Oral assessment and nursing interventions among Nigerian nurses-knowledge, practices and educational needs.

BACKGROUND: Assessment of oral condition, oral care, and informing the attending doctor of unusual oral findings for possible consultation or referral to a dentist are the advocated roles of hospital nurses. The objective of the study was thus to assess the roles of Nigerian nurses in the assessment of oral conditions of hospitalized patients. METHODS: This questionnaire-based cross-sectional survey of all nurses caring for hospitalized patients in the University of Benin Teaching Hospital was conducted in the first half of 2010. RESULTS: Of the 384 studied participants, 94.3% considered oral care as an important aspect of nursing care and 73.4% had oral health component in their nursing school curriculum. A total of 80.7% reported suspicious and abnormal findings in hospitalized patients to the attending doctor. Amongst the respondents, 38.0% reported ability to conduct good oral tissue examination. Only 28.1% demonstrated good knowledge of common oral diseases. Three-quarters (73.4%) thought that it is compulsory for nurses to assess the oral condition of hospitalized patients. The 67.7% and 21.9% of the respondents did the assessment on admission and discharge respectively. The majority (90.1%) desired training on oral care of hospitalized patients. CONCLUSION: There is a need to improve the skill and competence of nurses in the assessment of oral condition to make them a substantive partner in the oral care of hospitalized patients.

Occupational stress among dental house officers and students in a tertiary healthcare centre.

OBJECTIVE: To assess occupational stress among dental house officers and students treating patients in a tertiary healthcare centre in Nigeria. MATERIALS AND METHODS: This questionnaire-based cross-sectional study of dental officers and final year dental students at the University of Benin Teaching Hospital, Benin City was conducted in the second half of 2010. The questionnaire utilized was a modified form of stress screening questionnaire of International Stress Management Association. RESULTS: Out of the 100 questionnaires distributed, 88 questionnaires were returned, giving a response rate of 88.0%. A total of 53 (60.2%) the respondents were male and 35 (39.8%) were females. Dental students constituted 54 (61.4%) of the respondents while the remaining 34 (38.6%) were house officers. Amongst the respondents, 9 (10.2%), 68 (77.8%) and 11 (12.5%) reported severe, moderate and mild occupational stress respectively. The reported stress was significantly associated with gender (P = 0.032) as more female reported severe stress and more male reported moderate stress. The mean stress level was significantly higher among dental students than house officers (P = 0.007). CONCLUSION: One in every ten respondent reported severe occupational stress with a significant gender difference. Development of stress reduction strategies for dental house officers and students with gender bias is imperative.

Dentoalveolar abscess among children attending a dental clinic in Nigeria.

OBJECTIVE: To determine the incidence and causes of dentoalveolar abscess among children attending an outpatient dental clinic in Nigeria. MATERIAL AND METHODS: This is a retrospective study of paediatric dental patients treated in University of Benin Teaching Hospital, Benin City from October 2010 to September 2011. RESULTS: The incidence of dentoalveolar abscess was 6.4% (53/824). However only 42 cases had their case notes retrieved for final research analysis. It occurred mostly in the lower right quadrant of the mouth. The affected children were majorly males and first or second child of monogamous family. A total 17 (40.5%) of the affected children were in the 6-11 years age group. This was the first dentist consultation among 35 (83.3%) of the children. The presenting complaint was toothache among two-thirds of the children. History of asthma, tonsillitis, peptic ulcer disease and previous surgery were medical history elicited from 6 (14.3) of the patients. The most implicated tooth was deciduous first molar. The causes of abscess include untreated dental caries 35 (83.3%), trauma 5 (11.9%), failed restoration 1 (2.4%) and periodontal diseases 1 (2.4%). Periapical radioluscency was predominant radiological finding among affected children. Tooth extraction was commonest treatment done. CONCLUSION: The incidence of dentoalveolar abscess among children was significant. The high frequency of untreated dental caries as the cause of dentoalveolar abscess indicates the need for school and community-based preventive strategies like encouraging infant oral health and preventive dentistry programs and early treatment intervention and dental health education.

Oral health of psychiatric patients: the nurse's perspective.

OBJECTIVE: To assess nurses' perspectives on character, prevalence and cause of oral diseases among psychiatric patients and also their approach and suggestions in relation to the care of oral problems. MATERIALS AND METHODS: A questionnaire-based cross-sectional survey of all cadres of nurses (n = 136) at the Federal Psychiatric Hospital, Benin City, Nigeria, was conducted between December 2010 and January 2011. RESULTS: Two-thirds (67.6%) of the respondents reported that psychiatric in-patients in comparison with the general population have a higher occurrence of oral and dental problems. Commonly cited reasons for the poor oral health of patients included as follows: sedation for long periods, lack of care by family, psychopathological symptoms, poor access to dentists and lack of oral hygiene advice. The common oral health complaints received by the respondents included toothache, pain from the gums and inability to open the mouth. Majority (91.4%) of respondents claimed to be presently involved with oral care of psychiatric in-patients but oral care delivery is however bedevilled with lot of barriers like uncooperativeness of patients and lack of oral care materials. CONCLUSION: Oral complaints received are frequent and numerate with limited palliative action rendered. Attaching dentists to psychiatric hospitals and regular training of psychiatric nurses on oral care delivery are recommended to comprehensively cater for the oral health problems of psychiatric in-patients.

