Oral Hygiene Practices and Status among Orthodontic Patients in a Nigerian Teaching Hospital

Background: Orthodontic treatment is performed to correct occlusal problems and improve the dentofacial complex; however, it comes withits peculiarities, such that patients require strict adherence to optimum oral hygiene. When oral hygiene is compromised during orthodontictreatment, accumulation of dental plaque on the appliance can lead to periodontal problems and dental caries. Aim: To assess the oral hygiene practices and status of orthodontic patients attending the Lagos University Teaching Hospital. Materials and Methods: Interviewer-administered questionnaires were used to assess the patients attending the orthodontic clinic for their routine appointments. Their oral hygiene status was assessed using the Simplified Oral Hygiene Index by Greene and Vermilion. The data were analyzed using Statistical Package for the Social Sciences (SPSS version 21.0). Results: One hundred and ten subjects (73 females and 37 males) with a female-to-male ratio of 2:1 were recruited for the study. The mean age of the subjects was 20.7 ± 7.89 years. All the subjects used a toothbrush to clean their teeth. Only 22.7% of the subjects brushed their teeth once daily, while 65% of the subjects brushed twice daily and 20% brushed more than twice a day. About 44% had good oral hygiene, 49.1% had fair oral  hygiene, while 6.4% had poor oral hygiene. There was no statistically significant difference in the relationship between toothbrushing techniques, frequency of toothbrushing, and oral hygiene status. Conclusion: All the patients used toothbrush and toothpaste to clean their teeth. Majority of them had acceptable oral hygiene status irrespective of the frequency of toothbrushing. Keywords: Oral hygiene, practices, statu

Active matrix metalloproteinase-8 : A potential biomarker of oral systemic link

Objectives: This mini review aims to address some possible gaps in periodontal diagnosis in clinical studies particularly involving the oral-systemic connection with a view to minimize such gaps, and thus improve patient treatment experiences and outcomes. Methods: The conventional assessment of periodontitis has traditionally been by clinical and radiographic oral parameters. We reviewed numerous studies published mainly within the past decade, to affirm the oral-systemic link, the contribution of periodontitis to the inflammatory burden in various systemic diseases and conditions, and the potential role of active matrix metalloproteinase-8 (aMMP-8). Results: While it is established that periodontal pathogens in dental plaque biofilm are the primary initiating agents in periodontitis, it has become clear from the appraisal of recent studies that the host inflammation, including biomarkers such as aMMP-8 play a major role, being the driving underlying pathological mechanism in both periodontitis and systemic diseases. Conclusions: The apparent limitations of conventional diagnostic tools have led researchers to seek alternative methods of evaluation such as the quantification of biomarkers including aMMP-8, which can be a bridge between oral/periodontal and systemic diseases; aMMP-8 can form a mouth-body connection.Peer reviewe

Oral health related quality of life among HIV positive patients attending two HIV outpatient clinics in Nigeria - a cross sectional study

Background: The human immunodeficiency virus infection remains a devastating disease of public health importance. Objectives: To assess the association between oral health and quality of life and the factors affecting the oral health related quality of life among HIV positive patients in Nigeria. Methods: This was a cross sectional study of HIV positive patients attending two HIV outpatient clinics in Nigeria. Impact of oral health on quality of life was assessed using the OHIP-14. Oral health status was assessed by the DMFT and Simplified OHI indices. Level of significance was set at p< 0.05. Results: Three hundred and fifty-two patients were seen, 64.2% being females. Prevalence of impact was 8.5%; and the mean OHIP scores was 8.05\ub19.54. Highest impact was \u201cpainful aching\u201d 67(19.1%) with the domain of physical pain scoring the highest mean impact of 2.32. Most patients (88.6%) were on HAART. Following logistic regression, after controlling for potential confounders, independent factors associated with poor OHRQoL were perceived need for dental treatment, HAART use, and higher DMFT (p<0.05). Conclusion: The domain of physical pain had the highest impact, while perceived need for dental treatment, HAART use and higher caries index were contributory to poor OHRQoL

