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BACKGROUND: Few studies have investigated an association between CD4 counts, viral load (VL), WHO staging, and caries among HIV-positive (HIV+) children on HAART therapy (>12 months). AIM: To determine the strength of association between CD4 counts, WHO staging, VL, and dental caries. DESIGN: This cross-sectional analytical study comprised of 355 HIV + children, aged 4-12 years, attending a hospital in Johannesburg, South Africa. Demographic and clinical data such as decayed (d,D), missing (m,M), filled teeth (f,F) [dmft/DMFT], CD4 counts, and WHO staging were collected. Correlation and regression analyses were done to test for associations. RESULTS: Caries prevalence for this cohort of children was 57%. The dmft score for the primary dentition was 4.36 (SD 4.87) and DMFT for secondary dentition was 0.58 (SD 1.49). Pearson's correlation analyses showed significant association between VL and CD4 count (P = .003) and VL and WHO stage (P = .007). Weak associations were noted between caries (d, D) and VL, CD4 count, and WHO stage of disease for correlation and regression analyses. CONCLUSION: There appears to be no substantial evidence of any significant association between the presence of caries among HIV + children and CD4 counts, viral load, and WHO clinical stage of the disease.

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BACKGROUND: The effect of nutritional status on the timing of permanent tooth formation is not well understood, despite clear evidence that systemic stresses result in enamel defects during tooth formation. AIM: This study investigated the effect of nutritional status (measured as BMI, height, weight, mid-upper arm circumference, and head circumference) on permanent tooth formation. METHOD: This was a prospective cross-sectional study involving 642 (270 males, 372 females) healthy Black South African participants aged 5-20 years. The height and BMI were converted to z-scores using WHO z-score for age tables. The participants were grouped into underweight/short for age (<-2), normal (≥ - 2 to 2.0) and overweight/obese/tall for age (>2). Panoramic radiographs of the children were assessed using Demirjian's eight stages of permanent tooth formation and age was estimated using Demirjian's method. Probit regression analysis was used to calculate the mean age of attainment of the developmental stages for the left mandibular teeth (I2-M2). RESULTS: There was significant advancement in the age of attainment of the final (H) stage for the majority of permanent teeth in the overweight (mean male BMI 22.9; female 27.94) group compared to the underweight (p < .05). Negative binomial regression indicated that age, height, and BMI were significant predictors of the dental maturity score for males (p < .05), while age, height, weight, BMI and HC were significant predictors for females (p < .05). CONCLUSION: Nutritional status had a significant effect on the timing of tooth formation in males and females in the study population. The effect was mainly noticeable for children in the extremes of the spectrum of BMI z-scores.

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BACKGROUND: The prevalence of dental caries and its effect on the oral-health-related quality of life (OHRQoL) of children with special needs (CSNs) have not been established in South Africa. AIM: The study aimed to assess how caregivers of CSNs who attended Down Syndrome Association outreach sites in Johannesburg, South Africa, perceived the contribution of OHRQoL to the quality of life of these children. SETTING: The study was conducted at Down Syndrome Association (DSA) outreach sites in Johannesburg. These sites cater for children with several types of disabilities including cerebral palsy, hydrocephalus, autism, epilepsy and developmental delays. The association schedules and facilitates support group meetings for the caregivers of children with Down syndrome and other disabilities. These meetings are held at the outreach sites that are located at different district hospitals and community health centres in Johannesburg and are co-facilitated by the association's outreach coordinator together with a team of physiotherapists, occupational therapists and speech therapists. METHODS: This cross-sectional study was composed of a convenient sample of 150 caregiver and child pairs from five outreach sites during January - June 2015. The short-form Parent-Caregiver Perception Questionnaire (P-CPQ) was used. The caries status of the children was assessed using the decayed, missing and filled teeth (dmft/DMFT) indices (whereby dmft or DMFT stands for decayed missing filled teeth in primary dentition [dmft] and in permanent dentition [DMFT]) based on World Health Organization guidelines. RESULTS: The mean age of the caregivers was 39.52 years (standard deviation [SD] 9.26) and 8.72 years (SD 6.07) for the children. The mean P-CPQ score was 12.88 (SD 12.14). All the caregivers stated that dental caries had a negative impact on the OHRQoL of the CSNs. However, 60% of caregivers stated that an oral condition had no impact on the child's overall well-being. The majority (56.7%) of the caregivers rated their children's overall oral health status as average and only 12% reported the oral health status to be poor. There was a high prevalence of untreated caries among the CSNs regardless of the type of disability. CONCLUSION: All the caregivers stated that dental caries had a negative impact on the OHRQoL of the CSNs. However, they appeared to have contradictory perceptions of the oral health needs or status of their children.

