Co-morbidities associated with molar-incisor hypomineralisation in 8 to 16 year old pupils in Ile-Ife, Nigeria.

BACKGROUND: This study aimed to identify the prevalence of oral co-morbidities in 8 to 16 years old children with Molar Incisor Hypomineralisation (MIH) and compare this with the prevalence of same oral lesions in children without MIH. METHOD: Study participants were selected through a multi-staged sampling technique. The children were asked if they had dentine hypersensitivity or any concerns about their aesthetics. Children were examined for MIH, caries, traumatic dental injury and their oral hygiene status. The association between MIH and each of the independent variables was determined. RESULTS: Only children with MIH had aesthetic related concerns and dentine hypersensitivity. The differences in the oral hygiene status (p < 0.001) and caries prevalence (p < 0.001) of children with and without MIH were statistically significant. The prevalence of traumatic dental injury did not differ statistically between children with MIH and those without MIH (p = 0.24). CONCLUSION: Children with MIH had more oral pathologies than children without MIH. These co-morbidities (dentine hypersensitivity, aesthetic concerns, caries and oral hygiene) are capable of impacting negatively on the quality of life of the children. Screening for children with MIH may help facilitate prompt access to treatment.

Evaluation of radiographs, clinical signs and symptoms associated with pulp canal obliteration: an aid to treatment decision.

Pulp canal obliteration (PCO) is a sequela of tooth trauma. The dental clinician faced with this condition has to make a difficult decision. The aim of this study was to evaluate the clinical signs and symptoms associated with teeth with PCO and to assess the status of the periapical tissues using the periapical index (PAI) as an aid in making a treatment decision. The study included teeth diagnosed with PCO in patients with a history of traumatic injury to the involved teeth. Histories of associated signs and symptoms including pain, swelling and drainage from a sinus tract were elicited. Tooth color, sensibility to electric pulp testing, mobility and percussion tenderness were recorded. The periapical status was assessed using the PAI. Two hundred and seventy-six teeth were diagnosed with PCO. One hundred and fifty-seven (56.9%) and 119 (43.1%) demonstrated partial or total PCO, respectively. Yellow discoloration presented most frequently, occurring in 186 (67.4%) teeth. Sixty-two (33.3%) of these had developed periapical lesions and reacted negatively to sensibility testing. Fifty-seven (30.7%) of these teeth presented radiographically with a normal periapical appearance and reacted normally to sensibility testing, whereas 67 (36.0%) presented with small changes in the periapical bone pattern and reacted in the high normal range to sensibility testing. Teeth with PAI scores < or =2 presented with occasional spontaneous pain. Teeth with PAI scores > or =3 presented with clinical symptoms and signs ranging from pain on percussion to spontaneous pain, and slight swelling to sinus tract drainage. Based on the findings of this study, endodontic treatment should be initiated in teeth with tenderness to percussion, PAI scores > or =3 and a negative response to sensibility testing.

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.

Prevalence and causes of fractured permanent incisors in 12-year-old suburban Nigerian schoolchildren.

The aim of the study was to assess the prevalence and causes of traumatic dental injuries to the permanent dentition of 12-year-old school children in Ile-Ife, a suburban population in the south west of Nigeria. A dental trauma cross-sectional survey was carried out through clinical examination of upper and lower permanent incisors and interviews with 415 (212 boys, 203 girls) 12-year-old children attending private and public secondary schools in Ile-Ife, in 2004/2005 by one calibrated examiner. Garcia-Godoy's classification was used. The prevalence of traumatic dental injuries was 12.8%. There was no statistical difference in the prevalence between boys and girls P > 0.05. The most common cause of injuries was falls (49.1%), followed by traffic accidents (13.2%), collision against objects or people (11.3%) and misuse of teeth 9.4%. The commonest type of injury was enamel fracture alone (9.9%), followed by enamel-dentine fracture (4.8%). Majority of the accidents occurred at home (60.4%), followed by school (26.4%). The prevalence of traumatic dental injuries was on the increase among suburban Nigerian children in Ile-Ife and it has a potential to be considered an emerging public health problem.

Pulpal sequelae after trauma to anterior teeth among adult Nigerian dental patients.

BACKGROUND: Epidemiological studies show that about 11.6% to 33.0% of all boys and about 3.6% to 19.3% of all girls suffer dental trauma of varying severity before the age of 12 years. Moderate injuries to the periodontium such as concussion and subluxation are usually associated with relatively minor symptoms and hence may go unnoticed by the patient or the dentist, if consulted. Patients with these kinds of injuries present years after a traumatic accident most of the time with a single discoloured tooth. This study sets out to document the incidence of various posttraumatic sequelae of discoloured anterior teeth among adult Nigerian dental patients. METHODS: One hundred and sixty eight (168) traumatized discoloured anterior teeth in 165 patients were studied. Teeth with root canal treatment were excluded from the study. Partial obliteration was recorded when the pulp chamber or root canal was not discernible or reduced in size on radiographs, total obliteration was recorded when pulp chamber and root canal were not discernible. A retrospective diagnosis of concussion was made from patient's history of trauma to the tooth without abnormal loosening, while subluxation was made from patient's history of trauma to the tooth with abnormal loosening. RESULTS: Of the 168 traumatized discoloured anterior teeth, 47.6% and 31.6% had partial and total obliteration of the pulp canal spaces respectively, 20.8% had pulpal necrosis. Concussion and subluxation injuries resulted more in obliteration of the pulp canal space, while fracture of the teeth resulted in more pulpal necrosis (p < 0.001). Injuries sustained during the 1st and 2nd decade of life resulted more in obliteration of the pulp canal space, while injuries sustained in the 3rd decade resulted in more pulpal necrosis. CONCLUSION: Calcific metamorphosis developed more in teeth with concussion and subluxation injuries. Pulpal necrosis occurred more often in traumatized teeth including fractures.