Department of Child Dental Health- Journal Articles
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- ItemOpen AccessCommunity Inclusion in PrEP Demonstration Projects: Lessons for Scaling Up.(plos one, 0201) Reza-Paul, Sushena; Lazarus, Lisa; Jana, Smarajit; Ray, Protim; Mugo, Nelly; Ngure, Kenneth; Folayan, Morenike Oluwatoyin; Durueke, Florita; Idoko, John; Béhanzin, Luc; Alary, Michel; Gueye, Daouda; Sarr, Moussa; Mukoma, Wanjiru; Kyongo, Jordan K; Bothma, Rutendo; Eakle, Robyn; Dallabetta, Gina; Presley, Josie; Lorway, RobertPre-exposure prophylaxis (PrEP) has emerged as a new HIV prevention strategy. A series of demonstration projects were conducted to explore the use of PrEP outside of clinical trial settings. Learning from the failures in community consultation and involvement in early oral tenofovir trials, these PrEP projects worked to better engage communities and create spaces for community involvement in the planning and roll out of these projects. We describe the community engagement strategies employed by seven Bill & Melinda Gates Foundation-funded PrEP demonstration projects. Community engagement has emerged as a critical factor for education, demand generation, dispelling rumors, and supporting adherence and follow up in the PrEP demonstration project case studies. The increasing global interest in PrEP necessitates understanding how to conduct community engagement for PrEP implementation in different settings as part of combination HIV prevention.
- ItemOpen AccessRe: Pre-Exposure Prophylaxis for Mitigating Risk of HIV Transmission During HIV Cure– Related Clinical Trials With a Treatment Interruption(Oxford University Press, 0201) Morenike Oluwatoyin Folayan; Bridget Haire; Veronica Noseda
- ItemOpen AccessCommentary(Frontiers in oral health, 0202) Singhal, Sonica; Farmer, Julie; Quiñonez, CarlosA newly identified pneumonia outbreak was first reported in China in December 2019. This was caused by a highly infectious pathogen named the severe acute respiratory coronavirus 2 (SARCoV-2). It has caused the global pandemic, coronavirus disease 2019 (COVID-19), which has affected 1% of the global population (79,231,893 cumulative cases up to 27 December 2020) and disrupted the world’s usual socioeconomic daily activities [1]. As a result, managing and solving the COVID-19 crisis is currently a top government priority around the world.
- ItemOpen AccessChanges in the prevalence of dental caries in primary school children in Lagos State, Nigeria.(Original Article, 2014) Sofola, O O; Folayan, M O; Oginni, A BObjectives: To evaluate the changes in the prevalence of dental caries in Lagos State over a 3 years period and the role of age, sex, and playing in the changes observed. Materials and Methods: Three primary schools in Lagos State, Nigeria were randomly selected for the study. Six hundred and thirty‑three children age 2-12 years, were examined for caries in 2000 while 513 children were examined in 2003. The prevalence of tooth decay and the prevalence of untreated tooth decay were calculated for the two years, that is, 2000 and 2003. Also the degree of unmet treatment need among the population with caries experience was measured. Differences in the prevalence and severity of dental caries in the primary and permanent dentition were assessed. Results: Approximately 18% of children had untreated tooth decay in their primary dentition in 2003: A 26.1% increase from 2000. About 12.0% of the decay, extracted, and filled teeth (deft) index was seen with decayed teeth in 2000 and 16.6% in 2003. Extracted primary teeth decreased from 2.5% in 2000 to 1.5% in 2003. The change in mean deft between 2000 (0.42) and 2003 (0.47) was 11.9%. Over the study period, the overall reduction in the prevalence of dental caries was 34.8% in the permanent dentition. The decline was larger among children aged 5-9 years (62.1%) and among females (75%). Conclusion: The study showed no overall changes in caries severity but a decrease in caries prevalence in the permanent dentition over the study period. The largest decline in caries prevalence in the permanent dentition was observed in children aged 5-9 years and females. On the contrary, there was an increase in the caries prevalence in the primary dentition.
