Impact of the COVID‑19 Pandemic on the Psychosocial Wellbeing of Dental Therapists in Nigeria

Background: The first case of coronavirus disease 2019 (COVID‑19) was identified in Wuhan, China in December 2019, as a highlycontagious infection transmitted via droplets, and person-to-person contact. Airborne and aerosol transmission have also been implicated. Aerosol generating procedures such as scaling and polishing may increase the risk for developing COVID-19 in dental clinics, and may thus place some psychological strain on dental therapists. This study aimed to determine the psychosocial effect of COVID‑19 on dental therapists in Nigeria. Materials and Methods: This cross-sectional study was carried out following ethical approval from the institutional Ethics Committee. Data collection was through self-administered online questionnaires and included socio-demographic characteristics. Psychosocial well‑being was assessed using a five‑point Likert scale that assessed the level of worry. Scores were summed up to obtain the mean (range 5–25). Statistical significance was set at a level of P ≤ 0.05. Results: The 192 respondents had a mean age of 28.0 ± 7.2 years, 96.9% were aware of COVID‑19. Sixteen (8.3%) participants reported at least one medical condition. The mean psychosocial‑wellbeing score was 18.4 ± 4.9. Most (90.1%) were worried about the COVID-19  pandemic, while 76% were severely worried about getting infected with COVID-19 in the dental clinic, and 72.9% were severely worried about the availability of personal protective equipment (PPE) in the clinic. Participants with self‑reported medical conditions had a  slightly higher psychosocial score (18.6 vs. 18.4), but this was not significant (P = 0.902). Conclusion: The psychosocial effect of the COVID‑19 pandemic was considerable on the dental therapists. The provision of PPE,  training on Infection Prevention and Control, and psychosocial support will reduce the psychosocial effect of COVID‑19 on dental therapists in Nigeria as they are willing to ensure patients’ safety. Keywords: Coronavirus disease 2019, dental therapists, Nigeria, psychosocial wellbein

Oral conditions, periodontal status and periodontal treatment need of chronic kidney disease patients

Objective: To evaluate the periodontal status and periodontal treatment need (TN) of patients with chronic kidney disease (CKD). Methodology: All the patients with CKD who presented at the renal out-patient clinic of the University of Lagos University Teaching Hospital were recruited into the study. Data were collected using self-administered questionnaire with open and closed questions comprising demographic details such as age and gender, year of diagnosis, and stage of kidney disease and dialysis. Simplified oral hygiene index (OHI-S) of Green and Vermilion and Community Periodontal Index of TN were used to assess the patients′ periodontal status. Results: Participants′ age ranged between 21 years and 73 years with a mean age of 45.14 ΁ 14.14. Of the 65 participants, males were 64.6% and females were 35.5%. More than half of the participants were diagnosed within the last 5 years (54.6%). The cause of renal disease in 41 of them (63.1%) was hypertension. Other causes such as chronic glomerular nephritis (4.6%), diabetes mellitus (4.6%), and  hypertensive heart disease (3.1%) were also mentioned. Nearly, 6.2% had no known cause. About a fifth of the participants (16.9%) had other systemic conditions such as diabetes. Their mean OHI-S was 1.96 ΁ 0.90. About two-thirds of the participants had CPI score of 2, and the major treatment needed was code 2 consisting of scaling, polishing, and root planing. Conclusion: Majority of the CKD patients reviewed had poor periodontal status with code 2 TN. We, therefore, recommend nonsurgical periodontal treatment for all CKD patients to improve their oral health and forestall the systemic effects of periodontal pathology

Association between periodontal diseases and systemic illnesses: A survey among internal medicine residents in Nigeria

AbstractObjectiveTo assess internal medicine residents’ knowledge of associations between periodontal disease and systemic illnesses, and attitudes toward patients’ periodontal health.MethodsA cross-sectional survey using a self-administered questionnaire was conducted among internal medicine residents attending the Faculty of Internal Medicine 2014 Update Course organized by the National Postgraduate Medical College of Nigeria. Participants came from all over the country. Data on respondents’ demographic characteristics, periodontal disease knowledge, knowledge of associations between periodontal disease and systemic illnesses, and attitudes toward patients’ periodontal health were collected. Data were analyzed using Epi INFO software. The Pearson chi square test was used to measure significant association between categorical variables such as the knowledge of periodontal disease and gender, age group and designation of the participants (p⩽0.05).ResultsOf 150 questionnaires distributed, 123 were returned (82% response rate); 109 questionnaires were completed properly and included in the analysis. The most common source of residents’ information on oral health was television (59.4%). Only 11.2% of respondents were aware that gingival bleeding was the earliest sign of periodontal disease. Respondents correctly identified periodontal disease as a risk factor for coronary heart disease (45.9%), stroke (43.5%), hospital-acquired pneumonia (53.2%), diabetes mellitus (13.8%), and preterm birth (11%). Increased age (p=0.032) and male gender (p=0.022) were associated significantly with knowledge of periodontal disease as a risk factor for stroke. Higher designation (p=0.002) and longer duration in residency training (p=0.004) were associated significantly with knowledge of periodontal disease as risk factor for peripheral arterial disease. The majority (90.9%) of respondents had positive attitudes toward the referral of their patients for regular periodontal care.ConclusionsKnowledge of periodontal disease as a risk factor for systemic illnesses among medical residents in Nigeria is inadequate. These relationships should be emphasized in continuing medical education courses

