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.

Aim: The aim of the study was to determine the dental treatment needs and the level of dental service utilization among patients with mental disorders (PWMD).Setting: This was a cross-sectional study at a tertiary hospital in Nigeria conducted between March and November 2018.Methodology: The community periodontal index of treatment of needs and the Decayed, Missing and Filled Teeth index were used to determine the dental and periodontal treatment needs. Dental service utilization was determined using a self-reporting assessment questionnaire. All data analyses were carried out using the IBM SPSS® Statistics version 20 and the statistical significance was set at P < 0.05.Results: A total of 116 PWMD participated in the study with 51.7% being females. The age range was between 19 and 57 years and the mean age was 37.16 (±10.52). Dental treatment need was 40.8%, while 66% needed a range of periodontal interventions and this showed no statistically significant differences in terms of gender (P = 0.67, P = 0.15, respectively). While 32.7% had made previous dental visits, past caries experience, and other factors such as gender were significant predictors for dental visits.Conclusion: There was a high dental and periodontal treatment need among PWMD, yet the dental service utilization was low. More collaborations between oral and mental health specialists are needed to improve dental service utilization and promote holistic health care for PWMD.

Objective: The objective of this study was to determine and compare the oral health status of outpatients with mental disorders (OPMDs) and healthy controls (HCs) in a Nigerian tertiary hospital. Methodology: A comparative cross-sectional study among 140 OPMDs was consecutively recruited from the Mental Health Clinic of a Nigerian tertiary teaching hospital. Furthermore, 140 age- and sex-matched HCs screened using the 12-item General Health Questionnaire were recruited from the general outpatient clinic. Oral health status was assessed using the Decayed, Missing, and Filled Teeth (DMFT) index, the community periodontal index modified (CPI modified), the Oral Hygiene Index-Simplified (OHI-S), and the gingival index (GI). Bivariate analyses were carried out to make comparisons between the two groups, and the level of significance was set at P < 0.05. Results: A total of 280 participants were recruited. This comprised 68 male participants and 72 female participants in each group. The mean DMFT in the OPMD group was 0.50 (±1.09) and 0.17 (0.645) for the HC group. The prevalence of dental caries was 24.3% in the OPMD group and 10% in the HC group. The mean OHI-S score was 2.68 (±0.97) and 2.38 (±0.98) and GI score was 1.09 (±0.46) and 0.87 (±0.87), while clinical attachment loss was seen in 48.5% and 32.8% for the OPMD and HC groups, respectively. Conclusion: The prevalence of common oral diseases in OPMD was higher compared to HC, thus the study provides evidence on the poor oral health of OPMD. Furthermore, there is a need to incorporate preventive dental education into the management of OPMD.

Sub-Saharan Africa accounts for 13·5% of the global population but less than 1% of global research output. In 2008, Africa produced 27 000 published papers—the same number as The Netherlands. Informed by a nuanced understanding of the causes of the current scenario, we propose action that should be taken by African universities, governments, and development partners to foster the development of research-active universities on the continent. The twin-PhD model contributes to knowledge production in AfricaWe welcome the important and timely viewpoint by Sharon Fonn and colleagues1 about the challenges and potential solutions for increasing knowledge production in Africa. We would like to highlight the role of research collaboration and partnership at the individual (micro) level as an additional source of knowledge production in Africa. An example is the twin-PhD model, which invests in individual researchers by twinning doctoral students. Full-Text PDF

Background: The study investigated the common dental conditions of children seen in a Nigerian tertiary hospital. The referral patterns were also determined to know how many of the patients had sought care at the lower levels of health before visiting a tertiary hospital. Methods: All the children aged 0–15 years seen at the Dental hospital, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria over a 4-year period were included in the study. Information retrieved from their case notes including patterns of referral, presenting complaints, diagnosis, and treatment were extracted from the case records of the patients. Treatment plans for patients seen at this tertiary hospital were categorized into primary, secondary, and tertiary health-care services. Results: A total of 1,866 children sought treatment over a 4-year period at this tertiary hospital of which 1715 (91.9%) sought treatment without referral from lower levels of care. Only 102 (5.4%) children were referred from primary health care (PHC) centers. Six hundred and seventy-five (36.2%) children presented with pain while 502 (26.9%) attended for a “check-up.” Furthermore, 779 (41.8%) children were diagnosed with periodontal disease (including gingivitis) and 539 (28.9%) with dental caries. Scaling and polishing with oral hygiene instruction was the most common treatment recommended. Only 5% of children seen at this tertiary health facility required specialized oral health-care services provided by tertiary health institutions. Conclusions: The range of oral health care needed and service provided by and for patients who visited this tertiary health-care institution can be effectively provided in a primary or secondary oral health-care delivery center. The poor integration of oral health care into PHC services in Osun State burdens the tertiary health-care institutions to provide nonspecialized oral health-care services.

