Access to root canal treatment in a Nigerian sub-population: assessment of the effect of dental health insurance.

BACKGROUND: The final pathway of tooth mortality lies between tooth extraction, and the more expensive and less accessible root canal treatment (RCT). AIM: To determine the extent to which individuals' financial resources as measured by socioeconomic status and dental insurance coverage affects their access to RCT. METHODS: A hospital-based study that used a 15-item questionnaire to collect data among patients scheduled for RCT. All scheduled subjects (N = 291) over a one-year period constituted the sample for the study. Using the SPSS software, associations between the subjects' variables, and the dental insurance status were carried out with Chi square and independent t test respectively at 95% confidence interval. RESULTS: Two hundred and ninety-one subjects were to have 353 RCTs within the study period. A high proportion (79.7%, p < 0.001) of the subjects had dental health insurance, majority (95.3%) of which was government funded. 20.9% of those with previous tooth loss was due to inability to afford cost of RCT. The lowest socioeconomic group had the highest proportion (90%, p = 0.421) of insured that visited for RCT. CONCLUSION: Dental insurance increased access to RCT. Socioeconomic status did not affect dental insurance status and dental visit for RCT.

Management of long standing temporomandibular dysfunction in an edentulous patient with gunning type splint: a clinical case report

Objective: The aetiology of temporomandibular dysfunction (TMD) is multifactorial and controversial. It is associated with pain, clicking sounds and structural derangement within the joints. TMDs are believed to be a complex interaction between the temporomandibular joint (TMJ), the masticatory muscles, and possibly the occlusion of the teeth. The prevalence of TMDs in edentulous populations is similar to that in the dentate population. The objective of this study was to observe the effect of altering occlusal vertical dimension on the course of TMD and the overall rehabilitation of an edentulous patient. Clinical Case Report: This work reports a treatment protocol on a single edentulous woman with TMD. It was carried out at a tertiary centre in Kano, Nigeria. A misdiagnosed, and wrongly treated patient was referred to the prosthodontic clinic at this centre. Clinical and radiological assessments suggested a diagnosis of TMJ arthrosis secondary to neglected TMD. Gunning type splints were used to reduce pressure on the TMJs. Thereafter, conventional complete dentures were prescribed. The symptoms of TMD began to reduce after about 4 weeks and were self-reported to have completely disappeared after 12 weeks of treatment. Treatment with splint therapy was effective and patient was successfully rehabilitated. Conclusion: In this study, success was achieved with the use of splint therapy in the treatment of TMD. Gunning type splints are a viable option for splint therapy in the edentulous