|Year : 2014 | Volume
| Issue : 3 | Page : 108-111
Pattern of utilization of dental services at Federal Medical Centre, Katsina, Northwest Nigeria
Olanrewaju Abdurrazaq Taiwo1, Olujide Oladele Soyele2, Godwin Ugochukwu Ndubuizu2
1 Department of Surgery, College of Health Sciences, Usmanu Danfodiyo University; Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
2 Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
|Date of Web Publication||6-Sep-2014|
Olanrewaju Abdurrazaq Taiwo
Department of Surgery, College of Health Sciences, Usmanu Danfodiyo University, PMB 12003, Sokoto
Background: Oral health has been demonstrated to be an integral component of general health, with a serious impact on the quality of life and the overall well-being. Dental care utilization is an indispensable facilitator of oral health. Reports from the African continent highlight poor utilization of dental services across urban and rural populations. Hence, this study aims to determine the use of dental services by patients attending the dental clinic of Federal Medical Centre, Katsina between January 2011 and December 2012. Materials and Methods: The patients' records were retrieved and analyzed for demographic data, diagnosis, and treatment. Results: During the 2-year study period, a total of 2021 patients [1083 (53.6%) males and 938 (46.4%) females] were treated. The age of the patients ranged from 4 months to 94 years [mean ± standard deviation (SD) =28.6 years ± 16.2; median 28 years]. Approximately 80% of the patients were below the age of 40 years, with 21-30 years age group recording the highest frequency (28%). Most of the patients had caries and its sequelae, followed by periodontal disease (n = 352, 17.4%). Restorative and surgical procedures (n = 808, 40%) were the major treatment utilized by this cohort, with periodontal procedure trailing (n = 3951, 8.6%). Tooth extraction (n = 755, 37.3%) was the primary treatment accessed, followed by amalgam filling (n = 651, 32.2%) and scaling/polishing (n = 355, 17.6%). Conclusion: Our data demonstrate preponderance of male gender and young age group in the utilization of dental services among the study population. Tooth extraction was the most frequently provided dental treatment. We recommend preventive oral care as a means of reducing dental burden in the center.
Keywords: Demand, dental care services, dental caries, dental treatment, dental utilization, tooth extraction, utilization
|How to cite this article:|
Taiwo OA, Soyele OO, Ndubuizu GU. Pattern of utilization of dental services at Federal Medical Centre, Katsina, Northwest Nigeria. Sahel Med J 2014;17:108-11
|How to cite this URL:|
Taiwo OA, Soyele OO, Ndubuizu GU. Pattern of utilization of dental services at Federal Medical Centre, Katsina, Northwest Nigeria. Sahel Med J [serial online] 2014 [cited 2020 Aug 12];17:108-11. Available from: http://www.smjonline.org/text.asp?2014/17/3/108/140294
| Introduction|| |
Oral health has been demonstrated to be an integral component of general health, with a serious impact on the quality of life and the overall well-being. , Limited availability and accessibility of oral health services are risk factors for poor oral health and diseases, especially in sub-Saharan Africa. ,
Oral diseases such as dental caries, periodontitis, oropharyngeal cancers, and maxillofacial trauma are serious public health problems in both developed and developing countries. ,,,,, This burden is more severe in poor and disadvantaged population groups. , Moreover, the associations of oral diseases with non-communicable diseases such as cardiovascular diseases, chronic renal failure, chronic pulmonary diseases, and osteoporosis in developed countries are widely reported in the literature. ,,,
Dental care utilization is an indispensable facilitator of oral health. ,, Studies from the African continent highlight poor utilization of dental care across urban and rural populations because of economic difficulties, dwindling health funding, poor perceived oral needs, competing demand, misconceptions about oral health, inadequate facilities, and shortage of dental workforce. ,,,,,,, A Turkish study showed that women and individuals with higher levels of education use dental services more than others. 
There are limited studies on the utilization of dental services in northwestern Nigeria. This study determines the pattern of dental services and their utilization in a tertiary hospital in Katsina, northwestern Nigeria.
| Materials and methods|| |
This is a cohort study of patients who had dental treatment between 1 January 2011 and 31 December 2012 at the dental clinic of Federal Medical Centre, Katsina.