INTRODUCTIONThere have been claims that dental caries experience and prevalence in Kenya has been increasing as a result of increased sugar consumption. A review of the literature in 1986 failed to link dental caries experience with an increase in gross national sugar consumption. Subsequently, a number of studies were conducted, necessitating further review to examine trends in dental caries experience and to relate this to changes in per capita sugar consumption.METHODSStudies conducted since 1980 for children 3-15 years of age were examined. Dental caries prevalence and experience for 3-5 years' (deciduous teeth) and 12 years' (permanent teeth) age groups were analysed. Calculation of per capita sugar consumption was performed using gross national annual sugar consumption for 1969-2009 national population census years.RESULTSThere was a gradual increase in per capita sugar consumption, from 35.5 g/day in 1969 to 60.8 g/day in 2009. Dental caries experience in deciduous teeth for children 3-5 years of age increased from a decayed, missing and filled teeth/decayed and filled teeth (dmft/dft) index of 1.5 in the 1980s to 2.95 in the 2000s. At 12 years of age, caries experience for permanent teeth increased from a DMFT of 0.2 to a DMFT of 0.92 over the same period. Dental caries prevalence for both deciduous and permanent teeth also increased with time.CONCLUSIONThese observations suggest that dental caries prevalence and experience increased with time, in parallel to an increase in per capita sugar consumption. However, a clearer understanding can be derived from longitudinal studies, based on actual household age-specific sugar consumption and dental caries incidence.

A person's right to access his or her protected health information is a core feature of the U.S. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. If the information is stored electronically, covered entities must be able to provide patients with some type of machine-readable, electronic copy of their data. The aim of this study was to understand how academic dental institutions execute the Privacy Rule's right of access in the context of electronic health records (EHRs). A validated electronic survey was distributed to the clinical deans of 62 U.S. dental schools during a two-month period in 2014. The response rate to the survey was 53.2% (N=33). However, three surveys were partially completed, and of the 30 completed surveys, the 24 respondents who reported using axiUm as the EHR at their dental school clinic were the ones on which the results were based (38.7% of total schools at the time). Of the responses analyzed, 86% agreed that clinical modules should be considered part of a patient's dental record, and all agreed that student teaching-related modules should not. Great variability existed among these clinical deans as to whether administrative and financial modules should be considered part of a patient record. When patients request their records, close to 50% of responding schools provide the information exclusively on paper. This study found variation among dental schools in their implementation of the Privacy Rule right of access, and although all the respondents had adopted EHRs, a large number return records in paper format.

The increasing size of the elderly population in Spain underlines the need for the dental profession to pay particular attention to the oral health needs of older patients. The aim of this study was to perform a preliminary assessment of the Geriatric Dentistry education programs in Spanish dental schools and highlight the models being employed for the geriatric training programs in these schools. The assessment was designed to be a cross-sectional study, which involved all the dental schools (n = 19) in Spain. Using a simple, 12-item questionnaire, information regarding the geriatric dental education programs in the schools was collected from their official websites by researchers from the University of Seville. In the first instance, the information was collected from the dental schools' websites and included the history, frequency and characteristics of the geriatric dental program. The deans or their deputies from those schools with a geriatric dental education programme were then asked to validate the data obtained from the websites. Only eight (42%) of schools offered a specific geriatric dentistry course. Seven of these schools were public and only one was private. The other 11 Spanish dental schools (five public and six private) did not offer a specific geriatric dentistry course. Seven out of the eight schools taught the course using a didactic teaching method and none of these seven included a clinical component in the program. No school had a specific geriatric dentistry clinic within the school, neither did they run geriatric clinics at remote locations or operate mobile dental clinics for geriatric patients. This study has described the current provision of dental undergraduate education in geriatric dentistry in Spain. The results suggest that there is a need to develop the curriculum content, design, implementation and evaluation of geriatric dentistry programs. Research should also focus on assessing the access to and improvement in the oral care of the elderly population.

Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations.

This study has shown conclusively that the oral health policy processes has not achieved the desired goals in both South Africa and Nigeria, and that greater advocacy for oral health is required in both countries.

The limited access to oral health care in developing countries can be greatly improved by integrating oral health into the Primary Health Care (PHC) system. This study was designed to assess the views of PHC workers on integrating oral health care into the PHC system. A self-administered questionnaire survey was conducted in two selected local government areas of Lagos State. The instrument contained three sections assessing sociodemographic features, knowledge of common oral diseases and views on integration of oral health into PHC respectively. The mean knowledge score was 7.75 (SD=±1.81), while 60.4% of the respondents had average knowledge scores. Educational status (P=0.018) and designation (P=0.033) were significantly related to the mean knowledge scores. There was no significant difference in the oral health knowledge of the various cadres (P=0.393). Majority (85.4%) of the respondents were willing to include oral health education in their job schedule and 82% believed they needed more training on oral health. The knowledge of the respondents on the causes of the common oral diseases was deficient. Oral health education should be included in the future curriculum of these personnel.

