Overview of Early Childhood Caries in Nigeria and Global Recommended Treatment Guidelines

BACKGROUND

Early childhood caries (ECC) is characterized by "the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries), or filled surfaces, in any primary tooth in a child 71 months of age or younger". There have been reports of increased incidence of caries in developing countries.A systematic analysis of the global burden of diseases, injuries and risk factors for 195 countries from 1990 to 2015 reported that almost 8% of children globally were affected by untreated ECC. As such, ECC was classified as one of the diseases of public health concern because it affects millions of infants and preschool children worldwide. This study aimed to review the prevalence and associated factors of early childhood caries in Nigeria and also provides current overview alongside globally recommended treatment guidelines.

DATA SOURCE

PubMed database, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews (to February 2022) was used for articles search on the guidelines and recommendations for the treatment of ECC. Guidelines and recommendations published by the American Academy of Paediatric Dentistry, International Association of Paediatric Dentistry and European Academy of Paediatric Dentistry from 2017-2020 were retrieved. The following keys used in the MeSH were 'early childhood caries among Nigerian children, 'caries in preschool Nigerian children' 'treatment guidelines', 'treatment policies'and 'treatment recommendations.

STUDY SELECTION

A total of 105 (24 plus 81) articles were retrieved but 21(15 plus 6 articles) were selected after the removal of non-specific and duplicated articles.

RESULTS

The prevalence of early childhood caries ranged from 4.3-23.5% in Nigeria while the treatment guidelines and recommendations were case-specific.

CONCLUSION

The prevalence of early childhood caries varies within the country's geo-political zones.

Knowledge and attitude of parents toward child dental visits in a rural setting in Nigeria

Introduction

The study determined the proportion of rural parents with good knowledge about and good attitude toward children making their first dental visit by their first birthday. It also assessed the association among age, sex, level of education, past dental visits of parents, and knowledge about and good attitude toward children making their first dental visit by their first birthday.

Materials and Methods

This was a cross-sectional study that collected data from 115 parents in a rural setting using an interviewer-administered questionnaire. Data on age, sex, level of education, past dental visits, knowledge about, and attitude toward children making their first dental visit by their first birthday were collected from one of the parents of children aged 16 years and below. Socio-demographic factors associated with knowledge about and attitude to a child's dental visit were considered significant at the level of P < 0.05 using the Chi-square test. Logistic regression was conducted to determine the predictor of good knowledge.

Results

The age of the study participants ranged from 15 years to 63 years with a mean of 40 ± 15.51 years. Only 25 (21.7%) parents had visited the dentist. More females 31 (40.3%) than males 6 (15.8%) significantly (P = 0.008) had good knowledge of child dental visits while more males 12 (31.6%) than females 6 (7.8%) (P = 0.001) and a greater percentage of those with past dental visits 8 (32.0%) had significantly (P = 0.02) good attitude to child dental visit.

Conclusion

More mothers had good knowledge of child dental visits, while more fathers and those with past dental visits had a good attitude toward child dental visits.

Assessment of Oral Health Knowledge of Pharmacists in Two Tertiary Hospitals in Enugu, Nigeria

Introduction

Oral health is defined as a state of being free of mouth and facial pain, oral infections and sores, and other diseases that limit an individual's capacity for biting, chewing, smiling, speaking, and psychosocial well-being. This study assessed the knowledge, barriers, and facilitators of oral health knowledge among Pharmacists in Enugu, Nigeria.

Methods

This was a cross-sectional study of 163 pharmacists in two tertiary hospitals in Enugu, South East, Nigeria. Data on sociodemographic profiles, knowledge of oral health care, barriers, and facilitators of oral health knowledge was collected. Data were analyzed using SPSS version 26 and P < 0.05 was considered significant.

Results

There were more female 96 (58.9%) than male pharmacists 67 (41.1%). Their mean age was 32.98 ± 8.33 years. The majority of respondents, 56 (34.4%) graduated between 2010 and 2019, and 44 (27%) had additional qualifications. Many of the pharmacists 88 (54%) believed that oral health is part of general health. Also, 107 (65.6%) of the respondents had a good knowledge of oral health while 56 (34.4%) had poor knowledge. There was a significant association between academic qualification (P = 0.04) and having good knowledge of oral health care among pharmacists with those with additional qualifications having better knowledge than the others. Poor creation of oral health awareness by dentists 106 (65.0%) was considered as the main barrier to having good oral health knowledge by the pharmacists.

Conclusion

More than half of the pharmacists had good knowledge of oral health and academic qualification was associated with having a good knowledge of oral health care among pharmacists in the study population.

Perception and Concerns about the Use of Gloves, Facemask, and HIV Discriminatory Attitude of Children attending Dental Clinics in Southern Nigeria

INTRODUCTION

The use of face masks and gloves can prevent possible cross infection between dental patients and health care practitioners.

AIM

The study identified the perception of paediatric dental patients on the need for dentists to use face masks and gloves; and their attitude towards using the same clinic with paediatric dental patients living with HIV.