Information retrieved from the patients' records included age, gender, diagnosis, and treatment.
Data are presented as mean ± standard deviation (SD) for variables with a normal distribution, median and interquartile range for variables with skewed distributions, and percentage for categorical variables. Data analyses were performed using Analyze-it version 2.25 Excel 12+ (2013). Comparisons between some variables were made to determine the pattern of association using Pearson's Chi-square test and Fischer's exact test. P ≤ 0.05 was considered as statistically significant.
Departmental approval was obtained for this study.
| Results|| |
During the 2-year study period, a total of 2021 patients [1083 (53.6%) males and 938 (46.4%) females] were treated. The age of the patients ranged from 4 months to 94 years (mean ± SD = 28.6 years ± 16.2). Approximately 80% of the patients were below the age of 40 years, with the highest frequency recorded in those in the age group 21-30 years (n = 566, 28%) [Table 1].
Most of the patients were diagnosed with caries and its sequelae (n = 1477, 73.1%) and periodontal disease (n = 352, 17.4%) [Table 2]. Eighty-five (4.2%) patients had the serious complication of dentoalveolar abscess and three (0.2%) patients had the life-threatening infection of Ludwig's angina. Twenty-five (1.3%) of those diagnosed with trauma had maxillofacial fractures and were treated by closed reduction technique of maxillomandibular fixation (MMF) [Table 1] and [Table 3]. Restorative and surgical procedures were the major treatment utilized in 818 (40.5%) and 808 (40%) patients, respectively. Periodontal procedure was utilized in 375 (18.6%) patients [Table 3]. Tooth extraction (n = 755, 37.4%), amalgam filling (n = 651, 32.2%), and scaling and polishing (n = 355, 17.6%) were the primary forms of treatment [Table 3].
| Discussion|| |
The goal of dental service utilization research is to improve the health outcome of individuals and society at large. , In contrast to developed nations, studies across sub-Saharan Africa have shown gross neglect of oral diseases by individuals, policy makers, and health planners. This is partly responsible for limited availability of human and material resources for dental services and consequential poor dental attendance. This is compounded by limited availability of curative care concentrated in urban areas. ,,,,,,,,,
The present study showed an overwhelming proportion of dental services utilization was by the people belonging to younger age bracket, with the 21-30 year age group predominating. This is similar to the findings of previous studies reported from West Africa and India. ,,, Fotedar et al.  suggested that younger people have fewer barriers to oral health. On the other hand, Syrjala et al.  observed that the older age group considered oral health of less significance in comparison to their other chronic conditions. However, Ajayi et al.  mentioned that the younger age population of patients' health related morbidity is a reflection of lower life expectancy among Nigerians.  We speculate that all these factors might be responsible for the younger age group observed in the current study.
Our data demonstrated that the proportion of males seeking dental treatment was greater than females, which is in agreement with the observations of Olaleye et al. (Maiduguri)  and Oginni (Ile-Ife),  but contradicts the report of Varenne et al. (Burkina Faso).  An association between dental anxiety and poor dental utilization has been established in the literature.  Recent studies , found that anxiety and fear of dental treatment was more common in women, especially from low socioeconomic background.
There is a growing challenge of oral diseases such as dental caries, periodontitis, dental trauma, and oral cancer in resource-challenged countries. ,,, Dental caries and its sequelae and, to a lesser extent, periodontal disease were the most frequent reasons for receiving dental treatment in the present study. This agrees with many reports from Maiduguri  and Ile-Ife  from Nigeria, as well as from other African states such as Burkina Faso  and Tanzania. 
Episodic visit for relief of pain has been noted as the major motivating factor for most patients presenting for dental treatment. ,,,, However, self-medication, whether western or traditional, has been reported by several researchers. ,, According to the findings of this study, some patients presented with life-threatening complications like Ludwig's angina, which necessitated emergency surgical care, expensive medications, and long hospitalization, putting further strain on scarce resource and manpower.
