Oral Health Status and Treatment Needs of Individuals Attending a Special Education Center in South South Nigeria.

BACKGROUND: Dental care has been the most commonly reported unmet service need among individuals with special health care needs. OBJECTIVES: To assess the oral health status and treatment needs of individuals with special health care needs in a selected special education centre in South South Nigeria. METHODS: A cross sectional, descriptive study conducted among students of Special Education Centre in Calabar. Sociodemographic data was collected while oral health conditions and treatment needs of the participants were assessed through oral examination. Data entry and analysis was by IBM SPSS version 21 and statistical significance was set at p<0.05. RESULTS: Eighty-one participants were recruited for this study. More than half of the participants were males (56.8%) and had hearing impairments alone (56%). The most common oral condition was dental caries (40.7%) with a mean DMFT/dmft of 0.4 (±1.0). Majority of the participants had fair oral hygiene and the mean OHIS was 2.4(±1.3). Male participants and participants within the 21-30 years age group had poorer oral hygiene than their female counterparts and other age groups respectively. The preventive and restorative treatment needs were 56% and 18.5% respectively. CONCLUSION: Dental caries was the most prevalent oral health condition among this population with high unmet preventive and restorative treatment needs.

CONTEXTE: Les soins dentaires sont le besoin de service non satisfait le plus souvent signalé chez les personnes ayant des besoins spéciaux en matière de santé. OBJECTIFS: Évaluer l'état de santé bucco-dentaire et les besoins de traitement des personnes ayant des besoins spéciaux en matière de soins de santé dans un centre d'éducation spéciale sélectionné dans le sud du Nigeria. MÉTHODES: Étude descriptive transversale menée auprès des étudiants du centre d'éducation spéciale de Calabar. Des données sociodémographiques ont été recueillies tandis que les conditions de santé bucco-dentaire et les besoins de traitement des participants ont été évalués par un examen bucco-dentaire. La saisie et l'analyse des données ont été effectuées par IBM SPSS version 21 et la signification statistique a été fixée à p<0,05. RÉSULTATS: Quatre-vingt-un participants ont été recrutés pour cette étude. Plus de la moitié des participants étaient des hommes (56,8%) et présentaient uniquement des déficiences auditives (56%). L'affection buccale la plus fréquente était la carie dentaire (40,7 %), avec un indice CAOD/CAOD moyen de 0,4 (+1,0). La majorité des participants avaient une hygiène bucco-dentaire correcte et l'OHIS moyen était de 2,4 (+1,3). Les hommes et les participants de la tranche d'âge 21­30 ans avaient une hygiène bucco-dentaire moins bonne que leurs homologues féminins et les autres tranches d'âge respectivement. Les besoins en traitements préventifs et restaurateurs étaient respectivement de 56% et 18,5%. CONCLUSION: Les caries dentaires étaient le problème de santé bucco-dentaire le plus répandu dans cette population, avec des besoins élevés en traitements préventifs et restaurateurs non satisfaits. Mots clés: Santé bucco-dentaire, caries dentaires, hygiène buccodentaire, éducation spéciale, besoins en soins spéciaux.

The care of traumatic dental injuries in primary schools in Southern Nigeria.

AIM: To assess the standards of care given to children who sustain traumatic dental injuries (TDI) in Nigerian primary schools. STUDY DESIGN: cross-sectional study. Public and private schools were selected from the Southern geopolitical zones in Nigeria. An interviewer-administered questionnaire was used to obtain information on the presence or absence of a school clinic, trained nurse, records and first aid box from the head teachers. The record of past traumatic dental injury, cause of the injury and treatment measures were also obtained. STATISTICS: the information obtained were analysed using SPSS version 20. RESULTS: There were 90 private and 90 public primary schools; 61 (34.1%) schools had school clinics. Forty-two (23.9%) of the schools had school nurses (7 public and 35 private schools), and 27 (64.3%) of them had been trained to treat dental emergencies. Only 14 (7.8%) of the schools had records of dental injuries, and luxation injuries (31.6%) was the commonest injury. Children who sustained injuries in the school premises were sent home in 59 (38.7%) schools, while 36 (22.5%) and 37 (23.1%) schools were referred to physicians and dentists, respectively. CONCLUSION: Many schools do not have school clinics/sick bays or are poorly equipped to handle dental emergencies. Sending children home or to health centres without first aid could affect the prognosis of dental injuries, since timely intervention is of utmost importance for a successful outcome.