- ItemOpen AccessAddressing the socio-development needs of adolescents living with HIV/AIDS in Nigeria : a call for action(African Journal of Reproductive Health, 2014) Morenike O. Folayan; Morolake Odetoyinbo; Brandon Brown; Abigail Harrison AffiliationsThe widespread use of antiretroviral therapy and remarkable success in the treatment of paediatric HIV infection has changed the face of the Human Immunodeficiency Virus (HIV) epidemic in children from a fatal disease to that of a chronic illness. Many children living with HIV are surviving into adolescence. This sub-population of people living with HIV is emerging as a public health challenge and burden in terms of healthcare management and service utilization than previously anticipated. This article provides an overview of the socio-developmental challenges facing adolescents living with HIV especially in a resource-limited setting like Nigeria. These include concerns about their healthy sexuality, safer sex and transition to adulthood, disclosure of their status and potential stigma, challenges faced with daily living, access and adherence to treatment, access to care and support, and clinic transition. Other issues include reality of death and implications for fertility intentions, mental health concerns and neurocognitive development. Coping strategies and needed support for adolescents living with HIV are also discussed, and the implications for policy formulation and programme design and implementation in Nigeria are highlighted. L'utilisation généralisée de la thérapie antirétrovirale et des succès remarquables dans le traitement de l'infection du VIH chez les enfants a changé le visage de l'épidémie du virus d'immunodéficience humaine (VIH) chez les enfants d'une maladie mortelle ? celui d'une maladie chronique. Beaucoup d'enfants vivant avec le VIH survivent ? l'adolescence. Cette sous-population de personnes vivant avec le VIH est en train de devenir un problème de santé publique et de la charge en termes de gestion des soins de santé et l'utilisation des services que prévu avant. Cet article donne un aperçu des défis du développement social auxquels sont confrontés les adolescents vivant avec le VIH en particulier dans un contexte de ressources limitées comme le Nigeria. Il s'agit notamment des préoccupations concernant leur santé sexuelle, les rapports sexuels protégés et le passage ? l'âge adulte, la divulgation de leur statut et de la stigmatisation potentielle, les défis rencontrés dans la vie quotidienne, l'accès au traitement et l'observance du traitement, l'accès aux soins et au soutien, et la transition de la clinique. D'autres questions comprennent la réalité de la mort et des implications pour les intentions de la fécondité, des problèmes de santé mentale et le développement neurocognitif. Les stratégies d'adaptation et le soutien nécessaire pour les adolescents vivant avec le VIH sont également discutés, et les implications pour la formulation des politiques et de la conception des programmes et la mise en oeuvre au Nigeria sont mis en évidence.
- ItemOpen AccessAddressing Ebola-related Stigma(Global Health Action, 2014) Mariam Davtyan; Brandon Brown; Morenike Oluwatoyin FolayanBackground HIV/AIDS and Ebola Virus Disease (EVD) are contemporary epidemics associated with significant social stigma in which communities affected suffer from social rejection, violence, and diminished quality of life. Objective To compare and contrast stigma related to HIV/AIDS and EVD, and strategically think how lessons learned from HIV stigma can be applied to the current EVD epidemic. Methods To identify relevant articles about HIV/AIDS and EVD-related stigma, we conducted an extensive literature review using multiple search engines. PubMed was used to search for relevant peer-reviewed journal articles and Google for online sources. We also consulted the websites of the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and the National Institutes of Health to retrieve up-to-date information about EVD and HIV/AIDS. Results Many stigmatizing attitudes and behaviors directed towards those with EVD are strikingly similar to those with HIV/AIDS but there are significant differences worthy of discussion. Both diseases are life-threatening and there is no medical cure. Additionally misinformation about affected groups and modes of transmission runs rampant. Unlike in persons with EVD, historically criminalized and marginalized populations carry a disproportionately higher risk for HIV infection. Moreover, mortality due to EVD occurs within a shorter time span as compared to HIV/AIDS.