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

aMMP-8 Point-of-Care/Chairside Oral Fluid Technology as a Rapid, Non-Invasive Tool for Periodontitis and Peri-Implantitis Screening in a Medical Care Setting

This communication article addresses currently available rapid non-invasive methods to screen and detect periodontitis and dental peri-implantitis. In this regard, oral fluid biomarkers have been researched extensively but self-reported oral health (SROH)-questionnaires have also been developed. Both alternatives may offer a quick and easy way to screen and detect diseased patients. Active matrix metalloproteinase (aMMP-8) is one of the most validated biomarkers for screening and detecting periodontal breakdown related to periodontitis and peri-implantitis and monitoring their treatment effects revealing successful, less- and non-successful treatment results. Currently available aMMP-8 lateral-flow technologies allow this kind of analysis, as demonstrated here, to be conducted quantitatively online and real-time as point-of-care/chairside testing in dental and even medical care settings. In this study, an aMMP-8 peri-implant sulcular fluid point-of-care-test diagnosed peri-implantitis and healthy implants far more accurately than bleeding-on-probing or the other biomarkers, such as polymorphonuclear (PMN)/neutrophil elastase, myeloperoxidase and MMP-9. Although, SROH-questionnaires allow screening in similar settings but they lack the information about the current disease activity of periodontitis and peri-implantitis, which is of essential value in periodontal diagnostics and treatment monitoring. Thus, both methods can be considered as adjunct methods for periodontitis and peri-implant diagnostics, but the value of oral fluid biomarkers analysis does not seem to be substitutable.Peer reviewe

On the diagnostic discrimination ability of mouthrinse and salivary aMMP-8 point-of-care testing regarding periodontal health and disease

This study investigated the diagnostic utility of mouthrinse and saliva in aMMP-8 measurements to analyze patients' risk for active periodontal tissue destruction and progression of periodontal disease among 47 adolescents. Results show that measurements from mouthrinse produce better discrimination and should be used instead of saliva measurements. (C) 2019 Elsevier Inc. All rights reserved.Peer reviewe

Ability of matrix metalloproteinase-8 biosensor, IFMA, and ELISA immunoassays to differentiate between periodontal health, gingivitis, and periodontitis

Publisher Copyright: © 2022 The Authors. Journal of Periodontal Research published by John Wiley & Sons Ltd.Objective: The aim of this study was to determine the diagnostic utility of an MMP-8 biosensor assay in differentiating periodontal health from gingivitis and periodontitis and compare it with an established time-resolved immunofluorescence assay (IFMA) and enzyme-linked immunosorbent assay (ELISA). Background: Currently available antibody-based assays display a wide variability in their ability to accurately measure matrix metalloproteinase-8 (MMP-8) levels in saliva. Methods: Salivary MMP-8 levels were analyzed in 189 systemically healthy participants using an antibody-based biosensor prototype that operates using a surface acoustic wave technology and compared with IFMA and ELISA antibody assays. Participants were categorized into 3 groups: periodontal health (59), gingivitis (63), and periodontitis (67). A sub-population of participants (n = 20) with periodontitis received periodontal treatment and were monitored for 6 months. Results: All the assays demonstrated significantly higher salivary MMP-8 concentrations in participants with periodontitis versus gingivitis, periodontitis versus health, and gingivitis versus health (all p <.05). The biosensor data demonstrated significant correlations with IFMA (r =.354, p <.001) and ELISA (r =.681, p <.001). Significant reductions in salivary MMP-8 concentrations were detected by the biosensor (p =.030) and IFMA (p =.002) in participants with periodontitis 6 months after non-surgical periodontal treatment. IFMA had the best sensitivity (89.2%) for detecting periodontitis and gingivitis versus health and 96.6% for detecting periodontitis versus health and gingivitis. The biosensor had an AUC value of 0.81 and diagnostic accuracy of 74.2% for differentiating periodontitis and gingivitis from health; an AUC value of 0.86 and diagnostic accuracy of 82.8% for periodontitis versus health and gingivitis. Conclusions: The biosensor, IFMA, and ELISA assays differentiated between periodontal health, gingivitis, and periodontitis based on salivary MMP-8 levels. Only the biosensor and, particularly, IFMA identified an effect of periodontal treatment in the participants with periodontitis. Our findings support the potential utility of salivary oral fluid aMMP-8-based point-of-care technology in the future of periodontal diagnostics.Peer reviewe

