Oral Health Profile Of Primary And Post -Primary School Children At A Health Facility In Uselu, Benin-City

Objective: To investigate the oral health profile of otherwise healthy primary and post -primary school children in Uselu, Benin-city. Methodology: All consecutive primary and post-primary school children accompanying siblings and/or friends to access dental care at Mount Gilead hospital, Uselu between June 1, 2008 and May 31, 2009 and for who consents were obtained from parents or guardians on their behalf were recruited. Age, sex, and the gingival index were noted for these children. The Gingival Index was used to assess the severity and prevalence of gingivitis by examining the qualitative changes (that is, severity of the lesion) of the gingival soft tissue and scored on a four point scale 0-3, as follows: 0= No inflammation. 1= Mild inflammation 2= Moderate inflammation 3 = Severe inflammation Results: A total of 340 children were assessed, with a male to female ratio of 3:2 (That is 204 males and 136 females). Three (0.9%) had no gingivitis, 35(10.29%) had mild gingivitis, 110 (32.35%) had moderate gingivitis and 192 (56.47%) had severe gingivitis. Conclusion: The oral health profile of these children is poor and unacceptable. In line with the millennium development goals, appropriate agencies should liaise with the right professionals to achieve the desired goals. Recommendations: Massive oral health campaign

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury

Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing

A Review of Medical Emergencies in Dental Practice

Background: Medical emergencies in dental practice are those adverse medical events that may present in the course of dental treatment. Each of those events requires a correct diagnosis for effective and safe management. The contemporary dentist must be prepared to manage expeditiously and effectively those few problems that may arise with specific response. Basic life support is all that is required to manage many emergency situations, with the addition of specific drug therapy in some others.Objectives: The aims of this paper are to provide an overview of medical emergencies that can present in dental practice, highlight the basic emergency medications and equipment that should be available in a dental clinic, outline the prevention and management of such  emergencies, describe the specific response to some of the more common medical emergencies that can present in the course of a dental treatment and make recommendation for training and preparedness for handling medical emergencies.Methodology: Review of available literature on the subject matter via electronic search engines of Google- PubMed and Medline.Results: Medical emergencies are quite common in dental practice and the most common, from scientific studies and anecdotal evidences, is syncope; and dental surgeons, their staff and offices are usually ill prepared to handle these emergencies.Conclusion: Medical emergencies may be rare but they are challenging occurrences in the dental clinic, tasking the knowledge, skills and materials available to the practice. Adequate staff training and availability of appropriate drugs and equipment are essential in the management of emergencies that may arise in the dental clinic.Recommendation: An improvement in the training of dental surgeons including realistic simulation training in the management of medical emergencies, at the undergraduate, post-graduate and the continuing education levels

What impact has third molar surgery on the quality of life

Objective: The objective of this study is to evaluate patients' perceptions of changes in health related quality of life (HRQoL) over a twelve week period following third molar surgery. Methods: Health related quality of life measures, New 15D©, was administered to the study group prior to surgery. Standardized surgical and analgesic protocols were employed. Patients kept a diary of changes in life quality each postoperative day for seven days and they were contacted four and twelve weeks following surgery. Results: One hundred and six patients participated in this prospective study. HRQoL measure identified a significant deterioration in quality of life in the immediate postoperative period, during the first week (P<0.05). However, there was an improvement in HRQOL compared to preoperative status four weeks (P<0.05) and twelve weeks (P<0.05) postoperatively. Conclusions: The study concludes that there were significant improvements in quality of life following third molar surgery. However, in the immediate postoperative period patients experienced deterioration in HRQoL. Patients with symptomatic rather than asymptomatic third molars were more likely to benefit, in terms of improvement in quality of life, from third molar surgery. Keywords: Quality, life, third molar, surgery. Running title: What impact has third molar surger

Does concern about halitosis influence individual’s oral hygiene practices?