- ItemOpen AccessThe prevalence, pattern and clinical presentation of developmental dental hard-tissue anomalies in children with primary and mix dentition from Ile-Ife, Nigeria.(BMC Oral Health., 2014-10-16T00:00:00Z) Temilola, Dada Oluwaseyi; Folayan, Morenike Oluwatoyin; Fatusi, Olawunmi; Chukwumah, Nneka Maureen; Onyejaka, Nneka; Oziegbe, Elizabeth; Oyedele, Titus; Kolawole, Kikelomo Adebanke; Agbaje, HakeemThe study of dental anomalies is important because it generates information that is important for both the anthropological and clinical management of patients. The objective of this study is to determine the prevalence and pattern of presentation of dental hard-tissue developmental anomalies in the mix dentition of children residing in Ile-Ife, a suburban region of Nigeria.
- ItemOpen AccessPossible Risk factors in the occurrence of Molar-Incisor Hypomineralization among a group of Nigerian Monozygotic Twins(Babcock University Medical Journal (BUMJ), 2015-06) TA Oyedele; MO Folayan; EO OziegbeObjective Molar Incisor Hypomineralisation (MIH) is systemic in origin, and affects one to four permanent rst molars. It frequently affects the incisors also. Its aetiology remains unknown, with some evidence suggesting association with childhood diseases during the rst four years of life, the use of antibiotics (amoxicillin, a macrolide), and exposure to dioxins. This report is documented to highlight the possible risk factors for MIH in four sets of monozygotic twins. Methods A case series consisting of four related case reports. Results Identied. This ranged from prolonged use of antibiotics, to early childhood illnesses, prenatal maternal ill health, and long duration of breast feeding. The possibility of genes in the aetiology of MIH is further strengthened by the observation in this study, that all the monozygotic twin pairs identied with MIH during public oral health screening exercises, had the lesion. Conclusion The aetiology of MIH may be due to early childhood illnesses and the use of amoxicillin. Also, the possible role of genetic disposition needs to be further investigated.
- ItemOpen AccessEthics, emergencies and Ebola clinical trials: the role of governments and communities in offshored research.(Pan African Medical Journal, 2015-10-10) Folayan, Morenike Oluwatoyin; Peterson, Kristin; Kombe, FrancesThe Ebola Virus Disease (EVD) in West Africa has stimulated investments in EVD research. While these research efforts are most welcome, we are concerned about the potential to ignore effective community ethics engagement programmes and critical government regulatory agencies in light of the urgency to conduct clinical trials for EVD therapies and vaccines. We discuss the reasons why community engagement with various research stakeholders is essential, how community engagement should be conducted, and the potential consequences of failing to engage both communities and regulatory agencies by drawing on past experiences in the field of HIV research. We highlight the importance of a) capacity building to enable local researchers design and implement EVD research for future epidemics, b) the need to support community research literacy, and c) the need to build the competency of research regulatory agencies on the continent to address EVD therapy and vaccine research.
- ItemOpen AccessDebating Ethics in HIV Research: Gaps between Policy and Practice in Nigeria.(Developing world, 2015-12-01T00:00:00Z) Folayan, Morenike Oluwatoyin; Peterson, Kristin; Haire, Bridget; Brown, Brandon; Audu, Kadiri; Makanjuola, Olumide; Pelemo, Babatunde; Marsh, VickiHIV prevention is a critical health issue in Nigeria; a country that has one of the worst HIV epidemic profiles in the world. With 270,000 new infections in 2012, Nigeria is a prime site for HIV prevention research. One effect of the HIV epidemic has been to revolutionalise ethical norms for the conduct of research: it is now considered unethical to design and implement HIV related studies without community engagement. Unfortunately, there is very little commensurate effort in building the capacity of local persons to engage actively with researchers, and there is no existing platform to facilitate dialogue between researchers and communities engaged in research in Nigeria. In an effort to address this gap, we undertook a series of three community dialogues (Phase One) and two community-researcher interface meetings (Phase Two) in Nigeria. This paper aims to give an empirical account of the dialogue from these community engagement processes and provide a resulting critique of the implementation of research ethics practices in Nigeria. It is anticipated that the outputs will: (i) support researchers in designing community-based research protocols; (ii) inform ethics committees of key considerations during research protocol reviews from a community perspective; and (iii) inform policy makers and research sponsors about issues of primary concern to communities with respect to HIV research.
