title: PERIODONTAL SYSTEMIC INTERACTION: PERCEPTION, ATTITUDES AND PRACTICES AMONG MEDICAL DOCTORS IN NIGERIA.
abstract: BACKGROUND
  Periodontal diseases (PD) impact the outcome of some systemic illnesses. Medical doctors' knowledge and practices regarding this association may influence the effective management of their patients. This has been understudied among Nigerian doctors.
  
  
  OBJECTIVE
  The study aimed to determine the knowledge, attitudes and practices regarding periodontal-systemic disease interactions among medical doctors in Nigeria.
  
  
  METHODS
  This was a descriptive, cross sectional study by design, while the study setting was at the National Postgraduate Medical College of Nigeria (NPMCN), Ijanikin, Lagos. The study participants were senior resident doctors attending compulsory Research Methodology and Management courses organized by the NPMCN in 2014. Self-administered questionnaires were distributed among the participants to obtain information on their socio-demography, PD knowledge, association between PD and systemic illnesses, attitudes to periodontal health and oral hygiene practices questionnaires. Student t test and ANOVA were used to test associations between variables. The level of significance was set at p < 0.05.
  
  
  RESULTS
  A total of 236 doctors participated in the study with a mean age of 35.8 (± 4.5) years, males being predominant (62.7%). Few doctors (42.1%) knew dental plaque as the main cause of PD, while 16.5% were aware of gum bleeding as earliest sign. Female doctors displayed better knowledge than males (p= 0.044). Majority were aware of an association between PD and chronic kidney disease (88.6%) and diabetes (86.5%). Knowledge of PD as a risk factor for stroke was 33.1%, poor glycemic control (25.4%), and pre-term low birthweight (14.8%). Most doctors had positive attitudes towards patients' periodontal health, while 33.5% assessed their patients' oral cavity regularly. All the doctors used tooth brush and paste to clean their teeth, while 43.2% cleaned twice daily. Only 16.5% used dental floss frequently and was associated with higher PD knowledge (p<0.001) and higher attitude scores (p=0.005).
  
  
  CONCLUSIONS
  Senior resident doctors in Nigeria have positive attitudes regarding periodontal health. However, poor knowledge of PD and PD as risk factor for some systemic illnesses, coupled with unsatisfactory oral hygiene and dental examination practices are evident among the doctors.
authors.affiliation: Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
authors.forename: K A
authors.initials: KA
authors.lastname: Umeizudike
authors.affiliation: Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
authors.forename: S O
authors.initials: SO
authors.lastname: Iwuala
authors.affiliation: Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
authors.forename: O B
authors.initials: OB
authors.lastname: Ozoh
authors.affiliation: National Postgraduate Medical College of Nigeria (NPMCN) Km 26, Lagos-Badagry Expressway, Ijanikin, Lagos.
authors.forename: O O
authors.initials: OO
authors.lastname: Ekekezie
authors.affiliation: Department of Medicine, Lagos State University Teaching Hospital Ikeja, Lagos, Nigeria.
authors.forename: T I
authors.initials: TI
authors.lastname: Umeizudike
keywords: Doctors; Knowledge; Nigeria; Periodontal Disease; Systemic illness