Prevalence and Pattern of Pain Presentation among Patients Attending a Tertiary Dental Center in a Southern Region of Nigeria

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.

Assessment of oral health status and treatment needs among people of Foklyan area, Dharan, Nepal

Background

Oral diseases are a major public health problem globally due to high prevalence and significant social impact. Foklyan is a peri urban area with people belonging to indigenous population of low socioeconomic status. This study was conducted to assess the oral health status and treatment needs among the people of Foklyan area, Dharan.

Methods

Cross-sectional house to house survey was conducted on 310 randomly selected participants. The participants were stratified into five age groups as per WHO Basic Oral Health Survey Methods 1997 and further categorized by gender. WHO Oral Health Assessment form 1997, WHO oral health assessment questionnaire for adult/children 2013 and questionnaire for oral hygiene practice and cost as a treatment barrier were used. The examinations were done as per WHO standard guidelines.

Results

Most of the participants were from low socioeconomic background (71.3%). About 40% of the participants deferred dental visit due to financial burden. Although 99% of the participants brushed their teeth, there was high caries experience (DMFT: 3.18 ± 5.85; dft: 2.40 ± 2.65). Mean sextant score for bleeding was 5.58 in 35–44 years age group and 5.61 in 65–74 years age group. Tobacco consumption was seen in 70.9% of the adults. Prevalence of alcohol consumption was 58.8% among adult age groups.

Conclusion

The prevalence of dental caries, periodontal diseases, and prosthetic needs were more compared to national data. There is a need for oral health promotion in this area.

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.

Opioid prescribing habits of physicians in Kwara State, Nigeria

OBJECTIVE

Although opioid analgesics are effective in the treatment of moderate to severe acute, cancer and chronic non-malignant pains, they are under-prescribed in Nigeria. The objective of this study was to assess the prescription pattern of opioids among physicians in a north central State, Nigeria..

DESIGN

This was a descriptive cross sectional study.

SETTING

The study was conducted at the International Association for the Study of Pain (IASP)-sponsored workshops on pain and palliative care at the University of Ilorin Teaching Hospital, Ilorin, Nigeria.

PARTICIPANTS

These were physicians at the monthly workshops organized by the Pain and Palliative Care Unit of the hospital between August 2011 and July, 2012.

INTERVENTIONS

Pre-tested semi-structured questionnaires were used to obtain responses to questions on pain management including opioids utilization in the various hospitals of the 114 participants.

MAIN OUTCOME MEASURES

The main outcome measure was opioid prescription by the participants.

RESULTS

Out of the 114 questionnaires distributed, 113 were returned with complete information giving a response rate of 99.1%. The mean age of the respondents was 42.0±10.8 years. Although 97.3% of the respondents reported that pain was a frequent complaint in their practice, 69.5% of those who reported seeing patients with moderate to severe pain on a daily basis rarely or never prescribed opioid analgesics. The reasons given for poor opioid prescription were fear of respiratory depression (86.8%), fear of addiction (85.1%) and non-availability (28.9%).

CONCLUSION

Opioid prescription rate for patients with moderate-severe pain is low possibly due to myths and misconceptions about their adverse effects.

FUNDING

International Association for the Study of Pain (IASP) Initiative for Improving Pain Education Grant awarded to Dr. K.W. Wahab in 2011.

Oral health trends and service utilization at a rural outreach dental clinic, Udo, Southern Nigeria

Background:

The oral disease burden in Nigerian rural areas is considered high with limited dental services. Normative need assessment to facilitate oral health promotion and interventional activities is essential. Therefore, the aim of this study was to evaluate the dental service utilization and trends of patents attending a rural outreach dental clinic.

Materials and Methods:

A retrospective study was conducted using data from clinical records of patients seen over a period of 54 months at a rural outreach dental clinic of comprehensive health center, Udo, Edo State, and were analyzed for descriptive variables with Chi-square test and P value set at ≤0.05 significance.

Results:

One hundred and sixty four (164) patients [males = 74 (45.1%), females = 90 (54.9%)] were seen with a mean age of 36.15 ± 18.05 years. The major reason for clinic visit was due to dental caries (sequelae) and condition representing 43.3% and 34.8%, respectively. Extractions (41.5%) and scaling and polishing (S and P) (21.3%) accounted for the most frequently provided treatment. Almost 20% patients did not receive any form of treatment.

Conclusion:

The study revealed a low health seeking behavior, low utilization of dental services among the rural dwellers and need for oral health awareness, periodic screening, and preventive approach in the rural population through more frequent outreach visits of dental personnel resident in the community.

SELF REPORTED TOOTH DISCOLORATIONS AMONG PATIENTS SEEN AT DENTAL CENTER UNIVERSITY COLLEGE HOSPITAL IBADAN

BACKGROUND

Tooth discoloration is an aesthetic problem that is linked to a variety of causes and it could be a source of embarrassment, leading to reduced self-esteem.

AIM

To determine the prevalence of self reported tooth discoloration and the distribution of the different intrinsic tooth discolorations.

METHODOLOGY

A retrospective study that reviewed the distribution of tooth discoloration reported by patients that presented for treatment of tooth discoloration at conservation clinic of the dental centre University College Hospital, Ibadan between December 2011 and December 2014. Data collected from patients' case files included patients' demographics, type of tooth discoloration as diagnosed by attending consultant and treatment offered. Data were analyzed using SPSS version 20. Frequencies and means were used for continuous variables while chi square was used to compare the categorical variables. P value was set at ≤ 0.05.

