Association between oral health behavior and periodontal disease among Korean adults: The Korea national health and nutrition examination survey

Impact of public health and patient-centered prevention strategies on periodontitis and caries as causes of tooth loss in high-income countries

In high-income countries, the oral health of the population is influenced by public health interventions, widespread use of oral care products, dental practice measures, and the cost of dental treatment. We compiled information on changes of the prevalence of proximal and upstream determinants of periodontitis, caries, and tooth loss over the last three decades to outline their potential effects on changes of oral health during this period. Information was retrieved from repeated cross-sectional studies and from published literature. While both the prevalence of edentulism and the number of missing teeth (from the DMF-T index) decreased, the number of sound teeth as well as the total number of teeth increased. The prevalence of severe periodontitis was unchanged, whereas the prevalence of periodontal health and moderate periodontitis may have increased to a minor extent. Concerning oral health risk factors, the proportion of individuals with tertiary education increased, while smoking prevalence declined. More and more people used oral care products. Whether one reimbursement system worked better than another one in terms of tooth retention could not be elucidated. In tooth retention, population-wide use of fluoridated toothpastes had the greatest impact. To some extent, the higher number of teeth present may be related to the more frequent use of interdental cleaning aids and powered toothbrushes. Since there was no decrease in severe periodontitis in most cohorts, periodontal interventions probably contributed little to improved tooth retention.

Milk Consumption and Its Association with Dental Caries: Gender-Specific Insights from the Korea National Health and Nutrition Examination Survey (2013-2015)

Background and Objectives: This study aims to bridge these gaps by utilizing data from the Korea National Health and Nutrition Examination Survey (2013-2015), examining the nuanced associations between milk consumption's quantity, frequency, and type and the prevalence of dental caries. Materials and Methods: Utilizing data from the Korea National Health and Nutrition Examination Survey (2013-2015), this study explores the association between milk consumption and the prevalence of dental caries in a sample of 4843 subjects (weighted n = 15,581), including 2856 males and 1987 females; weighted sample sizes were 6656 and 8925 for men and women, respectively. The prevalence of dental caries was assessed by evaluating the number of decayed, filled, and missing teeth. Results: The analysis demonstrated a significant positive association between increased milk consumption and the risk of developing dental caries, with an overall odds ratio of 1.653 (95% CI: 1.153-2.370, p < 0.05). The association was more pronounced in females, exhibiting an odds ratio of 1.865 (95% CI: 1.157-3.006, p < 0.05), and age was identified as a significant variable, particularly among participants aged 50 and above. In contrast, the relationship among the male group, though positive (odds ratio: 1.613, 95% CI: 0.991-2.625), was not statistically significant (p = 0.054). Conclusion: These findings suggest that milk consumption may be a potential risk indicator for dental caries, particularly among women, emphasizing the need for targeted dietary recommendations in dental health practices.

The underlying relationship between exercise and the prevalence of periodontitis: a systematic review and meta-analysis

BACKGROUND

Although exercise has been proposed as an effective intervention for various lifestyle-related diseases and pathological scenarios, few researches assessed the impact of taking exercise on the prevalence of periodontitis.

PURPOSE

This study aimed to perform a comprehensive literature review and meta-analysis from both observational and intervention studies to explore the relationship between exercise and periodontitis and to provide references for future intervention programs aimed at preventing periodontitis.

METHOD

A systematic literature search was conducted in PubMed/MEDLINE, Web of Science, Cochrane Library, and Scopus for peer-reviewed studies published in English From January 1993 to January 2023 according to the PRISMA guidelines. Articles were selected if subjects were human and studies evaluating the association between exercise and periodontitis.

RESULTS

4098 references were retrieved. After screening the results, 30 studies were selected. Of these, 20 studies indicated an inverse association between exercise and periodontitis, while the remaining 10 did not reach conclusive findings. The meta-analysis demonstrated a risk ratio of 0.84 (95%CI: 0.77, 0.91) between the active group and the inactive group (P < 0.01), which indicated an inverse relationship between exercise and periodontitis.

CONCLUSION

Overall, the increase in exercise presents an inverse association with the presence and severity of periodontitis. Accordingly, taking exercise might be a potential approach that contributes to improvements in periodontitis.