METHODS

This was a cross sectional study that recruited 438 children aged 8-15 years attending three paediatric dental clinics located in Southern Nigeria.

STATISTICAL ANALYSIS

The dependent variables were perception of cross infection control and attitude towards children living with HIV. The independent variables were age, sex, socioeconomic status and location of clinic. Chi-square analysis was conducted to determine the associations between the dependent and independent variables. Logistic regression analysis was also conducted to assess the effect size of the associations between the dependent and independent variables. The level of statistical significance was inferred at P < 0.05.

RESULTS

Majority of the respondents agreed that it was necessary to wear gloves (98.6%) and facemasks (88.1%) during patients' management. More females 62(28.2%) than males 38(17.4%) assumed gloves were used by dentists to protect themselves from patients' bad breath (p=0.007). More children from Benin 97(64.2%) were aware that face masks protect the dentists and the patients (p=0.004), and a few believed that it is embarrassing to patients for dentists to wear facemasks (p=0.001). More children 102(70.8%) from Ile-Ife perceived that face masks protects from bad breath (p=0.004).Children less than 10 years (AOR: 0.85; 95% CI: 0.42-1.70; p=0.64), with high socioeconomic status (AOR: 0.90; 95% CI:0.53-1.52; p=0.70) and children aged 10 to 14 years (AOR: 0.85; 95% CI: 0.44-1.63; p=0.62), in the middle socioeconomic status (AOR: 0.72; 95% CI: 0.39-1.33; p=0.30) were less willing to use the dental clinic alongside children living with HIV.

CONCLUSION

There were sex, and clinic location disparity in the perception and attitude of children towards the use of Personal Protective Equipment and the use of the dental clinic alongside children living with HIV.

An Evaluation of a Supervised School Tooth Brushing Program on Plaque and Gingival Scores of a Group of Rural Nigerian Primary School Children

AIM

The study assessed the Plaque and Gingival scores of rural Nigerian school children before and after supervised school brushing program.

METHODS

This was an interventional study of 96 children aged 6 to 12 years in selected rural primary schools in Enugu, Nigeria. Data on sex, age, type of school, Plaque score and Gingival score were collected. Data was analyzed using SPSS version 20 and student's t- test was used to compare means. P<0.05 was considered significant.

RESULTS

There were 45(46.9%) male and 51(53.1%) female participants and their mean age was 8.45±1.83years. Forty nine(51.0%) children attended private school while 47(49.0%) attended public school. Only 10(10.4%) had good Plaque score while 8(8.3%) had healthy gingiva. Before intervention, 83(86.5%) children used tooth brush as cleansing tool, 7(7.3%) children brushed twice a day while after the intervention, 96(100.0%) children used toothbrush and 39(40.6%) children brushed twice a day. Also, before intervention, there was significant association between Plaque scores (p=0.012), Gingival scores (p<0.001) and type of school attended. The mean plaque score for the school children before and after intervention was 2.17±0.57, and 1.28±0.49 respectively and the change was statistically significant (p=0.01). The mean gingival score before and after intervention was 1.23±0.67 and 0.31±0.49 respectively and the change was also statistically significant (p<0.001).

CONCLUSION

Children who attended private schools had better Plaque and Gingival scores than those who attended public schools. Supervised school tooth brushing program improved the plaque and gingival scores of rural primary school children in the study population.

Prevalence and Associated Factors of Dental Caries among Primary School Children in South-East Nigeria

Objectives

The study aimed to identify the prevalence and associated factors of dental caries in primary school children.

Materials and Methods

This was a cross-sectional study of 657 primary school children from South East, Nigeria. Data on age, sex, birth rank, dental visits, oral hygiene status, and enamel defects were collected. The presence of dental caries was recorded by using the World Health Organization criteria. Mean DMFT/dmft scores were determined and SPSS version 21 was used for analysis. Chi-square test and multivariate logistic regression were conducted and P ≤ 0.05 was considered significant.

Results

The study participants were 316 (48.1%) males and 341 (51.9%) females, and their mean age was 8.41 ± 2.18 years. The prevalence of caries was 22.7% while the mean DMFT and dmft scores were 0.10 and 0.45, respectively. Bivariate analysis showed a significant association between birth rank (P = 0.04), oral hygiene status (P = 0.05), enamel defects (P < 0.001), and dental caries. Multivariate regression analysis showed that good oral hygiene (OR = 0.180, CI: 0.036-1.003, P = 0.04), fair oral hygiene (OR = 0.576, CI: 0.345-0.993, P = 0.04) and enamel defects (OR = 4.939, CI = 2.406-10.137, P < 0.001) were significant predictors of caries in this study.

Conclusion

The prevalence of dental caries in this study was high. Oral hygiene and enamel defects were predictors of dental caries in the study population.

The Knowledge, Perception and Practices regarding the Novel COVID-19 among Undergraduate Clinical Dental Students in Nigeria

BACKGROUND

Corona virus disease 2019 (COVID -19), is an infectious disease that has become a major public health emergency of international concern. It is necessary that Nigerian dental students have adequate knowledge about prevention/control of COVID-19 pandemic in dental practice. This study aimed to assess the knowledge and perception about COVID-19 among Nigerian dental students and its impact on their academic life.

