Genetic studies in the Nigerian population implicate an MSX1 mutation in complex oral facial clefting disorders

BACKGROUND

Orofacial clefts are the most common malformations of the head and neck, with a worldwide prevalence of 1 in 700 births. They are commonly divided into CL(P) and CP based on anatomic, genetic, and embryologic findings. A Nigerian craniofacial anomalies study (NigeriaCRAN) was set up in 2006 to investigate the role of gene-environment interaction in the origin of orofacial clefts in Nigeria.

SUBJECTS AND METHODS

DNA isolated from saliva from Nigerian probands was used for genotype association studies and direct sequencing of cleft candidate genes: MSX1 , IRF6 , FOXE1, FGFR1 , FGFR2 , BMP4 , MAFB, ABCA4 , PAX7, and VAX1 , and the chromosome 8q region.

RESULTS

A missense mutation A34G in MSX1 was observed in nine cases and four HapMap controls. No other apparent causative variations were identified. Deviation from Hardy Weinberg equilibrium (HWE) was observed in these cases (p = .00002). A significant difference was noted between the affected side for unilateral CL (p = .03) and bilateral clefts and between clefts on either side (p = .02). A significant gender difference was also observed for CP (p = .008).

CONCLUSIONS

Replication of a mutation previously implicated in other populations suggests a role for the MSX1 A34G variant in the development of CL(P).

Determinants of preventive oral health behaviour among senior dental students in Nigeria

BACKGROUND

To study the association between oral health behaviour of senior dental students in Nigeria and their gender, age, knowledge of preventive care, and attitudes towards preventive dentistry.

METHODS

Questionnaires were administered to 179 senior dental students in the six dental schools in Nigeria. The questionnaire obtained information on age, gender, oral self-care, knowledge of preventive dental care and attitudes towards preventive dentistry. Attending a dental clinic for check-up by a dentist or a classmate within the last year was defined as preventive care use. Students who performed oral self-care and attended dental clinic for check-ups were noted to have complied with recommended oral self-care. Chi-square test and binary logistic regression models were used for statistical analyses.

RESULTS

More male respondents agreed that the use of fluoride toothpaste was more important than the tooth brushing technique for caries prevention (P < 0.001). While the use of dental floss was very low (7.3%), more females were more likely to report using dental floss (p=0.03). Older students were also more likely to comply with recommended oral self-care (p<0.001). In binary regression models, respondents who were younger (p=0.04) and those with higher knowledge of preventive dental care (p=0.008) were more likely to consume sugary snacks less than once a day.

CONCLUSION

Gender differences in the awareness of the superiority of using fluoridated toothpaste over brushing in caries prevention; and in the use of dental floss were observed. While older students were more likely to comply with recommended oral self-care measures, younger students with good knowledge of preventive dental care were more likely to consume sugary snacks less than once a day.

Study motives, career choices and interest in paediatric dentistry among final year dental students in Nigeria

BACKGROUND

Students' motives for studying Dentistry have been a subject of interest for years because of the potential for understanding the psychological makeup and subsequent job satisfaction for the dentist. It is also useful in identifying expectations of the profession. This study therefore tried to identify study motives and career preferences of dental students especially with respect to the practice of paediatric dentistry.

METHODS

This was a cross-sectional study using a self-administered questionnaire. The final year students in six dental schools in Nigeria were required to fill the questionnaire. Students were asked to rank their motives and career preferences on a Likert like scale with points ranging from 0-5 where 0 represented a factor that had no influence on their decision and 5 represented a very influential factor. The underlying dimensions for study motives, career preference, impression about and motive for interest in the practice of paediatric dentistry were identified using factor analysis.

RESULTS

One hundred and seventy nine of 223 students (80.3%) participated in this study. Motives for the practice of dentistry included characteristics of the profession, altruism and intellectual challenges, existence of artistic theme in dentistry and parent's recommendation. Overall, 67.1% of respondents indicated interest in postgraduate studies and 50.8% were interested in paediatric dentistry practice. The main motives for showing interest in the practice of paediatric dentistry were 'personal interest, professional interest and interest of significant others in children', and 'family influence'. Significantly more males than females were interested in the practice of paediatric dentistry though the motives for interest in the practice of paediatric dentistry did not differ significantly by sex or age.

CONCLUSION

The non-significant sex difference in the motives for interest in the practice of paediatric dentistry is a possible reflection of changes in strong cultural themes in the motives for career choices in Nigeria.

Determinants of preventive dental practice for children among final-year dental students in Nigeria

BACKGROUND

This study aims to identify the determinants of caries prevention-oriented practice for children among final-year dental students in Nigeria.

METHOD

A questionnaire was distributed to 179 final-year dental students in six dental schools in Nigeria. It requested information on age, gender, knowledge of caries prevention measures, self-perceived competency in providing caries-preventive care for children, and caries prevention-oriented practice for two hypothetical cases with high and low risk of caries. Chi-squares tests and logistic regression analysis were done.

RESULTS

Between 24% and 41% of the respondents indicated their inability to determine the appropriate treatment modality for children with high and low caries risk. Majority of the students failed to differentiate between the caries-preventive practice for children with high and low risk of caries: preventive strategies for children with high caries risk were also used for those with low caries risk. Age, gender, knowledge of caries prevention measures, and self-perceived competency in providing caries-preventive care were not associated with student's capacity to provide caries-preventive practice for children.

