Adetayo Aborisade

Objective: In Nigeria, the burden of dental anxiety and dental fear (DFA) remains poorly characterized despite its possible contribution to poor dental service utilization and treatment avoidance. This study aimed to estimate the pooled prevalence of dental anxiety in Nigerian populations and identify associated risk factors. Methods: This systematic review and meta‐analysis was registered in PROSPERO: (CRD420261373453). A search was conducted in PubMed/MEDLINE, Embase, Web of Science, EBSCOhost, and African Journals Online from inception to March 2026. Studies were included if they were cross‐sectional, cohort, or case–control studies conducted in Nigerian populations of any age that reported prevalence estimates of DFA using validated instruments. Two independent reviewers extracted data and assessed the risk of bias using the Joanna Briggs Institute checklists. The primary outcome was the pooled prevalence of dental anxiety, calculated using random‐effects meta‐analysis with the Freeman‐Tukey double arcsine transformation. The associations between DFA and age, sex, and educational levels were also determined. Heterogeneity was assessed using I ² statistics. Results: Of 237 records identified, 30 studies met the inclusion criteria, comprising 7920 participants. The pooled prevalence of DFA was 61% (95% CI: 41%–79%; I ² = 97%). Severe to extreme DFA prevalence was 18% (95% CI: 12%–27%). The pooled mean dental anxiety score was 11.9 (95% CI: 10.6–13.2). Females had higher DFA scores than males (mean difference 1.3, p = 0.0003) although the certainty of evidence was low. Participants under 30 years had higher scores than those 30 years and older (mean difference 1.6, p = 0.0002). Education level showed no significant association. Most studies (86.7%) had a moderate risk of bias. No publication bias was detected. Conclusion: Dental anxiety and dental fear affect approximately three‐quarters of the Nigerian population, with a possible higher burden among females and younger adults. These findings highlight the possible value of routine anxiety screening and integration of behavioural management into Nigerian dental practice.

Background: Adolescents' satisfaction with dental appearance is a key patient-reported outcome in orthodontics. While Angle's classification is the standard for assessing sagittal molar relationships, its association with self-reported satisfaction in sub-Saharan Africa is underexplored. Since posterior molar relationships are not visible to adolescents, satisfaction likely depends on anterior features. This study examined this association in Northern Nigeria, hypothesizing no significant relationship given their conceptual mismatch.Methods: In a cross-sectional study, 198 in-school adolescents aged 12–15 years were selected via multistage sampling in Kano State, Nigeria. Clinical examinations used Angle's classification (intra-examiner kappa: 0.92–0.96). Satisfaction was assessed with a single-item measure. Data were analyzed using Fisher's exact test due to small expected cell counts.Results: Mean age was 13.5±1.1 years; 52.0% were female. Most participants (89.4%) reported satisfaction. Angle's Class I was predominant (91.4%), followed by Class II (5.6%) and Class III (3.0%). Satisfaction rates were 92.3%, 72.7%, and 100%, respectively. The association was not significant (p=0.108). Although dissatisfaction was higher in Class II (27.3%) than Class I (7.7%), the difference was not statistically significant.Conclusions: Most adolescents were satisfied, and Angle's Class I was predominant. No significant association was found, supporting the theoretical expectation that posterior molar relationships do not predict satisfaction. However, null findings must be interpreted cautiously due to limited power, single-item measurement, and absence of anterior feature assessment. Anterior aesthetics, cultural norms, and psychosocial factors may be more influential. Future research should include comprehensive anterior dental measures. Orthodontic assessment should integrate clinical evaluation with patient-reported satisfaction for patient-centered care.