- ItemOpen AccessAssociations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria.(PLOS ONE, 2016) Folayan, Morenike Oluwatoyin; Harrison, Abigail; Brown, Brandon; Odetoyinbo, Morolake; Stockman, Jamila K; Ajuwon, Ademola J; Cáceres, Carlos FSome individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status. We analyzed data from 436 sexually active 10-19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman's conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies. Eighty-one adolescents (18.6%) reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14-11.87), and transactional sex (OR: 2.80; 95% CI: 1.56-4.95). Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96-1.11) and loss and grief (OR: 1.34; 95% CI: 0.73-2.65), but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34-1.18). They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62-3.50) than avoidance responses (OR: 0.90; 95% CI: 0.49-1.64) to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03) and loss and grief (p = 0.009). Adolescents reporting forced sexual initiation and HIV-negative status were significantly less likely to use religion as a coping strategy (OR: 0.28; 95% CI: 0.09-0.83). History of forced sexual initiation and HIV status affected perception of events as stressors and use of specific coping strategies. Our study findings could inform best practice interventions and policies to prevent and address forced sexual initiation among adolescents in Nigeria and other countries.
- ItemOpen AccessPrevalence and family structures related factors associated with crown trauma in school children resident in suburban Nigeria.(BMC Oral Health, 2016-11-05T00:00:00Z) Oyedele, T A; Jegede, A T; Folayan, M OMultiple risk factors have been identified for traumatic dental injuries, including crown fractures, in various age groups and various populations. The objective of this study was to determine the prevalence, risk factors and family related factors for crown trauma among 8 to 16 year-old children in a suburban population, Nigeria.
- ItemOpen AccessHIV/AIDS: The Nigerian Response(Taylor and Francis group, 2017) Morenike FolayanThis chapter reviews the emerging governance structure in Nigeria, with specific focus on governmental strategies. Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS), has been increasing steadily in Nigeria since 1987. The Government of Nigeria established an AIDS/STDs control programme (NASCP) with assistance for its first medium term plan (MTPI) from the World Health Organisation (WHO) Global Programme on AIDS, as early as 1987. In June 2001, the number of reported AIDS cases stood at 60,564. The determinants of the HIV/AIDS epidemic are similar to those witnessed throughout the sub-Saharan region. The non-governmental organisations (NGOs) primarily involved in HIV/AIDS prevention and control in the country mainly draw upon resources from international donor agencies, and especially did so during the military era. Nigeria is beneficiary of the decision by leading Western pharmaceuticals to drop their law suit against the South African government which insisted it had a right to produce or buy cheaper generic versions of their anti-HIV/AIDS drugs.
- ItemOpen AccessA radiographic study of the mandibular third molar root development in different ethnic groups.(Journal of Forensic Odonto-Stomatology, 2017-12-01T00:00:00Z) Liversidge, H M; Peariasamy, K; Folayan, M O; Adeniyi, A O; Ngom, P I; Mikami, Y; Shimada, Y; Kuroe, K; Tvete, I F; Kvaal, S IBACKGROUND The nature of differences in the timing of tooth formation between ethnic groups is important when estimating age. AIM To calculate age of transition of the mandibular third (M3) molar tooth stages from archived dental radiographs from sub-Saharan Africa, Malaysia, Japan and two groups from London UK (Whites and Bangladeshi). MATERIALS AND METHODS The number of radiographs was 4555 (2028 males, 2527 females) with an age range 10-25 years. The left M3 was staged into Moorrees stages. A probit model was fitted to calculate mean ages for transitions between stages for males and females and each ethnic group separately. The estimated age distributions given each M3 stage was calculated. To assess differences in timing of M3 between ethnic groups, three models were proposed: a separate model for each ethnic group, a joint model and a third model combining some aspects across groups. The best model fit was tested using Bayesian and Akaikes information criteria (BIC and AIC) and log likelihood ratio test. RESULTS Differences in mean ages of M3 root stages were found between ethnic groups, however all groups showed large standard deviation values. The AIC and log likelihood ratio test indicated that a separate model for each ethnic group was best. Small differences were also noted between timing of M3 between males and females, with the exception of the Malaysian group. These findings suggests that features of a reference data set (wide age range and uniform age distribution) and a Bayesian statistical approach are more important than population specific convenience samples to estimate age of an individual using M3. CONCLUSION Some group differences were evident in M3 timing, however, this has some impact on the confidence interval of estimated age in females and little impact in males because of the large variation in age.
