Study protocol for a pilot quasi-experimental study on oral health education for nurses and community health workers in Nigeria.

Introduction: The primary health care system provides an ideal setting for the integration of oral health into general health care as well as equitable access to oral health care. However, the limited oral health knowledge of primary health care workers necessitates appropriate training before they can participate in health promotion efforts. This pilot training was designed to examine the impact of the Oral Health Education module for Nurses and Community Health Care Workers on their oral health awareness and referral practices. Methods: This study will utilize a quasi-experimental design (pre-and post with a non-equivalent control group) to assess the impact of a five-day pilot oral health education program on the knowledge and referral practices of Nurses and Community Health Workers in primary health care centers in three states in Nigeria-(Lagos, Oyo, and Kano). The training modules were developed based on the six iterative steps described in the intervention mapping framework - needs assessment, highlighting program objectives and outcomes, selection of theory and mode of intervention, designing program based on theory, designing implementation plans, and developing an evaluation plan. Only the intervention group will participate in the full educational training sessions but both groups will complete the pre-and post-intervention questionnaires. Discussion: This pilot training combined the standardized training modules from the recently launched "Oral Health Training Course for Community Health Workers in Africa" and a newly developed maternal and child oral health module by our group using an evidence-based approach. To the best of our knowledge, this is the first program to examine the impact of the standardized OpenWHO modules. The success of this training will lay the foundation for developing a sustained channel for providing oral health education at the primary health care level in Nigeria, West Africa, and Africa.

Correlates of illness behaviour related to orofacial infections of odontogenic origin among adults in a semi urban community in Nigeria.

BACKGROUND: Infections of facial spaces in the maxillofacial region occur in most cases as a complication of odontogenic infections. It often results in substantial morbidity, with serious and potentially life threatening outcomes if allowed to progress without prompt medical attention. OBJECTIVE: To identify factors that determine illness behaviour related to maxillofacial space infections. METHOD: This was a descriptive cross-sectional study of adult residents of pakoto community, Ifo local government area, Ogun state. The study was conducted using an interviewer administered questionnaire which included key information about respondents' awareness of predisposing factors of maxillofacial space infections; common actions taken with regards to treatment, and the factors that influenced their utilization of the available oral health care service. RESULTS: A total of 187 individuals were sampled, mean age was 30.5(SD 11.7) years with majority being females (59.4%) The proportion of the total respondents who reported a history suggestive of orofacial space infection was 20.3% (n=38). Visiting a patent medicine dealer (26.3%) along with visiting a dentist (31.6%) were the illness behaviours most frequently engaged in by respondents who have had an orofacial swelling following a toothache, with majority (73.7%) indicating the action they took was based on what was most convenient. CONCLUSION: This study has revealed that engagement in unorthodox practises by individuals in a semi-urban community studied is prevalent, and influenced by factors such as age, gender, level of education and occupation. FUNDING: None.

Smoking cessation counseling in dentistry: attitudes of Nigerian dentists and dental students.

The study was aimed at assessing the awareness, attitude, practices, willingness, and perceived barriers of dental students and dentists in Lagos University Teaching Hospital, Lagos, Nigeria, in relation to smoking cessation in the dental care setting. An anonymous self-administered questionnaire that contained questions relating to attitudes, views, and perceived barriers to smoking cessation activities in the dental clinic was hand-delivered to all dentists and clinical dental students in 2007. One hundred and thirty-six respondents took part in the study (response rate=81.9 percent). Although 95 percent of the respondents believed that smoking affects the dental management of the patient, only 65 percent always ask their patients about their smoking habits, and only 30 percent have heard about smoking cessation programs. A significantly higher proportion of students always ask patients about their smoking habits compared with dentists (p=0.0017). Also, a significantly higher proportion of dentists (97 percent) advised their patients against tobacco use compared with 77 percent of students (p=0.0000). Only 2 percent and 3 percent agreed that it is their professional responsibility to educate or encourage patients to quit smoking, respectively. Also, 98 percent strongly disagreed that it is within the scope of dental practice to ask about tobacco use, and 86 percent disagreed that tobacco counseling can be effective in helping patients quit tobacco use. Perceived barriers reported were lack of time (88 percent), lack of necessary materials (81 percent), and lack of knowledge of smoking cessation (74 percent). However, 81 percent of the respondents said they are willing to undergo training in tobacco use cessation. Since most of the dentists and dental students had poor attitudes and negative perceptions of smoking cessation activities, possibly due to lack of training and resources to carry it out in the clinics, there is need to include smoking cessation training in the dental curriculum in Nigeria.

Coping with oral pain: lay management strategies adopted by patients prior to presentation.

OBJECTIVES: To identify lay measures taken by patients in response to oral pain before seeking professional care and to determine factors leading to demand for professional oral health care. METHODS: A cross-sectional survey of patients aged 16 years and above who presented with oral pain at the oral diagnosis clinics of the Lagos University Teaching Hospital and the Lagos State University Teaching Hospital was carried out. Data was collected by means of questionnaires which sought information on onset and duration of pain, character, aggravating and relieving factors and actions taken by the patients before presentation at the dental clinic. RESULTS: A total of 215 patients participated. More than half of them described their pain as severe to very severe with 106 (49.3%) and 21 (9.8%) reporting sleep disruptions and severe agony respectively. Delay in presentation range from over a month in 56 (26%) patients to years in 85 (39.5%). Responses to pain symptoms included, communication with different persons for advice in 192 (89.3%) and application of at least one lay measure in 183 (85.1%) patients. Duration and persistence of pain was associated significantly with the use of more than one measure. There was no association between gender or age and the use of lay measures. Use of measures with possible adverse effects like petrol and acid was reported in 5 (2.7%) of the respondents. CONCLUSION: Lay strategies in response to oral pain are common in this Nigerian population and appear to be used as an alternative to professional oral health care.

Occupational exposure to bloodborne pathogens and management of exposure incidents in Nigerian dental schools.

The goal of this study was to determine the frequency of occupational exposures to bloodborne pathogens amongst Nigerian clinical dental students, their HBV vaccination status, and reporting practices. A cross-sectional study of all clinical dental students in the four Nigerian dental schools was carried out by means of an anonymous self-administered questionnaire that asked questions on demography, number and type of exposure, management of the exposures, personal protection against cross infection, and the reporting of such exposures. One hundred and fifty-three students responded (response rate of 84.5 percent). Only thirty-three (37.9 percent) were fully vaccinated against HBV. Ninety (58.8 percent) of the students have had at least one occupational exposure. There was no significantly associated difference between sex, age, location of school, and exposure. Most of the exposures (44.4 percent) occurred in association with manual tooth cleaning. There was inadequate protection of the eyes. None of the exposures were formally reported. It is the responsibility of training institutions to ensure the safety of the students by mandatory HBV vaccination prior to exposure and adequate training in work safety. Written policies and procedures should be developed and made easily accessible to all workers to facilitate prompt reporting and management of all occupational exposures.