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Perceived Oral Hygiene Status, Dental Service Utilization and Treatment Needs of Medical and Nursing Students at A Tertiary Institution in Nigeria: a Cross-sectional Study
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To evaluate the perceived oral hygiene status, dental service utilization, and treatment needs of medical and nursing students at a tertiary institution in Nigeria.
Methods
This descriptive cross-sectional study was conducted among clinical medical and nursing students at the University of Port Harcourt. A semi-structured questionnaire was used to collect data on socio-demographic variables, perceived self-rated oral hygiene status, dental service utilization, and treatment needs. Statistical analysis was performed using SPSS version 25.0 (IBM SPSS Inc., Chicago, Illinois). Descriptive statistics were computed, and associations were tested using the chi-square test and Fisher\u27s exact test where appropriate. A p-value < 0.05 was considered statistically significant.
Results
A total of 155 participants were included, with 85 (54.8%) being clinical medical students and 70 (45.2%) being clinical nursing students. Only 6 (3.9%) of the medical students and 5 (3.2%) of the nursing students rated their oral hygiene as excellent. Dental clinic visits in the last 12 months were significantly higher among nursing students (50.0%) compared to medical students (32.9%), p = 0.031. More nursing students (67.1%) than medical students (49.4%) reported needing further dental treatment (p = 0.034). The most commonly required treatment was scaling and polishing.
Conclusion
The overall perception of oral hygiene among participants was suboptimal. While half of the nursing students visited the dental clinic in the past year, a significant proportion of medical students did not. There is a need for improved oral health awareness and preventive dental care promotion among medical and nursing students
Comparative Evaluation of Diagnodent and Digital Radiography in Dental Caries Diagnosis at the National Hospital Abuja: a Diagnostic Accuracy Study
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Early caries detection is crucial for preventing and controlling the spread of dental caries. Conventional detection techniques (visual and radiographic) rely on subjective judgment and are prone to misinterpretation, which may lead to mismanagement. This highlights the need for objective and quantitative methods to detect and monitor the progression of carious lesions. Among several e m e r g i n g d i a g n o s t i c d e v i c e s , l a s e r fluorescence—particularly Diagnodent—has generated considerable interest. This study aimed to compare the performance of Diagnodent and digital bitewing radiography in detecting early dental caries, using Ekstrand\u27s criteria and manufacturer-recommended Diagnodent thresholds.
Study Design
This diagnostic accuracy study was conducted at the Restorative Dentistry Unit of the National Hospital, Abuja, from 8 August to 9 November 2022. Ethical approval was obtained from the Health Research Ethics Committee (HREC) of the National Hospital, Abuja (Approval No. NHA/EC/078/2019).
Participants
Thirty-one participants with 130 premolar and molar teeth that met the inclusion criteria were randomly selected.
Test Methods
Teeth with incipient, non-cavitated enamel caries were examined using Diagnodent, digital bitewing radiographs, and visual examination (considered the gold standard). Visual and radiographic assessments followed Ekstrand\u27s criteria, while Diagnodent results were interpreted using the manufacturer\u27s cut-off values. Sensitivity, specificity, predictive values, overall accuracy, and Kappa scores (intra- and inter-examiner agreement) were calculated. Data were analyzed using IBM SPSS Version 26.0. The significance level was set at P< 0.05.
Outcomes
For occlusal surfaces, the sensitivity of early caries detection was 95.6%, 80.0%, and 100% for visual examination, Diagnodent, and bitewing radiography, respectively. The corresponding specificity values were 90.2%, 95.4%, and 27.3%. On interproximal surfaces, all methods recorded 100% sensitivity, but bitewing radiography had the lowest specificity (70.9%). Differences in specificity among diagnostic methods were statistically significant (P < 0.05) for both occlusal and interproximal surfaces, while sensitivity differences were not. Overall diagnostic accuracy was statistically significant for all three methods on both surfaces. Kappa scores for intra- and inter-examiner agreement were 0.9 for each diagnostic method. Diagnodent was more accurate than bitewing radiography for detecting early carious lesions on both occlusal and interproximal surfaces. Although Diagnodent demonstrated high accuracy, it is recommended as an adjunct to visual and radiographic methods rather than a standalone tool
Assessment of Perceived Stress, Stressors, and Coping Strategies among Undergraduate Dental Students at Obafemi Awolowo University, Ile-Ife, Nigeria
No full textABSTRACT
Background: Dental school is known to be highly stressful, which sometimes affect student mental health, academic performance and professional development with differing opinion about the impact of age, gender, and educational level. Therefore, this study aimed to determine the level of perceived stress, identify the key stressors contributing to stress in dental student environment, examine the coping factors and relationship between Sociodemographic stress levels among undergraduate dental student Obafemi Awolowo University Ile-Ife, Osun state.
