The prevalence of early childhood caries and its associated risk factors among preschool children referred to a tertiary care institution

Objective: The aim was to determine the prevalence of early childhood caries (ECC) and its association with infant feeding and oral health‑related behavior among preschool children aged 6–71 months in Lagos.Materials and Methods: This was a descriptive cross‑sectional study in which 302 children aged 6–71 months were selected from four pediatric outpatient clinics in Lagos, Nigeria. A structured questionnaire was used to obtain information regarding oral hygiene practices, dietary habits, breast and bottle feeding, birth weight of child and socioeconomic status of the family, from mothers of the children. The status of dental caries was recorded according to the World Health Organization criteria.Results: The prevalence of ECC among 302 children aged 6–71 months was 21.2% while the mean deft was 0.735. Multivariate logistic regression analysis showed the correlation of ECC with the associated risk factors. ECC was significantly higher in children who were bottle‑fed at night. Method of tooth cleaning other than using fluoridated toothpaste significantly increased the prevalence of ECC. Breastfeeding for duration of 3–6 months showed significantly lesser caries prevalence. Caries significantly increased with age.Conclusion: Early childhood caries is a multifactorial disease in which prolonged duration of breastfeeding, nocturnal bottle feeding, and use of cleaning methods other than fluoridated toothpaste are risk factors for ECC. Oral health promotion programs should be targeted at mothers, pediatricians, nurses, caretakers at day care centers and primary care health workers.Keywords: Early childhood caries, Lagos, prevalence, risk factor

Effect of mineral trioxide aggregate and formocresol pulpotomy on vital primary teeth: A clinical and radiographic study

Background: Pulpotomy is the common therapy for cariously exposed pulps in symptom‑free primary molar teeth. Formocresol (FC) is considered the gold standard dressing agent for pulpotomy, but concerns have been raised over the years about its safety. Other alternative pulpotomy agents have been investigated and suggested.Objective: The objective was to evaluate and compare the clinical and radiographic response of FC and white mineral trioxide aggregate (MTA) as pulpotomy materials on primary molars.Materials and Methods: Fifty primary molars, with deep carious lesion that exposed a vital but asymptomatic pulp, in 37 children aged 4-7 years were treated with conventional pulpotomy procedure. The teeth were divided randomly into two groups. Group I (FC) and group II (MTA). The treated teeth were evaluated clinically and radiographically and were followed‑up for 12 months.Results: At the end of the 12 months follow‑up, the clinical success rates for FC and MTA were 81% and 100%, respectively. There was a statistically significant difference (P = 0.04) between the clinical success rates of FC and MTA. While the radiographic success rates for FC and MTA were 81% and 96%, respectively, there was no statistically significant difference between the radiographic success of MTA and FC.Conclusion: White MTA showed a higher clinical and radiographic success rate when compared to FC as a pulpotomy agent in vital primary molars, and it has a potential to become a replacement for FC in primary molars.Key words: Formocresol, mineral trioxide aggregate, primary molars, pulpotom

Double teeth in the primary dentition: Case reports from a Nigerian Tertiary Hospital

The term double tooth is used to describe the developmental dental abnormalities called gemination and fusion. Gemination is an attempted, incomplete division of a single tooth germ during the proliferation stage of odontogenesis, while fusion is the union of two or more independently developing teeth. Although the prevalence of primary double teeth is low, double teeth are of clinical interests because of the associated clinical problems. The clinical problems associated with the condition in the primary dentition are often downplayed for various reasons in spite of their importance. Primary double teeth ought to be carefully investigated so that these clinical problems which may affect the permanent dentition can be effectively managed. Perhaps primary double teeth have not received adequate documentation in our environment because of the low prevalence. This paper presents four primary double teeth in three patients. One of the cases presented occurred bilaterally, a relatively uncommon phenomena. The associated clinical problems are illustrated in the cases and the management discussed. Although primary double teeth are asymptomatic and in some cases may not interfere with function, they do have associated clinical problems. Early diagnosis and regular clinical and radiographic observations are necessary for effective management and appropriate treatment of the anomaly.Keywords: Double teeth, Primary dentition, Clinical significanc

Causes and pattern of tooth loss in children and adolescents in a Nigerian Tertiary Hospital.

Background: Tooth loss diminishes the quality of life and is also related to poorer general health. Premature tooth loss in children can have devastating effects such as compromised aesthetics and function, mesial and distal drifts of adjacent teeth leading to crowding and impaction of the permanent successors and other forms of malocclusion.Objective: To assess the causes and pattern of tooth loss in children and adolescents at the Paedodontic Clinic of the Lagos University Teaching Hospital, Lagos.Methods: This retrospective study was carried out at the Paedodontic Unit of the Lagos University Teaching Hospital, Lagos using clinical records over a period of time from January 2008 to April 2010. Information obtained included age, gender, missing and extracted teeth, and reasons for extraction/tooth loss. Exfoliated primary teeth and congenitally missing teeth were excluded. Data was analysed using Epi info 2007 statistical software. Chi-square test was used to compare proportions of tooth loss among age groups. The level of significance was set at P<0.05Results: A total of 493 patients aged 1-16 years had lost one or more teeth due to various reasons. There were 244(49.5%) males and 249 (50.5%) females. Majority of the subjects lost their teeth due to caries and its sequelae (64.3%) compared to trauma (10.8%) and orthodontic reasons (23.5%). Seven (1.4%) lost their teeth due to failure of previous treatment such as pulp therapy.Conclusion: Extraction largely due to caries and its sequelae was responsible for most of the tooth loss among the study population. There is the need for intensified oral health education and awareness programmes in the populace with emphasis on prevention of dental caries and early presentation for dental treatment in order to avert premature tooth loss in children and adolescents.Keywords: Causes, Pattern, Tooth loss, Children