Bidirectional associations between periodontal disease and systemic diseases: a nationwide population-based study in Korea

To evaluate the associations of periodontal disease (PD) with systemic diseases, including diabetes mellitus (DM) and cardiovascular disease (CVD), as well as the reciprocal association. The CVD included the cases of coronary heart disease and heart failure. A prospective study was conducted from 2007 to 2019 using linked data from three databases in Korea. Three separate study groups were formed to individually determine the risks of PD (n = 10,533), DM (n = 14,523) and CVD (n = 14,315). All diseases were confirmed based on physicians' diagnoses using medical records and self-reports. Cox proportional hazard regression was applied with 95% confidence intervals (CIs) to obtain hazard ratios (HRs). PD was significantly associated with an elevated risk of DM (HR [95% CI]: 1.22 [1.07-1.39]) after full adjustment for age, sex, lifestyle factors, body mass index, dental behaviour and CVD. PD was also found to increase the risk of CVD (1.27 [1.03-1.57]), whereas CVD increased the risk of PD (1.20 [1.09-1.32]) after full adjustment for other covariates including DM. This study found a bidirectional association between PD and CVD, as well as a positive association of PD with DM.

Number of Teeth According to Hand Strength in Adults: A Cross-Sectional Study of 11,499 South Korean Adults

Background and Objectives: Grip strength is a measure of general health and is associated with oral health. This study aimed to investigate the relationship between the number of teeth and grip strength in Korean adults. Methods and Materials: We recruited adult participants who underwent oral examinations in the Korean National Health and Nutrition Examination Survey (KNHANES) between 2016-2018. When performing the KNHANES oral examination, an experienced dentist performed it according to the oral examination guidelines and recorded the results. A total of 24,269 participants from the 2016-2018 KNHANES were included in this study. Of these, only 16,489 participants underwent oral screening. A total of 3209 were non-adult children and adolescents, and 1781 did not respond to the grip strength test; those who did not respond to the main independent confounder were excluded. The relationships between grip strength, general characteristics, general health, oral health, and the number of remaining teeth were analyzed. There were 11,499 subjects in total in this study, with 4839 males and 6660 females. The age groups were 19-65 years of age, with 8387 subjects, and 65 years and older, with 3112 subjects, and the number of remaining teeth was 0-9 for 936 subjects, 10-19 for 1015 subjects, and 20-28 for 9548 subjects. Results: The probability that the higher the grip strength, the higher the residual number of gingiva was estimated by multinomial logistic regression analysis using complex sampling. The higher the grip strength, the higher the probability of having 20-28 teeth remaining (adjusted odds ratio, 1.59; 95% confidence interval, 1.19-2.13). Conclusions: Maintaining general health is related to maintaining teeth; the higher the grip strength, the higher the number of remaining teeth.

Patients' awareness regarding the quality of their oral hygiene: development and validation of a new measurement instrument

BACKGROUND

The present research aimed to develop and validate a standardised survey instrument for the assessment of patients' awareness of the quality of their oral hygiene performance.

METHODS

A digital questionnaire was developed that assesses both patients' naïve self-perceptions of oral cleanliness (SPOCn) after tooth brushing and patients' perceptions after being informed how oral cleanliness may be captured in dentistry (SPOCd). Three studies (N = 56 adults, N = 66 adolescents and one of their parents, N = 24 university students) assessed the instrument's feasibility (patient reports), reliability (internal consistency), validity (correlation with other constructs; sensitivity to manipulation of actual tooth brushing), and the correlation with actual oral cleanliness after tooth brushing.

RESULTS

All study groups accepted the questionnaire well; average answering times were less than 5 min. Cronbach's α exceeds 0.90; correlational analyses support the discriminant validity regarding oral hygiene related self-efficacy expectations and stages of change; manipulation of oral hygiene behaviour results in the expected changes of SPOC scores. Patients' SPOC correlate only moderately with actual oral cleanliness. The comparison between SPOCd scores and actual oral cleanliness indicate that they considerably overestimate their oral hygiene performance.

CONCLUSIONS

The SPOC questionnaire is an easy-to-use, well-accepted, reliable and valid instrument for the assessment of patients' awareness of the quality of their oral hygiene for research and clinical purposes. The results of the questionnaire may help to reveal unrealistic self-perceptions of patients regarding their oral hygiene. It can raise their awareness of the need to improve their skills and/or efforts in this regard. Trial registration The third study was an interventional study and was registered in the appropriate national register ( www.drks.de ; ID: DRKS00018781; date of registration: 12/09/2019).

