Patients' Management Patterns for Restorative Treatment Procedures: A 4-Year Overview at the Restorative Clinic of a Tertiary Hospital in Nigeria

Abstract Objective: To determine the patients' management pattern for restorative treatment procedures at the Restorative Dentistry Clinic at the Lagos State University Teaching Hospital (LASUTH). Material and Methods: A descriptive and retrospective study design was employed to determine patients' management patterns for the restorative treatment procedures at the Restorative Dentistry Clinic at LASUTH. Treatment records of patients who attended the Restorative Clinic at the Lagos State University Hospital, Ikeja, Lagos, Nigeria, from 2011 to 2014 were reviewed; the effective treatments during the period under review were recorded as treatment procedures and were recorded as operative, endodontic, fixed prosthodontics, and removable procedures. Results: A total of 14,437 (75%) operative; 1,353 (7.0%) endodontic; and 559 (2.9%) fixed prosthodontics and 2,852 (14.9%) removable prosthodontic procedures were carried out during the period under review. This study showed that operative procedures were the most performed restorative procedures, whereas removable prosthodontics and endodontic procedures ranked second and third, respectively, to operative procedures. Fixed prosthodontics procedures were the least performed restorative procedures. Conclusion: This study showed that more efforts were being expended by dentists on operative services compared to endodontic, removable, and fixed prosthodontics services combined. Comprehensive studies, embracing all disciplines of dentistry, should be carried out to determine the level of demand and clinical relevance of procedures in clinical dental practice and hence to set specific and general objectives of dental education for the populace. Access to dental health Insurance services should also be increased in the country.

Public health challenges of restorative dental practice in low resource settings during the Covid-19 pandemic

Background: COVID-19 remains a major public health threat globally, and has challenged healthcare systems and services including oral health Objective: This study examines the key public health challenges posed by the COVID-19 pandemic in low resource settings. While healthcare services are learning to cope with the COVID-19 pandemic, dental care services, in particular restorative dental practice have been adversely impacted because of the closeness of caregivers to the patient's mouth as well as the generation of aerosols during most restorative procedures. This presents a challenge for low-and-middle-income countries (LMICs) such as Nigeria where weak and poor governance structures characterize healthcare systems in addition to paucity of economic resources. Another challenge in the form of COVID-19 conspiracy theories has threatened to undermine public health efforts designed to control the pandemic. Conclusion: The implementation of optimal guidelines and safety protocols for effective COVID -19 infection prevention and control is a major challenge for restorative dental care practice in low resource settings owing to paucity of key material resources and inappropriate behaviour associated with lingering doubts about COVID-19 reality among the majority of the populace. The Safer Aerosol-Free Emergent Dentistry concept offers a viable practical approach for restorative dental practice in LMICs during and in the post COVID-19 pandemic era. There is a need to deploy all resources, human and material, in the education and enlightenment of the populace regarding the reality of COVID-19.

Incidence of postoperative pain after use of calcium hydroxide mixed with normal saline or 0.2% chlorhexidine digluconate as intracanal medicament in the treatment of apical periodontitis.

OBJECTIVE: To compare the incidence of postoperative pain after the use of calcium hydroxide powder mixed with normal saline or 0.2% chlorhexidine digluconate as intracanal medicament. PARTICIPANTS: Fifty-five subjects aged 17-60 years with teeth diagnosed to have apical periodontitis. INTERVENTION: Two-visit conventional root canal treatment of seventy teeth. The teeth were divided by randomization (balloting) into two groups: control group and experimental group, each with thirty-five teeth treated with calcium hydroxide mixed with normal saline or with 0.2% chlorhexidine digluconate as intracanal medicament respectively. Incidence of postoperative pain was assessed using the universal pain assessment tool and whether or not analgesic was taken. MAIN OUTCOME MEASURED: Incidence of post-operative pain. RESULT: Postoperative pain occurred only at 1-day and 1-week reviews. In the control group, the overall incidence of pain was the same at both review periods (5.7%), while the experimental group showed a slight decrease in incidence between 1-day (17.2%) and 1-week (11.4%) reviews. Incidence of flare-ups was more in the experimental group (11.4%) than in the control group (5.7%). No significant statistical differences between the two groups were observed (p > 0.05). CONCLUSION: The incidence of postoperative pain was lower in the normal saline treatment group, but the difference was not statistically significant.