Craniofacial orthodontics and postgraduate orthodontic training in Nigeria.

INTRODUCTION: Craniofacial orthodontics has been shown to be a critical component of the care of patients with craniofacial anomalies such as cleft lip and palate. Thus, the purpose of this study was to assess the perceptions and clinical experience in cleft and craniofacial care, of orthodontic residents in Nigeria. METHODOLOGY: Questionnaires were sent out to orthodontic residents in the six Postgraduate Orthodontic Training Centers in the country at that time. The questionnaires were self-administered and covered areas in beliefs in cleft care and the clinical experience and challenges faced by the residents in the provision of craniofacial orthodontic care at their various institutions. RESULTS: Thirty-three respondents returned completed questionnaires, with a response rate of 97%. All the respondents believed that residents should be involved in cleft and craniofacial care. Postnatal counseling was the clinical procedure in which the residents reported the highest level of clinical experience (47.4%). The least clinical experience was recorded in pre-bone graft orthodontics (7.4%) and orthodontic preparation for orthognathic surgery (5.5%). Some of the challenges highlighted by the residents were low patients turn out for orthodontic care and the absence of multidisciplinary treatment for craniofacial patients in their centers. CONCLUSION: Orthodontic residents in Nigeria believe that they should be involved in the management of patients with craniofacial anomalies and cleft lip and palate. However, majority of the residents have limited clinical experience in the management of these patients. A lot more needs to be done, to expose orthodontic residents in training, to all aspects of the orthodontic and multidisciplinary team care required for the cleft/craniofacial patient.

Undergraduate dental education in Nigeria: perceptions of dental students and recent dental graduates.

Background: Students' perception of their education is a subject that has received very little attention by those providing dental school education. This is more so in the Nigerian environment, where limited research has been carried out in dental education, particularly with respect to the students' perspectives on the quality of training received. Objective: Thus, the aim of this study was to determine the perceptions of dental students and recent dental graduates in Nigeria on their level of satisfaction with the quality of academic and clinical training received in their respective dental schools and the challenges faced in receiving this training. Methods: This was a cross-sectional descriptive study carried out amongst 271 dental students and recent dental graduates from eight dental schools in the country. Ethical approval for the study was obtained from the Institutional Review Board of the Lagos University Teaching Hospital (LUTH). Data collection was via self-administered questionnaires. Statistical analysis was carried out using SPSS 17. Results: The final study sample was made up of 239 students, with a mean age of 24.57 (2.21) years. The two dental specialties in which the least level of satisfaction was recorded with regard to the quality of academic training received were Conservative Dentistry and Orthodontics, while for clinical training they were Conservative Dentistry and Oral Biology/Pathology. The three most common factors which were adversely affecting the quality of clinical training received were, poor electricity supply, insufficient dental chairs and quality of training received. Conclusion: Dental students and recent graduates of Nigerian Dental schools are not satisfied with the quality of undergraduate training received in some dental specialties at their respective dental schools.

Bad-breath: Perceptions and misconceptions of Nigerian adults.

OBJECTIVE: To provide baseline data about bad-breath perception and misconceptions among Nigerian adults. METHODS: Multi-center cross-sectional study of individuals aged 18-64 years using examiner-administered questionnaires. Age comparisons were based on the model of emerging adults versus full adults. Data were recoded for statistical analyses and univariate and secondary log-linear statistics applied. RESULTS: Participants had lopsided perceptions about bad-breath. While 730 (90.8%) identified the dentist as the expert on halitosis and 719 (89.4%) knew that bad-breath is not contagious, only 4.4% and 2.5% associated bad-breath with tooth decay and gum disease respectively. There were no significant sex differences but the older adults showed better knowledge in a few instances. Most respondents (747, 92.9%) would tell a spouse about their bad-breath and 683 (85%) would tell a friend. CONCLUSIONS: Participants had lop-sided knowledge and perceptions about bad-breath. Most Nigerian adults are their "brothers' keepers" who would tell a spouse or friend about their halitosis so they could seek treatment.

Holdaway's analysis of the nose prominence of an adult Nigerian population.

