Review of a community oral health programme in Nigeria after ten years

Abstract

This paper reviews the activities of a model community oral health programme (COHP) which is situated in Idikan, a low income urban community in Ibadan, south western Nigeria. The programme which has been in existence since 1988, is part of a comprehensive primary health care (PHC) delivery system that caters for the basic health needs of members of the community. The programme was designed to prevent diseases of the oral cavity and to provide basic oral care services. It comprises school health programmes, health education programmes for specific target groups, examination for early detection of diseases and provision of dental services at the clinic located on site. Within the first ten years under review (1988-1997), a total of 780 patients were seen at the dental clinic. Three hundred and eighty one were(381) males, while 399 were females and their ages spanned a wide range. Many were petty traders(43.3%), 187(23.9%) were students and 131(16.8%) were skilled artisans. Pain was almost invariably the presenting complaint. In many instances, pain was accompanied by dento-alveolar abscess. Only in a few cases did patients present for routine check-ups or for aesthetic purposes. Periodontal disease in varying degrees of severity was the most prevalent diagnosis (37.2%), and this was followed by dental caries (21.9%). Apart from these, a wide spectrum of conditions such as trauma, chronic gingivitis and necrotising ulcerative gingivitis were treated. An early diagnosis of squamous cell carcinoma was made amongst the patients attending the clinic. Extraction and dental prophylaxis were the treatments most frequently carried out. In many cases, antibiotics and analgesics were administered before the definitive treatment or referral. The clinic utilisation pattern indicates that the majority of the patients attend only once except in cases where the pain is not relieved after the first visit. Even though this programme is considered effective and appropriate, more effort is required in the area of health education to enable residents adopt more prevention oriented behaviour.

Keywords: Primary Health Care, Community Health, Oral Health