Enhancing Oral Health Care Access for School Children: A Perspective.

Inadequate access to oral health services for school children remains a pervasive issue in Nigeria. According to a study, a mere 20% of enrolled students have availed themselves of dental visits following referrals from dentists. Various barriers, such as geographical location, socioeconomic status, lack of awareness about the importance of oral health, and fear of treatment, contribute to this low utilization rate. The resulting problem exacerbates social class disparities within the country. To address this pressing concern, we conducted an exhaustive academic review encompassing peer-reviewed literature, policy documents, and other relevant materials. This review underscored three potential policy alternatives: bolstering educational campaigns on oral health, implementing mobile dental clinics, and establishing on-site school-based dental clinics—an innovative approach in the Nigerian context. Additionally, we will delve into insights from a successful case study of a model on-site school oral healthcare clinic in Ile-Ife. Recognizing that each approach comes with its own set of advantages and disadvantages, we propose a concise School Oral Health Policy. This policy aims to establish a framework for incorporating these remedies efficiently, providing a comprehensive solution to the issue of insufficient availability of dental healthcare services among Nigerian school pupils

Aggressive Periodontitis: A case report with exome sequencing and functional characterization of identified variant

Aggressive periodontitis (AgP) is characterized by rapid and progressive destruction of the periodontal tissues and eventual tooth loss. Genetic risk contributions have been explored and rare mutations in NOD2 were reported. Sequencing analysis of the coding regions of NOD2 was conducted using individuals of African ancestry, to identify the pathogenic protein-altering variants in individuals with AgP using: 1) In Silico tools and clinical variant classification system; 2) IF staining to understand the expression pattern, and 3) In vitro cell based assay to understand the variant protein function. We discovered a novel nonsense NOD2 variant (c.835G>T; p.Glu279Ter) ; a truncating protein variant that is clinically pathogenic, and the gene-product lacks domains regulating inflammatory responses. Murine studies suggest that this gene contributes to tooth development. In vitro analysis suggests a dominant-negative effect of the variant. NOD2 gene is expressed in the immune cells and periodontal tissues and regulates the inflammatory response within this tissue. This truncating variant found in one African family, which results in a dominant-negative effect, could explain the exacerbated immune response to pathogens in the pathogenesis of this periodontal disease. &nbsp

Onset of dental emergence stages among 4-15 years old Nigerian children: A guide for clinical intervention: Onset of Dental emergence among Nigerian children

ABSTRACTBackground: Dental emergence staging involves the utilization of a group of teeth to categorize the dentition into deciduous, mixed, adolescent and permanent. The various stages serve as guides for clinical intervention.Aims: This present study was conducted to determine the onset of the various dentition stages among a group of Nigeria children. Materials and method: it was a cross-sectional descriptive study and data were collected over a fourteen-month period among clinically healthy 424 participants comprising of 186 male and 238 females aged 4-15 years and analysed using SPSS statistics 22.0. The mean ages of onset of the various dental stages, the overall dental stages and the dental stages of each jaw were compared according to gender using unpaired t-test. Statistical significance level was set at P<0.05. Result: The average age of the fully established deciduous dentition was 4.61 ± 0.79 years among females and 5.00 ± 1.16 years in males, p=0.153. Females were also observed to have attained early mixed dentition, late mixed dentition and adolescent dentition earlier than male participants. The average age of the fully erupted first and second molars were 9.76 ±2.36 years and 13.06 ± 1.71 years respectively with female participants observed to have attained each of the stages earlier than male participants, P>0.05. Conclusion: The results shows that female participants attained early mixed dentition, late mixed dentition and adolescent dentition earlier than males. However, males had early attainment of the intermediate mixed dentition. The average age of the fully erupted first and second permanent molars which also tend to have occurred earlier among the females. Therefore, there is the need to individualized staging of the dentition stage to guide the appropriate timing of treatment intervention.Keywords: Dental emergence, Dental eruption, Dentition stag

Relationship between Quality of Marriages, Marital Counseling and Management of Oral Lesions among Married Female Worshippers attending Religious Worship Centers in South Western Population in Nigeria.

