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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 12  |  Issue : 2  |  Page : 88-92

Dental care demands and treatment needs among patients attending a rural private dental clinic in Northeast Nigeria


1 Department of Dental and Maxillofacial, Federal Teaching Hospital, Gombe, Gombe State, Nigeria
2 Department of Oral Pathology and Oral Biology, Faculty of Dentistry, University of Port Harcourt, Harcourt, Rivers State, Nigeria

Date of Submission11-Aug-2017
Date of Acceptance27-Aug-2018
Date of Web Publication15-Jan-2019

Correspondence Address:
Babatunde Oludare Fakuade
P O Box 629, Department of Dental and Maxillofacial, Federal Teaching Hospital, Gombe, Gombe State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/phmj.phmj_34_17

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  Abstract 


Background: Meeting dental care demands in poor-resource area is a challenge, both regarding personnel and facilities, patients in rural area travel long distances to access few available clinics where sometimes treatment options are limited.
Aim: The aim of this study is to determine the pattern of presentation and demand for oral health services among patients attending a private dental clinic in Gombe, North East Nigeria.
Methods: A retrospective review of all patients seen in the company clinic (Ashaka cement) over a 3-month period (August-October 2014) was done, information extracted from case notes were age, sex, primary diagnosis and treatment. Data were analysed using SPSS version 20 Summary statistics (percentage and frequency) were performed. Relationship between variables was checked with Chi-square test.
Results: A total of 122 patients were seen, 65 males (53.3%) and 57 females (46.7%) with a sex ratio of 1:0.9, total mean age was 15.7 years (range 3–59 years). 41–50 years was the majority group and 51–60 years was the age group in the minority. The most common diagnoses were dental caries, chronic gingivitis and chronic periodontitis while treatment commonly received were extraction, scaling and polishing and treatment filling.
Conclusion: Dental care demand of patients in this study was as a result of dental caries, chronic gingivitis and chronic periodontitis and treatment done were mainly extractions, scaling and polishing. Access to dental care in rural setting can be improved if government open more dental clinics in these areas and make personnel available.

Keywords: Dental care demand, rural facility, treatment needs


How to cite this article:
Fakuade BO, Omitola OG. Dental care demands and treatment needs among patients attending a rural private dental clinic in Northeast Nigeria. Port Harcourt Med J 2018;12:88-92

How to cite this URL:
Fakuade BO, Omitola OG. Dental care demands and treatment needs among patients attending a rural private dental clinic in Northeast Nigeria. Port Harcourt Med J [serial online] 2018 [cited 2019 Sep 22];12:88-92. Available from: http://www.phmj.org/text.asp?2018/12/2/88/250229




  Introduction Top


Oral health is essential to general health and quality of life. The distribution and severity of oral diseases vary among different parts of the world and within the same country or region. The global burden of oral disease is highly ranked among the non-communicable diseases and their impact on individuals and communities is considerable regarding pain and suffering.[1] The burden of the oral disease is enormous and is rising daily, according to the 2012 WHO statistics, an estimate of 60%–90% of school children and nearly 100% of adults had dental caries.[2] An increase in the patient population and need for dental restoration is driving the market in developed countries such as we have in the US, Germany, the UK, France, Japan and Singapore.

In Africa, dental care and access to oral health services is limited and teeth are often left untreated or are extracted when they are beyond repair either because of pain or discomfort,[3] this narrative is common and may be due to lack of dental facilities in localities or because the few available ones are in the urban area. Where oral health services are available, the utilisation depends on an array of factors that include financial restrictions, attitudes towards dental care and dental fear.

While previous studies on utilisation of dental services in African continent highlights poor utilisation across the rural and urban populations because of dwindling health funding and economic difficulties.[4] Studies by Taiwo et al.[5] and Adegbenro[6] typify the Nigerian urban experience. In addition, the capability for hospital-based dental care services is greater in urban settlements than rural communities;. the geographical spread of people living in rural communities had created challenges in developing models of care, which are financially viable for small populations.