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BACKGROUND: Many aspects of growth have been documented for Black Southern African children, yet their dental development has not been comprehensively investigated. AIM: The present study was designed to provide information on age of attainment of dental development stages in Southern African children and to compare the findings with other populations. METHOD: This was a community-based cross-sectional study of 642 children (270 males and 372 females). Panoramic radiographs of children aged 5 to 20 years were assessed using Demirjian's eight stages of permanent tooth formation and age was estimated using Demirjian's method. Resulting dental ages were compared to the chronological ages. Probit regression analysis was employed to calculate the mean age of attainment of the developmental stages for the seven left mandibular teeth. Maturity scores and age of attainment were compared by sex and with published data on other populations. RESULTS: Females show significantly advanced dental maturity and dental ages, as well as earlier attainment of all stages of mineralization, compared to males (p < 0.05). The Demirjian method overestimated dental age in both males (0.8 ± 1.02 years) and females (1.0 ± 0.98 years). Cross-population comparisons illustrate that Black Southern African children are generally advanced in dental maturity compared to children of European and Asian ancestry. CONCLUSION: The Demirjian method significantly overestimated the chronological ages of Black Southern African males and females. Southern Africans attain dental maturity earlier than South Korean, Canadian, and Belgian children. These differences in dental maturity clearly illustrate the need for population-specific, rather than global, dental maturity standards.

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Background: The prevalence of dental caries and its effect on the oral-health-related quality of life (OHRQoL) of children with special needs (CSNs) have not been established in South Africa. Aim: The study aimed to assess how caregivers of CSNs who attended Down Syndrome Association outreach sites in Johannesburg, South Africa, perceived the contribution of OHRQoL to the quality of life of these children. Setting: The study was conducted at Down Syndrome Association (DSA) outreach sites in Johannesburg. These sites cater for children with several types of disabilities including cerebral palsy, hydrocephalus, autism, epilepsy and developmental delays. The association schedules and facilitates support group meetings for the caregivers of children with Down syndrome and other disabilities. These meetings are held at the outreach sites that are located at different district hospitals and community health centres in Johannesburg and are co-facilitated by the association's outreach coordinator together with a team of physiotherapists, occupational therapists and speech therapists. Methods: This cross-sectional study was composed of a convenient sample of 150 caregiver and child pairs from five outreach sites during January ­ June 2015. The short-form Parent-Caregiver Perception Questionnaire (P-CPQ) was used. The caries status of the children was assessed using the decayed, missing and filled teeth (dmft/DMFT) indices (whereby dmft or DMFT stands for decayed missing filled teeth in primary dentition [dmft] and in permanent dentition [DMFT]) based on World Health Organization guidelines. Results: The mean age of the caregivers was 39.52 years (standard deviation [SD] 9.26) and 8.72 years (SD 6.07) for the children. The mean P-CPQ score was 12.88 (SD 12.14). All the caregivers stated that dental caries had a negative impact on the OHRQoL of the CSNs. However, 60% of caregivers stated that an oral condition had no impact on the child's overall well-being. The majority (56.7%) of the caregivers rated their children's overall oral health status as average and only 12% reported the oral health status to be poor. There was a high prevalence of untreated caries among the CSNs regardless of the type of disability. Conclusion: All the caregivers stated that dental caries had a negative impact on the OHRQoL of the CSNs. However, they appeared to have contradictory perceptions of the oral health needs or status of their children