Association between Dental Caries and Handgrip Strength: In a Population-Based Study in Korea (KNHANES 2016-2018)

This study aimed to verify the relationship between handgrip strength and oral health using data from the Korea National Health and Nutrition Examination Survey, representing Korean adults. Data from the seventh survey (2016−2018) conducted by the Korea Centers for Disease Control and Prevention were utilized, and 10,607 final study participants were recruited according to the selection and exclusion criteria. A complex sample logistic regression analysis was performed to confirm the relationship between handgrip strength and dental caries according to the sex of the study participants. On analyzing the correlation in men, “C1 (DMFT: 11−32),” when compared to “C4 (DMFT: 0−3),” in Model 1 without adjustment for potential confounders, was 2.92 (95% confidence interval [CI]: 2.15−3.97) times more likely to be associated with lower handgrip strength, and a statistically significant result was detected (p < 0.001). Additionally, significant odds ratios (ORs) were confirmed for all adjusted models. In women, the ORs in Model 1 without adjustment for potential confounders were 1.41 times (95% CI: 1.14−1.75) and demonstrated a significant result; however, the results were not significant in all adjusted models 2−4. Resultantly, a significant association was detected between dental caries and handgrip strength in Korean adults.

Analysis of Periodontal Conditions in the Provinces of Vietnam: Results From the National Dental Survey

Nationwide dental health surveys are crucial for providing essential information on dental health and dental condition-related problems in the community. However, the relationship between periodontal conditions and sociodemographic data has not been well investigated in Vietnam. With data from the National Oral Health Survey in 2019, we performed several machine learning methods on this dataset to investigate the impacts of sociodemographic features on gingival bleeding, periodontal pockets, and Community Periodontal Index. From the experiments, LightGBM produced a maximum AUC (area under the curve) value of 0.744. The other models in descending order were logistic regression (0.705), logiboost (0.704), and random forest (0.684). All methods resulted in significantly high overall accuracies, all exceeding 90%. The results show that the gradient boosting model can predict well the relationship between periodontal conditions and sociodemographic data. The investigated model also reveals that the geographic region has the most significant influence on dental health, while the consumption of sweet foods/drinks is the second most crucial. These findings advocate for a region-specific approach for the dental care program and the implementation of a sugar-risk food reduction program.

Relationship between diabetes self-care practices and control of periodontal disease among type2 diabetes patients in Bangladesh

INTRODUCTION

The prevalence of periodontal disease is high in diabetes patients worldwide, including Bangladesh. Although associations of periodontal disease outcomes and clinical determinants of diabetes have been investigated, few studies have reported on the relationship between periodontal diseases outcomes with modifiable factors, such as self-care and oral hygiene practices, in patients with diabetes. Moreover, in order to develop targeted strategies, it is also important to estimate their aggregated contribution separately from that of the established sociodemographic and diabetics related clinical determinates. Therefore, this study was performed to elucidate 1) the relationship of diabetes patients' self-care and oral hygiene practices to periodontal disease and 2) the relative contributions of selected factors to periodontal disease outcome in type 2 diabetes patients.

METHODS

The data were obtained from the baseline survey of a multicentre, prospective cohort study. A total of 379 adult patients with type 2 diabetes from three diabetic centres in Dhaka, Rajshahi and Barishal, received periodontal examinations using the community periodontal index (CPI) probe, glycated haemoglobin examination, other clinical examinations, and structured questionnaires. Multiple logistics regression analyses were performed to assess the associations between selected factors and prevalence of any periodontal disease and its severity.

RESULTS

More than half of the participants were female (53.8%) and 66.8% of the total participants was 21-50 years old. The prevalence of any (CPI code 2+3+4; 75.7%) and severe form (CPI code 4; 35.1%) of periodontal disease were high in type 2 diabetes patients. In multivariate analysis, the odds of periodontal disease increased with unfavourable glycaemic control indicated by HbA1c ≥ 7%, and decreased by 64%, 85% and 92% with adherence to recommended diet, physical activity, and oral hygiene practices, respectively. Diabetes self-care practice explained the highest proportion of the variance (13.9%) followed by oral hygiene practices (10.9%) by modelling any periodontal disease versus no disease. Variables of diabetes conditions and oral hygiene practices explained 10.9% and 7.3% of the variance by modelling severe (CPI code 4) or moderate (CPI code 3) forms of periodontal disease versus mild form of periodontal disease. Findings also conferred that while poor diabetes control had an individually adverse association with any form of periodontal diseases and its severity, the risk of diseases was moderated by oral hygiene practices.

CONCLUSIONS

This study suggested that, in addition to diabetes-related clinical determinants, self-care practices, and oral hygiene practices must be taken into consideration for prevention and control of periodontal disease in patients with diabetes.