BACKGROUND/ AIMS AND OBJECTIVES Quality of marriage is a strong indicator of human health. Happily married people tend to show signs of better health when compared to the unmarried. Women in unhappy homes are under chronic stress, they show impaired social behavior, mental stress disorders and cardiovascular diseases. Information on the effects of marriage on oral health is very scanty despite the huge influence of oral health care on the quality of life.   METHODOLODY This is a longitudinal designed study of female religious worshippers in a south western state of Nigeria.  Religious Worship Centres (RWCs) were selected at random in the city. Married females in the selected RWCs were contacted through their leaders on the scheduled date. They were offered health education and were asked to complete a structured questionnaire on their oral health and quality of their marriages. Extra oral and intra oral examination were carried out and the findings recorded. Scaling and polishing, marital counseling with emphasis on the needs to maintain quality marriages, and appropriate routine dental treatments were delivered to all participants. Data analysis was done with STATA 16 software. Relationship between frequency of oral lesions before and after intervention was analyzed for using ttest, p >0.01. RESULTS A total of 113 married female religious worshippers participated in the study. Their mean age was 57.9 years SD 12.8. Majority (101, 92%) currently reside with their husbands, 2(2%) divorced and 7% widowed.  81 (71.7%) had good quality of marriages while 32 (28.3%) had poor quality of marriages. Oral lesions seen before intervention are periodontitis (30, 26.5%), xerostomia (25, 22.1%), mouth odour (22, 19.1%) and Orofacial/TMJ pain (27, 23.3%). Lesions are significantly more prevalent among those with poor quality of marriages. After intervention the prevalence of mouth odour, periodontitis, xerostomia and extra marital romantic relationship reduced significantly by 82% (p=0.04), 53% (p=0.001), 76% (p=0.001) and 89 %( p=0.024) respectively.  CONSCLUSION One third of married, self employed women in their fifth decade of life had poor quality of marriages.  Oral lesions are more prevalent among married women with poor quality of marriage and they also have 94.4% chance of getting involved in extra marital romantic relationship. Significant oral lessons were mouth odour, Orofacial pain, xerostomia and periodontitis. Treatment of oral lesions coupled with marital counseling significantly reduced the prevalence of oral lesions and enhanced their marital life. Key words: Quality&nbsp

Factors that contribute to prolonged hospital stay after discharge among surgical patients in a tertiary hospital in North Central Nigeria : Factors contributing to prolonged hospital stay after discharge

Background: Surgical practice has hospitalization of patients for surgery and treatment as an inherent part of it; after which the patients are found fit for discharge. There is however a group of patients who remain on bed even after they have been deemed fit for discharge. This study aimed to determine the number of days surgical patients classified as having prolonged stay remain in hospital after they were deemed fit for discharge and identify the reasons for this. Methods: Surgical patients still on bed more than 48 hours after they were discharged who consented to participate in the study were recruited. Results: A total of 341 patients were recruited. The mean duration of stay after discharge was 17.6± 13 days. The specialty with the highest number of patients was Neurosurgery. Lack of finance and absence of a caregiver were the causes (96.5% and 3.5% respectively). The top three suggestions by patients on how to reduce prolonged hospital stay were bill waiver for indigent patients, reduced cost of health care services and financial aid by philanthropists. Conclusion: The mean number of days patient remained in hospital after discharge was 17.6 days. Financial reasons and absence of a caregiver are the major reasons for prolonged hospital stay. There is a need for a multi-sectoral approach to improve enrollment in the National Health Insurance Scheme and provide social support for patients in need of care post-discharge to reduce the adverse effects of prolonged hospital stay on the hospital and patients

Seizures Associated with Povidone-Iodine Impregnated Antral Pack in a Child: a Case Report and Review of Literature: Runing title: Povidone-Iodine induced seizures