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OBJECTIVES: This study investigates mean age, sequence, and temporal trends of permanent tooth emergence in Black Southern African children and compares the findings with other population samples. MATERIALS AND METHODS: This community-based cross-sectional study involved 639 Black Southern African children between 5 and 20 years of age. Probit analysis was used to derive the mean age at emergence of the permanent teeth. Sex and cross-population comparisons were undertaken to determine similarities and differences in emergence timing and sequence. RESULTS: Females emerged all teeth earlier except for M3s (p < .05). Black Southern Africans have earlier mean ages of emergence compared to population samples from the USA, Europe, Australia, and Asia. Sexual dimorphism was detected in the mandibular I1/M1 emergence sequence (females, M1 I1 ; males, I1 M1 ). The sequence in males is similar in both jaws to males from other sub-Saharan African, USA, and European samples. Females show a similar sequence pattern in the maxilla with other sub-Saharan African, and also Australian and US females of European ancestry. There is a high frequency of polymorphism in the P1P2C1 emergence sequence, with significantly more P2P1C1 maxillary sequences seen among males. Polymorphic variation was common for the I1 M1 sequence in both males and females. DISCUSSION: Mean age of tooth emergence among Black Southern African children is similar to children from most other sub-Saharan African populations. No temporal change was seen in the mean age of emergence. Earlier permanent tooth emergence in Black Southern Africans is part of a general sub-Saharan pattern that is distinct from European and Asian populations.

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Current dental maturity charts, such as the widely applied London atlas, do not take into consideration advanced tooth emergence and formation patterns observed in children of African ancestry. The result is inaccurate age estimation in Southern Africa, a region where there is great forensic and anthropological need for reliable age estimation. OBJECTIVES: To develop a population-specific atlas of permanent tooth emergence and formation for age estimation of Black Southern Africans. MATERIALS AND METHODS: Using data from a cross-sectional study of 642 school children aged 5-20 years, panoramic radiographs taken during routine dental examination in a mobile treatment van were analyzed using the Demirjian method of eight (A-H) tooth formation stages. Tables of the stages of tooth development for each tooth, including the third molars, were generated separately for age cohorts and by sex. The most frequently occurring (modal) stage of tooth formation was considered the signature developmental stage for the age. The relationship of the third molar occlusal surfaces with occlusal tables on the radiographs were checked and compared with the findings recorded during intra oral examination. RESULTS: Comparison with the London atlas shows that at age 9.5 years, the canine and premolar emergence are at least one year ahead and the third molar formation completes four years earlier in the WITS Atlas. DISCUSSION: Similarities in advancement in tooth formation and emergence across sub-Saharan Africa suggest that the WITS Atlas can be used for those populations as well.

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The accuracies of the original Demirjian, modified Demirjian and Willems dental age estimation methods were compared for a Black Southern African population to determine their usefulness for forensic and anthropological purposes. Data were collected using a community-based prospective study design. Panoramic radiographs of seven left mandibular teeth from 540 children aged 5-15.99 years were scored using the three methods. Obtained estimates were compared to the chronological ages and mean absolute errors were calculated. The original Demirjian method significantly overestimated ages (males 0.85 years, female 1.0 years; mean absolute errors of 1.1 years for both sexes), as did the modified Demirjian method (males 0.90 years, females 1.21 years; mean absolute errors of males 1.1 years, females 1.4 years). The Willems method was the most accurate for Black Southern Africans, with the lowest significant mean difference (males 0.2 years, females 0.3 years) between dental and chronological age, with the least mean absolute errors (males 0.70 years, females 0.68 years).