THE PATTERN OF DENTAL CARIES IN CHILDREN IN PORT HARCOURT, NIGERIA.

BACK GROUND: Dental caries is a preventable oral disease in children and its prevention can only be effective when the pattern is known. There is paucity of this information in South - South Nigeria. AIM & OBJECTIVES: To describe the pattern of dental caries in Nigerian children in Port Harcourt, Rivers State, Nigeria. DESIGN OF THE STUDY: A Retrospective study. SETTING: Paediatric Dental clinic, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria. MATERIALS AND METHODS: The dental records of 334 patients that attended the dental clinic in 2013 were reviewed for the following information: socio demography, oral hygiene practices, dietary habits and presence and pattern of dental caries. RESULTS: One hundred and forty two (42.5%) children had dental caries during the study period. They consisted of 65 (45.8%) males and 77 (54.2%) females with a mean age of 9.14 (+ 3.94) years and a range of 1to16years. Majority (78.5%) cleaned their teeth once a day and 83.3% of the children below seven years of age cleaned their teeth by themselves. All the children ingested refined carbohydrates in varying frequencies. The 5 to 9 year age cohort was 43% of those who had dental caries. Most of the carious lesions were located on the occlusal surfaces (61.2%) while the least sites (1.2%) were the lingual surfaces in both dentitions. The carious lesions were more in the posterior teeth of the lower jaw. There were no anterior teeth affected in the permanent dentition. There was an association between the age and the severity of caries (p<0.05). CONCLUSION: The occlusal surface was the commonest occurrence site of the dental caries, therefore the children at risk of developing caries will benefit more from dental sealants placement.

Causes and pattern of tooth extractions in children treated at the University of Port Harcourt Teaching Hospital.

BACKGROUND: Tooth mortality is mainly a reflection of untreated dental caries and periodontal disease and is considered a crude but useful measure for the dental status of a community. Oral health status of the people of Niger Delta particularly that of children, is currently vague. AIM: To investigate the reasons and pattern of tooth extractions among children who presented at the Paediatric dental clinic of University of Port Harcourt Teaching Hospital (UPTH). METHODS: A retrospective study of children aged 16 years and below who attended the paediatric dental clinic of UPTH for treatment from March 2008 to August 2010 was done. The following information was retrieved from hospital records of the patients: age, sex, indications for extraction and the extracted teeth. RESULTS: A total of 462 children aged between 2-16 years were seen out of which 115 (24.9%) patients had extraction. On the whole, 145 teeth were extracted. Dental caries and its sequelae (irreversible pulpitis, dentoalveolar abscess etc) accounted for the highest indication for extraction 71 (61.7%) while periodontal disease accounted for the least (2.6%). The other indications for extractions were trauma, orthodontic reasons and eruption anomalies. Primary teeth 103 (71.0%) were mostly affected with the anterior teeth (33.8%) being the most frequently involved. The molars (73.8%) were the most frequently involved teeth in the permanent dentition. CONCLUSION: Dental caries and its sequelae is the commonest reason for tooth extraction. Efforts must be made to improve the dental health awareness and status of Nigerian children in this region.

Tooth crown dimensions in a selected population of Nigerians with Down Syndrome.

OBJECTIVE: To determine and compare tooth crown dimensions in primary and permanent dentitions of subjects with Down Syndrome (DS) and a selected Nigerian population without DS. MATERIALS AND METHODS: A sample of subjects with DS and a control group were selected from the Down Syndrome Resource Centre and the Dental Clinic of the Lagos University Teaching Hospital, Lagos respectively. Dental stone models were made from maxillary and mandibular alginate impressions of the population samples after obtaining consent from the subjects and their parents/caregivers. Measurement of tooth dimensions (Mesiodistal, Buccolingual and Clinical Crown Heights) was carried out using an electronic digital caliper. The descriptive statistics were obtained and compared for all parameters using SPSS version 17. RESULTS: The mean mesiodistal tooth dimensions were smaller in the permanent dentition of subjects with DS and the difference in dimensions was statistically significant in most tooth types. The mean tooth dimensions in the primary dentition were generally smaller in DS individuals except in the mesiodistal tooth dimensions of maxillary central incisors and canines, mandibular canines and the clinical crown heights of the maxillary central incisors and 2nd molars. CONCLUSION: The tooth dimensions were generally smaller in both primary and permanent dentitions of subjects with DS than in controls without DS.

