The Dental Neglect Scale in adolescents

<p>Abstract</p> <p>Background</p> <p>Dental neglect has been found to be related to poor oral health, a tendency not to have had routine check-ups, and a longer period of time since the last dental appointment in samples of children and adults. The Dental Neglect Scale (DNS) has been found to be a valid measure of dental neglect in samples of children and adults, and may be valid for adolescents as well. We administered the DNS to a sample of adolescents and report on the relationships between the DNS and oral health status, whether or not the adolescent has been to the dentist recently for routine check-ups, and whether or not the adolescent currently goes to a dentist. We also report the internal and test-retest reliabilities of the DNS in this sample, as well as the results of an exploratory factor analysis.</p> <p>Methods</p> <p>One hundred seventeen adolescents from seven youth groups in the Seattle-Tacoma metropolitan area (Washington State, U.S.) completed the DNS and indicated whether they currently go to a dentist, while parents indicated whether the adolescent had a check-up in the previous three years. Adolescents also received a dental screening. Sixty six adolescents completed the questionnaire twice. T-tests were used to compare DNS scores of adolescents who have visible caries or not, adolescents who have had a check-up in the past three years or not, and adolescents who currently go to a dentist or not. Internal reliability was measured by Cronbach's alpha, and test-rest reliability was measured by intra-class correlation. Factor analysis (Varimax rotation) was used to examine the factor structure.</p> <p>Results</p> <p>In each comparison, significantly higher DNS scores were observed in adolescents with visible caries, who have not had a check-up in the past three years, or who do not go to a dentist (all p values < 0.05). The test-retest reliability of the DNS was high (ICC = 0.81), and its internal reliability was acceptable (Cronbach's alpha = 0.60). Factor analysis yielded two factors, characterized by home care and visiting a dentist.</p> <p>Conclusion</p> <p>The DNS appears to operate similarly in this sample of adolescents as it has in other samples of children and adults.</p

Global Theme Issue: Poverty and Human Development The effect of poverty on access to oral health care in Nigeria

Nigeria is a country with a population of over 140 million people (1). Over 60% of Nigerians live in rural areas. Poverty is especially severe in rural areas where social services and infrastructure are limited or non existent. Africa is the continent where the poorest people in the world live. Nigeria is the most populous black African country where about 70% of the population live under one dollar per day (2). Nigeria has been classified as a poor nation. In Nigeria, majority of those living in rural areas are poor and depend on agriculture for food and income. Small scale farmers who cultivate tiny plots of land and depend on rainfall rather than irrigation system produce about 90% of the country\'s food. Women play a major role in the production, processing and marketing of food crops. The poorest group go on subsistence living but are often short of food, particularly during the pre-harvest period. Many poor Nigerians suffer from malnutrition and other diseases related to poor nutrition such as acute necrotizing ulcerative gingivitis (ANUG) and cancrum oris (3-6). The HIV/AIDS pandemic has also taken a heavy toll on the rural population and could be considered an emerging public health problem. The extremes of poverty in Nigeria are outrageous. The outrage is not just that avoidable deprivation, suffering and death are intolerable; it is also that these situations coexist with affluence. Corruption is endemic in Nigeria and this has impoverished the nation. Intergenerational poverty exists in the country. Fight against poverty is necessary to reduce intergenerational transfer of poverty in Nigeria because most Nigerian children are born into poverty. The oral health status of underprivileged Nigerians is generally poor. Many Nigerians suffer from oral diseases such as caries, fracture teeth, gingivitis, periodontitis, acute necrotizing ulcerative gingivitis, cancrum oris, malocclusion, tumours and other dental problems (7-15). Non availability of National data on the prevalence of common oral diseases among Nigerians is a major problem and poses a great challenge to the Nigerian Dental Association whose members are major stakeholders regarding oral health care delivery system in the country. Lack of national data has affected planning meaningful oral health care for Nigerians. This paper identified the barriers to access oral health care and stress the various strategies by which the Nigerian Dental Association and all stakeholders could assist the Federal Government of Nigeria to overcome these barriers and formulate policies that will prevent oral disease and move the nation forward to achieve the millennium development goal. Nigerian Dental Journal Vol. 16 (1) 2008: pp. 40-4

A case of broomstick in the root canal extending beyond the apex causing epistaxis