This is a case of 11 years-old patient diagnosed of suppurative osteomyelitis of the right maxilla. He had incision and drainage with sequestrectomy under general anaesthesia, and povidone-iodine-impregnated antra pack. About 60 hours after surgery, patient began to have seizures, about 6 episodes on the first night, generalized, tonic-clonic, each lasting about 1 minute with post-ictal vomiting. An initial assessment of meningitis (to rule out cerebral abscess) was made. The seizure episodes which lasted for 3 days began to reduce gradually, and completely subsided 24 hours after the removal of the antra pack. However, when the patient had a CT scan with iodine-based contrast as requested by the paediatric neurologist (to rule out cerebral abscess), the episodes went up significantly again for another 24 hours, after which it began to reduce, till none was recorded 48 hours after contrast administration. Povidone-Iodine (PVI) slowly liberates free iodine to exhibit its broad range of microbicidal activity. However, depending on the amount of iodine absorbed, there is a possibility of iodine toxicity, with different systemic manifestations including seizures, especially in children. The seizure is believed to be a result of disruption in the blood-brain barrier by free iodine from PVI and the iodine-based contrast media. Therefore caution should be taken in using PVI as an antiseptic agent in antra packs or on any mucosa surface, especially in children. &nbsp

Mentoring Perceptions and Experiences among Nigerian Undergraduate Dental Students

Introduction: Mentoring among undergraduate dental students in Nigeria has never been evaluated, despite being well reported, to improve academic performance and learning process globally. This study assessed perceptions and experiences of Nigerian undergraduate dental students to mentoring. Materials and Methods: A sample of 382 students was recruited across all the thirteen Nigerian dental faculties. A self-administered online questionnaire prepared on google form was sent to the students for completion. The completed forms were analyzed using SPSS version 20. Descriptive and analytical statistics were applied, and set the statistical significant level at P<0.05. Results: The students showed a very good knowledge of mentoring (99.0%) and an adequate understanding of the role of a mentor (67.3%). Many students had experienced mentoring prior to their dental training; mainly from religious institutions (60.0%). The majority (96.1%) of the students would have preferred to be mentored at the start of their training; however, only 21.2% had assigned mentors. More than half (57.6%) of the students would have preferred to choose their mentor, and the majority (43.2%) were indifferent about gender preference of a mentor. About two-thirds of the students perceived career development as the most important reason for mentoring. The benefits of mentoring were ranked very highly, especially among the female students. Gender was the only predictor for successful mentoring (P< 0.05). Conclusions: Dental students reported low faculty mentoring. Career development was perceived as the most important factor in mentoring. Students recommended that mentoring should be incorporated into the dental curriculum right from the commencement of their training.    Keywords: mentoring, perceptions, experiences, dental students, Nigerian undergraduates&nbsp

Dental Attendance Among the Elderly in Benin-city, Edo state

Background: Despite the increase in the elderly population globally, it appears that several studies focused on dental clinic attendance by other age groups and with sparse data on the elderly. Aim: This study therefore, aimed to determine the rate of dental clinic attendance among the elderly in Benin-city. Materials and methods: This was a half year multi-center, prospective cross-sectional study. This study conducted among dental patients at the outpatient departments two tertiary health facilities in Benin-city.  A three-sectioned questionnaire was used to collect data. The data collected were sex, age, and level of educational, marital status, occupational level, religion, and ethnicity. Other collected data were co-morbidities, previous visit to dental clinic, time of   last visit, reason for last visit, intention to visit the clinic again, presenting complaints and barriers to dental attendant.  Both descriptive and inferential statistics were analyzed. Results: a total number of patients seen were 1450. The prevalence of the elderly patients was 27.7 %. Mean age was 70.4 ± 5.7 years with age range of 65- 97 years. The female elderly were more (52.9%) than their male counterparts. More than half (53.6%) had hypertensions. Less than half (30.2%) rate their dental health as good. More than half (56.9%) have never visited the dental clinic.  Of all the presenting complained asked of the respondents, highest (18.5%) proportion was for toothache. Majority (71.3%) of the respondents affirmed that cost of transportation and long distance was the barrier for attending dental clinic. The rate of attendance (χ = 8.9; p = 0.03) and time of last visit (T =2.84; p = 0.01) was affected by the age of the respondents Conclusions: There was poor attendance to dental clinic by elderly in Benin City mainly due to cost of transportation and long distance. Age was related to poor attendance and time of visitation for attendance. Key words: Dental clinic, attendance, elderl