CHILD AND MATERNAL ORAL HEALTHCARE: AN ASSESSMENT OF THE KNOWLEDGE OF NIGERIAN AND GHANAIAN NURSES.

OBJECTIVE: To ascertain and compare knowledge of child and maternal oral healthcare amongst a group of Nurses and Midwives in Ghana and Nigeria. DESIGN: A cross-sectional survey. SETTING: Health institutions in Cape Coast, Ghana and Port Harcourt, Nigeria. SUBJECTS: One hundred and sixty Nurses and Midwives (80 Ghanaians and 80 Nigerians). RESULTS: They had an age range of 21-65 years and a mean age of 37.8 (SD ± 9.6) years. Majority of the Nurses in both countries indicated that women should brush their teeth with a toothbrush and toothpaste (92.1%), whilst the children should use salt and cotton wool twice daily. Although more of the Ghanaian Nurses (98.8%) considered routine dental visits to be important than the Nigerian population (80%), only 3.8% of the Ghanaian Nurses against 33.8% of the Nigerians indicated there was a connection between oral disease and delivery status. Opinions differed significantly as to the reason for the first dental visit with 65.4% of the Nigerian Nurses indicating this should be when the child has toothache whereas 51.9% of Ghanaian Nurses believed it is when the first tooth erupts. However, four to six years was the common choice for when self brushing should start in both countries. CONCLUSION: The knowledge of this group of Nurses and Midwives on maternal and child oral healthcare was insufficient. The Ghanaian Nurses had a better knowledge of preventive dental care than their Nigerian counterparts.

THE STANDARD OF PLAYGROUNDS AND SAFETY MEASURES IN PREVENTION OF TRAUMATIC DENTAL INJURIES IN NIGERIAN PRIMARY SCHOOLS.

BACKGROUND: Playgrounds provide a recreational refuge for children and play a role in the development of their cognitive, psychosocial, and physical coordination skills. Unfortunately, it may also be a source of traumatic dental injuries (TDI). AIM: To assess the standards of playgrounds in primary schools in Southern Nigeria. SETTING: Selected public and private primary schools in Lagos (Southwest), Enugu (Southeast) and Rivers (Southsouth) states of Nigeria. MATERIALS & METHODS: Multi-stage sampling was used to select 180 schools (30 private and 30 public schools in each state) spread across the 3 study states of Lagos, Enugu and Rivers of Nigeria. A structured questionnaire which was interview administered was used to obtain information from the head teachers of 180 selected schools in Southern geo-political zones of Nigeria. The presence or absence of playgrounds & play equipment; quality of playgrounds and equipment; and supervision of the pupils during play were assessed. Statistical comparison of public and private schools, as well as comparison between the three geopolitical zones was by chi square statistics and one way ANOVA respectively. RESULTS: Playgrounds were present in 147(81.7%) schools; 83 (56.5%) and 64 (43.5%) were public and private schools respectively. Ninety three (51.7%) schools had teachers or minders at the play grounds during recreation. Most of the public schools had no minders. Majority (69.7%) of the playgrounds surfaces were bare earth. Ninety three (55.4%) schools had play equipment with about 7.5% of them padded. The maintenance of the play equipment was not regular in 54.3% of the schools. The impact absorbing surfaces under the play equipment were majorly (66.6%) pits filled with sand in the three zones while rubber matting was found only in 7.7% of schools which were exclusively in the Southwestern zone of the country. CONCLUSION: Most of the schools had playgrounds but inadequate consideration was given to safety measures in terms of playground size, surfaces, equipment type, height and supervisions by teachers. We therefore recommended that playgrounds should be standardized in Nigerian primary schools and more awareness about the occurrence and prevention of TDI during recreation should be created in schools.

Maternal knowledge and awareness of factors affecting oral health in the paediatric population.