Access to oral health facilities in Nigeria is limited, and most times are found in state capitals or local government headquarters. Patients living in rural areas have to travel long distances before they can have their oral problems attended to. Thus, most studies on the pattern and demands for oral health services are from urban and semi-urban areas and are based on tertiary hospital setting[7],[8] with none from rural area and a company-based clinic. This study was designed to determine the pattern of patient presentations and demand for oral health services among patients presenting in rural dental clinic of Ashaka cement company, Gombe Nigeria. The results of this study may help government to formulate the policies that will be best suited for people living in rural settings in Nigeria.


  Methods Top


The study was conducted in the dental centre of the medical facility of Ashaka cement factory in Bajoga, Gombe state. The clinic is patronised by the staff of the company as well as member of the rural communities surrounding the company, these include people from Bajoga, Biliri Filia and Kaltungo all in Gombe state.

This was a retrospective review of all the patients seen over a 3 months period (August-October, 2014) in Ashaka cement company clinic. The case notes of the patients were reviewed and the following information were retrieved; age, sex, the primary diagnosis, other diagnosis, main treatment and treatment at subsequent visits. The information were entered into a computer and analysed using SPSS version 20 (SPSS Inc., Chicago Illinois, USA). Summary statistics (frequency, percentage) were performed to determine the prevalence and pattern of presentation. Chi-square test was used to assess the relationship between variables; significant level was set at P < 0.5. The Ethical approval for this study was gotten from the Ethical Board of the Federal Teaching Hospital, Gombe where the principal author works.


  Results Top


During the 3 months study, a total of 120 patients presented in the clinics. This consisted of 65 males (53.3%) and 57 females (46.7%). The patients' age ranges from 3 to 59 years with a mean ± standard deviation of 29.2 ± 15.7 years. The highest number of patients was found within 41–50 years age group with 25 (20.4%) while the least was found within 51–60 years age group with 11 (9%) [Table 1].
Table 1: Patients age distribution

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[Table 2] shows primary diagnosis for the main complaints and secondary diagnosis for accidental findings/minor complaints in the same patient, only 63 patients out of the 120 who presented had such secondary diagnosis. In both groups, the most commonly treated condition were dental caries, chronic gingivitis and chronic periodontitis while other less common conditions that treatment was sought for were facial laceration, missing teeth and pericoronitis. Among the patients having more than one diagnoses, teeth extraction was the most common treatment, followed by scaling and polishing and treatment filling, while for patients with a single diagnosis, scaling and polishing were the most common treatment followed by extraction and treatment filling [Table 3].
Table 2: Distribution of oral diseases among the patients

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Table 3: Dental treatment received by patients

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Analysis of the diagnosis and sex of patients showed that dental caries, pulpitis, retained primary teeth and dentinal sensitivity were more common in females while chronic gingivitis and periodontitis were commoner in males. Subacute pericoronitis and tooth fracture were among lesions exclusively seen in male [Table 4]. In this study, caries was most common in the first and third-decade, chronic gingivitis and periodontitis were seen across all age groups with the highest prevalence in the fifth decade while retained deciduous teeth was seen within the first and second decades of life [Table 4].
Table 4: Distribution of patient's oral diseases by age group and gender

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  Discussion Top


Dental clinic attendance is important and it is one of the four preventive oral health behaviours recommended by London Education Authority.[9],[10] In most developing countries like Nigeria, access to oral health services is limited and in most case restricted to certain area of the state especially the state capitals. There is slight male predominance among patients seeking oral healthcare in our center, this is similar to the report of Oginni[7] in Ile-Ife Taiwo et al.[5] in Katsina and Omitola et al.[11] in Port Harcourt all in Nigeria. The reason for this observation is not clear and differs from the observation of several researchers who have reported female predominance in their studies.[9],[10],[12],[13] The observation in this study may be related to the cultural and religious believe of the environment of the study where free movement of females are restricted thereby affecting their access to healthcare delivery.

