Toothache and self-medication practices: a study of patients attending a niger delta tertiary hospital in Nigeria

Oral health in an urban slum, Nigeria: residents' perceptions, practices and care-seeking experiences

BACKGROUND/INTRODUCTION

One of the key recommendations for the new WHO global strategy for oral health is inclusion of disadvantaged populations and their engagement in policy dialogues such that their needs and views are addressed in policy decisions.

OBJECTIVES

This study explored oral health perceptions, practices and care-seeking experiences of slum residents in Ibadan, Nigeria.

METHOD

Focus group discussions (FGD) were conducted with family health-decision makers in an urban slum site. Oral health perceptions, practices, and care-seeking experiences were discussed. FGDs were recorded, transcribed, and translated. ATLAS.ti qualitative research software was deployed for analysis using thematic analysis.

RESULTS

Six FGD sessions, divided by gender and age, were conducted between September-October 2019, (N = total 58 participants, aged 25 to 59 years). Common dental ailments mentioned were dental pain, tooth sensitivity, bleeding gums, tooth decay, mouth odor, gum disease, and tooth fracture. Perceived causes of dental conditions included poor dental hygiene and habits, sugary diets, ignorance, and supernatural forces. Mouth cleaning was mostly done once daily using toothbrush and paste. Other cleaning tools were ground glass, wood ash, charcoal, "epa Ijebu" (a dentrifice), and "orin ata" (a type of chewing stick). Remedies for relieving dental pain included over-the-counter medicines, warm salted water, gin, tobacco (snuff/powdered), cow urine/dung, battery fluid, and various mixtures/ concoctions. Visits to the dentists were mentioned by a few but this was usually as last resort. Main barriers to accessing care from dental care facilities were unaffordability of service charges and fear of extreme treatment measures (extraction). Suggested measures to improve timely access to dental health care included reducing/subsidizing costs of treatments and medications, offering non-extraction treatment options, and oral health education programmes.

CONCLUSION

The slum residents experience various forms of dental ailments mostly pain-related. The residents perceived formal dental clinics as unaffordable, thereby engaging in self-care remedies and harmful oral health practices before seeking professional help. Policymakers and decision-makers may leverage this empirical evidence for the people's education on early dental care and address challenges to affordable, available, and acceptable oral healthcare services among slum residents to improve access to care facilities.

Strengthening the oral health system in Nigeria: A health systems building block approach

AIM

The present study aimed to describe the building blocks of the oral health system, including the role that the community plays in strengthening the oral health system in Nigeria.

METHODOLOGY

This research was a scoping review of the existing literature retrieved from search engines and databases. Thus, we utilised grey literature, peer-reviewed literature, policy documents and websites. The oral health system was analysed using the World Health Organisation's Health systems framework, and we adapted this framework by introducing a seventh block, community participation. We also inserted the links between the oral health service delivery and oral health workforce blocks of the framework to improve the oral health outcomes.

RESULTS

More dental clinics are required to improve the availability and accessibility of oral health services. Dental workforce expansion is imperative. This can be approached by training of junior cadre dental professionals and incorporating community health practitioners to deliver basic oral care. There is an unregulated access to medication to treat dental conditions; hence, oral disease treatments need to be included in the country's treatment guidelines to improve standard of care. The government needs to improve on overall health spending and invariably increase oral health care allocation urgently. Furthermore, the country's stewardship of oral health care is hinged on well disseminated and implemented national policies on oral health. The oral health system can achieve its overall goals with community participation, engagement and ownership.

CONCLUSION

Strengthening the oral health system in Nigeria requires urgent attention on each building block and cross-cutting interventions across the system's building blocks. The role of the community will need to be recognised because it is vital in sustaining any organisational change.

[Frequency and characterization of self-medication for dental manifestations in patients attending private clinics in Lima in 2021]

Introduction

The self-medication is the use of drugs without health professionals' prescription that many times, instead of helping, aggravate the patient's health. Dental pain is the main reason for performing this act in the area of odontology. It is important to know if patients self-medicate in order to develop strategies to reduce the misuse of drugs and avoid this practice.

Objective

Establish the frequency and characterization of self-medication in patients who visit to the three private dental clinics between the months of march to July in the year 2021.

Materials and methods

Cross-sectional observational study with a sample of 450 patients from three dental clinics in the city of Lima. The assessment tool was a 13-question quiz about the main characteristics of self-medication.

Results

The 85,8% of patients use drugs without medical prescription. 41.5% of the patients self-medicated did it with old prescriptions made by the dentist. The age group that more self-medicated was 26-35 years old with 35.5%. The most frequent type of disease was dental pain with 45.6%, The degree of instruction with the highest percentage was complete university superior with 32.9%.