RESULTS

One hundred and thirty six patients reported tooth discoloration as their major reason for presentation at the clinic. The patients were between age 16-75 years with mean age of 35.62±14.31 years and male to female ratio of 1:1.13. Prevalence of reported tooth discolouration during the study period was 9.8%. Pulpal necrosis was the most reported cause of (86.8%) tooth discolouration, while fluorosis was the least (0.7%) reported. Non vital tooth bleaching was the most common treatment (72.1%) offered for tooth discoloration. No significant comparison was observed between gender and type of tooth discoloration, p=0.088.

CONCLUSION

Pulpal necrosis is a major cause of discoloration which leads to reduced self esteem. There is need to improve on dental awareness on causes of tooth discoloration for prevention and early presentation for management.

Assessment of pain among a group of Nigerian dental patients

Background

Pain is considered a key symptom associated with possible impairment of oral-health-related quality of life and its assessment is important for the planning and evaluation of preventive and treatment effort. The tools for assessing pain must therefore be valid and consistent. The objective of this study was to assess dental patients’ level of pain based on the clinical diagnosis of their dental condition and the correlation between two pain assessment scales, Visual analogue scale (VAS) and the Full Cup Test (FCT), for the assessment of pain among dental patients.

Methods

A total of 185 patients presenting at the University of Benin Teaching Hospital dental outpatient clinics with various forms of orofacial pain were included in this study. The mean VAS scores and mean FCT scores for the different dental conditions were compared. Agreement between VAS and FCT was evaluated using the Intra-class correlation (ICC) coefficients and Cronbach alpha coefficient was also calculated to assess consistency of the two pain scales.

Results

Majority i.e. 95.1, 96.2 and 100% who presented with acute pulpitis, acute apical periodontitis and pericoronitis respectively, presented with moderate to severe pain levels (p < 0.05). Only 25.9 and 4% who presented with chronic marginal gingivitis and chronic pulpitis respectively presented with no pain (p < 0.05). A large proportion (75%) of patients with no pain had single diagnosis while more than half (52.1%) of those who presented with severe pain had multiple diagnoses (p = 0.025). The mean VAS and FCT scores for acute pain were 6.1 ± 2.1 and 5.9 ± 2.4 respectively and for chronic pain 3.9 ± 2.7 and 3.7 ± 2.7 respectively (P = 0.001). The interclass correlation coefficient revealed that the mean VAS and FCT scores were statistically correlated and reliable with a Cronbach alpha coefficient of 0.85.

Conclusion

It can be concluded that patients who presented with either acute or chronic dental conditions may experience moderate to severe level of pain, with patients with multiple diagnoses experiencing more severe pain, and there is a correlation between the VAS and FCT for pain assessment among dental patients.

Prevalence of dental caries and oral hygiene status of a screened population in Port Harcourt, Rivers State, Nigeria

Objectives:

The study was designed to determine the prevalence of dental caries and partial edentulism, in addition to assessing the oral hygiene status and restorative care among adults in a community-based outreach program in Port Harcourt.

Materials and Methods:

A cross-sectional study was conducted among adults who participated in oral health screening program, which took place in Alakahia and Obigbo rural communities in Port Harcourt, Rivers State, Nigeria. After a brief oral health education, clinical examination was conducted and the diagnosis of caries was made based on the guidelines laid down by World Health Organization. Prevalence of caries was measured using decayed missing and filled teeth (DMFT) index, and oral hygiene status was assessed using the OHI-S. The restorative index [(F/F + D) ×100] was also calculated and the sociodemographic factors of the subjects were noted. Chi-square test, independent t-test and descriptive statistic were employed for analysis.

Results:

One fifty-five females (53.8%) and 133 males (46.2%) attended the events and their mean age was 29.3 ± 10.5 years. About one-third of the participants (35.1%) presented with dental caries. The mean DMFT for the whole group was 0.67 ± 2.0. The restorative index for the subjects was 26.8%. The oral hygiene status of most of the participants was fair. This was significantly better in females than in males (P = 0.002).

Conclusion:

Although about one-third of the participants had dental caries, only a quarter of them had received restorative care. Most of the respondents had fair and poor oral hygiene, this suggests the need to educate and motivate the community toward adopting and maintaining positive oral health attitudes and practices.

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

Background:

There is evidence that self-medication practices among dental patients with toothache are common, and despite the adverse clinical consequences, there is a paucity of literature on it, and only few programs are available for its control.

Aim:

The aim was to assess the self-medication practices among adult dental patients suffering from toothache.

Subjects and Methods:

An instrument adapted from modified form of 117-item self-report questionnaire based on world Health Organization guidelines for students’ substance use survey and open-ended questionnaire was administered to adult patients attending the Dental and Maxillofacial Surgery Clinic of this Health Institution for a period of 6 months.

Results:

The results show that 80.6% (287/356) subjects indulged in self-medication practices. Majority of the patients 42.9% (123/287) were in the 2-4^th decades of life, whereas the male: female ratio was 1.3:1. The most commonly abused medications/substance was analgesics/non-steroidal anti-inflammatory drug (243/287; 24.5%), antibiotics (233/287; 23.5%), “touch and go” (187/287; 18.8%). The practice of self-medication cut across all social strata, P < 0.01 (significant) and only 3.8% (11/287) subjects admitted knowledge of the dosage and side-effects of the used medications/substances. The toothache not being serious initially (112/287; 22.5%) and time constraints to attend dental clinic (93/287; 18.7%) were the major reasons for self-medication.

Conclusion:

This study suggests that the practice of self-medication is common among adult dental patients with toothache in Nigeria. This should be reduced to the barest minimum by dental health education, upgrading of dental health facilities, and enforcement of drug control mechanisms.