- ItemOpen AccessTime expended on managing molar incisor hypomineralization in a pediatric dental clinic in Nigeria(Brazilian Oral Research, 2018) TA Oyedele; MO Folayan; E OziegbeThis study assessed the difference in the number of visits made to a dental care clinic and the time spent providing specific dental treatment for children with and without molar incisor hypomineralization (MIH). Children aged 8 to 16 years who presented at the Pediatric Dental Unit of the Obafemi Awolowo University Teaching Hospital Complex, in Ile-Ife, Nigeria, were eligible for the study. A comprehensive medical and dental history was taken, and each child was clinically examined, diagnosed, and treated according to a drawn-up plan. The time taken to establish a diagnosis and to provide specific treatments (scaling and polishing, restoration, pulpectomy, extraction, and placement of stainless steel crowns) and the number of visits made to complete the treatment plan were recorded for each child. Differences in the number of visits, time expended to make a diagnosis and to treat children with and without MIH were analyzed. The average time for diagnosis (p = 0.001) and the average time for placing amalgam restorations (p = 0.008) were significantly longer in children with MIH than in those without it. Children with MIH made more visits to the clinic (p < 0.001).There was no significant difference in the average time for scaling and polishing (p = 0.08), glass ionomer cement restorations (p = 0.99), composite restorations (p = 0.26), pulpectomy (p = 0.42), tooth extraction (p = 0.06), and placement of a stainless steel crown (p = 0.83) in children with and without MIH. In conclusion, children with MIH required more time for oral health care. Placing amalgam restorations took significantly longer than placing tooth bonding restorative materials in children with MIH than in those without it.
- ItemOpen AccessGeneral anxiety, dental anxiety, digit sucking, caries and oral hygiene status of children resident in a semi-urban population in Nigeria(Springer Nature, 2018-04-20) Morenike O. Folayan; Kikelomo A. Kolawole; Nneka K. Onyejaka; Hakeem O. Agbaje; Nneka M. Chukwumah; Titus A. OyedeleDigit sucking can represent untreated anxiety or other emotional problems. The aim of this study was to determine if digit sucking is a predictor of general anxiety and dental anxiety; and if general and dental anxiety are associated with caries and oral hygiene status of children resident in sub-urban Nigeria.
- ItemOpen AccessAssociation between malocclusion, caries and oral hygiene in children 6 to 12 years old resident in suburban Nigeria(BMC Oral Health, 2019) Kikelomo Adebanke Kolawole; Morenike Oluwatoyin FolayanBackground: There are conflicting opinions about the contribution of malocclusions to the development of dental caries and periodontal disease. This study’s aim was to determine the association between specific malocclusion traits, caries, oral hygiene and periodontal health for children 6 to 12 years old. Methods: The study was a household survey. The presence of malocclusion traits was assessed in 495 participants. The caries status and severity were assessed with the decayed, missing, and filled teeth (dmft/DMFT) index and the pulpal involvement, ulceration, fistula and abscess (pufa/PUFA) index. The Simplified Oral Hygiene Index (OHI-S) and Gingival Index (GI) were used to assess periodontal health. The association between malocclusion traits, the presence of caries, poor oral hygiene, and poor gingival health were determined with chi square and logistic regression analyses. Statistical significance was inferred at p < 0.05. Results: Seventy-four (14.9%) study participants had caries, with mean (SD) dmft/DMFT scores of 0.27 (0.82) and 0.07 (0.39), respectively, and mean (SD) pufa/PUFA index scores of 0.09 (0.43) and 0.02 (0.20), respectively. The mean (SD) OHI-S score was 1.56 (0.74) and mean (SD) GI score was 0.90 (0.43). Dental Aesthetic Index scores ranged from 13 to 48 with a mean (SD) score of 20.7 (4.57). Significantly greater proportions of participants with crowding (p = 0.026) and buccal crossbite (p = 0.009) had caries. Significantly more children with increased overjet (p = 0.003) and anterior open bite (p = 0.008) had moderate to severe gingivitis. Poor oral hygiene (OR: 1.83; CI: 1.05–3.18 p = 0.033), crowding (OR: 1.97; CI: 1.01–3.49; p = 0.021) and buccal crossbite (OR: 6.57; CI: 1.51–28.51 p = 0.012) significantly increased the odds of having caries. Poor oral hygiene (p < 0.001), increased overjet (p = 0.003), and anterior open bite (p = 0.014) were the only significant traits associated with gingivitis.