Effect of calcium channel blockers on gingival tissues in hypertensive patients in Lagos, Nigeria: A pilot study

Background: Long-term treatment of common chronic cardiac conditions such as hypertension with calcium channel blockers (CCBs) has long been associated with gingival hyperplasia. This oral side effect may affect esthetics and function, yet often overlooked and therefore underreported among Nigerians. Aim: This study aimed to determine the association of CCBs with gingival overgrowth (GO) in hypertensive patients. Methods: This was a hospital-based, case–control study conducted among 116 hypertensive patients (58 CCB and 58 non-CCB age-matched controls) attending the medical outpatient clinic of a tertiary health institution in Lagos, Nigeria. Data collection tools included interviewer-administered questionnaires and periodontal examination. Sociodemographic details, medical history, and periodontal indices (gingival index, plaque index, class of GO according to drug-induced GO [DIGO] Clinical Index) were recorded. Results: The mean age was 59.4 ± 12.6 years, females representing 50.9%. In the CCB group, 39 (67.2%) participants were on amlodipine and 19 (32.8%) were on nifedipine. The mean duration of CCB use was 55.6 ± 53 months. DIGO was higher in CCB (36.2%) than that in non-CCB participants (17.2%) (χ2 = 4.4, P = 0.036). The risk of GO was higher in CCB users (odds ratio [OR] 2.7, [95% confidence interval (CI)]: 1.1–6.5). Amlodipine users had higher DIGO (37.5%) than that of nifedipine users (21.1%) (OR 2.3, [95% CI]: 1.0–5.3). The predominant class of DIGO among the CCB users was Class 2 DIGO Clinical Index (90.5%). Conclusion: The study reveals that the risk of GO is nearly three times in CCB than that of non-CCB users and twice higher in amlodipine than nifedipine users in Nigeria

Periodontal disease and targeted prevention using aMMP-8 point-of-care oral fluid analytics in the COVID-19 era

Periodontal disease is a chronic multifactorial infectious and inflammatory disease associated with several chronic systemic diseases, such as diabetes, cardiovascular diseases (CVD), chronic obstructive pulmonary disease, hypertension, Alzheimer's disease and so on. These same systemic diseases have been associated with severe COVID-19 infections. Several recent studies have suggested hypotheses for the potential association between periodontal disease and severe COVID-19. Periodontal disease is also one of the most prevalent diseases globally. All this supports the importance of good oral health, also in the COVID-19 era. Thus, new strategies and approaches to identify patients at risk of periodontal disease could be beneficial to enhance secondary prevention, especially if targeted to COVID-19 risk groups. Diagnostic biomarkers for periodontal disease have been researched extensively. Potential biomarkers in oral fluid with currently available rapid non-invasive point-of-care technology, such as aMMP-8, could help to extend screening and identification of patients at risk for periodontal disease also to situations and places where professional dental expertise and equipment are limited or unavailable. i.e., nursing and care homes, and rural and distant places. The oral fluid point-of-care technologies could also be useful in the hands of medical professionals (diabetes, CVD, etc.) to identify patients at risk for undiagnosed periodontal disease and to refer them to a dentist for examination and evaluation. Finally, if there is a causality between periodontal disease and severe COVID-19 infections, these point-of-care oral fluid biomarker technologies could possibly also help in the assessment of the risk of deterioration and complications.Peer reviewe