Promoting behavioural changes to improve oral hygiene in patients with periodontal diseases: A systematic review

AIM

This systematic review investigates the impact of specific interventions aiming at promoting behavioural changes to improve oral hygiene (OH) in patients with periodontal diseases.

METHODS

A literature search was performed on different databases up to March 2019. Randomized and non-randomized controlled trials evaluating the effects of behavioural interventions on plaque and bleeding scores in patients with gingivitis or periodontitis were considered. Pooled data analysis was conducted by estimating standardized mean difference between groups.

RESULTS

Of 288 articles screened, 14 were included as follows: 4 studies evaluated the effect of motivational interviewing (MI) associated with OH instructions, 7 the impact of oral health educational programmes based on cognitive behavioural therapies, and 3 the use of self-inspections/videotapes. Studies were heterogeneous and reported contrasting results. Meta-analyses for psychological interventions showed no significant group difference for both plaque and bleeding scores. No effect was observed in studies applying self-inspection/videotapes.

CONCLUSIONS

Within the limitations of the current evidence, OH may be reinforced in patients with periodontal diseases by psychological interventions based on cognitive constructs and MI principles provided by oral health professionals. However, no conclusion can be drawn on their specific clinical efficacy as measured by reduction of plaque and bleeding scores over time.

A Case-Control Study of Type 2 Diabetes Mellitus and Periodontitis in Saudi Arabian Adults

Objective

The relationship between type 2 diabetes mellitus (T2DM) and periodontitis is bidirectional and has been investigated. However, the evidence from the middle-eastern region is sparse. The current report assessed the association between uncontrolled T2DM and periodontal status from a sample of the Saudi Arabian adult population.

Methods

A case–control study was carried out. Cases were adults diagnosed with periodontitis (clinical attachment loss ≥1 mm) and controls were patients from the same dental setting with no gum conditions matched with age, sex, and location. Diabetes was recorded using HbA1c readings. The other health conditions including hypertension, epilepsy, bronchitis, thyroid disorders, and arthritis were obtained from medical records. Data on the use of tobacco and related products (smoking, khat/qat, sheesha, shammah) were gathered using a self-perceived questionnaire. Frequencies, percentages, p-values, crude and adjusted odds ratios (OR) with 95% confidence intervals were computed.

Results

Overall sample comprises 166 cases and 332 controls with a mean age of 37.5 years. Multivariable analysis indicated uncontrolled T2DM as an important predictor for periodontitis among Saudi Arabian adults, and they had nearly three times greater odds (OR: 2.779; 95% CI: 1.425–5.419; p=0.003) of being diagnosed with periodontitis in contrast to non-diabetics. Secondary findings revealed that cigarette ever-users were two times more likely to be suffering from periodontitis than never-users, and those brushing once per day or less had five times greater odds of developing periodontitis as compared to those brushing twice daily.

Conclusion

To conclude, the current evidence from Saudi Arabia is supportive of earlier studies and an awareness of this association is warranted among all healthcare providers and patients in the region for early detection of periodontitis.

The Association Between Oral Hygiene Behavior and Gingival Health Status with the Stage and Grade of Periodontitis: A Cross-Sectional Study

Aim:

To analyze the association between teeth brushing (TB) and interdental cleansing (IDC) frequency changes with gingival health status and the stage and grade of periodontitis.

Materials and Methods:

This cross-sectional study consisted of clinical examination and questionnaires. The questionnaires include demographic information and oral hygiene (TB and IDC) behavior. More than 18-year-old participants who underwent a periodontal treatment were randomly included. 548 individuals were classified as gingival healthy, gingivitis, and periodontitis according to the 2017 classification system. The degree of periodontitis was based on stage and grade systems. The data were analyzed by using Kruskal–Wallis and Mann–Whitney U tests.

Results:

The highest TB frequency (twice daily) was the highest in patients with gingivitis (83.7%) followed by healthy patients (82.9%) and patients with stage I periodontitis (52.2%). Compared to those who performed IDC daily, 18.9% of patients were healthy and 8.1% had stage II periodontitis. There was a statistically significant association between the oral hygiene behavior and periodontal health status of participants. Statistically significant association was seen between the TB and IDC with stage-grade of periodontitis. When the TB and IDC scores of different grade groups were compared at the same stage level, no statistically significant difference was found.

Conclusion:

This study showed that periodontal health status was positively correlated with TB and IDC frequency.

The effectiveness of an oral hygiene program combined with health-promoting counseling for rural adults with cardiometabolic risks: A quasi-experimental design

AIM

The aim of this study was to explore the effectiveness of an oral hygiene program combined with home-phone health promoting counseling for rural adults with metabolic syndrome.

