BackgroundPrevious reports indicate that worldwide, the technical quality of root canal fillings is poor. There are few reports from sub-Saharan Africa and none yet from Nigeria where most patients access treatment from non-specialists especially at general dental clinics. The aim of this study was to evaluate the technical quality of root canal fillings done in a general dental clinic with emphasis on the effects of professional experience of the operator, whether tooth was anterior or posterior and whether it was a maxillary or mandibular tooth.MethodsRetrospective study of case notes and periapical radiographs of patients with completed root canal fillings seen between 2008 and 2011. Inclusion criteria included cases of primary treatment with available case notes, good quality pre-operative and post-operative periapical radiographs. Technical quality that was assessed was root canal length and homogeneity. Root canal fillings were classified either as Good Quality Endodontic Work (GQEW) or Non- Good Quality Endodontic Work (NGQEW).ResultsFifty-one patients aged between 8 and 54 years (mean 28) fulfilled the inclusion criteria for this study. From these, there were 62 root filled teeth giving a ratio of 1.2 root canal filled teeth per person. There were acceptable length of root canal fillings in 71% of teeth, 58.1% were homogeneous while 53.2% were GQEW. There was no statistically significant difference in whether tooth was root filled by junior or senior dentist (p = 0.43), anterior or posterior (p = 0.11). There was significant association between GQEW and maxillary teeth (p = 0.03).ConclusionThis study showed that the overall technical quality of root canal fillings done by non-specialists was better than earlier reports but lower than that done by endodontists. Since many patients receive treatment from non-specialists in developing countries, it is necessary to improve technical quality of root canal fillings done in general dental clinics. These could be through improvement in the quality of undergraduate training and more post graduate continuing education courses for skills update.

Dental care services are available in many urban communities worldwide where discerning and sophisticated clients expect quality care. Many available studies evaluated satisfaction rather than quality of dental care; others did not reveal the patients' perception of gaps in the quality of care. Service quality (SERVQUAL) tool assesses quality of service based on the dimensions of tangibles, reliability, responsiveness, assurance and empathy as described by Parasuraman et al. (1985). The aim of this study was to assess the gaps in quality of dental care in a Nigerian government owned dental clinic using an unweighted SERVQUAL tool to determine the difference between expectations and perceptions of patients. Consenting patients seen during the study period were given a 32-items questionnaire divided equally between expectations and perception of quality of dental care services received. Out of 112 questionnaires analysed, patients had the most expectation for neatness (4.69 ± 0.85) and least for pain free treatment (3.76 ± 1.16). Highest perception was for knowledgeable clinic staff (4.34 ± 0.71) while support to enable staff work well was the least perceived quality (3.73 ± 0.86). Overall, among the 5 dimensions of quality, there were marked statistically significant quality gaps in assurance (p = .0001) and tangibles (p = .0006). This study showed that patients in a Nigerian government-owned dental clinic, there is need for greater attention to be paid to assurance, tangibles and reliability dimensions of service quality to improve patient perceptions.

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