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BACKGROUND: The accuracy of radiographic methods for dental age estimation is important for biological growth research and forensic applications. Accuracy of the two most commonly used systems (Demirjian and Willems) has been evaluated with conflicting results. This study investigates the accuracies of these methods for dental age estimation in different populations. METHODS: A search of PubMed, Scopus, Ovid, Database of Open Access Journals and Google Scholar was undertaken. Eligible studies published before December 28, 2016 were reviewed and analyzed. Meta-analysis was performed on 28 published articles using the Demirjian and/or Willems methods to estimate chronological age in 14,109 children (6,581 males, 7,528 females) age 3-18 years in studies using Demirjian's method and 10,832 children (5,176 males, 5,656 females) age 4-18 years in studies using Willems' method. The weighted mean difference at 95% confidence interval was used to assess accuracies of the two methods in predicting the chronological age. RESULTS: The Demirjian method significantly overestimated chronological age (p<0.05) in males age 3-15 and females age 4-16 when studies were pooled by age cohorts and sex. The majority of studies using Willems' method did not report significant overestimation of ages in either sex. Overall, Demirjian's method significantly overestimated chronological age compared to the Willems method (p<0.05). The weighted mean difference for the Demirjian method was 0.62 for males and 0.72 for females, while that of the Willems method was 0.26 for males and 0.29 for females. CONCLUSION: The Willems method provides more accurate estimation of chronological age in different populations, while Demirjian's method has a broad application in terms of determining maturity scores. However, accuracy of Demirjian age estimations is confounded by population variation when converting maturity scores to dental ages. For highest accuracy of age estimation, population-specific standards, rather than a universal standard or methods developed on other populations, need to be employed.

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PURPOSE: This study assessed the comparative efficacy of three in-office treatment agents in patients presenting with dentin hypersensitivity (DH) at a university teaching hospital. MATERIALS AND METHODS: A randomised, controlled study was conducted to compare the efficacy of Gluma desensitiser, Pro-Relief and Copal F in relieving the pain of DH. In 68 subjects with 508 hypersensitive teeth, the agents and placebo (distilled water) were applied to 127 hypersensitive teeth each. At baseline, the pain of DH to tactile and evaporative stimuli was measured using the visual analogue scale (VAS) and verbal rating scale (VRS). Post-application assessment was carried out at 10 min, 1 week, 2 and 4 weeks. RESULTS: The mean difference in VAS between baseline and post-treatment periods significantly increased for all the desensitising agents (p < 0.05) with both tactile and air-blast stimuli, except for the placebo. Gluma desensitiser had the highest mean difference at 10 min (3.7 ±â€¯1.8) and 4 weeks (5.4 ±â€¯2.3) for tactile and air-blast stimuli, respectively. However, using the VAS, no statistical significance was noted in the mean differences between the agents. With the application of Gluma desensitiser, a significantly higher number of teeth had no pain at 4 weeks using the VRS. CONCLUSION: Gluma desensitiser can be suggested as an appropriate desensitising agent for in-office treatment of DH.

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Background Third molar influence on anterior crowding is controversial, but they are assumed to play a major role in compromising dental arch space. Aim To evaluate the relationship among impaction, agenesis and crowding in black South African males. Subjects and method Mandibles and maxillae of 535 black South African males in the Raymond A. Dart Collection of Human Skeletons, University of the Witwatersrand were examined for anterior crowding and third molar agenesis and impaction. Dental crowding was determined using Little's irregularity index. Results Individuals with impaction showed more moderate-to-extreme crowding than those with agenesis. Bilateral third molar presence was more frequently associated with ideal-to-minimal crowding. Weak positive but significant correlations between crowding and impaction were found (mandible, ρ = 0.154, p = 0.000; maxilla ρ = 0.130, p = 0.000). The direction was the opposite for bilateral presence of molars (mandible, ρ = -0.135, p = 0.02; maxilla, ρ = -0.111, p = 0.010). Odds of mandibular crowding were greatest in individuals with impaction (OR = 3.22, CI = 1.716-6.05, p < 0.001). Maxillary results were similar. Conclusion Third molar impaction plays a role in anterior crowding. Third molar presence was not associated with anterior crowding, while agenesis did not explain absence of crowding.