On the whole, there was slightly more demand for conservative than surgical treatment in the present study. This is not in concordance with previous studies that demonstrated an overwhelming popularity of surgical treatment. ,,,, If the outcome is satisfactory, this approach to dental care may reduce the prevalence of edentulism and the need for expensive oral prosthesis in a resource-depleted setting.
It was found in the present study, in concordance with earlier findings, ,, that tooth extractions accounted for approximately 37% of dental treatment. Studies from sub-Saharan Africa and other developing nations observed that tooth extraction remains the most frequent dental treatment. ,,, This is probably because of lower cost of dental extraction compared to conservative dental care. Contrary to earlier findings, , we observed a female bias toward tooth extractions and a male preference for restorative procedures in the present study. The low figure recorded for scaling and polishing in the present study might portend the necessity to promote preventive oral care among our population.
Management of maxillofacial fractures in the present cohort was by closed reduction technique of MMF in accordance with numerous studies conducted across Africa. ,,, The controversy of the superiority of open reduction and internal fixation (ORIF) over the former remains inconclusive,  but globally, it is accepted as the gold standard of craniomaxillofacial fracture management. , Recent reports have implicated impediments such as low funding of health sector, low socioeconomic status of patients, limited theater space, high cost of the titanium plates and screws, and lack of expertise and training as being responsible for this preference. 
In conclusion, majority of the dental services utilizers in the study population were males, especially in the 21-30 years age group, with tooth extraction being the most frequent dental treatment. We recommend emphasizing on preventive oral care to reduce the burden of oral diseases in our center.
| References|| |
|1.||Torwane NA, Hongal S, Goel P, Chandrashekar BR. Role of Ayurveda in management of oral health. Pharmacogn Rev 2014;8:16-21. |
|2.||Florida Dental Association. Improving access to oral health care in Florida. Todays FDA 2012;24:29-40. |
|3.||Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ 2005;83:661-9. |
|4.||Opeodu OI, Dosumu EB, Arowojolu MO. Dental health service utilization by resident doctors/medical officers in the University College Hospital, Ibadan, Oyo State, Nigeria. Afr J Med Med Sci 2012;41:277-82. |
|5.||Taiwo OA, Alabi OA, Yusuf OM, Ololo O, Olawole WO, Adeyemo WI. Reasons and pattern of tooth extraction among patients presenting at a Nigerian semi-rural specialist hospital. Nig Q J Hosp Med 2012;22:200-4. |
|6.||Umeizudike KA, Ayanbadejo PO, Savage KO, Taiwo OA. Pattern of periodontal treatments performed at the periodontology clinic of the Lagos University Teaching Hospital: 22 months review. Nig Q J Hosp Med 2012;22:7-13. |
|7.||Majchrzak E, Szybiak B, Wegner A, Pienkowski P, Pazdrowski J, Luczewski L, et al. Oral cavity and oropharyngeal squamous cell carcinoma in young adults: A review of the literature. Radiol Oncol 2014;48:1-10. |
|8.||Adeyemo WL, Ladeinde AL, Ogunlewe MO, James O. Trends and characteristics of oral and maxillofacial injuries in Nigeria: A review of the literature. Head Face Med 2005;1:7. |
|9.||Kamulegeya A, Lakor F, Kabenge K. Oral maxillofacial fractures seen at a Ugandan tertiary hospital: A six-month prospective study. Clinics (Sao Paulo) 2009;64:843-8. |
|10.||Bokhari SA, Khan AA. Growing burden of noncommunicable diseases: The contributory role of oral diseases, Eastern Mediterranean Region perspective. East Mediterr Health J 2009;15:1011-20. |
|11.||Wahid A, Chaudhry S, Ehsan A, Butt S, Ali Khan A. Bidirectional relationship between chronic kidney disease and periodontal disease. Pak J Med Sci 2013;29:211-5. |