BACKGROUND

Metabolic syndrome is an important risk factor for cardiometabolic diseases. Evidence indicates that the poor oral hygiene and unhealthy lifestyles are closely related to metabolic syndrome.

METHODS

A prospective quasi-experimental design involved a total of 136 community adults, with metabolic syndrome living in two rural townships, were clustered and conveniently assigned to intervention and control group between June 2017 and December 2018. The primary outcome was the change in cardiometabolic biomarkers. The secondary outcome comprised changes in the health-promoting behaviors. The intervention effect was assessed using a generalized estimating equation model.

RESULTS

There were 80 and 56 participants in the intervention and control group, respectively. The mean age was 56 years and ranged from 33 to 70 years. The intervention group exhibited a greater improvement in body mass index (P < 0.01), waist circumference (P < 0.05), body fat percentage (P < 0.05), triglyceride level (P < 0.05), use of dental floss (P < 0.05), regular tooth scaling (P < 0.05), physical activity (P < 0.001), and total score of health-promoting behaviors (P < 0.001) than the control group.

CONCLUSION

This study supports the use of an oral hygiene program combined with home-phone counseling, which offers more advantages than its counterpart. Considering the global epidemic of cardiometabolic diseases, this is a community health nursing model worth to replicate and evaluate. Further study should consider innovative strategies to improve the awareness and adoption of a healthy lifestyle in residents with cardiometabolic risks.

Relationship between oral health behaviour and handgrip strength: a cross-sectional study with 7589 Korean adults

Objective: This cross-sectional study investigated the relationship between handgrip strength and oral health behaviours among Koreans.Methods: The data of 7589 individuals (3384 men and 4205 women) aged ≥19 years who participated in the Korea National Health and Nutrition Examination Survey 2014-2015 were analyzed. Oral health behaviour was assessed based on the number of daily toothbrushing sessions and the use of secondary oral-care products. The association between oral-health behaviour and handgrip strength was investigated adjusting for confounders. Multivariable logistic regression analysis was performed (α = 0.05).Results: The proportion of participants diagnosed with sarcopenia was significantly higher in the group with poor oral-health behaviours. After adjusting for confounders including age, the adjusted odds ratios and 95% confidence intervals of female participants with low handgrip strength in groups toothbrushing thrice or more per day, twice per day, and once or less per day were 1 (reference), 1.18 (0.99-1.4), and 1.24 (0.89-1.71), respectively. There were significantly more participants with low handgrip strength in the group that did not use secondary oral products for both sexes.Conclusions: Oral health behaviour is associated with handgrip strength among adults. Poor oral self-care habits may constitute a risk indicator for low muscle strength.

Dental caries experience and related risk indicators of 12-year-old students in Jilin, China

An effective prevention policy for dental caries is absent in Jilin, China because of outdated and insufficient data. Therefore, this study aimed to investigate dental caries status and related risk indicators among 12-year-old students in Jilin Province.We conducted a cross-sectional investigation among 2324 children aged 12 years from 9 regions of Jilin in 2017. Caries was evaluated with the decayed-missing-filled teeth index and the significant caries index. The rate of pit and fissure closure, education level of patients, brushing habits, and sugar consumption were evaluated in a structured questionnaire. The associated risk indicators of caries were also assessed through logistic regression analysis.The prevalence of dental caries is 56.11%, and the value of decayed-missing-filled teeth was 1.53. More dental caries was found in students living in high-fluorine areas (P < .01). The results of logistic regression analysis show that females, poor self-assessment of oral health, toothache experience, dental visits, and education levels of parents are risk indicators for caries (P < .01).Regarding the current status of DC among 12-year-old students in Jilin Province, (1) The high-fluorine areas have lower DC prevalence than the non-high fluorine areas, (2) Female students have higher DC prevalence than male students, (3) Poor self-assessment of dental health, toothache experience, dental visits, and low education levels of parents can increase the risk of dental caries.

The oral health and periodontal diseases awareness and knowledge in the Iraqi population: Online-based survey

OBJECTIVES

This study aimed to evaluate oral health (OH) and periodontal diseases (PD) awareness in the Iraqi population.

MATERIAL AND METHODS

This study was a questionnaire-based online survey of two weeks duration. The questionnaire was built using a Google platform and was distributed randomly via social media (Facebook and Telegram). The questionnaire consisted of a demographic data section and two other main sections for the evaluation of OH and PD awareness. Each response was marked with "1" for a positive answer and "0" for the other answers. For each respondent, answers were summed to give an overall score. The frequency of positive responses was used to determine the association of awareness with demographic data and the level of awareness into low, moderate, and high levels.