Conclusions

The frequency of self-medication of the patients who visited the three dental centers is considerably high.

Knowledge and Practice about Self-Medication for Oral Health Problems among Population in Riyadh Region, Saudi Arabia

Aim:

The aim of this study was to know self-medication practices among the population of Riyadh region for oral health issues.

Methodology:

A questionnaire consisting of demographic self-practice of medication for oral health problems and knowledge about self-medication practices was sent through Google forms and it was in Arabic and English languages. The link of the questionnaire was sent through social and requested to send the link to their friends and relatives.

Results:

About 50.4% of study participants were having self-practice of medication for oral health problems. Self-practice of medication for oral health issues was statistically significant according to age gender and education (P < 0.05). Toothache (62.4%) is the main problem triggering self-medication and lack of time (44.6%) is the main reason for self-medication. Pain killer (68.8%) was the main medication and antibiotics were used by 2.2% of subjects.

Conclusion:

Self-medication practice is prevalent in the world and hence, education regarding its consequences and adverse effects for the general public is mandatory.

Trends in Antibiotic Self-Medication for Dental Pathologies among Patients in the Dominican Republic: A Cross-Sectional Study

The World Health Organisation has warned of the increase in antibiotic resistance, estimating that by 2050 it could become the leading cause of death worldwide. Several studies and literature reviews show a correlation between antibiotic use and bacterial resistance, with unnecessary broad-spectrum antibiotics, such as amoxicillin/clavulanic acid and azithromycin, being one of the main causative factors. An interview-based survey of 2160 participants was conducted to assess the prevalence in the practice of self-medication with antibiotics among dental patients in the Dominican Republic. A series of open-ended questions regarding self-medication and class of antibiotics were put to the patients. Over a third of the study population (39.7%) admitted to the practice of antibiotic self-medication. Most of the respondents (58.4%) who indulged in self-medication were females, and it was prevalent in the older adults between 32–42 years old (36%). There was a negative correlation between age and self-medication practice (p < 0.001) observed with point biserial correlation test. Binary logistic regression analysis found an odds ratio of 0.97 (p < 0.001). The most consumed antibiotics were amoxicillin/clavulanic acid (52%), amoxicillin (31.1%), and azithromycin (10.1%). It is imperative to educate patients about the harmful effects of self-medication and to stress the need for governments to implement stricter laws on non-prescription drug availability.

Antibiotics and toothache: a social media review

OBJECTIVES

Antibiotics are inappropriate for the treatment of toothache, yet many seek them. Social media allows users to express their opinions, share experiences and offer support. This study used social media to investigate the public's experiences of, and attitudes towards, antibiotics for toothache.

METHODS

A systematic search of posts on Facebook and Twitter was undertaken. Eligibility criteria were applied to select relevant social media posts for thematic analysis of word content. An inductive descriptive coding system was developed from the data and exemplary quotes were identified to illustrate the themes and subthemes identified. Key findings Searches identified 174 posts, of which 144 were selected for analysis. Five themes were identified: experience and expectations, self-care and professional treatment, access to dental care, quality of life and coping strategies. The belief that antibiotics are an appropriate treatment for a toothache was widespread. Antibiotic-seeking behaviour was related to access to professional dental care, including avoiding dental appointments due to dental anxiety and the perceived affordability of dentistry. A range of strategies to cope with the severe impact toothache was having on people's quality of life were identified, from prayer to antibiotics.

CONCLUSIONS

Social media is used extensively to seek antibiotics, avoid dental treatment and provide support to people with toothache. A general belief that antibiotics are an appropriate and necessary treatment for toothache exists. This improved understanding about the factors driving antibiotic-seeking behaviour provides new targets for the development of approaches to tackling antibiotic resistance, by reducing unnecessary antibiotic use in dental clinics and beyond.

Prevalence of Self-Medication with Antibiotics amongst Clients Referred to Outpatient University Dental Clinics in Iranian Population: A Questionnaire-Based Study

Self-medication with antibiotics may increase the risk of inappropriate use and development of antibiotic-resistant bacteria. The aim of this study was to determine the prevalence of self-medication with antibiotics amongst dental outpatients in Iranian population.

Methods and Materials

One thousand and two hundred of dentistry patients, who were referred to dental school clinics in ten major provinces of Iran, participated in this study. A valid self-administered questionnaire regarding self-medication with antibiotics in case of dental pain was used to collect data. Data were analysed using descriptive statistics and Logistic regression analysis.

