RESUMO
BACKGROUND: Orofacial bacterial infections present in diverse patterns due to the anatomical complexity of the area. The likelihood of spread from the initial area of infection is also high because of the presence of contiguous spaces in the head and neck region. AIM: To determine the pattern and management outcome of orofacial bacterial infections in Southwest Nigeria. STUDY DESIGN: A prospective study. SETTING: University College Hospital, Ibadan, Nigeria. MATERIALS AND METHODS: A prospective study on 102 patients with orofacial bacterial infections seen between June and December, 2011 was carried out. The information collected with data sheet included socio- demographic data, clinical history and examination, treatment and outcome. Frequencies, means, medians and diagrams of relevant variable generated. Chi square test was used to test association between categorical variables at p<0.05. RESULTS: Male to female ratio was 1.1: 1 with age range 10 months to 83 years and mean age 33.0 (±20.3) years. The median number of days between onset of orofacial bacterial infection and presentation for treatment was 7 (range 3-90) days. Sixty seven (65.7%) patients presented to hospital within 7 days of the onset of symptoms of infection. Pain was the common symptom 100 (98.04%), followed by sleep disturbance 71 (69.6%) while the least common symptom was dyspnea 18 (17.7%). Most of the early presenters had complaint of sleep disturbance (67.6%) while most of the late presenters had dyspnea (44.4%). Positive medical history including diabetes mellitus was reported by 28 patients (27.6%). Sixty seven (65.7%) had fascial space involvement, of which the majority 38 (56.7%) had multiple space involvement. Eight (21%) of those with multiple space involvement had submental, bilateral sublingual and submandibular spaces (Ludwig's angina).The majority 12 (41.4%) of those with single space infection had it in submandibular space. The majority 35 (45%) of the patients with odontogenic infections had it in right posterior mandible. All the patients had antibiotics prescribed for them and also had one form of surgical treatment or the other which included extraction, incision and draina cge with extraction, decompression, exploration and debridement and sequestrectomy. The majority (90.5%) of the participants whose orofacial bacterial infection resulted into swelling had regression of the swelling and majority (90.0%) of those who had inadequate mouth opening had adequate mouth opening after treatment. Three mortalities were recorded in the course of the study. CONCLUSION: Odontogenic aetiology is commoner than non odontogenic. Multiple fascial space involvement occurred more than single space. Outcome was good with adequate treatment although few cases of mortalities were recorded.
RESUMO
BACKGROUND: Criteria for a good dental practice as expressed by patients have influence on their behavior in terms of compliance with clinical advice, less pain and anxiety and more utilization of dental care. OBJECTIVE: To assess the opinion of patients attending the dental clinic of a tertiary hospital Southwestern, Nigeria about their perception of a good dental practice. MATERIALS AND METHODS: A 16 item semi-structured bi-lingual interviewer-administered questionnaire comprising socio-demographic characteristics and 24 criteria of a good dental practice generated by clinicians and patients was administered to 156 patients who were blinded from knowing which criteria were clinicians' or patients' criteria. Patients were then asked to pick 12 criteria out of the 24 criteria that they considered of greater priority. Frequency of the most picked criteria in a descending order was determined. Student's t-test was used to compare mean scores at P < 0.05. RESULTS: The mean age of study participants was 36.7 ± 13.8 years. The majority 139 (89.1%) of the study participants ranked ''clinician's procedure should be as painless as possible'' as the most important clinician determined criteria of a good dental practice while 31 (19.9%) of them ranked hotlines available for emergencies as the least. The majority 133 (85.2%) of the study participants ranked ''sterile procedure and proper handling of equipment'' as the most important patient determined criteria of a good dental practice while 30 (19.2%) of them ranked patients being attended by just one clinician as the least. There was a statistically significant difference between mean scores of clinicians' criteria and patients' criteria ( P = 0.00001), participants ranked more patients' criteria than clinicians' criteria. CONCLUSION: In determining the criteria for a good dental practice, clinicians' perspective as well as patients' perspective should be considered.