The mean age for patients in this study is similar to that reported by Omitola et al.[11] in their study. Most patients in this study were in the third to fifth decades of life, this is in agreement with the reports of other studies.[7],[8],[10],[11] Dental caries was the most common diagnosed condition in this study and is in agreement with the reports of other researches.[7],[8],[11],[12],[14] Also reported in the previous studies[7],[12],[15] is the female preponderance to dental caries partly because their teeth tend to erupt early and are exposed to oral environment, this may be why dental caries are more common among females. The second most common condition reported in this study was periodontal diseases, this in agreement with the report of Varenne et al.[12] who reported periodontal diseases as the second most common reason why patients seek dental care. In addition, in agreement with this study, Varenne et al.[12] reported that periodontal diseases are more predominant in the male. However, this differs from the observation of Gbenga Omitola and Olabisi Arigbede.[8] and Soroye et al.,[16] who reported a female predominance among patients with periodontal diseases in Port Harcourt, Nigeria. Restricted access of the female due to cultural practise in the environment of the study may be responsible for the apparent male predominance among patients with periodontal diseases. In addition, chronic periodontitis are most common in patients within the third to fifth decades of life in this study; this is in agreement with the observation of Soroye et al.[16]

Dental trauma was more common in males in this study; this is similar to the findings of Gbenga Omitola and Olabisi Arigbede[8] and Varenne et al.[12] in their studies. The higher involvement of the males in high-risk activities such as contact sport may be a reason for this observation. Pulpitis and dentinal sensitivity were more prevalent among females in this study, Omitola et al.[11] also reported that pulpitis was more common in females in their study while Azodo et al.[17] reported significant female predominance among patients with dentinal sensitivity. However, contrary to the report of this study as regards dentinal sensitivity, Omitola et al.[11] and Rane et al.[18] reported a male predominance. The reason for this varied observations is not clear.

Extraction and scaling and polishing were the most common procedures performed in the clinic. A good number of patients also required treatment filling (formerly called temporary filling) because of the status of the carious lesions at presentation, only few cases (16 patients) had composite and glass ionomer cements filling placed directly. Most patients are poorly motivated and the awareness of oral health services is still very low in Nigeria, especially in rural areas; thus, they present when the condition is bad and not salvageable.

This study has been able to show the pattern of dental services demand in the rural setting and the results of this study showed there is no much different in the pattern of patients demand for dental care in the urban and rural settings. However, in the rural setting, availability of dental facilities, materials and personnel are very scarce making patients to travel long distances before their dental needs can be met. There is need for establishment of dental care centres at each local government area to take care of the dental need of this group of people. In addition, as noted by Omitola et al.[11] those that present early enough will still prefer extraction over restorative procedures due to financial reason. Thus, there is need to widen the scope of procedures covered by National Health Insurance Scheme so as to improve accessibility to dental restorative procedures.

This study was a clinic-based study, and the pattern of presentations presented may not be a true reflection of what is obtained in the community and therefore should be interpreted with this background. In addition, the fact that the clinic is a company-based clinic may limit the access of people to the facility; this may have skewed the data available for this study.


  Conclusion Top


The pattern of attendance and demand for oral health services at the dental clinic of Ashaka Cement Company is similar to that in urban centres in Nigeria. There is slight male predominance in clinic attendance, and of all the cases reviewed, dental caries and periodontal diseases were the most common dental conditions seen. Extraction and scaling and polishing were the most common procedures, but demand for restorative procedures was poor. There is need for government to improve access to oral health in rural setting by establishment of more dental centres manned by qualify personnels. In addition, need for dental education to increase dental awareness in the rural setting is very imperative.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
FDI Policy Statement on Non-Communicable Diseases. Adopted by the FDI General Assembly: Istanbul; Turkey, 2013. Doi.org/10.1111/idj.12078  Back to cited text no. 1
    