Objective: The objective of this study was to assess whether the concern about halitosis influence oral health attitude and practices among young literate adults in Nigeria. Materials and Methods: This cross-sectional survey of 400 randomly selected temporary camp resident adults in Anambra state, South Eastern Nigeria was conducted using a modified version of the Hiroshima University-Dental Behavioral Inventory questionnaire. Results: Out of the 400 questionnaires distributed, only 294 were filled and returned giving an overall response rate of 73.5%. Half (50.0%) of the participants in this study expressed concern about halitosis. The participants that expressed concern about halitosis were mostly in the 25- to 27-year-old age group, females, known smoker, regular dental floss, and mouth wash users, had incorrect tooth brushing knowledge, brushed teeth more frequently and more forcefully, had no previous dental treatment, prefer symptomatic dental visit, experienced gingival bleeding, expressed worry about the color of their gingiva and teeth but were satisfied with the dental appearance.Conclusion: Data from this study showed that concerns about halitosis-triggered behavioral reaction in oral self-care practices namely tooth brushing frequency, tooth brushing force, mouth wash, and dental floss use. Also revealed were poorer oral health and lower preventive dental visit practices among participants concerned about halitosis. There is need for improved public knowledge and awareness about halitosis by the dentist in Nigeria.Key words: Concern, halitosis, oral hygiene practice

Errata: Reasons For Tooth Extraction Among Nigerian Children Attending A General Dental Practice Clinic

This paper had to be republished to correct some minor errors spotted out in the earlier publicationTo investigate the reasons for tooth extraction among children attending a general dental practice clinic in Uselu, Benin City, Edo State. All pediatric patients that had tooth extraction between January 2006 and December 2008 in a general dental practice in Uselu were recruited for this survey. The data collected include age, sex, reason for tooth extraction and type of tooth extracted. A total of 756 tooth extractions were done during the survey period. Female constituted 57.4% of patients seen. Caries was the most frequent reason for tooth extraction (82%). The deciduous teeth were mostly extracted (66.1%) than permanent teeth (33.9%). Deciduous molar accounted for 42.6% of all extraction in children. Mandibular teethwere more frequently extracted (60%) than maxillary teeth (40%). Exodontia was also more on the right side of the mouth and lower right quadrant. Dental caries was the predominant reason for exodontia in Nigeria children attending a general dental practice in Uselu, Edo State. Extensive prevention programmes targeted at children with high caries risk in schools and the communities is a necessity.Key words: exodontia, reasons, children, general dental practic

Reasons For Tooth Extraction Among Nigerian Children Attending a General Dental Practice Clinic

Please see the ERRATA published in the 7 (1&2) 2011 issue of this journal for the corrected version of this article - the PDF is also available there.

Infection control in Dental Laboratories: A survey of Nigerian dental technology students

Context: Transmission of infection may occur in laboratory oral healthcare setting with undermined infection control.Objective: To assess infection control knowledge and confidence in protecting self from occupational acquisition of HIV infection among Nigerian dental technology students.Methods: This questionnaire-based cross-sectional survey of dental technology students of Federal School of Dental Therapy and Technology Enugu, Nigeria was conducted in 2010.Results: The infection control knowledge among the respondents in this study was high. The roles of dental technologists in infection control expressed by the respondents were use of protective wares-(74.3%),sterilization-(39.4%), disinfection of impression-(13.1%), proper instrument handling-(9.1%) and hand washing-(4.0%). A total of 68.2% of the respondents asserted that infection can be transmitted from impression with 44.4% of them pinpointing tuberculosis as the most likely transmissible infection. The majority (87.9%) of the respondents expressed confidence in the ability to protect self from occupational HIVacquisition. More than half (57.1%) of the respondents reported having adequate HIV-related knowledge for information delivery to the patients and public.Conclusion: Overall the infection control knowledge and expressed  confidence in the ability to protect self from occupation HIV acquisition was good in this study.Key words: Knowledge, infection control, transmission, dental technology students