AIM: To assess expectant mothers on their knowledge and awareness of factors affecting paediatric oral health. METHOD: Seven hundred and six women in different stages of pregnancy were recruited from the antenatal clinic of the University of Port Harcourt Teaching Hospital over a period of four weeks. A self-administered structured questionnaire on socio-demographic information, oral health knowledge and oral health behaviour was filled by the participants. Data was analyzed using SPSS version 17. RESULTS: The mean age of the subjects was 29.6 (SD + 4.4) years. Seventy percent of them had tertiary education and 63.9% were unemployed. A significant proportion (83.4%) of the women had medium to high score (> 50%) in the knowledge of causal and preventive factors in dental caries and gingivitis. Over seventy nine percent (79.2%) of them acknowledged that primary teeth are important, but 43.6% did not know whether primary teeth should be restored or not. Only 39.3% of the women knew that leaving a feeding bottle/breast in the mouth of a sleeping child could be harmful to the teeth. Knowledge of the role of bacteria in gingivitis (81.3%) and dental caries (86.6%) was high. Over 45% of participants agreed that mothers could transmit cariogenic bacteria to their children. Only 0.7% of the women had taken their children to the dental clinic for routine checkup. CONCLUSION: Most of the participants had medium to high knowledge of the factors that affect paediatric oral health, yet the participants did not demonstrate adequate and proper concomitant oral health practice.

Perception of graduating medical students on child and maternal oral health in a selected tertiary institution in the southern part of Nigeria.

BACKGROUND: Oral health care imparts on the quality of life and general health outcomes, therefore essential for the knowledge of graduating medical students OBJECTIVE: To assess the knowledge of graduating medical students on child and maternal oral health METHODS: A cross sectional survey was undertaken among the graduating medical students of the University of Port Harcourt using an anonymous structured questionnaire with open and closed ended questions. Participants' knowledge about aetiology of dental caries, gingivitis and preventive oral health care and behaviours associated with early childhood caries (ECC) were assessed. Information gathered was collated and analyzed using a statistical software-SPSS Version 17. RESULTS: There were 166 participants with a mean age of 25.4 (+/- 3.0) years, range 20-45 years. Over 80% knew the roles of diet and bacteria in aetiology of dental caries. Regarding ECC, 59% agreed that breast milk and infant formula may be harmful to the teeth and 41.4% were aware that a mother can transmit cariogenic bacteria to the child. The importance of dental check up in pregnancy and the association between oral diseases in pregnant women and infant health was known by 63.3% and 51.8% respectively. Also, the importance of age at first visit and frequency of routine dental visits in a child was known to 40.4% and 54.8% respectively. Only 12.7% of participants knew that a carious primary tooth should be restored. Over 90% agreed that they needed to increase their knowledge on child oral health. CONCLUSION: The knowledge base of graduating medical students on the subject of maternal and child oral health was inadequate. A curriculum review that accommodates clinical exposure to child and maternal oral health during undergraduate and postgraduate medical residency training in Paediatrics is advised to increase their knowledge.

Variations of crown dimensions of permanent dentitions in a selected population of Nigerian children.

BACKGROUND: Race, gender, genetic/ environmental factors contribute to tooth variations which could be in size or shape. However, little has been reported on dimensional variations in permanent dentitions among Nigerians. OBJECTIVE: To investigate the pattern of variability of mesiodistal and buccolingual tooth dimensions of permanent dentition in Nigerians. METHODS: Mesiodistal (MD) and buccolingual (BL) tooth dimensions were obtained from teeth on dental stone models of selected 400 healthy adolescents aged 12-15 years using an electronic digital caliper. The descriptive statistics and the variability (determined from the Coefficient of Variation; SD/mean x100) were obtained using SPSS version 13. RESULTS: The mean tooth dimensions were larger in the males than in the females in all tooth types except in mean MD tooth dimension of maxillary second premolars which was larger in the females though not significant (p = 0.70). The coefficient of variation (CV) in the mean MD and BL dimensions ranged from 5.02 in the mandibula rfirst molars to 7.68 in the maxillary lateral incisors and from 5.38 to 11.07 in the maxillary first molars and the mandibular central incisors respectively. The least variable teeth in MD dimensions were the maxillary first molars in males (CV = 4.94) and mandibular first molars in females (CV = 4.88), while the highest variability was seen in the maxillary second premolars in females (CV = 10.46). In BL dimension the maxillary first molars were the least variable in both genders (CV = 5.22 in males, CV = 5.24 females) while the maxillary lateral incisors of males had the highest variability(CV = 11.90). CONCLUSION: The pattern of variation showed that the later-forming teeth in each tooth class showed more variability than the mesial members. The mesiodistal tooth dimensions were less variable than the buccolingual tooth dimensions.