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.

Dental care of HIV-positive individuals plays a vital role in improving their nutritional intake, medication tolerance and effectiveness, treatment success rate, and quality of life. It is therefore important to ensure optimal dental care of this group of people, especially since more of them, with or without knowledge of their serologic status, are now utilizing dental services. The objective of this study was to assess Nigerian dental students' willingness to treat HIV-positive individuals. A descriptive crosssectional survey of all seventy-six final-year dental students of the University of Benin, Nigeria, was conducted in December 2007 using a self-administered questionnaire that elicited information on the students' demography, self-rated knowledge on HIV/ AIDS, attitude towards homosexuals, infection control practices, occupational risk perception, and willingness to provide care for HIV-positive individuals. The response rate was 76.3 percent. Over 77 percent of the respondents were in the twenty-five to thirty years age group. The male-female ratio was approximately 1.6:1. HIV-related knowledge was reported as high by only 31 percent of the respondents. Eighty-one percent showed great interest in HIV-related information, while about half (53.4 percent) exhibited significant worry about occupational contagion. Forty-eight (82.7 percent) desired more knowledge about safety precautions during treatment of HIV patients. Fifty respondents (86.2 percent) reported good infection control practices. About three-fourths (74.2 percent) rated the risk of HIV contagion from patients high, while only one-fourth (25.8 percent) reported having an unsympathetic attitude towards homosexuals. Almost all respondents (98.3 percent) agreed that oral care for HIV-positive individuals improves their quality of life, but only 58.8 percent expressed a willingness to treat HIV-positive patients and only 46.5 percent said they will render volunteer dental services in HIV centers. HIV prevalence will determine the location of practice of 41.4 percent of the respondents. The result suggests the need to have a comprehensive educational/motivational program for the next generation of dentists in Nigeria in order to ensure adequate care of HIV-positive individuals. The perceived deficiency revealed in this study can also serve as a vital guide for curriculum change on HIV-related issues.Dr. Azodo is Senior Registrar/Associate Lecturer,

Similar pattern of incomplete oral health knowledge, inappropriate oral practices but positive oral health attitude was observed among the two groups of the studied teachers. This observation suggests that the primary school teachers can serve as oral health educators after organized training to heighten their oral health knowledge and perfect their oral practices.

Objective: To determine the pattern of self-medication among dental, midwifery and nursing students and to evaluate the factors associated with self-medication. Materials and Methods: A questionnaire-based cross-sectional of dental, nursing and midwifery students undergoing clinical training in University of Benin Teaching Hospital, Nigeria was conducted in 2010. The elicited data include demography, use of drug without doctor's prescription, type of drug used (pain relievers, antibiotics, anti-malarial, cough medication and nutritional supplement), reasons for self-medication, factors that influenced the choice of drug and source of drug. Results: A total of 76.8% of the respondents indulged in self-medication practices. Of which, 33.0% used the medication inappropriately. The type of self-medication use was, pain relievers (60.5%), antibiotics (43.2%), anti-malarial (40.5%), cough medication (16.7%) and nutritional supplement (16.0%). Previous experience with the illness and perceived minor nature of the illness were the predominant reasons for the self-medication practices among the respondents. The major factors that influenced their choice of medication were previous experience with similar symptoms (39.7%), advice of non-doctor health professional (33.5%). Pharmacy shop was the main source of the self-medicated drugs. Conclusion: Self-medication was a common practice among this studied group of health workers. The level of inappropriate drug use denotes self-medication as an unhealthy option, and it therefore, should be discouraged.

Objective: Sharp injuries constitute important occupational exposure in hospital environment, and perhaps the newly graduated medical and dental students, known as House Officers, in the first twelve months of their practice, are the most vulnerable of all health workers. This study was designed to examine the nature and prevalence of occupational injuries among medical and dental house officers and factors associated with reporting these injuries. Materials and Methods: A self-administered questionnaire was used to obtain information on demography, types of exposure, and barriers to official reporting of occupational injuries. One hundred and forty-four medical and dental house officers in 3 government owned hospitals in Edo State, Nigeria participated in the study, between April and May, 2010. Descriptive and multivariable analyses were performed. Results: The overall response rate was 96%. Out of all participants, 69.4% were male; 82.6% were medical house officers. Prevalence of percutaneous injury was 56.9%; where needlestick injury constituted one-third of all injuries. Mean frequency of injury was 1.86±2.24, with medicals having more injuries (p = 0.043). The ward was the most common location for the injury and 14.8% of exposures occurred as a result of lapse in concentration. At least 77.0% did not formally report their injury and perceived low injury risk was the most common reason given (51.67%). Conclusion: This study shows that a substantial number of House Officers are exposed to occupational injuries and that the majority of them does not formally report these. Safer work environment may be achieved by implementing adequate educational programs tailored specifically to house officers, and policies encouraging exposure reporting should be developed.