Expectations and perceptions of Nigerian patients regarding infectious diseases in dentistry.

OBJECTIVE: To assess the expectations and perceptions of Nigerian patients regarding infectious diseases in dentistry. METHODS: A questionnaire based cross-sectional survey of patients attending the dental centre of University of Benin Teaching Hospital, Nigeria was conducted in 2009. RESULTS: Out of the 405 patients that responded, 75.6% expressed worry about contracting infection during the dental treatment. Respondents felt that they are at risk of contracting the following infection from the dental clinic, HIV (47.4%), hepatitis B and C (15.5%), herpes (3.5%) and tuberculosis (1.7%). One-quarter (25.4%) of the respondents would avoid dental treatment because of fear of contracting HIV. Ninety-two (22.7%) would switch from dental clinic with HIV infected personnel and 37.8% would allow HIV-infected dentist to treat them. Only 10.4% of the respondents would expect the dentist to refuse to render dental treatment to the HIV-infected patients. CONCLUSION: This survey revealed that a high proportion of Nigerian patients are worried about contracting infectious disease during dental treatment and this impacted negatively on how they seek dental care. Improved public education and communication on the risk involved with dental treatments is needed to allay the fear of Nigerian patients.

Nigerian dental students' compliance with the 4As approach to tobacco cessation.

OBJECTIVE: To assess the Nigerian dental students' present effort at tobacco cessation assistance using the simple stepwise 4As model. METHODS: A cross-sectional survey of all the final level dental students in the Nigerian premier dental schools was carried out using a pretested self administered questionnaire. RESULTS: The response rate was 98.9%. Majority (95.6%) of the respondents routinely take history of tobacco use. A total of 93.9% of the respondents routinely advice patient who smoke to quit but only 46.1% actually counsel patient on how to quit. Six-tenth of the respondents knew about nicotine replacement therapy but only 36.1% knew the role antidepressant therapy in tobacco cessation. Majority (87.2%) want cigarette sales to adolescents banned, 73.9% want adverts of cigarettes prohibited, 81.1% want cigarette smoking banned in public areas and only 2.8% will permit smoking in a dental office. CONCLUSIONS: The survey revealed deficiency in compliance to the 4As approach to tobacco cessation among Nigerian dental students. The incorporation of proper tobacco counseling cessation protocol, with emphasis on the pharmacological therapy, into the dental curriculum is therefore desirable. Dental professionals at all levels should be involved effectively with tobacco cessation to significantly reduce the morbidity and mortality of tobacco use.

Occupational violence against dental professionals in southern Nigeria.

OBJECTIVE: To determine the prevalence of workplace violence in Oral healthcare centres against Nigerian dental professionals. METHODS: A questionnaire-based cross-sectional survey of 175 randomly selected dental professionals working in Oral healthcare centres of University Teaching Hospitals in Southern Nigeria was conducted. RESULTS: The survey response rate was 78.9%. The respondents were dentists (58.0%), dental nurses (18.1%), dental technologists (12.3%), dental therapists (8.0%) and dental record officers (3.6%). The prevalence of violence in Nigerian Oral healthcare centres was 31.9%. There was no statistically significant difference in the prevalence of violence against dentist and dental auxiliaries. Violence was often associated with long waiting time (27.3%), cancellation of appointment (13.6%), outcome of patient's treatment (11.4%), alcohol intoxication (9.1%), psychiatric patient (6.8%,) patient's bill (4.5%) and others (27.3%). Non-physical violence in form of loud shouting (50.0%) threat (22.7%), sexual harassment (6.8%) and swearing (2.3%) constituted the majority while physical violence in form of bullying and hitting constituted the remaining 18.2%. The main perpetrators of the violence were patients (54.5%) and patient's relatives/friends (18.2%). The expressed impact of violence among the respondents include fear (18.2%), impaired job performance (15.9%), psychological problems (13.6%) and off duty (9.1%). No impact was declared by 43.2% of respondents. CONCLUSION: The prevalence of workplace violence in Oral healthcare centres against dental professionals in Southern Nigeria was significant and had a substantial effect on dental professionals' well-being thus necessitating urgent attention.

Reasons for exodontia in rural Nigerian children.

OBJECTIVE: To investigate the reasons for exodontia in children attending a general dental practice in Uselu, Edo State. MATERIAL AND METHODS: All pediatric patients that had extraction between January 2006 and December 2008 in a general dental practice in Uselu were recruited for this prospective survey. The data collected include age, sex, reason for extraction and tooth extracted. RESULTS: A total of 756 extractions were done during the survey period. Female constituted 57.4% of treated patients. Caries was the most frequently reason for childhood exodontia (82%). The deciduous teeth were mostly extracted (66.1%) than permanent teeth (33.9%). Deciduous molar accounted for 42.6% of all exodontia in children. Mandibular teeth were more frequently extracted (60%) than maxillary teeth (40%). Exodontia was also more on the right side of the mouth and lower right quadrant CONCLUSION: This survey highlights the need for extensive prevention programs targeted at rural children with high caries risk.