RESULTS

A total of 1,465 were included in the final analysis after application of exclusion criteria. The respondents showed significantly higher levels of awareness about PD (mean ± SD = 3.66 ± 1.42) than OH awareness (mean ± SD = 2.19 ± 1.29). Analysis of data showed that OH awareness was mainly associated with high degree holders (OR 1.851) and age > 45 years (OR 1.730). However, PD awareness did not show any evident association with demographic variables investigated. In general, the respondents exhibited low levels of OH knowledge and low to moderate level of PD knowledge.

CONCLUSIONS

Despite limitations, this study revealed inappropriate levels of OH and PD awareness and knowledge in the Iraqi population and provided the baseline data necessary for the development of Governmental educational programs and health awareness campaigns which are highly suggested particularly focusing on the primary and high schools, in an attempt to improve the levels of awareness.

Prevalence and associated factors of periodontal conditions among 55- to 74-year-old adults in China: results from the 4th National Oral Health Survey

OBJECTIVE

The purpose of this study was to assess periodontal health conditions among 55- to 74-year-old Chinese people and to analyze the factors associated with periodontal diseases.

MATERIALS AND METHODS

In total, 9054 subjects aged 55-74 years were enrolled from all 31 provinces using a stratified multistage probability sampling method, autonomous regions and municipalities of the Chinese mainland, the response rate was 86.9%. All subjects underwent clinical examinations on the severest site for every tooth and completed a questionnaire that collected information on their sociodemographic characteristics and oral habits. T tests, chi-square tests and binary logistic regression analysis were performed to analyze the data.

RESULTS

The percentage of people without bleeding on probing, probing depth ≥ 4 mm and attachment loss > 3 mm was 5.0 and 9.3% in the 55- to 64-year-old and the 65- to 74-year-old age group. The prevalence of bleeding on probing was 88.4% among 55 to 64 years old and 82.6% among 65 to 74 years old. Mean number of teeth with bleeding on probing were 13.87 among 55 to 64 years old and 11.25 among 65 to 74 years old. The prevalence of probing depth ≥ 4 mm and attachment loss > 3 mm were 69.3 and 69.9% in people aged 55-64 years and were 64.6 and 74.2% in people aged 65-74 years. Mean number of teeth with probing depth = 4-5 mm and probing depth ≥ 6 mm were 4.48 and 0.36 in 55-64 age group and 3.70 and 0.33 in 65-74 age group. And mean number of teeth with attachment loss > 3 mm were 5.17 among 55 to 64 years old and 5.63 among 65 to 74 years old. Besides, attachment loss > 3 mm was associated with age, gender, smoking, toothbrushing frequency and toothpick use.

CONCLUSIONS

Periodontitis was not highly prevalent among 55- to 74-year-old Chinese adults. Age, gender, smoking, toothbrushing frequency and toothpick use could be risk factors.

CLINICAL RELEVANCE

Scientific rationale for the study: The periodontal conditions among 55 to 64 and 65 to 74 years old Chinese population were not highly serious, but prevalence of bleeding on probing, periodontal pockets and attachment loss should be drawn enough attention by relevant public health administrations.

PRINCIPAL FINDINGS

The prevalence of periodontal diseases was evaluated in 55- to 64-year-old and 65- to 74-year-old subjects in a nationally representative Chinese sample population. The prevalence of probing depth ≥ 4 mm and AL > 3 mm were high; these values were 69.3% and 69.9%, respectively, in the 55-64 age group and 64.6% and 74.2%, respectively, in the 65-74 age group. In addition, case percentage of AL = 4-5 mm combined with PD < 6 mm were 23.1 and 19.4% among 55- to 64-year-old and 65- to 74-year-old people. And case percentage of AL> 5 mm combined with PD ≥ 6 mm were 11.1% and 12.1% among 55- to 64-year-old and 65- to 74-year-old people, respectively.

PRACTICAL IMPLICATIONS

The present study provides a reference for the epidemiological analysis of periodontal diseases. To reduce widespread inadequate treatment of periodontal diseases, clinical management should be performed in dental practices. Furthermore, oral health recommendations should be made at multiple levels.

