Determinants of oral pathogen prevalence in North-East Nigeria: a cross-sectional study

Oral diseases remain a major public health problem globally, with limited data available from North-East Nigeria. This study assessed the prevalence of oral pathogens and their risk factors among patients in North-East Nigeria.

A hospital-based cross-sectional study was conducted between March and August 2025, among 300 patients with oral health complaints in selected health facilities. Data were collected using structured questionnaires. Oral swabs were collected, processed and assessed for pathogens using standard microbiological techniques. Statistical analyses were performed using chi-square tests and logistic regression to identify predictors of oral pathogens' colonization, with p < 0.05 considered significant.

Overall, 37.67% of participants were positive for at least one oral pathogen. The most prevalent bacteria detected were Staphylococcus aureus (16.33%) and Streptococcus mutans (12.33%). Candida albicans (4.67%) was only the fungal pathogen detected. Females (22.00%) and urban residents (23.33%) exhibited significantly higher prevalence than males (15.67%) and rural residents (14.34%). Brushing frequency (χ² = 11.74, p < 0.01) and flossing (χ² = 8.31, p = 0.02) were significantly associated with lower prevalence of oral pathogens. Female gender (OR = 5.62; 95% CI: 3.35-9.41; p < 0.01), urban residence (OR = 2.10; 95% CI: 1.26-3.50; p = 0.01), chronic illness (OR = 5.19; 95% CI: 1.01-26.6; p = 0.03), and poor flossing practice (OR = 0.52; 95% CI: 0.30-0.90; p = 0.01) are associated with high odds of oral pathogens detection.

The study revealed a high prevalence of oral pathogens among patients with oral problems in North-East Nigeria, with S. aureus and S. mutans as the predominant isolates. Poor oral hygiene practices, female gender, and area of residence were associated with high risk of the pathogens colonization. Strengthening oral health education, promoting regular tooth brushing and flossing, and improving access to preventive dental services could help in reducing the burden of oral pathogens in the region.