MATERIAL AND METHODS

A web-based questionnaire assessing knowledge and perception with a total of 46 scoreable responses was created using Survey Monkey, an online survey tool. We surveyed 178 out of 507 clinical dental students attending the 10 dental schools. Bivariate analysis was conducted to test the association between students' age, gender and knowledge and perception of COVID 19 infection. Logistic regression was also conducted to determine the predictors of having good knowledge of COVID 19. The effect of all significant factors was inferred at P< 0.05.

RESULTS

The mean knowledge score of the dental students about infection control and COVID-19 was 32.19 (SD: 7.30, Range: 2-46). Knowledge scores significantly differed across genders, age-groups, class levels, university of study, previous lectures on infection prevention and control and risk-perception. The linear regression analysis showed that male gender (vs. female, β: 0.242, P<0.001), age-group of 18-24 years (vs. 45-54years, β: -0.305, P<0.001), class level 600 (vs. 500 level, β: -0.154, P<0.001), previous lectures on infection prevention and control (vs. no lecture, β: -0.186 , P=0.007), and a high-risk perception of COVID-19 ( vs. low-risk perception, β: 0.220, P=0.001) were significantly associated with higher knowledge scores.

CONCLUSION

The students were knowledgeable about mode of transmission, complications and diagnosis of COVID-19 but had limited understanding of the extra precautionary measures against COVID-19. These results imply that there is a need for an update of the infection prevention and control curriculum for dental students and improved quality assurance.

General anxiety, dental anxiety, digit sucking, caries and oral hygiene status of children resident in a semi-urban population in Nigeria

BACKGROUND

Digit sucking can represent untreated anxiety or other emotional problems. The aim of this study was to determine if digit sucking is a predictor of general anxiety and dental anxiety; and if general and dental anxiety are associated with caries and oral hygiene status of children resident in sub-urban Nigeria.

METHODS

This was a secondary data analysis of a household survey conducted in Ile-Ife, Nigeria. The level of general anxiety and dental anxiety of 450 6 to12 year old children were measured using the Revised Child Manifest Anxiety Scale and Dental Subscale of the Child Fear Survey Schedule respectively. Presence of digit sucking habit, caries and oral hygiene status were determined. General anxiety and dental anxiety scores were dichotomized into low and high levels respectively. Logistic regression was conducted to determine if digit sucking was a predictor of general anxiety and dental anxiety; and if general anxiety and dental anxiety were predictors caries and good oral hygiene status. Adjustments were made for age and sex.

RESULTS

Digit sucking is not a significant predictor of dental anxiety (p = 0.99) and general anxiety (p = 0.79). Children with high general anxiety (AOR: 5.02; 95% CI: 2.9-9.74; p <  0.001) and high dental anxiety (AOR: 1.74; 95% CI: 1.15-2.65; p = 0.009) had higher odds of having caries and good oral hygiene respectively.

CONCLUSION

Digit sucking was not a significant predictor of general anxiety and dental anxiety. General and dental anxiety however, had effects on the likelihood of having caries and good oral hygiene.

Digit Sucking, Age, Sex, and Socioeconomic Status as Determinants of Oral Hygiene Status and Gingival Health of Children in Suburban Nigeria

BACKGROUND

This study determines prevalence of digit sucking and gingivitis, and association among age, sex, socioeconomic status, presence of digit-sucking habits, oral hygiene status (OHS), and gingivitis among a group of Nigerian children.

METHODS

Data of 992 children aged 1 to 12 years recruited through a household survey conducted in Osun State, Nigeria were analyzed. Information on age, sex, socioeconomic status, and history of digit-sucking habits were collected. Children were assessed for OHS and severity of gingivitis using the simplified oral hygiene index and the gingival index, respectively. Predictors of presence of gingivitis and poor oral hygiene were determined using multivariate logistic regression.

RESULTS

One (0.2%) and 454 (93.0%) children aged 1 to 5 years had poor oral hygiene and mild gingivitis, respectively. Twenty-two (4.4%) and 361 (72.9%) children aged 6 to 12 years had poor oral hygiene and mild gingivitis, respectively. The odds of having poor oral hygiene (adjusted odds ratio [AOR]: 0.26; 95% confidence interval [CI]: 0.20 to 0.35; P <0.001) and gingivitis (AOR: 0.21; 95% CI: 0.14 to 0.31; P <0.001) was significantly reduced for children aged 1 to 5 years. The odds of having gingivitis was increased in children with low socioeconomic status (AOR: 2.09; 95% CI: 1.32 to 3.31; P = 0.002). There was no significant relationship among sex, digit sucking, OHS, and presence of gingivitis.

CONCLUSIONS

A digit-sucking habit did not increase chances of having poor oral hygiene and gingivitis. Increasing age and low socioeconomic status were factors that significantly increased chances of having poor oral hygiene and gingivitis.