The aim of the present study is to evaluate the levels of dental anxiety among patients undergoing various dental treatments and to compare the anxiety levels with those of similar studies conducted with subjects from different socio-cultural backgrounds. Dental anxiety was evaluated by the administration of a questionnaire based on the Corah's Dental Anxiety Scale (DAS). Student t-test and analysis of variance (ANOVA) with Bonferoni correction was employed to compare the mean DAS scores. Females recorded higher total DAS scores than males (7.49 ± 2.96 and 7.16 ± 3.44, respectively). Patients in the 24-34 year age group showed the highest total DAS scores (8.25 ± 3.20) followed by the <24 year age group. The total DAS scores for age groups 35-39 and >50 years differ significantly from those of age groups <24 and 24-34 years. The highest DAS score was recorded for root canal therapy (9.30 ± 2.84) followed by extraction. The level of dental anxiety among this study population is lower than those reported elsewhere. The observed avoidance of dental treatment among Nigerians, despite the seemingly low mean DAS scores, may be related to dental anxiety. The authors are, however, of the opinion poor dental awareness may be a contributory factor. Citation Udoye CI, Oginni AO, Oginni FO. Dental Anxiety Among Patients Undergoing Various Dental Treatments in a Nigerian Teaching Hospital. J Contemp Dent Pract 2005 May;(6)2:091-098.

Background The objectives of this study were to determine the prevalence and pattern of traumatic dental injury (TDI) among adults presenting in a tertiary health care facility in Nigeria, the time interval between injury and presentation in the hospital, the reasons for seeking treatment, and the complications arising due to late presentation.Methods Information obtained from history taking and clinical examination included Patient’s demographics, the when, where, and how of the injury, previous history of trauma, time elapsed between injury and presentation at the hospital, reason for seeking treatment, tooth/teeth involved, sensibility, tenderness to percussion, mobility, presence of discolouration, swelling, sinus tract, and mobility. Radiographic findings such as periapical radiolucency, pulp canal obliteration, and root resorption were also documented. TDI was classified using the Andreasen’s classification.ResultsOut of the 2645 adult patients that attended the outpatient clinic, 184 Presented with TDI giving a prevalence of 6.96 %. Their age range and mean age were 17–69 years and 30.6 ± 11.2 years respectively. Falls accounted for most (26.4 %) of the trauma to anterior teeth followed by motor cycle accidents (18.4 %) and domestic accidents (12.9 %), while opening bottle cork accounted for 1.2 %. The most common type of injury was enamel-dentine fracture accounting for 28.8 %, followed by complicated crown fracture 18.6 %, and avulsion 11.7 %. The maxillary central incisors were the most commonly affected followed by the maxillary lateral incisors and canines. More than half (51.5 %) of the patients presented in the hospital more than 1 year after injury. Majority of patients in the age groups ≤20 and 51–60 sought treatment because of pain, while more of those in the age groups 21–30 and 31–40 sought treatment because of aesthetic considerations. Seventy three (45.3 %) of the patients presented with complications involving 138 teeth. Majority of the complications were in teeth with enamel-dentine fracture (93.4 %), followed by concussion injury (55.6 %).ConclusionsThe prevalence of TDI in this study falls within previously reported figures. However, the high number of teeth developing complications may have resulted from late presentation for care.

The findings of this and other studies demonstrate the need for major initiatives to address the underlying causes of cancrum oris and to promote the utilization of health care.

The majority (85%) of nonsyndromic cleft lip with or without cleft palate (nsCL/P) cases occur sporadically, suggesting a role for de novo mutations (DNMs) in the etiology of nsCL/P. To identify high impact protein-altering DNMs that contribute to the risk of nsCL/P, we conducted whole-genome sequencing (WGS) analyses in 130 African case-parent trios (affected probands and unaffected parents). We identified 162 high confidence protein-altering DNMs some of which are based on available evidence, contribute to the risk of nsCL/P. These include novel protein-truncating DNMs in the ACTL6A, ARHGAP10, MINK1, TMEM5 and TTN genes; as well as missense variants in ACAN, DHRS3, DLX6, EPHB2, FKBP10, KMT2D, RECQL4, SEMA3C, SEMA4D, SHH, TP63, and TULP4. Many of these protein-altering DNMs were predicted to be pathogenic. Analysis using mouse transcriptomics data showed that some of these genes are expressed during the development of primary and secondary palate. Gene-set enrichment analysis of the protein-altering DNMs identified palatal development and neural crest migration among the few processes that were significantly enriched. These processes are directly involved in the etiopathogenesis of clefting. The analysis of the coding sequence in the WGS data provides more evidence of the opportunity for novel findings in the African genome.

Objective: To document the prevalence and management of Ludwig's angina in a suburban population. Methods: All consecutive cases of Ludwig's angina seen and managed at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria between 1988 and 2002. Results: There were 16 cases with 10 males and 6 females whose ages ranged from 8 to 75 years; mean+ SD; 43.8 + 19.9 years. Symptom duration ranged from one day to three weeks; mean + SD; 6.4 + 4.9 days of the onset of illness. Odontogenic infection was the commonest etiologic factor in 12 cases (75%) and 4 of these were attributed to post dental extraction sepsis. Seven patients had underlying disease such as diabetes mellitus, lobar pneumonia, severe anaemia and mental retardation. The commonest was diabetes mellitus in 4 cases. Microbiological investigations showed a polymicrobial nature of the infection with Staphylococcus aureus (6 cases) out of 11 patients that had the examination. Treatment involved high doses of broad-spectrum parenteral antibiotics, immediate surgical drainage under local and general anaesthesia in 14 (75%) and single patients respectively. This was in addition to extraction of involved tooth/teeth where applicable. The complications recorded in 5 cases (31.3%) were septicaemia, mediastinitis, empyema thoracic, necrotising fasciitis, laryngeal spasm and renal failure. Mortality occurred in 4 cases (25%). Conclusions: Ludwig's angina is a serious disease and late presentation remains a typical feature. Associated co-morbid condition is common. Prompt clinical evaluation and definitive care will considerably improve its prognosis and reduce the high mortality associated with the condition