Results

In our study population, the prevalence of self-medication was 42.6%. Amongst the Iranian cities, the highest prevalence of self-medication with antibiotics belonged to the city of Bandar Abbas (64%) and the lowest was seen in the city of Kerman (27.3%). Men were more likely to take antibiotics. Amoxicillin was the mostly used antibiotic. Severe pain, previous self-medications and high costs of dental visits were the most common reasons for self-medication with antibiotics in the investigated population. In addition, the present study showed that marriage, acceptable financial status and high level of education could decrease self-medication with antibiotics.

Conclusions

In the current investigation, an alarming fact was that self-medication for dental problems seemed very common amongst the studied population. One of its most important consequences was bacterial resistance. Therefore, there should be plans to promote and prioritize public health awareness and encourage general public's motivation to reduce the practice of self-medication.

SELF-MEDICATION PROFILE OF DENTAL PATIENTS ATTENDING A NORTH EASTERN TERTIARY HOSPITAL IN NIGERIA

BACKGROUND

Self-medication is widely practiced worldwide. Literatures abound on its use for medical ailments but there is paucity of information for dental complaints especially in Northeastern Nigeria. Hence, this study was designed to determine the prevalence of self-medication for dental problems before dental consultation and its associated factors among patients attending Federal Teaching Hospital (FTH), Dental and Maxillofacial Outpatient Clinic, Gombe, Gombe State, Nigeria.

MATERIALS AND METHODS

A descriptive cross-sectional study based on a structured pretested close-ended interviewer-administered questionnaire was distributed among adults visiting FTH outpatient dental clinic, Gombe, Nigeria for a period of 8 months. The questionnaire was composed of two main sections: demographic characteristics and questions assessing the behaviour of self-medication. The non-probability convenient sampling technique was used and data was stored and analysed using IBM-Statistical Package for Social Sciences (SPSS) version 23.0.

RESULTS

The results showed that the prevalence of self-medication was found to be 41.5% (194/468), with a higher prevalence among females (55.1% or 107/194) than males (44.9% or 87/194). The majority (52% or101/194) of the patients were in the 2-4th decades of life. Educational status was significantly associated with self-medication. Analgesics accounted for the greatest percentage (98/164 or 59.8%) of orthodox drugs used followed by antibiotics (62/164 or 37.8%). However, with respect to individual medication consumed, paracetamol accounted for the majority (28.7%). A greater number (55/194 or 28.4%) could not remember the name of the orthodox drugs they took before consultations. Street hawkers were the main source of these medicaments (36.6 or 71/194%). Fear of dental treatment (20.1% 39/194), ailment is simple and the need not to see a dentist (20.1% 39/194) were claimed to be the main reason for practicing self-medication with periodontitis (53.1% or 103/194), pulpitis (13.9% or 27/194) and pericoronitis (10.8% or 21/194) the main predictors.

CONCLUSION

The prevalence of self-medications to dental problems in this study was discovered to be high with the use of both orthodox and unidentified traditional drugs. National Health Insurance Scheme should be made to cover all social group of Nigerians in order to encourage easy accessibilities of all people to wide range of medical and dental consultations, thereby discouraging the practice of self-medication.

Self-medication for oral health problems among adults attending the University Dental Hospital, Sharjah

Objective

The aim of this study was to investigate the self-medication practices for oral health problems among adults attending the University Dental Hospital Sharjah (UDHS). The reasons for visits and types, durations, and sources of self-medication were recorded.

Methods

This cross-sectional study was conducted among adult patients attending UDHS. A total of 566 participants were recruited using pre-determined inclusion and exclusion criteria. Data collection was performed using a self-administered closed-ended questionnaire, and information was analysed using SPSS software version 22.

Results

Four hundred of 566 (70.7%) respondents indicated that they practice self-medication. Among those who practiced self-medication for oral health problems, the mean age was 26 ± 9.4 years (52% men and 48% women), and the majority (46%) had obtained higher education, although their profession was not related to the medical field (69.97%). The most common factor that triggered self-medication practices was toothache (56.5%), while the main reasons for self-medication were both lack of time to visit a dental clinic (37.6%) and the perception that dental ailments were not serious health issues (36.8%). Analgesics were the main medicines used for self-medication.

Conclusion

Self-medication for oral health problems is a common practice in UAE. Lack of time to visit dental clinics and the perceived low importance of oral health problems were the main reasons for self-medication. Analgesics for toothache were the most frequent medications purchased from the local pharmacy.