Methods: A cross-sectional study was conducted in the 2020/2021 academic year, among 123 dental students using a structured questionnaire. Dental Environment Stress (DES) was used to access the various stress levels, perceived Stress Scale (PSS) was used to determine the perceived stress level.
Results: 62.6% of the participants were male while 37.4% were females with the mean age of 22.31±3.31 years. Overall mean stress for the population was 23.32±5.95, female students reported significantly higher stress level than male (P = 0.034). Workload (3.79±1.01) and performance pressure (3.63 ± 1.00) were the most reported stressors those living in the hospital hostel or receiving mid-range allowance appeared to undergo more stress, while religious coping was the mostly reported coping strategy
Conclusion: It was found that perceived stress in dental environment is still relatively high most especially among female students. There is no clear association between income and perceived stressed level. Major stressors identified were workload and performance pressure. Religion, active coping and planning were the coping strategies mostly utilized in the management of these stressors
Impact of Oral Pain on Oral Health and Daily Performance in Pregnancy: A Cross-sectional Study
No full textBackground: Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pregnancy-related oral pain can affect emotional well-being, oral health-related quality of life, and general health. If left untreated, poor oral health may lead to premature delivery, pre-eclampsia, epulis gravidarum, tooth mobility, and other complications.
Objectives: This study assessed the prevalence of oral pain, evaluated oral impacts on daily performance (OIDP), and examined associations between oral health, service utilization, and parity status during pregnancy.
Methods: A cross-sectional design was used, incorporating data on sociodemographic characteristics, pain symptomatology, oral impact on daily performance (OIDP), and clinical examination. Sociodemographic and pain variables were analyzed using descriptive statistics (frequencies, proportions, summary statistics). Statistical significance was set at p<0.05.
Results: The median age was 30 years; most respondents (71%, n=149) had post-secondary education and were primigravida. Oral pain during pregnancy was reported by 29% (n=61) of respondents, predominantly mild and most commonly affecting the gingiva (16%, n=33). Pain, site of pain, and OIDP were significantly associated with parity (p=0.04, 0.010, 0.037, respectively), and OIDP was also related to trimester (p=0.04). Dental service utilization was 24% (n=50), with 17% (n=36) satisfied; satisfaction was higher among multigravida compared to primigravida (p=0.01). More women in the third trimester reported OIDP, while none in the first trimester did so (p=0.04).
Conclusion: Mild oral pain is a frequent experience during pregnancy, most often gingival in origin, and is associated with parity and trimester. These findings emphasize the need for routine oral health assessment during antenatal care, with timely management to reduce oral impacts on daily functioning
Prevalence and Pattern of Labial Frenal Attachments in Adult Nigerians - a Pilot Study
No full textIntroduction
The frenum is a band of mucous membrane which connects the lips and cheeks to the alveolar mucosa, underlying periosteum, or the gingiva with a primary function of stabilizing the lips and tongue. There are variations of frenal attachment and morphologies, some associated with health, others resulting to loss of periodontium. This study therefore aims to assess the various attachments and morphologies within our study population.
Materials and Methods
This was a descriptive cross-sectional study conducted at the Oral Diagnosis and Periodontology clinics of the Lagos University Teaching Hospital Idi-Araba among participants who reported to both clinics. Convenience sampling method was employed in participants’ selection, and interviewer-administered questionnaires were used for data collection and documentation of socio-demographic variables, and findings of intra-oral examination. Ethical approval was obtained from the institutional Health Research Ethics Committee and informed consent was obtained from each participant. Data was analyzed using the Statistical Product and Service Solutions (SPSS) version 27. P values < 0.05 were statistically significant.
Results
The study comprised 337 participants, 203 (60.2%) were females. Mean age was 34.6±15.2 years. The frenal attachment distribution in the maxilla was mucosal 204 (60.5%), gingival 105 (31.2%), papillary 23 (6.8%), and papillary penetrating 5 (1.5%);while in the mandible, 233 (69.1%), 92 (27.3%), 9 (2.7%) and 3 (0.9%) presented with mucosal, gingival, papillary, and papillary penetrating frenal attachment respectively. Simple frenum was the most prevalent frenum morphology in the maxilla [328 (97.3%)] and the mandible [321 (95.2%)], followed by trifid frenum in both maxilla [5 (1.5%)] and mandible [4 (1.2%)]. Diastema was present in 27.6% in maxilla and 11.0% in the mandible.
Conclusion
In this study, mucosal type was predominant among all age groups. Males presented more with gingival and mucosal type of frenal insertion, while females presented more with papillary type of frenal insertion. Papillary and/or papillary penetrating were significantly associated with the presence of diastema.