Relations between periodontal status, oral health-related quality of life and perceived oral health and oral health consciousness levels in a Turkish population

OBJECTIVES

This study aimed to evaluate the interrelationship of periodontal status, socio-demographic characteristics, perceived oral health and oral health consciousness levels as well as the impact of these factors on quality of life using a questionnaire and the Oral Health Impact Profile-14(OHIP-14) scale.

METHODS

Seven hundred and fifty systemically healthy individuals aged ≥18 years referred to a Periodontology Department were included in the study. The OHIP-14 scale and survey were applied to identify socio-demographic characteristics, oral hygiene characteristics, perceived oral health and oral hygiene consciousness levels. Three groups were established based on periodontal status (periodontally healthy [H], gingivitis [G] and periodontitis [P]) determined using periodontal indexes, and the relationship between the above-mentioned factors and periodontal status with quality of life was assessed.

RESULTS

Oral health-related quality of life differed significantly by gender, marital status, education level, oral hygiene habits and periodontal status. A statistically significant positive relationship was found between high OHIP-14 scores and unfavourable socio-demographic characteristics, increased severity of periodontal disease, and irregular dental care practices. The perceived oral health and oral health consciousness levels significantly differed due to periodontal status.

CONCLUSION

Periodontal status, gender, marital status, education level, dental care practices, perceived oral health and oral hygiene consciousness levels are important determinants of oral health-related quality of life (Clinical Trial No. NCT03549247).

Prevalence of periodontitis in high school children in Saudi Arabia: a national study

BACKGROUND

The occurrence of periodontitis is rather infrequent in children and adolescence and increases with age. We conducted this study because there have been few epidemiological studies on prevalence of periodontitis in children in Saudi Arabia.

OBJECTIVE

Determine the prevalence of periodontitis in high school children in Saudi Arabia.

DESIGN

Cross-sectional, using cluster and multistage sampling.

SETTING

High school children in Saudi Arabia.

PARTICIPANTS AND METHODS

Periodontal examinations were conducted on a randomized sample of high school children between the ages 15 to 19 in Saudi Arabia. The study spanned from September 2012 to January 2016. Clinical examinations included measurements of the probing depth (PD) percentage of PD ≥4 mm per patient.

MAIN OUTCOME MEASURES

The prevalence of periodontitis (PD ≥4 mm and CAL ≥1 mm), the mean percentage PD ≥4 mm, the mean percentage CAL ≥1 mm, plaque index (PI) and gingival index (GI).

SAMPLE SIZE

2435 high school students.

RESULTS

Of 2435 high school children in the sample, 209 students (8.6%) had periodontitis. The mean (standard deviation) for the PD was 0.59 (0.17) mm. Differences in percentage PD ≥4 mm and CAL ≥1 mm were greater in students with periodontitis ( P<.001). The prevalence of periodontitis was higher among non-Saudis, students who did not brush their teeth and did not visit their dentist regularly. In the bivariate analysis, periodontitis was positively associated with GI, PI, number of teeth extracted, mean percentage PD ≥4 mm, and mean PD. However, in the multivariate analysis, tooth brushing was the main factor protective against periodontitis (odds ratio: 0.62, 95% CI 0.42-0.92, P=.017).

CONCLUSION

Periodontitis prevalence was high compared with Western countries in a nationally representative sample of high school students in Saudi Arabia.

LIMITATIONS

Partial mouth study design, which may underestimate the disease prevalence.

CONFLICT OF INTEREST

None.

Behavioral risks of student dental health

Aim. To increase the effectiveness of treatment and prevention of periodontal diseases in smoking students. Methods. A comprehensive dental examination and survey was conducted among 380 students 180 of whom were smokers, and the other 200 students were not tobacco smokers. The students were comparable by age (mean age 21.1±0.09 and 21.4±0.10 years, p=0.1009) and the initial state of the oral cavity. To assess the effectiveness of treatment and preventive measures, smoking students with inflammatory changes in periodontium were divided into the groups. The first group (52 subjects) was divided into three subgroups: 1a (n=15) — removal of plaque by the piezoelectric ultrasound apparatus Vector; 2a (n=20) — use of the Air-Flo C2 air-abrasive apparatus; 3a (n=17) — use of Gracey curette. The second group (n=32) was divided into two subgroups: control (n=15) where only conventional therapy was applied, including professional oral hygiene (removal of supra- and subgingival dental deposits) and the main one (n=17), where, unlike the control group, additional supportive therapy was introduced with Antitobacco Chamomile-Sage conditioner. Repeated clinical examinations were carried out 1 and 6 months after the completion of treatment using periodontal and hygienic indices. Results. Students were found to have caries and periodontal inflammation but it was more pronounced in patients with a bad smoking habit in history: 4.37±0.12 and 3.98±0.09 — the intensity of caries in smokers and non-smokers, respectively (p <0.05). Among the smoking students in relatively rare cases a healthy periodontium was detected: 2.78±1.22, versus 9.0±2.02 in the group of non-smoking students (p <0.05). With the inclusion of Antitobacco Chamomile-Sage conditioner in the complex therapy, the values of OHI-S and papillary marginal attachment indices were significantly lower than in the control group 1 and 6 months after treatment. A comparative analysis of the data obtained in another treatment group, divided into three subgroups, revealed that with the use of Gracey curette a more pronounced positive shift in the indices was observed. Conclusion. Favorable dynamics in the reduction of hygienic and periodontal indices at all stages of the research, indicating improvement of oral hygiene and periodontal condition, was recorded when using periodontal Gracey curette and “Antitobacco Chamomile-Sage” herbal conditioner in the complex treatment.