What do people do before going to the dentist? Qualitative study of cultural practices of pain relief in primary care

Objective: To describe and classify the main cultural practices used to relieve orodental pain in people who seek emergency dental care in vulnerable urban and rural areas of central Chile. Methodology: A sample of 88 adults residing in urban and rural sectors, who received treatment at primary care emergency dental services in three districts of the central area of Chile was studied using a qualitative descriptive approach of sociocultural epidemiological orientation based on Grounded Theory. Interviews were conducted in the waiting room of the emergency service or at the patient’s home. Empirical saturation and triangulation of temporal data were protected. Results: Practices of biomedical origin (self-medication and care received at dental emergency services) and socio-cultural practices were documented. They include the use of chemical products (iodine, phosphorus, battery acid, hydrogen peroxide, gasoline, and alcoholic drinks, among others), herbal infusions (Buddleja globosa, Aloe vera), mechanical-physical techniques (use of cold or heat, massage); subjects also perform the mechanical manipulation of the area with sharp objects, occasionally extracting the tooth itself. Practices occur more frequently at home when the person feels the pain in the affected area, and end on the dental chair with the tooth extraction. Conclusions: The coexistence of biomedical practices and alternative cultural strategies was observed. These practices complement each other and make people postpone seeking professional dental care, which may worsen their health condition.

Patterns of Self-Medication Behavior for Oral Health Problems Among Adults Living in Riyadh, Saudi Arabia

Self-medication is a widespread behavior worldwide. It is defined as the practice of self-diagnosis and drug prescription without proper professional consultation. Aim: To determine the prevalence and predictors of self-medication for oral health problems among adults living in Riyadh city. Methods: A cross-sectional study based on a structured close-ended questionnaire was distributed among adults visiting shopping malls in all different five regions of Riyadh. A two-stage sampling technique was used: cluster and simple random sampling. The questionnaire was composed of two main sections: demographic characteristics and questions assessing the behavior of self-medication. Results: The prevalence of self-medication was found to be 63.25%, with a higher prevalence among females than males. Gender and nationality were significantly associated with self-medication. Salt in hot water locally (52.57%) and acetaminophen (47.43%), a type of an analgesic, were, systemically, the most frequently used. Pharmacy shops were the main source of these medicaments (66.01%). Similarly, the advice for using them was mainly given by pharmacists (53.36%). Lack of time was claimed to be the main reason for practicing self-medication (54.55%) with abscess, toothache, and gingival bleeding being the main predictors. Conclusions: Self-medication was found to be a common practice among the population of Riyadh city.

Self-medication practices among female students of higher educational institutions in Selangor, Malaysia: A quantitative insight

Background:

World Health Organization has defined self-medication as the selection and use of medications (including herbal and traditional product) by individuals to treat self-recognized illnesses or symptoms. The prevalence of self-medication is reported to be higher among female students.

Objective:

To investigate the awareness and self-medication practices among female students of higher education institutions in Malaysia.

Method:

A descriptive, cross-sectional study was conducted in four higher education institutes of Selangor, Malaysia. Convenience sampling approach was used to collect data from a sample 475 students. A “pretested” questionnaire was used as a study instrument.

Results:

A total of 461 questionnaires were returned (response rate 97.05%). The prevalence of self-medication among female students in higher educational institutions was 57.2% (n = 262). The most common source of self-prescribed medicine was a pharmacy or clinics (n = 206; 45%). It was found that antipyretics were the most common medications used without doctor's consultation (n = 212; 89.1%). Analgesics and antipyretics (n = 79; 62.7%) were highly recommended by students to their family and friends. The common reason for self-medication was prior successful experience (n = 102, 81.0%). The majority of respondents (n = 280; 61.1%) reported that they believed over-the-counter medications were as effective as medications prescribed by a doctor.

Conclusion:

The prevalence of self-medication practice among female students in the sample of the four higher education institutions was moderate. More studies are required to generalize these findings across Malaysia.

Observations on the Prevalence, Characteristics, and Effects of Self-Treatment

Aims

When facing illness, a person may choose self-treatment as an alternative to hospital (and primary care)-based treatment. Despite its important role in health care, the study on self-treatment remains limited. The goal is to collectively report the observations in the literature on the prevalence, characteristics, and effects of self-treatment.

Methods

Databases (Medline/PubMed and Google Scholar) were searched. Articles were scrutinized for country of origin, sample size, recall period, prevalence, associated factors, etc.

Results

Published studies have reported that in some regions, the prevalence of self-treatment is high and varies across illness conditions and treatment approaches. Self-medication is the most popular self-treatment approach. Multiple regional, demographic, personal, cultural, and religious factors have been implicated in the pursuit of self-treatment. In addition, accessibility of health care also plays a role. In general, self-treatment has a positive clinical and financial effect. However, there have been concerns on abuse and possible negative effects.

Conclusion

This article reviews observations made in recent studies on several important aspects of self-treatment. Comprehensive and systematic study is still lacking. Interventions are needed to solve several problems associated with self-treatment.