Background: Oral hygiene is linked with dental caries experience. This systematic review and meta-analysis assessed the associations between oral hygiene status, the frequency of tooth brushing, and the prevalence of dental caries in Nigeria. It also examined how the geographical zones and dentition type moderate these associations, and identified the tools commonly used for oral hygiene maintenance. Methods: The systematic review and meta-analysis was registered with PROSPERO (CRD42022367763). A search was conducted in PubMed, Web of Science, Scopus, African Journals Online, African Index Medicus, and Google Scholar in January 2026 for studies conducted between January 2001 and December 2025. Observational studies and clinical trials reporting baseline caries prevalence were included. There was no language restriction. Studies were excluded if they did not provide information on the sample size, had no study outcome data, featured duplicate samples, or were review articles, meta-analyses, case reports, case series, in vitro studies, commentaries/letters (editorials, opinion pieces) devoid of primary data. Pooled odds ratios (ORs) were estimated using random-effects models. Subgroup analyses were conducted by dentition type, geopolitical zone, study design, publication year, mean age, and sample size. Results: Twenty-three cross-sectional studies were included, of which 20 (86.9%) were conducted in Southern Nigeria. Pooled data from 10 studies suggested poor oral hygiene was associated with 100% higher odds of dental caries (95% CI: 1.26–3.96; p = 0.003). After removing an influential outlier, the analysis showed a 76% increase in dental caries prevalence associated with poor oral hygiene (95% CI: 1.41–2.18; p = 0.003; I² = 0.00%). Brushing at least twice daily was associated with reduced dental caries (p < 0.001). Dentition type and publication year were significant moderators. The most common oral cleaning tool was a toothbrush with toothpaste, though chewing sticks, cotton wool, and other traditional tools were also reported. Conclusion: Poor oral hygiene was linked to increased odds for dental caries, while twice-daily tooth brushing was protective in Nigeria. The type of cleaning tool was not significantly associated with dental caries risk, highlighting the importance of brushing frequency over tool type. Studies reporting on oral hygiene and dental caries in Northern Nigeria are needed to improve the national representativeness of the data.

Background: Malocclusion can negatively impact psychosocial well-being and oral health-related quality of life (OHRQoL), particularly during adolescence and young adulthood. This study evaluated the prevalence and severity of psychosocial burden associated with self-perceived malocclusion and its relationship with OHRQoL among adolescents and young adults in Kano State, Nigeria. Methods: This cross-sectional study included 316 participants aged 13–25 years recruited from secondary schools and a university in Kano metropolis using convenience sampling. Data were collected using self-administered questionnaires comprising the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN-AC), the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and the Oral Health Impact Profile (OHIP-14). Descriptive statistics, Wilcoxon rank-sum tests, Pearson’s chi-squared tests, and Spearman’s correlations were used. Multivariable logistic regression identified predictors of high psychosocial impact (PIDAQ grade). Statistical significance was set at p < 0.05. Results: Of 316 participants (mean age 16.9 ± 3.6 years; 55% male), 45.2% perceived a need for orthodontic treatment (34.8% moderate, 10.4% definite). High psychosocial impact (PIDAQ > 31) was recorded in 63.3% ( n = 200), with male participants showing significantly higher median PIDAQ scores than females (38 vs. 34, p = 0.03). A negative impact on OHRQoL (OHIP-14 > 14) was reported by 32.9% ( n = 104). IOTN-AC showed mild positive correlations with aesthetic concern (ρ = 0.13) and psychological impact (ρ = 0.18). OHIP-14 was strongly correlated with psychological impact (ρ = 0.62) and social impact (ρ = 0.59). In multivariable analysis, male sex (OR = 2.65, 95% CI:1.48–4.83), higher OHIP-14 score (OR = 1.14, 95% CI:1.10–1.19), and higher IOTN-AC score (OR = 1.30, 95% CI:1.12–1.53) were independent predictors of high psychosocial impact, while tertiary education was protective (OR = 0.07, 95% CI:0.02–0.31). Conclusion: Self-perceived malocclusion is associated with reduced dental self-confidence, impaired OHRQoL, and adverse social and psychological well-being among Nigerian adolescents and young adults. These associations vary by sex and education level. Early orthodontic assessment and integrated oral health education may mitigate psychosocial burdens.

