Dental education in Nigeria

Undergraduate training of dentists in Nigerian universities officially started at the University of Lagos, in 1964¹⁰. Thereafter, over the years, more and more dental schools have been established. According to the MDCN, there are 8 accredited dental schools in Nigeria¹¹; this implies that Nigeria currently has the capacity to produce over 100 dentists per year. Since the commencement of undergraduate dental training in Nigeria, the academic curriculum of dental education has undergone a series of reviews and modifications^12,13. Undergraduate dental education in Nigeria traditionally takes a minimum of six years and another one year of internship, after which a trained dentist in Nigeria can be fully registered with the MDCN¹³.

It is noteworthy to say that the academic curriculum of dental education in Nigeria is very rich and fortified¹³. However, the curriculum has some deficiencies^9,13; for instance, the curriculum failed to include academic and clinical training on tobacco cessation intervention strategies, for dental students⁹. This curricular deficit is not a universal phenomenon, as some dental schools in other countries, such as Japan, have it included in their own academic curriculum⁸.

Furthermore, in the curriculum for postgraduate clinical training of dentists in Nigeria, there is no clear evidence that clinical training on tobacco cessation intervention strategies exists^9,14. However, based on the author’s experience, the opportunities available for dental students or dentists who are willing to acquire extra-curricular clinical skills on tobacco cessation interventions are few and limited. A common example of these few opportunities is CME programmes, such as workshops, seminars, etc.

Tobacco and dental practice

As a practicing dentist in Nigeria, it is almost practically impossible not to have at least one tobacco user (usually a smoker) among the pool of patients treated at the dental clinic in a week. This is so because: 1) tobacco smoking is a common social practice in LMICs, like Nigeria²; and 2) tobacco is a leading cause of oral diseases⁴.

Since tobacco is a known major risk factor for so many oral diseases⁴, it becomes imperative for dentists to have a vast knowledge on tobacco-related clinical issues that are of relevance to dentistry. However, research has shown that not all Nigerian dentists have a sound knowledge on tobaccorelated clinical topics⁹.

Importantly, a dentist may be the first healthcare provider to detect early complications of tobacco use in a patient. Hence, it is of huge clinical and public health benefit if dentists can play decisive roles in tobacco cessation interventions, since scientific evidence has shown that clinical interventions offered by dentists, in a dental setting, increase the likelihood of a tobacco smoker to quit tobacco use¹⁵.

The situation of dentists’ role in tobacco cessation intervention in Nigeria

Raw tobacco is a nicotine-containing addictive psychoactive substance. Also, all products made from raw tobacco (such as snus, khaini, cigar, bidis, kreteks, cigarettes, shisha, and pipe) contain nicotine^16,17.

Chronic consumption of tobacco and tobacco-products can cause nicotine addiction – tobacco nicotine dependence^3,18. Fortunately, many tobacco users are willing to quit its use¹⁹.

There are two major strategic protocols developed to clinically manage tobacco nicotine dependency in patients^3,19,20: 1) clinical counselling therapy; and 2) NRT. The former involves non-pharmacological management of tobacco using patients while the latter involves the use of drugs in such management^3,19,20.

Tobacco causes damage to the mouth⁴ – the primary jurisdiction of the dentist. Hence, a dental patient deserves to benefit from tobacco cessation intervention in order to have better oral health outcomes^4-7. Based on the available evidence, dentists in Nigeria are playing very little or no role in supporting tobacco smoking dental patients to quit tobacco use. Research has shown that Nigerian dentists have inadequate knowledge on tobacco cessation strategies^9,14.

Ways forward

The Nigerian dentist occupies a very influential position in patient care; in fact, they are one of the first-line healthcare practitioners sought for care, especially at the community level. Also, dentists can play an effective role in the creation of tobacco-free individuals, through their participation in counselling their patients to quit^9,14,20.