n = 4, 5.3%). A total of 63 (82.9%) patients complied with the post-extraction regimen, giving a significant high compliance to the post-extraction instructions (P = 0.001). There were 10 (13.2%) cases of post-extraction localised alveolar osteitis, with predilection for the lower molar teeth (n = 6, 7.9%) and a significant predilection for females (n = 8, 10.5%) [P = 0.005]. Overall, there were five (6.6%) cases each of localised alveolar osteitis in the compliant patients (n = 63, 82.9%) and non-compliant patients (n = 13, 17.1%), giving a ratio of 1:13 and 1:3, respectively. There was significant association of compliance with post-extraction instruction and the reduced incidence of localized alveolar osteitis (P = 0.015). CONCLUSION: This study showed a significant patients' compliance with post-extraction warm saline rinse, prophylactic antibiotics and analgesic and a corresponding significant reduction in the incidence of localised alveolar osteitis following intra-alveolar molar tooth extraction. This study emphasises the need to properly educate patients on the effect of compliance to various combination of post-extraction regimen.

Impact of infant feeding practices on caries experience of preschool children.

AIM: This study investigated the association between breastfeeding, bottle feeding, night feeding, age, and sex of the child on the caries experience. METHOD: Information was collected from the mothers of preschool children. Information included the age of the child, sex of the child, form of breastfeeding (whether exclusive, almost exclusive or mixed), duration of breastfeeding, night feeding habits of the child, and duration and content of bottle feeding. Intraoral examination was done to assess the dmft. The impact of the variables on the caries experience (rampant caries, no caries and the dmft) was then assessed. RESULTS: The duration of breast feeding (p = 0.002), and form of breast feeding (p = 0.03) were significant predictors of the dmft. The dmft was highest in children who were breastfed for longer than 18 months and highest for children who were exclusively breastfed. There is a strong association between rampant caries and duration of breast feeding only (p < 0.001). The risk of having rampant caries increases by 10% (p = 0.012) with every month increase in the duration of breastfeeding. CONCLUSION: The duration of breastfeeding increased the risk for rampant caries in preschool children in Nigeria. The longer the duration, the higher the risk for caries.

Teething problems and parental beliefs in Nigeria.

AIM: To determine signs and symptoms associated with teething, parental beliefs about teething, and the effects of socioeconomic status on teething in Nigerian children. METHODS AND MATERIALS: A cross-sectional study consisting of 1,013 mothers of children between the ages four to 36 months who visited the immunization clinics at the Community Health Centres in Ife Central and Ife East Local Government Areas. Data was analyzed using STATA (Intercooled release 9) for Windows. RESULTS: A total of 765 mothers (75.5%) reported systemic signs and symptoms in their children. Fever (51.8%), diarrhea (12.5%), and vomiting (2.9%) were the most prevalent symptoms and signs reported. Teething problems were reported by 60% of mothers from a high socioeconomic class, as well as 76.7% and 77.9% from middle and low socioeconomic classes, respectively. Interestingly, 65.5% of mothers believed teething should be accompanied with systemic signs and symptoms such as fever (42.1%), diarrhea (13.9%), and vomiting (0.6%). No significant difference was noted between breastfeeding status, gender of the child, and reported systemic signs and symptoms noticed by the mothers. CONCLUSION: Most mothers in the study reported signs and symptoms adduced to teething in their children irrespective of their beliefs. Fever ranked highest of the signs and symptoms reported. Mothers of children from the high socioeconomic class reported fewer teething symptoms. Breastfeeding status and gender of the child had no effect on teething problems in the children studied. CLINICAL SIGNIFICANCE: Most signs and symptoms adduced to teething by parents may actually be due to underlying infections. Thus, there is a need to rule out occult infection during the tooth eruption period.

Relationship between socio-demographic and anthropometric variables and number of erupted primary teeth in suburban Nigerian children.

The socio-demographic and anthropometric variables could influence the number of teeth present in the child's mouth. To determine the effect of anthropometric and socio-demographic variables on the number of erupted primary teeth, a cross-sectional study was performed involving 1013 children aged between 4 and 36 months who attended the immunization clinics in Ile-Ife, Nigeria. Statistical analyses were performed using STATA. The analyses included frequencies, cross-tabulations, chi squared test and t-test. The number of erupted teeth was modelled as the dependent variable in a multiple regression (Binomial) model, and the socio-demographic (age, gender and socio-economic status) and anthropometric variables, such as weight and height at presentation, as predictor variables. Statistical significance was inferred at P < 0.05. The age and height at presentation had significant association with the number of erupted teeth in this study population (P < 0.001). Also children from high socio-economic class in relation to low socio-economic class had significant larger number of erupted teeth in this study population (P < 0.001). The age and height of the child at presentation were significantly related to the number of erupted teeth. Also children from high socio-economic class had significant lager number of erupted teeth compared with children from low socio-economic class.

Clinicopathology of soft tissue lesions associated with extracted teeth.

PURPOSE: The study assessed the prevalence and the clinical and histologic pattern of soft tissue lesions associated with extracted teeth and determined the validity of clinical diagnoses in comparison with histologic diagnosis. PATIENTS AND METHODS: Soft tissue from the apices of 100 teeth extracted by the intra-alveolar approach and from the follicle of 50 teeth extracted by the transalveolar approach was examined histologically subsequent to clinical diagnosis. The subjects were seen within a 2-year period at the Oral Surgery unit of a Nigerian teaching hospital. Association between age, gender, and the histopathologic diagnosis was assessed, and the clinical presumptive diagnoses were compared with the histopathologic diagnoses using the epidemiologic parameters of sensitivity, specificity, and positive and negative predictive values. RESULTS: There were 76 (50.7%) males and 74 (49.3%) females, with age range of 17 to 77 years (33 +/- 14 years). Although clinical diagnosis indicated that all the cases were inflammatory in origin, histopathologic diagnosis reported 84% to be of inflammatory origin, 10% to be normal tissue, and 6% to be noninflammatory in nature. The noninflammatory lesions included dentigerous cyst (4%), central giant cell granuloma (1.3%), and ameloblastoma (0.7%). Gender and age were not associated statistically with type and frequency of pathology. Inflammatory conditions showed the highest sensitivity (98%). CONCLUSIONS: The study showed that the probability of clinical misdiagnosis of pathologically significant lesions associated with extracted teeth is lowest with inflammation and highest with cysts and neoplasms. Thus, routine histopathologic examination of all recoverable soft tissues associated with extracted teeth would contribute to improve management of cases although the cost and related implications of this need to be investigated further.