2.
WHO Fact Sheet on Oral Health 2012 Statistics. Available from: http://www.who.int/mediacentre/factsheets/fs318/en/. [Last assessed on 2016 Aug 20].  Back to cited text no. 2
    
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Drury TF, Garcia I, Adesanya M. Socioeconomic disparities in adult oral health in the United States. Ann N Y Acad Sci 1999;896:322-4.  Back to cited text no. 3
    
4.
Okullo I, Astrøm AN, Haugejorden O. Social inequalities in oral health and in use of oral health care services among adolescents in Uganda. Int J Paediatr Dent 2004;14:326-35.  Back to cited text no. 4
    
5.
Taiwo AO, Soyele OO, Ndubusi GU. Pattern of utilization of dental services at Federal Medical Center Katsina Northwest Nigeria. Sahel Med J 2014;17:108-11.  Back to cited text no. 5
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6.
Adegbembo AO. Household utilization of dental services in Ibadan, Nigeria. Community Dent Oral Epidemiol 1994;22:338-9.  Back to cited text no. 6
    
7.
Oginni AO. Dental care needs and demands in patients attending the dental hospital of the Obafemi Awolowo university teaching hospital's complex Ile-Ife, Nigeria. Niger J Med 2004;13:339-44.  Back to cited text no. 7
    
8.
Gbenga Omitola O, Olabisi Arigbede A. Prevalence and pattern of pain presentation among patients attending a tertiary dental center in a Southern region of Nigeria. J Dent Res Dent Clin Dent Prospects 2010;4:42-6.  Back to cited text no. 8
    
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Kikwilu EN, Masalu JR, Kahabuka FK, Senkoro AR. Prevalence of oral pain and barriers to use of emergency oral care facilities among adult Tanzanians. BMC Oral Health 2008;8:28.  Back to cited text no. 9
    
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Al-Turck MA, Al-Shawaf MD, Al-Musaed A, Al-Ahmary Z. Incidence of orofacial pain in a selected population at King Saud University College of Dentisry Emergency Clinic. Saudi Dent J 1995;7:155-61.  Back to cited text no. 10
    
11.
Omitola OG, Osagbemiro B Akadiri OA. Spectrum of diseases and pattern of referral at the oral diagnosis clinic of a tertiary dental center. Niger Dent J 2011;19:66-70.  Back to cited text no. 11
    
12.
Varenne B, Msellati P, Zoungrana C, Fournet F, Salem G. Reasons for attending dental-care services in Ouagadougou, Burkina Faso. Bull World Health Organ 2005;83:650-5.  Back to cited text no. 12
    
13.
Lilany I. Sexes Split over Health-Women seek Healthcare More than Men. Available from: http://www.standforddaily.com/article/1999/2/10. [Last accessed on 2016 Aug 21].  Back to cited text no. 13
    
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van Palenstein Helderman WH, Nathoo ZA. Dental treatment demands among patients in Tanzania. Community Dent Oral Epidemiol 1990;18:85-7.  Back to cited text no. 14
    
15.
Okunseri C, Hodges JS, Born D. Self-reported toothache experience in an adult population in Benin city, Edo state, Nigeria. Oral Health Prev Dent 2005;3:119-25.  Back to cited text no. 15
    
16.
Soroye MO, Braimoh OB, Omitola OG. Prevalence and pattern of periodontal diseases at the periodontal clinic of the university of Port Harcourt Teaching Hospital, Niger. Port Harcourt Med J 2014;8:193-914.  Back to cited text no. 16
    
17.
Azodo CC, Amayo AC. Dentinal sensitivity among a selected group of young adults in Nigeria. Niger Med J 2011;52:189-92.  Back to cited text no. 17
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18.
Rane P, Pujari S, Patel P, Gandhewar M, Madria K, Dhume S. Epidemiological study to evaluate the prevalence of dentine hypersensitivity among patients. J Int Oral Health 2013;5:15-9.  Back to cited text no. 18
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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