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AIM: To evaluate the associated weight loss of extracted teeth after immersed in cough syrups for a period of time so as to predict the erosive potential of the liquid medicines. MATERIAL AND METHODS: pHs of the medicines were measured at the start of the study. 25 extracted test teeth were weighed to 0.01 mg and assigned at random to each syrup under evaluation. The test medicines were placed in 10 mL screw-cap plastic containers and the test teeth were weighed after 7 days. RESULTS: 88 % of the medicines caused reduction in weights of the test teeth after seven days of immersion. Weight loss of the test teeth also noticed with basic syrups. Also lowest pH syrup did not produce the greatest weight loss. CONCLUSION: Majority of the cough syrups caused loss of weight of the test teeth. Thus, they possess the potential to cause dental erosion.

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This study measured the mean age, duration, and sequence of the emergence of permanent dentition in Nigerian children and compared the findings with other population groups. The cross-sectional study involved 1,078 Nigerian children, aged 4-16 years old, from selected primary and secondary schools in the Ife Central local government area in Ile-Ife, Osun State. In general, compared to boys, girls had an earlier mean age of emergence of all the permanent teeth. Children from high socioeconomic class had an earlier mean age of emergence for the maxillary incisors (6.43 and 7.58 years) and mandibular incisors (5.28 and 6.44 years) compared to children from middle and low socioeconomic classes, although socioeconomic effects were more mixed for premolars and molars. Compared to their counterparts in the USA, Australia, Belgium, and Iran, Nigerian children showed an earlier mean age of emergence of all the permanent teeth studied except for Pakistani boys, who had an earlier mean age of emergence of the maxillary premolars and second molar. Poorer economic status has been associated with delayed dental development; however, when compared to other populations, the Nigerian children in this study have earlier mean emergence ages than children from wealthier countries such as the USA and Australia.

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PURPOSE: To identify the barriers to restorative care as perceived by dentists working in urban and semi-urban dental hospitals in Nigeria. MATERIALS AND METHODS: The study was cross sectional and the sample consisted of 189 of 280 dentists who consented to, filled out and returned the questionnaire mailed to them. The questionnaire consisted of fifteen itemed statements and the respondents were asked to what extent they agreed or disagreed with each item on a four-point Likert scale; 'not at all', 'slight extent', 'some extent' and 'great extent'. Five barrier factors were extracted from the questionnaire. These were 'beliefs of patients', 'knowledge of patients', 'equipment/materials', 'attitude' and 'motivation of practitioner'. Two questions were not grouped with the barrier factors: 'dentistry is being looked down on by administration' and 'patients prefer extraction to filling'. RESULTS: The barrier factor 'attitude of patients' had the highest score (mean = 3.73), followed by the 'knowledge of patients' (mean = 3.27). The barrier factor 'belief of patients' had the lowest score (mean = 2.43). CONCLUSION: Within the limitations of the study, the barrier factor 'attitude of patients' was the most important barrier to restorative care as perceived by dentists working in urban and semi-urban regions of Nigeria.

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PURPOSE: Oral health problems have been increasingly recognized as important factors causing a negative impact on daily performance and quality of life. The purpose of this study was to assess the impact of tooth extraction with no replacement, untreated fractured anterior teeth, malocclusion, dental restorations, and orthodontic braces on the quality of life in Nigerian schoolchildren. METHODS: A total of 197 9- to 17-year-old schoolchildren completed the Oral Health Impact Profile (OHIP) index/questionnaire. RESULTS: Students who had tooth extraction with no replacement and untreated fractured incisors had significantly higher mean OHIP scores for functional limitations, physical pain, psychological discomfort, physical, psychological, and social disabilities, and handicaps (P<.001) when compared to other groups and the control. The mean OHIP scores of students with features of malocclusion were significantly higher for functional limitations, psychological discomfort, and psychological disability compared to the control group (P<.001). CONCLUSIONS: Untreated dental problems had some negative impact on the quality of life on the 7 subscales of the OHIP.