Background Multiple guidelines and systematic reviews recommend sealant use to reduce caries risk. Yet, multiple reports also indicate that sealants are significantly underutilized. This study examined the knowledge, opinions, values, and practice (KOVP) of dentists concerning sealant use in the southwest region of Andalusia, Spain. This is a prelude to the generation of a regional plan for improving children’s oral health in Andalusia. Methods The survey’s target population was dentists working in western Andalusia, equally distributed in the provinces of Seville, Cadiz, and Huelva (N=2,047). A convenience sample of meeting participants and meeting participant email lists (N=400) were solicited from the annual course on Community and Pediatric Dentistry. This course is required for all public health sector dentists, and is open to all private sector dentists. Information on the dentist’s KOVP of sealants was collected using four-part questionnaire with 31, 5-point Likert-scaled questions. Results The survey population demographics included 190 men (48%) and 206 women (52%) with an average clinical experience of 10.6 (± 8.4) years and 9.3 (± 7.5) years, respectively. A significant sex difference was observed in the distribution of place of work (urban/suburb) (p=0.001), but no sex differences between working sector (public/private). The mean ± SD values for each of the four KOVP sections for pit and fissure sealants were: knowledge = 3.57 ± 0.47; opinion = 2.48 ± 0.47; value = 2.74 ± 0.52; and practice = 3.48 ± 0.50. No sex differences were found in KOVP (all p >0.4). Independent of sex: knowledge statistically differed by years of experience and place of work; opinion statistically differed by years of experience and sector; and practice statistically differed by years of experience and sector. Less experienced dentists tended to have slightly higher scores (~0.25 on a Likert 1–5 scale). Statistically significant correlations were found between knowledge and practice (r=0.44, p=0.00) and between opinion and value (r=0.35, p=0.00). Conclusions The results suggest that, similar to other countries, Andalusian dentists know that sealants are effective, have neutral to positive attitudes toward sealants; though, based on epidemiological studies, underuse sealants. Therefore, methods other than classical behavior change (eg: financial or legal mechanisms) will be required to change practice patterns aimed at improving children's oral health.

Objective. Pit and fissure sealants have been used for many decades to prevent the initiation of caries on susceptible tooth surfaces. The purpose of this study was to analyze the peer-reviewed published scientific literature on pit and fissure sealants over the last 50 years. Materials and methods. On the PubMed database, all publications on pit and fissure sealants from 1962-2011 were extracted using the search phrase [(pit OR fissure) AND (sealant OR sealants OR adhesive)]. Details of all retrievals were individually entered into SPSS for analysis. Results. A total of 2829 publications were found. The mean number of authors was 2.73 +/- 1.90 (range = 1-23). Although single-authorship was the modal group with 32.1%, it had a sustained decrease from 75.0% for 1962-1971 to 17.6% for 2002-2011. On the contrary, publications with three or more authors increased from 8.3% to 47.3% during the same period. Human studies accounted for 88.6% and clinical trial was 11.9%, followed by reviews at 10.2% and randomized controlled trials at 6.9%. English was the language of reporting for 82.0% of the studies. Conclusion. It is anticipated that future research on pit and fissure sealants will focus on newer and more effective materials.

GerodontologyVolume 30, Issue 1 p. 1-2 Editorial Population ageing and the implications for oral health in Africa Eyitope O. Ogunbodede, Eyitope O. Ogunbodede e_ogunbodede@yahoo.co.uk Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, 02115 USA Department of Preventive and Community Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, NigeriaSearch for more papers by this author Eyitope O. Ogunbodede, Eyitope O. Ogunbodede e_ogunbodede@yahoo.co.uk Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, 02115 USA Department of Preventive and Community Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, NigeriaSearch for more papers by this author First published: 05 February 2013 https://doi.org/10.1111/ger.12041Citations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume30, Issue1March 2013Pages 1-2 RelatedInformation

Medicinal plants have been used in healthcare since time immemorial. Studies have been carried out globally to verify their efficacy and some of the findings have led to the production of plant-based medicines. The global market value of medicinal plant products exceeds $100 billion per annum. This paper discusses the role, contributions and usefulness of medicinal plants in tackling the diseases of public health importance, with particular emphasis on the current strategic approaches to disease prevention. A comparison is drawn between the 'whole population' and 'high-risk' strategies. The usefulness of the common-factor approach as a method of engaging other health promoters in propagating the ideals of medicinal plants is highlighted. The place of medicinal plants in preventing common diseases is further examined under the five core principles of the Primary Health Care (PHC) approach. Medicinal plants play vital roles in disease prevention and their promotion and use fit into all existing prevention strategies. However, conscious efforts need to be made to properly identify, recognise and position medicinal plants in the design and implementation of these strategies. These approaches present interesting and emerging perspectives in the field of medicinal plants. Recommendations are proposed for strategising the future role and place for medicinal plants in disease prevention.