CONCLUSION

Caries-preventive practice among dental students in Nigeria could be improved. It may be important to explore the possible role of problem-based learning approach in addressing this challenge.

Assessment of time taken to treat dental trauma in Nigerian children

AIM

To assess the clinical time (diagnosis and treatment times) to manage traumatic dental injuries (TDIs) in children attending paediatric dental clinics in Nigeria.

STUDY DESIGN

Cross sectional observational pilot study on children presenting at four government hospitals in South West Nigeria over a 3-month period.

METHODS

Dental injury was classified using the method recommended by Andreasen et al. [2003]. A standardized protocol was followed and the details of the diagnosis time, treatment time and total clinical time for management of different traumatic injuries to the primary and permanent dentition were recorded and calculated on a data collection form.

RESULTS

There were 73 dental injuries in 39 children. For the primary dentition, complicated crown fracture had the highest average total treatment time namely 76.0±48.1 minutes as well as the highest average number of visits (2.6 visits). More time was spent manageing the same level of injury in the permanent dentition than in the primary dentition. For the permanent dentition, extrusive luxation injury had the highest average total treatment time (103.3±11.5 minutes).

CONCLUSION

The clinical time for management of dental injuries in children was relatively high and varied by type of injury.

Prevalence of Dental Caries among Visually Impaired Institutionalized Adolescents in Lagos State

OBJECTIVES

To assess and compare caries prevalence among institutionalized visually impaired and sighted 10dash;19 year old children in Lagos State, Nigeria.

METHODS

A cross sectional study of institutionalized visually impaired and sighted 10-19-year-old adolescents was carried out using the World Health Organisation (WHO) Basic Oral Methods caries diagnostic criteria. A random sample of 10-19-year-old visually impaired and sighted institutionalised children was carried out. The mean decayed, missing, filled teeth (dmft/DMFT) and significant caries (SiC) indices of both groups were obtained and compared with Chi-square test using SPSS version 20.

RESULTS

Mean age of visually impaired participants was 16 years while that of sighted was 12.5 years. The male to female ratio was 1:1 among the visually impaired participants and 1:1.5 among the sighted. Caries prevalence of 28.8% (64/222), mean dmft/DMFT 1.98±1.25 and 27.5% (63/229), mean dmft/DMFT 1.90±1.28 were obtained for the sighted and visually impaired 10dash;19 years old children respectively. The significant caries (SiC) indices for both groups were 3.3.

CONCLUSION

Caries prevalence among the visually impaired and sighted adolescents in this study was considerable with no significant differences between them. Both populations had significant caries experiences. There is therefore need for oral health promotion among both sighted and visually impaired institutionalized adolescents in this environment.

Challenges of cleft care in Africa

Professionals involved in the care of patients with clefts in Africa face unique challenges when compared with what obtained in western countries. It is the purpose of this paper to review some of the challenges of cleft care in Africa. A computerized literature search using electronic databases; Ovid MEDLINE, EMBASE and AJOL databases was conducted for published articles from 1965 to 2006. Mesh phrases used in the search were: Cleft lip, Cleft palate, Cleft care, Management, Challenges and Africa. The search produced 46 articles. A critical evaluation of the 46 articles using the inclusion and exclusion criteria led to selection of 20 articles for the review. The findings were: (1) No reliable data on incidence of cleft; (2) Strong traditional beliefs system exist regarding etiology of cleft; (3) Health problems attributed to clefts common at presentation; (4) Patients with cleft commonly present late; (5) Lack of multidisciplinary approach to care. The chance that a child born with a cleft tomorrow in Africa will receive the best care possible can not yet be guaranteed. The need to formulate basic strategies to improve the standard of cleft care in Africa and the rest of the developing world is overdue. We hope that the findings in this review will provoke solutions that might ultimately improve the standard of cleft care in Africa and the rest of the developing world.

Oral health and nutritional Status of Preschool-Aged Children in Maiduguri, North-East, Nigeria

BACKGROUND

The most prevalent oral diseases, dental caries and periodontal disease, result in pain, discomfort, and loss of oral functions, often leading to poor nutrition.

OBJECTIVES

To assess the prevalence and relationship between oral health and nutritional status among children aged 2 to 5 years in Maiduguri, North-East Nigeria.

METHODS

A cross-sectional study that assessed caries experience, gingival status and nutritional status of children. Anthropometric measurements of weight-for-age and mid-upper arm circumference (MUAC) were used to assess nutritional status. Participants were randomly selected from three private schools. The MUAC was measured using a standardised tape rule. The weight-for-age by sex of the participants was extrapolated from the weight-for-age WHO chart. Oral health was assessed using the WHO Oral Health Survey Methods. Data were analysed using SPSS for Windows (version 23). Statistical significance was placed at 95% confidence and p ≤ 0.05.

RESULTS

There were 239 participants with a male:female ratio of 1.2:1 (SE=0.03). Mean dmft was 0.72 (SE 0.09) and 63.2% had healthy gingiva (SE 0.04). The mean weight was 16.8kg (SE=0.15) and mean MUAC was 15.3 cm. Caries prevalence was associated with nutritional status and positively correlated (r=0.03, P=0.64). Gingival status was associated but inversely correlated with MUAC (r= -0.02, P= 0.76).

CONCLUSION

Normal nutritional status was associated with no caries prevalence and healthy gingiva. Underweight was associated with caries prevalence. Adequate and healthy nutrition promotes good oral health in children.