Prevalence of self-reported halitosis and associated factors among dental patients attending a tertiary hospital in Nigeria

Objectives: To determine the prevalence of self-reported halitosis among dental patients seen in a teaching hospital. Materials and Methods: This was a cross-sectional study that included 135 dental patients enrolled at the Oral Diagnosis/Periodontology Clinics of the Lagos University Teaching Hospital. Self-administered questionnaires were used to assess self-reported halitosis (oral malodor) in the subjects. Association between self-reported halitosis and sociodemography (age, gender, education, marital status, ethnicity, and religion) and intraoral findings (gingivitis, periodontitis, tongue coating, caries, and number of mobile teeth) was determined. Results: The prevalence of self-reported halitosis was 14.8% and was significantly associated with age of 40 years and above (P = 0.025), and male gender (P = 0.032). Subjects with gingivitis were 2 times more likely to have halitosis than those without gingivitis (odds ratio [OR] = 2.19 while subjects with tongue coating were 2 times more likely to have halitosis than those without tongue coating OR = 2.02. About 50% perceived halitosis by themselves, 25% by family and friends, and 20% from presumed actions of people around them. The majority (70%) of the patients perceived the halitosis from their mouths, 30% from their mouth and nose. Most (75%) of the subjects had perceived the halitosis for more than 4 weeks while only 3% had sought professional treatment. Conclusion: Older age of 40 years and above and male gender were the factors associated with self-reported halitosis in this study. The health-seeking behavior of the patients for the treatment of the halitosis was poor

Antimicrobial activities of Garcinia kola on oral Fusobacterium nucleatum and biofilm

The extracts from the root, bark and seed of Garcinia kola are currently used in traditional medicine in Nigeria. The aim of this study was to evaluate the inhibitory activity of crude extracts of G. kola on Fusobacterium nucleatum isolated from the oral cavity. Methanol and aqueous extracts were prepared from the seed and the minimal inhibitory concentration was evaluated by the agar dilution method, using a Wilkins-Chalgren agar supplemented with horse blood (5%), hemin (5 mu g/ml) and menadione (1 mu g/ml). Antimicrobial activity of plant extracts on microbial biofilms was determined in microtiter plates. The seed of G. kola demonstrated significant inhibitory action on F. nucleatum isolates at a concentration of 1.25 and 12.5 mg/ml for amoxicillin resistant strain. It was able to inhibit the microbial biofilm formed by the association of F. nucleatum with Porphyromonas gingivalis ATCC 33277, Aggregatibacter actinomycetemcomitans ATCC 33384 and Prevotella intermedia ATCC 2564 at a concentration of 25 mg/ml. The in-vitro inhibitory effect of G. kola on F. nucleatum population suggests a potential role for its use in oral hygiene.F-Thecla Ventures Nigeria Lt

Isolation and molecular identification of Fusobacterium nucleatum from Nigerian patients with oro-facial infections.

Fusobacterium nucleatum is one of the most common anaerobic bacteria present in the oral cavity and is often isolated from infections involving other body sites. To characterise F. nucleatum strains from patients attending a teaching hospital in Nigeria in order to provide information on the methods for accurate identification of anaerobes in clinical specimen. Fusobacterium nucleatum specie from 50 patients presenting with oro-facial infections were studied by culture on Fusobacterium selective agar and fastidious anaerobe agar. The isolates were characterised based on colonial morphology, microscopy, lipase production, susceptibility to kanamycin and colistin and resistance to vancomycin. Biochemical tests were performed using a commercial test kit. The identity of the isolates was confirmed based on molecular characterization performed using polymerase chain reaction (PCR) analysis. Forty-eight (96%) F. nucleatum isolates were obtained from the 50 patients by culture and all the isolates were identified by colonial appearance and microscopy based on their unique spindle shape with tapered ends. Only 26 (54.2%) of the 48 isolates were identified by commercial API 20A test kit while PCR confirmed the identity of all the isolates. Anaerobes are involved in human infections and their study is quite cumbersome due to tedious nature and high cost of the techniques involved. Cultural method is reliable in the isolation and identification of F. nucleatum species. PCR is a rapid and simple method that can complement the phenotypic identification of anaerobes and would assist in their full identification