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PURPOSE: To determine the perceptions/beliefs and related practices of child healthcare workers regarding teething problems in Ile-Ife, Nigeria. MATERIALS AND METHODS: This cross-sectional study consisted of 103 out of 140 child healthcare workers at the Obafemi Awolowo University Teaching Hospitals Complex who responded to a structured self-administered questionnaire. The child healthcare workers comprised dentists, paediatricians, community health physicians, pharmacists and community health nurses. The data were analysed using STATA (Intercooled release 9) for Windows. RESULTS: A total of 77 (74.8%) child healthcare workers believed in systemic signs and symptoms of teething in children. A majority of the dentists (79.3%) and pharmacists (96.2%) believed in teething problems. None of them based their belief on evidence-based scientific principles, but instead on personal experience (36.4%), books (26%), local myths (20.8%) and school/workshop (16.8%). Fever (18.2%) and diarrhoea (15.6%) were the most prevalent symptoms and signs believed to be associated with teething. Fifty-seven of the child healthcare workers routinely prescribed various drugs for teething problems. The most prescribed drugs were paracetamol (70.2%), antibiotics (14.0%) and teething mixture (7.0%). CONCLUSIONS: Most child healthcare workers in the study believed in teething problems and the beliefs were not based on evidence. They also prescribed various drugs for teething problems.

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PURPOSE: To review major mechanisms of dentine hypersensitivity and the treatment approaches offered. MATERIALS AND METHODS: Medline was used to find relevant literature published up to December 2006. Based on abstracts and full articles, studies (in human and in animals) were identified describing mechanisms and management of dentine hypersensitivity. Additional information was also obtained by using manual library search for relevant topics in standard texts and journals of dentistry. RESULTS: Discussion about the sensitivity of dentine started over a century ago, but it was not until sixty years later that a possible theory was posited. The so-called hydrodynamic theory became popular and was applied to understand the mechanism responsible for hypersensitive dentine. Nevertheless, because of the discrepancies in the pattern by which the dentine responds to various stimuli, several theories of dentine hypersensitivity were proposed which include the hydrodynamic theory, odontoblast transducer mechanism and direct innervation theory. None of these mechanisms was said to fully explain dentine hypersensitivity, thus indicating that as-yet unexplained mechanisms were possibly responsible. A multitude of products were tried and reported to be effective. The efficacy of many was not clearly established and their mechanisms of action were inadequately elucidated. The potential of gene therapy to reduce the burden of dentine hypersensitivity in the future is being examined. CONCLUSIONS: Considerable effort has been made to precisely explain dentine hypersensitivity, but doubt still exists whether any one theory can be applied to understanding this condition. This has led to a constant increase in therapeutic approaches worldwide, but with no conclusive evidence of reliable, successful treatment regimens.