- ItemOpen AccessCommunity stakeholder engagement during a vaccine demonstration project in Nigeria: lessons on implementation of the good participatory practice guidelines.(Pan African Medical Journal, 2019) Folayan, Morenike Oluwatoyin; Durueke, Florita; Gofwen, Wika; Godo-Odemijie, Godwin; Okonkwo, Chuks; Nanmak, Bali; Osawe, Sophia; Okporoko, Evaezi; Abimiku, Alash'leTo report on the successes and challenges with implementing the good participatory practice guidelines for the Nigerian Canadian Collaboration on AIDS Vaccine (NICCAV) project. An open and close ended questionnaire was administered to 25 randomly selected community stakeholders on the project. The questions sought information on perception about the community entry, constitution and function of the community advisory board (CAB) and community based organization (CBO), media engagement process, and research literacy programmes. The quantitative and qualitative data were analysed and findings triangulated. The project exceeded its targets on CBO engagement and community members reached. Stakeholders had significant improvement in knowledge about HIV vaccine research design and implementation (p=0.004). All respondents felt satisfied with the community entry, CAB constitution process, function and level of media engagement; 40% were satisfied with the financial support provided; 70% felt the community awareness and education coverage was satisfactory; and 40% raised concerns about the study site selection with implications for study participants' recruitment. The NICCAV community stakeholder engagement model produced satisfactory outcomes for both researchers and community stakeholders. The inclusion of an advocacy and monitoring plan enabled it to identify important challenges that were of ethical concerns for the study.
- ItemOpen AccessChallenges with study procedure fidelity when conducting household survey: reports from the field.(BMC Research Notes, 2019-08-07T00:00:00Z) Folayan, Morenike Oluwatoyin; Alade, Micheal O; Oziegbe, Elizabeth OThe aim of the study was to identify reasons for protocol deviations during conduct of large epidemiological surveys despite training of field workers, validating clinicians, and providing field supervisory support. Enquiries focused on breaches of recruitment procedures, privacy, confidentiality, and informed consent. The case study was a household survey conducted in Ile-Ife, Nigeria.
- ItemOpen AccessA proposed one-stop-shop approach for the delivery of integrated oral, mental, sexual and reproductive care to adolescents in Nigeria(Pan African Medical Journal, 2020) Morenike Oluwatoyin Folayan; Nadia Adjoa Sam-Agudu; Abiola Adeniyi; Elizabeth Oziegbe; Nneka Maureen Chukwumah; Boladale MapayiThe interconnectedness of oral, mental, sexual, and reproductive health (OMSRH) in adolescents prompts exploration of novel approaches to facilitate comprehensive access of this population to the relevant health services. This paper proposes an integrated one-stop-shop approach to increasing adolescents' access to OMSRH care by leveraging on dental clinics as a template for integration, using a non-stigmatized platform to deliver stigmatized healthcare. Novel healthcare delivery models are needed to enhance adolescents' access to the comprehensive prevention and treatment services that they critically need. Effective, integrated health care for this population is lacking, especially across various health areas. This is a proposal for leveraging dental clinics for integrated OMSRH care, using facility-based services, to adolescents. Emphasis will be placed on reducing stigma as a barrier to service accessibility, acceptability, equitability and appropriateness. Empirical studies will be required to test the feasibility, validity and effectiveness of this proposed model.