Radiographic Assessment of Features of Impacted Mandibular Third Molars With Post-Operative Injury to the Inferior Alveolar Nerves: A Record-Based Cross-Sectional Study
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Surgical removal of impacted mandibular third molars (IMTMs) is among the most common minor oral and maxillofacial surgical procedures. However, it carries the risk of complications, including injury to the inferior alveolar nerve (IAN). Panoramic radiography can predict this risk based on certain radiographic features, including root darkening, interruption of the radiopaque line of the inferior alveolar canal, canal diversion, dark and bifid apex, root deflection, narrowing of the IAN canal, and root narrowing.
Objective
To assess the prevalence and distribution of seven radiographic signs predictive of IAN injury during mandibular third molar surgery namely, root darkening, interruption of the white line, IAN canal diversion, root deflection, narrowing of the IAN canal, dark and bifid apex, and root narrowing and evaluate their correlation with clinical outcomes in adult patients.
Methods
This retrospective, cross-sectional study reviewed 258 panoramic radiographs of adult patients aged 18–60 years (120 males and 138 females) with 341 impacted mandibular third molars located in proximity to the IAN canal. Predictor variables were the seven radiographic signs listed above. The primary outcome variable was postoperative IAN injury. Data were analyzed using SPSS version 23.0. Statistical tests included ANOVA, chi-square, and correlation coefficients, with significance set at p<0.05. Data were presented using descriptive statistics, tables, charts, and graphs.
Results
The most frequent radiographic sign was interruption of the radiopaque superior margin of the IAN canal (n = 182, 70.5%), followed by narrowing of the IAN canal (n = 143, 55.4%) and root darkening (n = 105, 40.7%). Of the 341 IMTMs, 76 (21.4%) were surgically removed, and 13 (17.1%) of these cases resulted in IAN injury. Among them, eight had interrupted radiopaque lines, three had canal narrowing, and one each showed root deflection and root darkening.
Conclusion
The most predictive radiographic signs of IAN injury during surgical removal of IMTMs were interruption of the radiopaque canal margin, canal narrowing, and root darkening. Surgeons should carefully assess these signs preoperatively to reduce the risk of nerve injury.
Awake Nasotracheal Intubation via Fibreoptic Bronchoscope for Surgical Treatment of Temporomandibular Joint Ankylosis: A Case Report
No full textTemporomandibular joint ankylosis (TMJA) causes immobility due to fusion of the joint. It most often results from trauma or infection, but it may be congenital or a result of rheumatoid arthritis. The condition is very common in children and rarely seen in adults. Administration of effective and safe anesthesia to patients with TMJA often poses a serious challenge during surgical correction. Hence, we report a case of a 68-year-old Nigerian woman with no comorbidities who presented to the Oral and Maxillofacial Surgery clinic of our facility with a 5-year history of progressive limitation of mouth opening associated with a painful left cheek swelling. Examination revealed severely limited mouth opening with an interincisal distance of 6 mm. Computerized tomogram of the jaws and the TMJ showed fusion of the condylar head and the temporal articular fossa on the left TMJ. She underwent gap arthroplasty after successful awake nasotracheal intubation via fibreoptic bronchoscope and recovered uneventfully with no recurrence
Improving Oral Health Service Uptake Among Urban Informal Sector Workers in Nigeria: Trader Perspectives on Affordability, Accessibility, and Delivery Innovations
No full textBackground:Urban Informal Sector Workers face unique barriers to preventive healthcare; however, little is known about their oral health behaviors in rapidly growing market economies. This study examined the patterns, determinants, and perceived facilitators of dental service utilization among traders in an urban marketplace.
Methods:A cross-sectional survey was conducted among traders and businessmen in Lagos State, collecting demographic, occupational, and behavioral data, along with self-reported oral health status, service utilization, and perceived barriers. Associations between occupational demands, symptom frequency, and care-seeking behaviors were analyzed using chi-square test. Open-ended responses were analyzed thematically.
Results:Among the participants (n= 123), most were aged 30–39 years (45.5%), with a balanced gender distribution and predominant engagement in gadget and equipment sales (61.8%). Although 66.7% rated dental check-ups as important, 83.7% had not visited a dentist in the past year, with the absence of perceived dental problems (54.4%), work-related time constraints (22.3%), and cost (15.5%) cited as the main reasons. The most reported access challenges were the cost of care (34.5%) and long wait times (26.8%). Symptom frequency was significantly associated with dental visits (p=0.021) and treatment delays (p=0.002). Qualitative data revealed three main intervention priorities: financial accessibility (e.g., subsidized/free services, HMO inclusion), targeted outreach and education (e.g., quarterly market-based programs, workplace health promotion), and service innovations aligned with traders’ schedules (e.g., mobile clinics, extended/24-hour services). Mobile dental clinics (33.2%) and extended clinic hours (56.9%) were the most favored solutions, with 70.7% of the participants willing to participate in on-site outreach near their business premises.
