African Journal of Oral Health

Minimum intervention dentistry in resource challenged practice environments

G.T Arotiba — 2020-10-09

This paper highlighted the clinical strategies for implementing minimum intervention dentistry (MID) in dental practice and in dental education in resource challenged practice environments (developing economies). The objectives of each of the 4 phases of minimum intervention treatment plan (MI Identify, MI Prevent, MI Restore and MI Recall) were highlighted and three levels of caries risk (Low risk, High risk and Super high risk) were adopted with the appropriate targeted preventive non restorative treatments. Three evaluation rating scales were introduced (early recall evaluation rating scale, caries control evaluation rating scale and oral health outcome evaluation rating scale) for monitoring the success or failure of counselling, the targeted preventive (non-surgical) treatments and the oral health outcome. Practitioners and academics in resource challenged practice environments should embrace MID with open minds, its goal is maximum preservation of healthy oral tissues with oral health promotion and targeted preventive non- surgical treatments as its cornerstones. Furthermore, MID is mercury free and will safeguard our environment from mercury pollution for the benefit of future generations.

Keywords: Minimum intervention dentistry, mercury free dentistry, dental practice, dental education, resource challenged practice environments

Oral health characteristics and treatment of individuals with special needs a tertiary institution: A 3 year retrospective study.

T.O Ligali — 2020-10-09

Objectives: To assess the oral health characteristics and the treatments carried out on individuals with special needs attending the Dental Clinic of Lagos University Teaching Hospital.
Methods: A three-year retrospective study of all individuals with special needs that ttended the dental clinic of a tertiary health center. All relevant data including biodata, type of special need, oral health conditions and treatments carried out were extracted from the case notes and analyzed.
Results: Out of 115 records extracted, there were 15 different types of special needs. More than half of the participants were males (54.8%) and their mean age was 12.4 years (SD±7.2). The most frequently recorded study participants with special needs were those with Down syndrome (20.9%). The most common oral conditions were gingivitis (65.2%) and dental caries (37.4%). Dental caries was significantly prevalent among participants with cleft lip/palate and the visually impaired (p=0.02). Of all treatments offered, preventive therapies were most commonly performed.
Conclusion:The most common oral health problems among the study population were gingivitis and dental caries. There is need for improved oral health promotion strategies and provision of services for these underserved populations.

Keywords: Oral health, treatment, special needs

Attitude and perception of orthodontic patients to orthodontic treatment time and accelerated orthodontics.

O.D Umeh — 2020-10-09

Objectives: The purpose of this study was to evaluate the a?itude and perception of orthodontic patients to the duration of orthodontic treatment and the procedures for accelerating orthodontic tooth movement.
Methods: This was a cross-sectional analytical study. The study population was made up of patients undergoing fixed appliance orthodontic treatment at the Orthodontic Unit of the Lagos University Teaching Hospital. A convenience sampling technique was used and data collection was via selfadministered questionnaires and an information sheet. The questionnaires assessed patients' knowledge of accelerated orthodontic procedures as well as their perception of orthodontic treatment time and willingness to undergo some accelerated orthodontic treatment procedures. The procedures evaluated included corticotomy, piezocision, micro-osteoperforation, laser therapy, local administration of injections and use of vibrations.
Results: One hundred orthodontic patients (n=100, adolescents, 46%; adults, 54%) were surveyed comprising 36 males and 64 females. Most of the participants (88%) had never heard of accelerated orthodontics. A majority of respondents (75%) believed that orthodontic treatment time was too long, and were willing to undergo additional procedures to reduce treatment time (81%). Subjects' willingness to undergo the procedures were inversely proportional to the degree of its invasiveness for all groups, with at least a third of the patients willing to accept a 10% increase in treatment fees for a reduction in treatment time across all techniques surveyed.
Conclusion: The orthodontic patients surveyed considered treatment time protracted and were interested in undergoing adjunctive orthodontic procedures to accelerate tooth movement, with a consequent increase in treatment cost. They, however, had a limited knowledge of the different methods of accelerating orthodontic treatment.

Key words: Accelerated orthodontics, orthodontic treatment time

Oral squamous cell carcinoma in patients less than 40 years in a Nigerian population

A.O Lawal — 2020-10-09

Objectives: Oral cancer ranks amongst the sixth to eight most common cancers worldwide and exhibits a great variation in incidence among countries. Oral squamous cell carcinoma (OSCC) is rare in individuals less than 40 years of age, with occurrences averaging 4 to 6% in people less than 40 years. The aim of this study was to review the clinical and pathological characteristics of OSCC cases in patients less than 40 years of age in five tertiary health facilities in Nigeria.
Methods:All OSCC in the period from 1970 to 2015 from case file records and biopsy reports were retrieved from the records of the five teaching hospitals, to obtain age, gender, location and histologic grades.
Results: Ninety-seven (17.4%) cases of OSCC were diagnosed in patients less than 40 years of age. These included 58 males and 38 females giving a male: female ratio of 1.5:1. The mandibular mucosa with 27 (28.7%) cases was the most common site followed by the maxillary mucosa with 24 (25.5%) and palate with 14 (14.4%) cases. Only 5 (5.3 %) cases of OSCC occurred in the tongue. The well differentiated OSCC was the most common histological grade accounting for 48 (50.0 %) cases while the moderately differentiated and poorly differentiated OSCC accounted for 31 (32.3 %) and 17 (17.7 %) cases respectively.
Conclusion: OSCC was relatively more common in patients less than 40 years of age in this study than those of previous studies from other regions and OSCC in patients less than 40 years of age was relatively rare in the tongue when compared with similar cohorts from other continents.

Key words: oral squamous cell carcinoma; age less than 40; tongue; mandibular mucosa, Nigeria