Impact of perinatal HIV exposure and infection on salivary properties among Nigerian children.

BACKGROUND: There is growing evidence that perinatal HIV infection and exposure affect salivary pH and flow rate in children in most parts of the world, but not against the background of caries and the African demographic. This study aimed to evaluate the impact of HIV infection as well as exposure on salivary properties and their influence upon the dental caries experience among school-aged children in Nigeria. METHOD: This cross-sectional study assessed the salivary flow rates and salivary pH of HIV infected and exposed school-aged (4-11) children receiving care at a Nigerian tertiary hospital. A total of 266 consenting participants which comprised of three groups as follows: (1) HIV Infected (HI) (n = 87), (2) HIV Exposed and Uninfected (HEU) (n = 82) and (3) HIV Unexposed and Uninfected (HUU) (n = 97) were recruited for the study. Questionnaires completed by parents/guardians were used for data collection. Three calibrated dentists performed oral examinations for dental caries. International Caries Detection and Assessment Scores (ICDAS) was used and presented as dmft/DMFT. Salivary pH was measured using MColourpHast™ pH indicator strips, while salivary flow rate was determined by collecting unstimulated whole saliva using the suction method. Data analysis relied on comparative statistics to determine the correlation between HIV exposure and infection on salivary pH and flow rates. RESULT: Across the groups, (HI, HEU, and HUU) mean pH of the HI was significantly less than that of HEU and HUU. Similarly, there was a statistically significant difference in the SFR across the three groups (p = 0.004). Other variables such as gender, age and oral hygiene status expressed by the gingival inflammatory scores had no significant influence on the pH and SFR of study participants. There was a rather unexpected positive correlation of DMFT of HI and HEU groups with increasing salivary flow rate; though, the relationship was weak and not significant. CONCLUSION: Perinatal HIV exposure and infection significantly impact salivary pH and flow rate among school-aged children in Nigeria. The findings of this study imply that HIV infection influenced the salivary pH, while HIV maternal exposure (without infection) impacted salivary flow rates when compared to the controls.

Oral complications of systemic sclerosis; a case report

Objective: Systemic Sclerosis is a connective tissue disorder with multi-system involvement. It is an autoimmune disease with multiple aetiological factors including; genetic, birth disorder, infectious and environmental factors. Sclerosis of the skin and systemic fibrotic manifestations are the hallmark of this condition. We report a case of a 30-year-old female, who presented to the Periodontology clinic of the University of Benin, Teaching Hospital, Benin City with complaints of breakage of her teeth and previous multiple extractions. Clinical examination revealed multiple carious lesions, retained root, mobile teeth with varying degrees of mobility, tooth wear lesions and gingival recession. Case Description: She also presented with extra-oral features which include sparse and fluffy hair, reduced lacrimation, progressively reducing mouth opening and thickening of skin of the forehead, cheeks, and extensor surfaces of the upper and lower limbs Conclusion: A multidisciplinary management approach, involving the periodontology's, oral surgeons, oral physicians, prosthodontist, rheumatologists, chest physicians and dermatologists, was instituted