|12.||Makusidi MA, Liman HM, Yakubu A, Isah MD, Jega RM, Adamu H, et al. Prevalence of non-communicable diseases and its awareness among inhabitants of Sokoto metropolis: Outcome of a screening program for hypertension, obesity, diabetes mellitus and overt proteinuria. Arab J Nephrol Transplant 2013;6:189-91. |
|13.||Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg 2006;100:191-9. |
|14.||Ajayi DM, Arigbede AO. Barriers to oral health care utilization in Ibadan, South West Nigeria. Afr Health Sci 2012;12:507-13. |
|15.||Fotedar S, Sharma KR, Bhardwaj V, Sogi GM. Barriers to the utilization of dental services in Shilma, India. Eur J Gen Dent 2013;2:139-43. |
|16.||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. |
|17.||Lawal FB, Taiwo JO, Oke GA. Oral health practices of adult inhabitants of a traditional community in Ibadan, Nigeria. Niger J Med 2013;22:212-7. |
|18.||Adeniyi AA, Ogunbanjo BO, Sorunke ME, Onigbinde OO, Agbaje MO, Braimoh M. Dental attendance in a sample of Nigerian pregnant women. Nig Q J Hosp Med 2010;20:186-91. |
|19.||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. |
|20.||Varenne B, Petersen PE, Fournet F, Msellati P, Gary J, Ouattara S, et al. Illness-related behaviour and utilization of oral health services among adult city-dwellers in Burkina Faso: Evidence from a household survey. BMC Health Serv Res 2006;6:164. |
|21.||Westaway MS, Viljoen E, Rudolph MJ. Utilisation of oral health services, oral health needs and oral health status in a peri-urban informal settlement. SADJ 1999;54:149-52. |
|22.||Adegbembo AO. Household utilization of dental services in Ibadan, Nigeria. Community Dent Oral Epidemiol 1994;22:338-9. |
|23.||Mosha HJ, Scheutz F. Perceived need and use of oral health services among adolescents and adults in Tanzania. Community Dent Oral Epidemiol 1993;21:129-32. |
|24.||Mumcu G, Sur H, Yildirim C, Soylemez D, Atli H, Hayran O. Utilisation of dental services in Turkey: A cross-sectional survey. Int Dent J 2004;54:90-6. |
|25.||Olaleye AO, Suleiman IK, Solomon S. Pattern of dental treatment in patients attending the Dental Centre University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. BOMJ 2013;10:12-9. |
|26.||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. |
|27.||UNICEF. At a Glance: Nigeria-Statistics. Available from: http://www.org/infobycountry/Nigeriastatistics.ttml. [Last accessed on 2014 Mar 13]. |
|28.||Syrjälä AM, Knuuttila ML, Syrjälä LK. Reasons preventing regular dental care. Community Dent Oral Epidemiol 1992;20:10-4. |
|29.||Gambhir RS, Brar P, Singh G, Sofat A, Kakar H. Utilization of dental care: An Indian outlook. J Nat Sci Biol Med 2013;4:292-7. |
|30.||van Palenstein Helderman WH, Nathoo ZA. Dental treatment demands among patients in Tanzania. Community Dent Oral Epidemiol 1990;18:85-7. |
|31.||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. |
|32.||Ekanayake L, Weerasekare C, Ekanayake N. Needs and demands for dental care in patients attending the University Dental Hospital in Sri Lanka. Int Dent J 2001;51:67-72. |
|33.||Fasola AO, Nyako EA, Obiechina AE, Arotiba JT. Trends in the characteristics of maxillofacial fractures in Nigeria. J Oral Maxillofac Surg 2003;61:1140-3. |
|34.||Deogratius BK, Isaac MM, Farrid S. Epidemiology and management of maxillofacial fractures treated at Muhimbili National Hospital in Dar es Salaam, Tanzania, 1998-2003. Int Dent J 2006;56:131-4. |
|35.||Akadiri OA, Omitiola OG. Maxillo-mandibular fixation: Utility and current techniques in modern practice. Niger J Med 2012;21:125-33. |
|36.||Motamedi MH. An assessment of maxillofacial fractures: A 5-year study of 237 patients. J Oral Maxillofac Surg 2003;61:61-4. |
|37.||Okoturo EM, Arotiba GT, Akinwande JA, Ogunlewe MO, Gbotolorun OM, Obiechina AE. Miniplate osteosynthesis of mandibular fractures at the Lagos University Teaching Hospital. Nig Q J Hosp Med 2008;18:45-9. |
[Table 1], [Table 2], [Table 3]