Conclusion:Despite awareness of the value of preventive dental care, utilization remains low among traders due to cost, time constraints, and symptom-driven care-seeking behavior. Interventions should integrate occupationally compatible service models, financial subsidies, and targeted outreach to bridge the knowledge–action gap in this population. Policy efforts addressing both perceptual and structural barriers may substantially improve preventive oral health care uptake in urban informal economies
ORAL MALODOUR: AN INDICATOR OF ORAL NEGLECT AND POOR SELF-ESTEEM AMONG SLUM DWELLING CHILDREN IN NIGERIA: ORAL MALODOUR: AN INDICATOR OF ORAL NEGLECT AND POOR SELF-ESTEEM
No full textObjective: Oral malodour, an inadequately studied disease in children, is the third most prevalent reason for dental consultations, with negative impacts on psychosocial health. This study assessed self-rated and normatively assessed oral malodour and its impact on quality of life among a cohort of slum dwelling children in Lagos, Nigeria.
Method: This descriptive survey was conducted among slum dwelling children in Lagos State, Nigeria. A multi-stage sampling method was utilized to select participants for the study. The Organoleptic test was utilized by two calibrated dentists to assess oral malodour. The Self-Reported Scale for Oral Health (SOHO) and the Rosenberg Self-Esteem Scale (RSE) were used to assess quality of life and self-esteem. Regression analysis was done using sociodemographic, clinical, self-esteem and QOL variables as the predictor variables to identify their strength of association with oral malodour. The probability level of p<0.05 was considered significant.
Results: Majority of the 427 respondents were aged between 10-14 years of age (67%), and were females (54.4%). Thirty four percent of the respondents self-rated themselves as having oral malodour; Normatively, 22.6% of the respondents had oral malodour. There was a significant association between OHRQOL (aOR: 2.724; CI: 1.563-4.932), gingival inflammation (aOR: 2.402; CI: 1.417-4.078), self-esteem (aOR: 2.546; CI :2.015-5.246), self-rated oral malodour (aOR: 3.846; CI: 2.118-8.571), parental education (aOR: 1.483; CI: 1.034-1.940), history of dental visit (aOR: 8.375; CI: 2.435-28.810), reason for dental visit (aOR: 2.224; CI: 0.932-5.310), and number of children in in the family (aOR: 1.106; CI: 1.010-1.212), with oral malodour.
Conclusion: Oral malodour was significantly associated with low self-esteem, poor OHRQOL poor oral health and dental attendance pattern. The oral health of slum dwelling children needs to be seen by policymakers as an important predictor of their mental health and wellbeing
Knowledge on Periodontal Diseases and Systemic Health Inter-Relationship among Nursing and Dental Surgery Technician Students in Southwest Nigeria
No full textBackground: Periodontal disease is a potential source of systemic inflammation that impacts overall health. Therefore, successful prevention and management of the disease is pivotal in avoiding systemic inflammation with its attending complications. This will involve creating awareness about its causes, early identification of symptoms and effective treatment.
Objective: To assess and compare the level of knowledge about periodontal diseases and its interrelationship with systemic diseases among nursing and dental surgery technician (DST) students.
Methods: A descriptive cross-sectional study was conducted among DST and nursing students using a structured questionnaire which consisted of questions on bio-data and knowledge on periodontal-systemic diseases. Questions regarding their oral hygiene practices and dental service utilization were also asked. Data was analyzed using SPSS version21.
Result: Respondents consisted of 31(10.8%) males and 257(89.2%) females with their mean age being 21.5± 2.5 years; having more nursing students 173(60.1%) compared to DST students 115(39.9%). Majority of the respondents (79%) had good knowledge on the interrelationship between periodontal disease and systemic health, with a greater level of knowledge significantly noted among the DST students (85.3%) compared with the nursing students (75%) [p= 0.041]. Similarly, the level of knowledge about symptoms of periodontal diseases was high (85%) and significantly more reported by the DST students (98.2%) compared to the nursing students (76.1%). Assessment of the respondents’ dental service utilization revealed that only 40% had ever visited a dentist, more significantly noted by the DST students (64.0%) compared to the nursing students.
Conclusion: There was a good level of knowledge on periodontal-systemic interrelationship among the respondents. Their dental service utilization and oral hygiene practices were found to be fair. There is an inevitable need for interdisciplinary collaboration between nursing and dental professionals for the development of oral health curriculum for nurses to promote oral health and prevent dental diseases in the community