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AIM: The aim of this study was to identify the causes and patterns of tooth loss among Nigerian adults. BACKGROUND: Tooth loss continues to be a major problem in clinical dentistry and has received significant attention in everyday dental practice. In Nigeria there is a discernible lack of current data that would explain the reasons and patterns of tooth loss from its different geopolitical zones. METHODS AND MATERIALS: The reasons for tooth extractions during a period of 12 months were obtained from the hospital records of teaching and specialist hospitals in Nigeria's six geopolitical zones and the Federal Capital Territory (FCT). Data were analyzed using Statistical Package for the Social Sciences for Windows (SPSS) version 9.0. RESULTS: A total of 4,204 teeth were extracted from 3,431 patients. Of these teeth 52.4 percent were lost due to dental caries while 30.2 percent were removed because of periodontal disease, 5.0 percent were missing as a result of trauma, and 3.9 percent were impacted and required extraction. The remaining 8.5 percent were extracted for a variety of reasons such as orthodontic treatment, overeruption, neoplasms, supernumerary teeth, attrition, a cystic lesion, and hypoplasia. Dental caries was the most common diagnosis given for tooth loss in the South-South (79 percent), South-East (68 percent), North-East (47 percent), North-West (69 percent), and North-Central (35 percent) zones followed by periodontal disease. In contrast, periodontal disease was the most common cause of tooth loss in the South-West zone (65 percent) and in the FCT (55 percent), followed by dental caries at 22 percent and 33 percent, respectively. CONCLUSION: Although teeth were extracted based on a variety of diagnoses, dental caries was identified as the common reason cited for tooth loss in Nigeria and to a lesser extent periodontal disease. Also different reasons were given for tooth loss among the various geographical zones. CLINICAL SIGNIFICANCE: Tooth loss among Nigerians was attributed largely to dental caries and secondarily to periodontal disease. Both conditions can be prevented if diagnosed early enough and treatment is instituted in a timely manner.

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AIM: To determine signs and symptoms associated with teething, parental beliefs about teething, and the effects of socioeconomic status on teething in Nigerian children. METHODS AND MATERIALS: A cross-sectional study consisting of 1,013 mothers of children between the ages four to 36 months who visited the immunization clinics at the Community Health Centres in Ife Central and Ife East Local Government Areas. Data was analyzed using STATA (Intercooled release 9) for Windows. RESULTS: A total of 765 mothers (75.5%) reported systemic signs and symptoms in their children. Fever (51.8%), diarrhea (12.5%), and vomiting (2.9%) were the most prevalent symptoms and signs reported. Teething problems were reported by 60% of mothers from a high socioeconomic class, as well as 76.7% and 77.9% from middle and low socioeconomic classes, respectively. Interestingly, 65.5% of mothers believed teething should be accompanied with systemic signs and symptoms such as fever (42.1%), diarrhea (13.9%), and vomiting (0.6%). No significant difference was noted between breastfeeding status, gender of the child, and reported systemic signs and symptoms noticed by the mothers. CONCLUSION: Most mothers in the study reported signs and symptoms adduced to teething in their children irrespective of their beliefs. Fever ranked highest of the signs and symptoms reported. Mothers of children from the high socioeconomic class reported fewer teething symptoms. Breastfeeding status and gender of the child had no effect on teething problems in the children studied. CLINICAL SIGNIFICANCE: Most signs and symptoms adduced to teething by parents may actually be due to underlying infections. Thus, there is a need to rule out occult infection during the tooth eruption period.

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The socio-demographic and anthropometric variables could influence the number of teeth present in the child's mouth. To determine the effect of anthropometric and socio-demographic variables on the number of erupted primary teeth, a cross-sectional study was performed involving 1013 children aged between 4 and 36 months who attended the immunization clinics in Ile-Ife, Nigeria. Statistical analyses were performed using STATA. The analyses included frequencies, cross-tabulations, chi squared test and t-test. The number of erupted teeth was modelled as the dependent variable in a multiple regression (Binomial) model, and the socio-demographic (age, gender and socio-economic status) and anthropometric variables, such as weight and height at presentation, as predictor variables. Statistical significance was inferred at P < 0.05. The age and height at presentation had significant association with the number of erupted teeth in this study population (P < 0.001). Also children from high socio-economic class in relation to low socio-economic class had significant larger number of erupted teeth in this study population (P < 0.001). The age and height of the child at presentation were significantly related to the number of erupted teeth. Also children from high socio-economic class had significant lager number of erupted teeth compared with children from low socio-economic class.

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