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BIOLOGICAL PROFILE OF ORAL HEALTH SUBSCRIBERS IN BOTH TERTIARY AND SECONDARY HEALTHCARE CENTRES: A POSTMORTERM ANALYSIS AND POLICY IMPLICATION

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Madukwe I. U.

Department of Oral Surgery and Pathology, Faculty of Dentistry,
College of Medical Sciences, University of Benin, Benin City, Nigeria

ABSTRACT
Oral health and dentistry in Africa have been afflicted by the problems characterizing the world’s developing regions, such as poverty, malnutrition, high incidence of infectious diseases and child mortality, lack of oral health policy, and inadequate national budget for oral health.  The retrospective study period of 10 years, in both centres revealed 72,818 subscribers, of which 54.23% were from tertiary health centre (UBTH).  Female subscribers were dominant in both centres; 54.89% (UBTH) and 56.06% (Central Hospital, Benin City), with the means and the analysis of variable between means and within means (ANOVA), with an F-test, one tail probability of P>0.05.  We conclude that a well articulated strategy and policy on increased oral health subscription in our communities is most desirable.  Integration of oral health into national and community health programs is recommended.

Keywords: Biological, profile, oral health, subscribers.

INTRODUCTION
Oral health and dentistry in Africa have been afflicted by the problems characterizing the world’s developing regions, such as poverty, malnutrition, high incidence of infectious diseases and child mortality, lack of oral health policy, and inadequate national budget for oral health.[1] Oral health is a state of being free from chronic mouth and facial pain, oral and throat cancer, oral sores, birth defects such as cleft lip and palate, periodontal (gum) disease, tooth decay and tooth loss, and other diseases and disorders that affect the oral cavity[2] and craniofacial complex[3] oral health subscription pattern shows females are usually higher than males[4] most patient attend because of pains and subscription is however as from ages above 15 years[5].  On the contrary, Matsuolaet al[6] reveals higher subscription of males than females with age range from 20 years to 80 years.  Australian survey on the other hand showed that the comparison of dental attendance pattern by age and gender showed significant variations.  The proportion of adults with formidable pattern of dental attendance was lowest among those aged 25 – 34 years and highest among those aged 65 years and above.  Males have lower attendance than females[7].

MATERIALS AND METHODS
In this study, is in the tertiary healthcare centre, University of Benin Teaching Hospital, while the secondary healthcare Centre is the general Hospital, Benin City.  These two centres are located in Egor and Oredo Local Government Areas respectively for ease of comparison of data.  A retrospective analysis of non-confidential records of both centres was done within a study period of 1995 – 2015 representing a 10-year period.  Estimate of oral health subscription by number, age and gender was done for the two centres.  Statistical analysis was for means, analysis of variance between means and within means (ANOVA)

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RESULTS
The retrospective study period of 10-year (1995-2005) in both the tertiary healthcare (University of Benin tertiary hospital) and secondary health care (General Hospital, Benin City) Centres have a combined attendance figure of 72,818 subscribers.  Oral health subscription was more in the tertiary health care centre (54.23%) table I.  Most subscribed age is 21-30-year in both centres(UBTH 49.55%) Table 2 and(General Hospital 52.04%) table 5; with female subscription dominant in both centres;  (54.89%) table 3 and (56.06%) table 6 respectively.  The means and the analysis of variable between means and within means (ANOVA) Table 7, with an F-test, one tail probability of P > 0.05.

DISCUSSION
Chronic disease and injuries are overtaking communicable diseases as the leading health problems in all but a few parts of the world. This rapidly changing global disease pattern is closely linked to changing lifestyles, which include diets rich in sugar, widespread use of tobacco and increased consumption of alcohol.  These lifestyle factors also significantly impact on oral health, and oral diseases quality as major public health problems owing to their high prevalence in all regions of the world.  The traditional treatment of oral diseases is increasingly becoming extremely costly even in industrialized countries and is unaffordable in most low and middle income countries.[8] Subscription pattern to oral health in the developing countries need to be evaluated both in number, age and sex, and fine-tune effective mechanism to boast it. This will no doubt add to the gains of preventive, oral health strategies and avert future oral disease. It is common knowledge that dental caries is a major oral health challenge in most industrialized countries and it is on the increase in the developing countries, affecting 60 – 90% of school children and vast majority of adults.  Our studies revealed age 21 – 30 years as highest subscribers.  This is encouraging as it represents school age period with females more dominant.
Aesthetics is a major problem in the female generation, this generation of school age should be encouraged to attend oral healthcare centres.  In most developing countries access to oral health services is limited and teeth are often left untreated or are extracted because of pain or discomfort.  Tooth loss and impaired oral function are expected to increase as a public health problem in many developing countries[9], we therefore conclude that a well-articulatedstrategy and policy on increased oral health subscription in communities is most desirable.  We recommend the integration of oral health into national and community health programmes to reduce future high human, financial and material resources required in the management of unchecked oral disease.[10]

REFERENCES

  1. Hescot, P., China E, Bourgeois Denis, Maina S, Monteiro da Silva O, Eisele JL, Simpson C, Horn V.  The FDI African strategy for oral health:  addressing the specific needs of the continent.  Int. Dent. J. 2013; 63: 113-120.
  2. Oral Health/en/World Health Organization.
  3. U.S. Department of Health and Human Services.  Oral health in America.  A report of the surgeon general.  Rockville, MD: US Department of Health and Human Services; National Institutes of Health, National Institute of Dental and Craniofacial Research, 2000 NIH Publication 00 – 4713.
  4. Akaji EA, Chukwuneke FN, OkekeUf.  Attendance pattern amongst patients at the Dental Clinic of the University of Nigeria Teaching Hospital, Enugu.  Niger. J. Med. 2012 Jan – March, 21 (1): 74-7.
  5. Esa R, Razak I.A., Jallaudin RL, Jaafar N.  A survey on oral hygiene practices among Malaysian adults.  Clin. Prev.
  6. Matsuoka Y, Arai K, Kawatsura E, Fukaik, Dental Attendance pattenrs of patients with non-communicable diseases by six-year follow-up study.  Health Sciences, Health Care Jur. 2011; 11 (1): 4-8.
  7. Australian Research Centre for Population Oral Health, The University of Adelaide South Australia.  Aust. Dent. Jour. 2014; 59: 129-134.
  8. Peterson PE.  Challenges to improvement of oral health in the 21st Century – the approach of the WHO. Global Oral Health Programme.  Int. Dent. J. 2004; 54: 329-343.
  9. Peterson P.E.  The world oral health report 2003:  Continuous improvement of oral health in the 21st century – the approach of the WHO Global oral Health Programme 2003. Count. Dent. Oral. Epid. 2003; 31 Suppl. 1:3-24.
  10. Kandelman D, Arpins, Baez RJ, Baehni PC, Petersen PT.  Oral health care system in developing and developed countries.  Periodontal 2000.  2012 Oct., 60 (1): 98-109.