There have been several reports describing the placement, by patients of foreign objects in to the exposed pulp chambers and canals. Foreign objects inserted in the canal have varied from radiolucent objects like wooden tooth picks or tooth brush bristles to radiopaque materials like paper pins, needles and pencil leads. In this present case a 13 year old boy reported at the outpatient clinic of the Department of Preventive Dentistry, Obafemi Awolowo University, Ile-Ife with a 6 year history of trauma to the upper anterior teeth. There was bleeding from the nose, painful labial swelling, and discharging sinus around the maxillary right permanent central incisor for 4 days. A periapical radiograph did not show presence of a foreign object in root canal of the fractured discoloured right maxillary central incisor. The patient denied inserting any object in the canal. The tooth was extracted and a broomstick extending by 12mm beyond the apex of the tooth and bleeding from the nose was observed. A case of a unique foreign object in the pulp chamber projecting beyond the apical foramen and resulting in epistaxis is reported. The importance of early treatment of fractured teeth in children is stressed to prevent complications. Keywords: Broomstick, root canal, epistaxisNigerian Dental Journal Vol. 15 (1) 2007: pp. 39-4

Perceived and Normative Needs of Facial Cleft Patients Seen in Nigeria

Objective: To evaluate the pattern of presentation and assessing treatment needs of children with facial clefts. Material and Methods: This was a cross sectional study of 49 patients seen at the cleft clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife for a 39-month period of study. Data collected were patient’s bio-data including age, date of birth, sex, social class, age of parents, dental findings, associated malformations, treatment given and referral using an interviewer-administered questionnaire. Data was analyzed using the Statistical Package for Social Sciences. Frequency distributions were carried out for all variables and the Pearson Chi-Square Test was applied to assess the significance of differences between groups at a p value of 0.05. Results: Cleft lip and palate had the highest preponderance 23 (47.0%) followed by cleft lip 14 (28.6%) and cleft palate 12 (24.5%). There were more females 28 (57.14%) than males 21 (42.9%) at male to female ratio of 3: 4, though; it was not statistically significant (p-0.73). Most of the patients (73.5%) belong to the low social class. The high social class had 13 (26.5%) cases. Conclusion: The most important treatment needs of cleft patients in this study were: review/follow-up of treatment protocol, oral hygiene instructions, cleft palate repair, cleft lip repair, and referral to the Orthodontist for treatment of varying degrees of malocclusion in descending order. This trend in the treatment needs arose because most of the patients were still ignorant of the implications of managing facial cleft defects through the multi-disciplinary treatment approach

Dental Caries in 12-year-old Suburban Nigerian School Children

BACKGROUND: Dental caries is one of the commonest oral diseases in children. Despite this fact, not much attention has been given to studies on this issue among suburban Nigerian children. OBJECTIVE: To investigate the prevalence of dental caries, dental attendance and oral health behaviours among the 12-year-old suburban Nigerian children. SUBJECTS AND METHODS: Four hundred and two schoolchildren (349 boys, 153 girls) from both private and public schools age 12-year-old participated in the study in 2003. One examiner was calibrated and performed the screening procedures using standard method of WHO diagnostic criteria. RESULTS: The prevalence of caries was 13.9 % and mean DMFT was 0.14. The decayed component accounted for 77.2 % of the DMFT while filling and missing teeth accounted for 15.8% and 7% respectively. Over 85 % of the children examined were caries free. Seventy seven per cent of the teeth affected by caries were untreated. The probability of having caries experience DMFT>0 was significantly associated with the type of school and regular sweet consumption p< 0.05. The children who had not visited the dentist had higher caries prevalence than other children. This was statistically significant p<0.05. Dental attendance was generally poor in both public (90.6%) and private (83.1%) school children. CONCLUSION: The findings in this study for the caries prevalence in 12 year - old suburban Nigerian schoolchildren was as low as in developed countries of central Europe and lower than the global standard according to WHO references for the year 2000

Changes in dental health investment across the adolescent years

Background Studies investigating investment in health across the life course are lacking. The aim of this study was to examine investment in dental health across adolescence. Methods Changes in dental health investment, as measured by dental registration (months) between when adolescents were aged 11/12 years compared to when they were 15/16-years-old, were investigated using ordinary least squares (OLS) regressions. Adolescents aged 11 or 12 years in April 2003 in the Northern Ireland Longitudinal Study were included (n = 13,564). The overall change in registration and changes according to socio-economic status, highest educational attainment of household reference person, parental marital status, as well as the individuals' gender and number of siblings were examined. Within variable disparities at both age groups were also investigated. Results Average number of months registered with a dentist fell from 8.14 months (11/12 years old) to 7.38 months (15/16 years old) (p &amp;lt; 0.001). No gender disparities existed when adolescents were aged 11/12 years but when adolescents were 15/16 years old, females had significantly higher registration than males (8.72 months: 8.20 months; p &amp;lt; 0.001). Conclusions During the transition from childhood to adulthood, an individual's dental health may suffer as a result of a decline in registration rates with a dentist. This risk is likely to be greater among males than females. The role of children's services within dentistry should be reviewed