BACKGROUND: Facial beauty is a function of harmonious balance among all parts of the face, and the nose plays a dominant role in this because of its location exactly in the middle of the face. Therefore, an evaluation of the nasal form and its position relative to other facial structures should play an important part in the assessment of patients before orthognathic surgery, rhinoplasty or orthodontics. AIM: The aim was to establish normative values for the nose prominence of an adult Nigerian population using Holdaway's soft tissue cephalometric analysis. METHODOLOGY: Lateral cephalometric radiographs of 100 adults aged 18-25 years, with normal occlusion and a harmonious facial appearance were analyzed. The nose prominence was assessed using Holdaway's analysis. Twenty radiographs randomly selected, were retraced to assess for errors. Data analysis included descriptive statistics, Student's t-tests and analysis of variance using the Statistical Package for Social Sciences. RESULTS: The mean value recorded for the nose prominence of the study population was 3.49 mm (standard deviation [SD], 3.26 mm), with a range of -5.0 mm to 15.0 mm. Mean values obtained for females were 3.73 mm (SD, 2.88 mm) and males 3.19 mm (SD, 3.70 mm). No statistically significant gender difference was observed (P>0.05). In addition, no significant difference was observed between the nose prominence values recorded for different age-groups (P>0.05). CONCLUSION: Normative values were established for the nose prominence of an adult Nigerian population. The values obtained for Nigerians in this study are comparatively lower than that reported for other populations. These values would aid in treatment planning for orthognathic surgery, rhinoplasty and orthodontics in Nigerians.

ORAL HEALTH QUALITY OF LIFE IN A NIGERIAN UNIVERSITY UNDERGRADUATE POPULATION.

INTRODUCTION: Oral health related quality of life is utilized in health services research to examine trends in oral health and population-based needs assessment. OBJECTIVE: To assess both the generic and orthodontic specific aspects of the Oral health-related quality of life of a University undergraduate population. METHODOLOGY: This was a cross-sectional descriptive study carried out among 420 undergraduate students, aged 18-30years old, attending the University of Lagos, Nigeria. The data collection was carried out through oral interviews and self-administered questionnaires. Two Oral health related quality of life instruments were used (1) A generic scale: the Shortened version of the Oral Health Impact Profile (OHIP-14) and (2) A condition specific scale: the Psychosocial impact of dental aesthetics questionnaire (PIDAQ). Data analysis was carried out using the Statistical Package for Social Sciences (SPSS). RESULTS: With respect to the Oral Health Impact Profile (OHIP-14) scale, the overall mean score recorded by the students was 10.43+7.85. The physical pain subscale recorded the highest impact with 93.3%, while the least impact was recorded in the handicap subscale, with 29.9%. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) scales revealed significant gender differences, with the subscales of 'social impact', 'psychological impact' and 'aesthetic concern' recording low mean subscale values. CONCLUSION: . The mean Oral Health Impact Profile (OHIP-14) score of the students (10.43 + 7.85) in this study reflects that the oral health status of most of the students did not significantly affect their Oral health-related quality of life. However, the physical pain domain was the most severely affected aspect of their Oral health-related quality of life. The Psychosocial Impact of Dental Aesthetics (PIDAQ) scale scores recorded significant gender differences.

Knowledge and attitude of some nigerian school teachers on the emergency management of avulsed permanent incisor.

BACKGROUND: Tooth avulsion has been known to be the most severe of all dental injuries. The immediate action taken at the accident site will determine the prognosis of the tooth. Replantation of an avulsed tooth is the treatment of choice. AIM & OBJECTIVES: To assess the knowledge and attitude of primary and secondary (Basic educational) school teachers on the emergency management of avulsed permanent incisors. SETTING: Twenty public and private basic educational schools were randomly selected from Lagos State. SUBJECTS & METHODS: Descriptive cross-sectional study. A 23 item self administered questionnaire was distributed to teachers to determine their knowledge and attitude on the emergency management of avulsed permanent incisors. Data was analysed using SPSS (Statistical Package for Social Sciences), Version 21.0. The responses obtained were tabulated and expressed as frequency distributions and then computed in percentages. Chi-square was used to test the association between knowledge of the schools teachers regarding the emergency management of avulsed permanent incisors and their socio-demographic variables. Multivariate analysis was used to adjust for confounding variables. The level of significance was set at P ≤0.05. RESULTS: A total of 320 teachers answered the questionnaires. Most of the teachers were female (63.1%). Only (30.9%) had received first aid training which included emergency management of dental trauma. Forty- two percent (134) didn't know that an avulsed permanent tooth could be replanted. Twenty teachers (44.4%) would clean an avulsed tooth with toothbrush and toothpaste. A greater proportion of the respondents 130 (40.6%) would transport an avulsed tooth using a clean white handkerchief. The overall knowledge of the school teachers was poor (84%).There was a statistically significant association between the knowledge of the school teachers and the inclusion of emergency management of dental trauma in the first aid training of the teachers P=0.05. Predictors of teachers' level of knowledge of emergency management of avulsed teeth were receipt of advise on management of traumatic dental injuries (OR= 2.5, CI=1.19-4.28) and type of school (OR=0.93, CI=0.206-0.750). CONCLUSION: The school teachers had insufficient knowledge about the emergency management of avulsed permanent teeth. School oral health campaigns with regards to emergency management of avulsed teeth will help improve teachers' knowledge and modify their behaviour.