Risk factors for development of chronic periodontitis in Bulgarian patients (pilot research)

Spatiotemporal trends of disease burden of edentulism from 1990 to 2019: A global, regional, and national analysis

Background

Understanding the spatiotemporal trends in disease burden of edentulism is critical to reducing disease burden of edentulism and deploying medical resources. We assessed the changing patterns of disease burden of edentulism at global, regional, and national levels from 1990 to 2019.

Methods

Data on incident cases, prevalent cases, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of edentulism were extracted from the Global Burden of Disease 2019 Study. We calculated the estimated annual percentage change (EAPC) to quantify spatiotemporal trends in the ASRs of edentulism.

Results

In 2019, the number of prevalent cases and DALYs of edentulism were 35.2 and 9.6 million, and the ASPR and ASDR were 43.12/1,000 and 1.18/1,000, with EAPCs of -0.18 [95% confidence interval (CI): -0.28, -0.09] and -0.16[95% CI: -0.26, -0.07] from 1990 to 2019, respectively. Females and the elderly had a higher burden of edentulism. Although the ASPR, ASDR, and ASIR in the high SDI, high-middle SDI, and middle SDI regions showed a decreasing or stable trend, the absolute disease burdens of edentulism in these regions were still high. Although the absolute disease burdens of low SDI and low-middle SDI were low, their ASPR and ASDR showed an upward trend. In countries with high initial disease burden or high SDI, ASPR, ASDR, and ASIR showed stable or declining trends.

Conclusion

The absolute disease burden due to edentulism was increasing in many countries and regions. Countries should reduce the disease burden caused by edentulism by adopting measures including the prevention and treatment of dental caries and periodontal disease.

Cross Adaptation Quality of Life Questionnaire for Periodontitis Patients (Modified Indonesian Version) in Menopausal Women

Background:

Changes in steroidal sex hormones in peri- and post-menopausal women affect their bodies, including their periodontal tissues. Disorders of periodontal tissues can impact the patient’s quality of life, so a valid instrument in measuring quality of life is needed in order to know how much periodontitis affects the quality of life of sufferers in peri and postmenopausal women.

Objective:

This study aimed to examine the validity and reliability of the quality of life questionnaire for patients with periodontitis (modified Indonesian version).

Methods:

Cross-cultural adaptation was tested in peri- and post-menopausal women aged 45–59 years. The reliability and validity of the questionnaire was examined among 268 women, who lived in Jakarta and were undergoing a periodontal examination to determine periodontitis severity.

Results:

Cronbach’s α coefficients for internal consistency were: 0.929 (questions related to gums) and 0.942 (questions related to teeth); The test-retest reliability was good as determined based on a test–repeat test involving 27 women; the interclass coefficient was 0.880 (questions related to gums) and 0.878 (questions related to teeth). The construct validity of the questionnaire (questions related to gums and teeth) showed that the questionnaire was significantly associated with oral health and food taste (P<0.001). The discriminant validity of the questionnaire, the influence of the gums on speaking difficulties (P=0.011) and family life (P=0.025) and the influence of the teeth on family life (P=0.020) and mood (P=0.019) could enable differentiation of periodontal severity in peri- and post-menopausal women.

Conclusion:

This study confirmed the reliability and validity of the quality of life questionnaire for patients with periodontitis (modified Indonesian version) in peri- and post-menopausal women, therefore this questionnaire can be used to measure the quality of life of periodontitis patients in peri and postmenopause in Indonesia.

Impact of chronic stress on periodontal health

Introduction: Periodontal diseases are caused by pathogenic microorganisms that induce increases in of local and systemic proinflammatory cytokines, resulting in periodontal damage. The onset and evolution of periodontal diseases are influenced by many local and systemic risk factors. Educational objective: In this article, we aim to review the results of the research on the impact of chronic stress on the occurrence, development, and response to periodontal disease treatments and on the pathophysiological mechanisms of periodontal disease. Conclusion: Chronic stress has a negative impact on the occurrence, development, and response to the treatment of periodontal disease via indirect actions on the periodontium. This can result from behavioral changes caused by stress (poor dental hygiene, smoking, etc.) and a direct neuroimmunoendocrinological action related to the consequences (particularly immunological) of the secretion of certain chemicals (e.g., cortisol) induced by the activation of the hypothalamus and the autonomic nervous system in response to stress. These factors necessitate multidisciplinary management (e.g., physician, oral surgeon, and psychologist) of patients to identify subjects with chronic stress and to employ countermeasures to decrease the impact of stress on the periodontium.

Promoting oral health practice among patients with diabetes attending primary health care clinics

The oral public health program for patients with diabetes was initiated by Saudi Arabia Ministry of Health (MoH) based on international quality standard to control the severity of oral disease in patients with diabetes through improving the accessibility of patients to dental clinics in primary health care centers (PHCC). This program intends to deliver oral health care (OHC) for each patient with diabetes at least one visit every six months. However, we found that more than 90% of patients with diabetes that visited prince Mohammed bin Saud PHCC in Riyadh do not get their regular dental check up every six months. We developed a quality improvement project (QIP) using the quality improvement model to activate MoH oral health program for patients with diabetes visiting prince Mohamed bin Saud PHCC.

The aim of our QIP was to increase number of patients with diabetes receiving their regular oral health check up during the PHC visit. The quality team tested two simple improvement ideas. The first idea was having the dentist signature on appointment request. The testing of the first idea led to the second idea, that both physician and dentist should sign the referral form. After running several PDSA cycles to test these interventions ideas, we found the number of patients with diabetes seen in dental clinic had increased dramatically compared with the baseline assessment. We conclude that the idea of signing the referral form by both physician and dentist is a practical and simple strategy to be executed and has a direct impact on the patient clinical flow between clinics.