Multiple maxillofacial fractures in a patient undergoing orthodontic treatment: a case report

Severe maxillofacial injuries among patients receiving orthodontic treatment are very rare. When they occur, they can be life threatening with several complications which include neurologic deficits, malunion of fracture segments secondary to delay in reduction and immobilization of fracture segments and massive blood loss. Delay in treatment of such maxillofacial injuries in the presence of other life threatening injuries predisposes the patient to residual and minor malocclusion. The interdisciplinary management of injuries sustained by an orthodontic patient and the challenges associated with its management are highlighted in this report.Reduction and immobilization was carried out under general anaesthesia using an arch bar in the mandibular arch. Direct bonded brackets in the maxillary arch with additional eyelet wires were used in the management of the fractures. An acceptable reduction of bilateral parasympseal fractures was obtained with available intermaxillary fixation. There was some residual and minor malocclusion attributed to the delay in treatment and possibly the method used.A multi-disciplinary team approach for the management of maxillofacial fractures in patients undergoing orthodontic treatment with fixed appliances is suggested. Orthodontic treatment with surgical involvement has been found to improve both facial aesthetics and occlusal function.Key words: Maxillofacial, trauma, reduction, immobilization, orthodonti

Pain on Propofol Injection: The Gender Differences in Pain Perception

Background: Injection pain, which distresses patients, is a major disadvantage of propofol as an induction agent. Lignocaine pretreatment is the most popular method for reducing this pain but this drug alone cannot eliminate the problem. The aim of this study was to investigate the gender differences in pain perception/responses, and the analgesic effect of lignocaine and metoclopramide combination, compared with lignocaine alone, during propofol injection in an adult Nigerian population at the Lagos University Teaching Hospital (LUTH).Methods: A total of seventy patients were studied, comprising twenty-seven men (38.57%) and forty-three women (61.43%). Thirty-five patients in each group; who came in for various elective surgical procedures under intravenous general anesthesia were randomly assigned to two different groups, A or B. The effectiveness of a combination of i.v lignocaine 20mg/ i.v metoclopramide 10mg ( group A, n=35) when mixed with i.v propofol 2.0mg/kg in reducing pain on injection at induction of anesthesia was compared with i.v lignocaine 20mg alone mixed with i.v propofol 2.0mg/kg into a dorsal hand vein (group B, n=35). During a ten-second pause, after the first 25% of the calculated propofol dose (mixed with study drugs), the patients were asked standard questions regarding pain on injection before induction of anaesthesia. The incidence and intensity of pain were assessed using a four point Verbal Rating Scale 0 to 3 during propofol injection. Thereafter, the induction of anesthesia was continued and completed with the remainder of the calculated propofol dose and endotracheal intubation facilitated with 0.1mg/kg pancuronium in the two groups. In all other respects, except for the type of surgery, the patients had the same treatment.Results: With regard to incidence of pain on injection, the difference between the two groups was statistically significant (P<0.05) using the Chi-square test. There was no statistical difference in Verbal Pain Response (intensity) (P>0.05) Female patients had statistically significant greater pain responses/perception than men in both groups (P< 0.05).Conclusion: A lignocaine/metoclopramide combination was more effective than lignocaine alone for reducing pain on injection of propofol, and in addition, women had significant greater pain perception than men.Keyword: propofol injection pain, gender differences, pain perception, lignocaine, metoclopramide

Natal and neonatal teeth: Literature review and report of seven cases in a Nigerian Tertiary Hospital

Teeth that are present in newborn infants are called "natal teeth" while teeth that erupt within the first 4 weeks after birth are called "neonatal teeth". The incidence of the appearance of natal and neonatal teeth has been reported to be between one in every 1000 and one in every 6000 births. Natal teeth may be uncomfortable for a nursing mother and present a risk of aspiration and swallowing by the infant if they are loose. Also, they may cause irritation and trauma to the infant's soft tissues. Under these circumstances, these teeth need to be extracted. This paper presents 7 cases of natal and neonatal teeth. Three of the cases presented with natal molar teeth which are rare. The clinical features, complications and management are discussed.Keywords: Primary dentition, natal tooth, neonatal tooth, treatmentNig Dent J Vol 20 No. 1 Jan - June 201

Knowledge of Australian primary education providers towards dental avulsion injuries: a cross-sectional study

Background/aim The aim of this study was to evaluate the knowledge of school professionals regarding the emergency management of dental avulsion. Methods This cross‐sectional study utilised a self‐administered, pilot‐tested questionnaire for school staff from primary schools. Descriptive statistics were used for the analysis – the prevalence and univariate associations between a categorical outcome and the variables under consideration, were evaluated using Pearson’s Chi‐squared test. Results This survey yielded a response rate of 43.5% (n = 313). Approximately 60% of participants held valid first‐aid certificates and 23% had received avulsion advice previously. Over 80% of participants expressed an unwillingness to replant an avulsed tooth, and over 90% believed that there should be greater awareness in this area. This unwillingness to replant was influenced by respondents’ age (x2 = 8.13 df = 3, P = 0.043) and receiving advice previously (x2 = 13.15, df = 1, P < 0.001). Under‐preparedness was related to years of experience (x2 = 15.03, df = 5, P = 0.010), first‐aid training (x2 = 6.41, df = 1, P = 0.011) and receiving advice previously (x2 = 43.47, df = 1, P < 0.001). It was also evident that first‐aid training positively influenced appropriate dental referral in the management pathway (x2 = 10.49, df = 1, P = 0.001). Conclusion This study suggests that there is an inadequate level of knowledge on the appropriate management of dental avulsion injuries amongst primary school professionals in Australia