Knowledge of Oral Prophylaxis and Dental Check-up Amongst Primary School Teachers in Lagos State: An Urban-rural Comparative Study: Dental Public Health

ABSTRACT Background: Oral health knowledge of school teachers will influence the success of the strategy of the National Oral Health Policy at the Community level. Aim: This study aimed to assess and compare the oral health knowledge in Urban and Rural areas of Lagos State. Methodology: A cross-sectional study, using a multistage sampling technique to select 200 primary school teachers in both urban and rural areas. A pretested, self-administered questionnaire was used. Data was analysed using SPSS version 20. Descriptive and crude odd ratio were used, and p-value ⩽0.05 is significant. Result: The mean age of the respondent is 39±10.92 and 47±7.56 for rural and urban areas respectively. More teachers were females in rural and urban areas. The ever-married were majority in both rural and urban areas. Majority had National Certificate of Education in rural and urban areas.  Urban teachers [55%] had adequate oral health knowledge and 63% in the rural had inadequate oral health knowledge.  Crude odd ratio revealed a significant association between geographical location and oral health knowledge [p=0.0102; OR=2.081]; marital status [p=0.0204; OR=0.26] and teaching experience [p=0.0442; ≤10years, OR=1.533; ≤15years, OR=2.130 and ˃16years, OR=3.179].  Conclusion: Primary school teachers in urban area showed adequate oral health knowledge than their counterparts in the rural area of Lagos State

Antibiotics Prophylaxis for Implant Surgery in Nigeria

                                                  Abstract Objectives: Bacterial contamination of dental implants during insertion is of serious concern to dental surgeons as it poses significant risk to the success of the procedure. Consequently, routine use of antibiotic prophylaxis during dental implant surgery has been recommended. This study was designed to investigate the use of antibiotics prophylaxis in implant surgery among dentists in Nigeria; to determine the preferred choice, and dosage of antibiotics prophylaxis. Material and Methods: This is a cross-sectional study of dental surgeons prescribing antibiotics prophylaxis for implant surgery in Nigeria. Using Survey Monkey (By Momentive.ai. California, USA) questionnaire investigating choice, dosage and prescription pattern of antibiotic prophylaxis was posted electronically on the WhatsApp Group platforms of the Nigeria Dental Association (NDA) for a period of 3months. Permission to carry out the survey among dental surgeons on the electronic platform was granted by NDA. Data was analyzed with SPSS 25.0 statistics program (SPSS® Inc, Chicago, IL, USA) and statistical significance was set for p≤0.01. Results: Dental Surgeons that returned the completed forms were 72, among which 63.9% prescribed antibiotics prophylaxis. Respondents that administered antibiotics prophylaxis 24hours before surgery were 48.2% and this is statistically significant at p-value 0.266. Clindamycin was the preferred choice of antibiotic for 30.6% and this is statistically significant at p-value 0.743. A 5-day regular dose of Clindamycin 150mg 6hourly beginning 24hours before surgery was practiced by 58.3%. Amoxicillin at 500mg 8hrly for 5 days is the second most commonly used antibiotic prophylaxis.   Conclusion: The result from this study suggests that a high number of respondents were using antibiotics prophylaxis before placing implant, and this is in consonance with studies from other parts of the world. Clindamycin 150mg 6hourly for 5days, beginning 24hours before surgery was the preferred choice.   Key Words: Antibiotics, Contamination, Implant Surgery, Prophylaxis