Background: Dental anxiety and fear are significant barriers to oral healthcare, contributing to treatment avoidance and poorer oral health outcomes. In Nigeria, the burden remains poorly characterized. This study aimed to estimate the pooled prevalence of dental fear and anxiety (DFA) in Nigerian populations and identify associated risk factors.Methods: This systematic review and meta-analysis was registered in PROSPERO: (CRD420261373453). A search was conducted in PubMed/MEDLINE, Embase, Web of Science, EBSCOhost, and African Journals Online from inception to March 2026. We included cross-sectional, cohort, or case-control studies conducted in Nigerian populations of any age that reported prevalence estimates of DFA using validated instruments. Two independent reviewers extracted data and assessed the risk of bias using the Joanna Briggs Institute checklists. The primary outcome was the pooled prevalence of dental anxiety, calculated using random-effects meta-analysis with the Freeman-Tukey double arcsine transformation. Heterogeneity was assessed using I² statistics. Findings: Of 237 records identified, 30 studies met the inclusion criteria, comprising 7920 participants. The pooled prevalence of dental anxiety was 74% (95% CI: 44–92%; I²=97%). Severe to extreme dental anxiety prevalence was 17% (95% CI: 11–25%). The pooled mean dental anxiety score was 11·88 (95% CI: 10·62–13·15). Females had significantly higher anxiety scores than males (mean difference 1·31, p=0·0003), and participants under 30 years had higher scores than older adults (mean difference 1·64, p=0·0002). Education level showed no significant association. Most studies (86·7%) had a moderate risk of bias; no publication bias was detected.Interpretation: Dental anxiety affects approximately three-quarters of the Nigerian population, with a higher burden among females and younger adults. These findings highlight the need for routine anxiety screening and integration of behavioural management into Nigerian dental practice.

Background: The use of fluoride-containing dentifrices can reduce the risk of dental caries. The systematic review was conducted to address two research questions: (i) the prevalence and frequency of fluoridated toothpaste use among Nigerian children and adolescents across geographic and demographic settings, and (ii) its association with dental caries prevalence, stratified by location and baseline caries risk. Methods: This systematic review, registered with PROSPERO (CRD42022362116), followed the PRISMA guidelines. A PIO framework was applied to include children and adolescents (6 months–19 years) in Nigeria using fluoridated toothpaste, with caries outcomes measured via dmft/DMFT indices. A comprehensive search of PubMed, Web of Science, Scopus, Embase, AJOL, and Google Scholar was conducted from January 2001 to January 2026, supplemented by reference and grey literature searches. Study selection, data extraction, and risk of bias assessment using an adapted Hoy et al. tool were performed independently by multiple reviewers, with high inter-rater reliability (Kappa=0.90). Data were pooled using a random-effects model, with sensitivity, subgroup, and meta-regression analyses conducted to explore heterogeneity and effect modifiers. Publication bias was assessed using funnel plots and Egger’s test. Results: Of 1,194 identified records, 18 studies (n=12,719 participants) were included. The use of fluoridated toothpaste was widespread (prevalence: 61.9% to 95.8%), yet its association with dental caries varied significantly by location. A meta-analysis of 14 studies indicated a significant 16% reduction in caries odds with fluoridated toothpaste use after removal of an influential outlier (OR = 0.84, 95% CI: 0.71–0.99, p=0.04). Subgroup analyses revealed this protective association was significant in urban and rural settings (p<0.05) but absent in suburban Nigeria. Furthermore, dental caries prevalence and severity (DMFT/dmft) were substantially higher in urban and rural areas, where the association was significant, compared to suburban regions. All studies were assessed as having a low risk of bias, and no significant publication bias was detected. Conclusion: Fluoridated toothpaste is widely used in Nigeria and associated with a reduction in the prevalence of dental caries in Nigeria. It appears the relationship is moderated by residential location, and the DMFT/dmft. Longitudinal studies are needed to explore the interactions between the DMFT/dmft, use of fluoridated toothpaste, and residential location in Nigeria.