Transport media for avulsed teeth: A review

Management protocols for avulsed teeth should include management of the pulp and periodontal ligament (PDL) cells in order to improve the long‐term prognosis and survival of these teeth. The use of an inappropriate transport or storage medium potentially increases the risk of PDL cell necrosis, which can result in ankylosis and replacement resorption of the tooth root. Considering the critical role of these media, an informed choice of a suitable medium is essential for a favourable outcome. The literature regarding transport media for avulsed teeth was reviewed using PubMed/MEDLINE up to February 2010. This review outlines the common storage media that are available and highlights their specific features or problems. Although HBSS, ViaSpan and Eagle's medium have great potential to maintain the PDL cells in a viable state after avulsion, the practicalities of using these solutions, the costs and the lack of ready availability to the general public make them less than ideal. Milk remains the most convenient, cheapest and readily available solution in most situations while also being capable of keeping PDL cells alive. Hence, milk remains the storage medium of choice for avulsed teeth that cannot be replanted immediately or very soon after the avulsion.     

The increase in dental disease in the northern states of Nigeria and its manpower implications

An epidemiological survey of dental decay was carried out in the six northern states of Nigeria on a popluation sample of 1396. The average number of decayed, missing and filled (DMF) teeth per person for the whole sample was 2·7. The percentage of caries-free persons was 47·1.

Dental decay was more severe and widespread in the cities, where the mean DMF value was 2·8 and 42 per cent were caries-free, than in the villages, where the mean DMF value was 2·0 and 66·9 per cent were caries-free.

The mean DMF index for the age group 10–19 years (which formed nearly 60 per cent of the sample) was 3·1, and untreated dental decay alone almost entirely accounted for this figure. This amount of untreated dental disease is an indication of the lack of dental treatment available as a consequence of the shortage of dental manpower, since only 15 dentists are available for a population of 28 800 000 in this area.

Examination of the dietary habits of the population studied showed a remarkable level of consumption of sweets and sweet foods both in villages and cities. Overall, no fewer than 87 per cent of the people admitted to taking these cariogenic foods as snacks between meals.

These habits are sufficient to explain the alarmingly increased incidence of dental decay and the decline in the number of caries-free persons when compared with earlier studies. This is an unhappy augury for the future dental health of Nigeria.

The evidence of deterioration of dental health makes a national programme of dental health education and preventive dental treatment a matter of urgency. This necessitates a considerable increase in dental manpower if the population is to receive the maximum benefit.     

The Gingival Health of Eight-Year-Old Nigerian Children*

A total of 860 eight-year-old schoolchildren in Lagos Nigeria, were examined between April 1981 and March 1982: 409 from private schools and 451 from government schools. Half were boys and the other half were girls. The mean Gingival Index score for children in private schools is 0.4 and 0.5 in the government schools. The GI score was slightly higher for boys than for girls in each group. The prevalence of calculus (24.7 percent) and gingivitis (46.5 percent) in the private schoolchildren is significantly lower than that found in the government schoolchildren (59.6 percent and 61.6 percent respectively) (p values < 0.002). The mean OHI-S score is lower in the private schools (0.8 for boys and 0.7 for girls) than in the government school (1.1 for both boys and girls). These findings suggest better oral hygiene habits in the higher socioeconomic group of private schoolchildren. Among the boys, 47.3 percent had calculus and 52.2 percent had gingivitis while 38.7 percent of the girls had calculus and 56.6 percent had gingivitis. Overall, 43 percent of the children examined had calculus, 54.4 percent had gingivitis. The mean GI Score was 0.4 and the mean OHI Score was 1.0. The results indicate a trend toward a lower prevalence of gingivitis and better oral hygiene among Nigerian children now when compared with studies reported two decades ago.     

Dental status of patients with mental disorders in a Nigerian teaching hospital: a preliminary survey

Although individuals with mental disorders are reported to experience dental problems similar to the general population, evidence suggests they actually have higher risks of dental disease and increased oral health needs. This study describes the dental status of 105 psychiatric outpatients in a Nigerian hospital. Information was obtained from subject interviews, medical records, and an oral examination to determine their dental caries and periodontal disease status. The oral hygiene status of the study participants was poor; the mean oral hygiene index score was 2.7 ± 1.20. The decayed, missing, and filled teeth ranged from 0 to 9 with a mean of 2.3 ± 2.28. Only five subjects (4.9%) had restorations and the mean number of filled teeth was .14 ± .67. The subjects’ age was significantly related to the mean oral hygiene score (p= .005), the mean gingival score (p= .006), and caries occurrence (p= .047). The oral health status of psychiatric patients in Nigeria is poor, indicating the need to provide oral health education and increase access to dental care for these patients.