Relationship of oral hygiene status and practices with oral lesions in a group of HIV positive patients in Lagos, Nigeria

Objective: The oral health of HIV positive patients may be compromised because of their depressed immunity and may increase their risk of developing some oral lesions. This study was carried out to assess the relationship of the oral hygiene status and practices with oral lesions in HIV positive patients at a dedicated HIV clinic in Nigeria. Method: A cross sectional study of adult HIV positive patients aged 18 years and above at the HIV outpatient clinic of the Lagos University Teaching Hospital. Data on age, gender, marital status, level of education and oral hygiene practices were collected. Their CD4 counts were recorded. Oral examination was carried out on all patients to assess their oral hygiene status using the Simplified Oral Hygiene Index. Oral lesions were recorded when present. Result: A total of 134 HIV positive patients were seen, most (71.6%) of whom had never visited a dentist. The mean oral hygiene index (OHI-S) score of the patients was 1.85 and 55.2% had a fair oral hygiene status. The majority (77.6%) cleaned their teeth once daily. Oral candidiasis and linear gingival erythema (LGE) were the two most prevalent oral lesions being 26.1% and 11.2% respectively. The mean oral hygiene index (OHI-S) score was higher in males [2.10] compared with females [1.71] (p<0.05), in patients who had never visited the dentist [1.99] compared with those who had visited the dentist previously [1.49] (p<0.05) and in patients with linear gingival erythema compared with those without the lesion (p< 0.05).The CD4 + Tlymphocyte count was not associated with the OHI-S (p>0.05). Conclusion: Poorer oral hygiene was significantly associated with male gender, no previous dental visits and linear gingival erythema lesions in the HIV positive patients in this study. Regular oral health education programmes should be incorporated into the treatment protocol of HIV positive patients at the HIV clinic to improve their overall health status

The associations of malaria parasite and ABO blood groups with aggressive periodontitis in Nigerians - a preliminary study

Objective: Aggressive Periodontitis (AgP) is a rare form of periodontitis which has been associated with aetiological factors including genetic predisposition, Aggregatibacter actinomycetemcomitans, and blood group B. It seems to have a racial predisposition being more common among blacks, particularly people of West African origin. The role of endemic factors such as malaria is yet to be investigated in AgP. The aim of this study was to explore the associations of malaria parasites and ABO blood groups with aggressive periodontitis. Method: A preliminary case-control study on localized aggressive periodontitis patients and age and gender matched controls. Microbiological and hematological tests were performed to determine the presence of malaria parasites and ABO blood groups respectively. Result: Eight LAgP patients and 9 age and gender-matched controls were seen. Six patients were positive for Plasmodium Falciparum malaria parasite, compared with 2 controls. This difference was statistically significant (p=0.044). The prevalence of malaria infection was not significantly associated with age (p = 0.44) or gender (p = 0.34) of the subjects. Conclusion: This preliminary study showed a high prevalence of malaria parasites among patients with aggressive periodontitis. Malaria infection may be associated with AgP. Studies with larger sample sizes may be needed to further investigate the relationship between aggressive periodontitis and malaria infection

Diagnostic and treatment dilemma of gingival enlargement: a report of 3 cases

Gingival enlargement is a common feature of periodontal disease which is occasionally associated with medication use for systemic conditions such as hypertension and epilepsy. However, other local and systemic factors have been implicated in the aetiopathogenesis of this condition which could pose diagnostic and therapeutic challenge for clinicians. This paper presents the management of three cases of gingival enlargement recently seen at the Dental Centre of the Lagos University Teaching Hospital, Lagos. The association of unusual secondary aetiological factors is emphasized

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