Clinical implication of fasting glucose and systolic/diastolic blood pressure on the prevalence of periodontitis in non-diabetic and non-hypertensive adults using nationally representative data

The prevalence of diabetes mellitus and hypertension is increasing worldwide and an association between fasting glucose/blood pressure and periodontitis has been suggested. The present study was performed to assess the association between fasting glucose and systolic/diastolic blood pressure on the prevalence of periodontitis in non-diabetic and non-hypertensive adults using nationally representative data. Subgroup analysis was performed to evaluate the combined effects of obesity/abdominal obesity and impaired fasting glucose. This study involved a cross-sectional analysis using data from the Republic of Korean National Health and Nutrition Examination Survey from 2013 to 2015. A total of 8,341 respondents without diabetes and hypertension over 19 years old without missing values were included in the present study. A significant increase was observed in the prevalence of periodontitis with increasing systolic blood pressure and diastolic blood pressure. The percentage of periodontitis increased with increased glucose levels, with similar trends in glycated hemoglobin. The odds ratios (ORs) and 95% confidence intervals (CIs) for systolic blood pressure of 90≤x<100, 100≤x<110, 110≤x<120, 120≤x<130 and 130≤x<140 were 1.116 (0.591-2.107), 1.165 (0.624-2.175), 1.238 (0.673-2.278), 1.008 (0.538-1.888) and 1.042 (0.545-1.993), respectively, when systolic blood pressure <90 was considered as a reference. The ORs and 95% CIs for glucose of 90≤x<100, 100≤x<110 and 110≤x<126 were 1.074 (0.92-1.253), 1.214 (0.986-1.494) and 1.358 (1.005-1.834), respectively when glucose <90 was considered as a reference. The association between fasting glucose/blood pressure and periodontitis was confirmed by multiple logistic regression analyses after adjusting for confounding factors among non-diabetic and non-hypertensive Republic of Korean adults. Subgroup analysis revealed that higher ORs of periodontitis were observed in participants with impaired glucose level and obesity when compared with individuals without impaired glucose level or obesity. The results of the present study suggest that detection of fasting glucose and blood pressure may serve as a risk indicator for periodontal disease.

Clinical implications of age and sex in the prevalence of periodontitis in Korean adults with diabetes

The present study was performed to assess the risk factors for periodontitis in Korean adults with diabetes. Data from the Korean National Health and Nutrition Examination Survey of the Korean population, conducted between January 2012 and December 2014 were used in the investigation. The presence of periodontitis in participants with diabetes in association with demographic variables and the anthropometric characteristics of the participants was investigated. Multiple logistic regression analyses were used to assess the associations between periodontitis and age, sex, diabetic control and duration of diabetes, following adjustment for confounding factors. The odds ratio of periodontitis was higher in individuals ≥65 years old compared with individuals <65 years old (1.152). The odds ratio of periodontitis was significantly higher in males compared with females (1.774). The number of patients with moderate and severe periodontitis differed significantly between different age groups. The present study revealed that age, sex and oral health behavior are risk indicators for periodontitis in patients with diabetes. The present study suggests that that an increased age, being male and engaging in poor oral health behavior increases the risk of periodontitis in participants with diabetes.

Oral Health Status and Behavior among Cancer Survivors in Korea Using Nationwide Survey

Cancer survivors remain at life-long risk of developing oral complications. This study investigated the oral health status and behavior among cancer survivors in comparison to subjects without a history of cancer using a nationwide survey. Cancer survivors and control subjects were selected from the sixth Korean National Health and Nutrition Examination Survey (2013-2015). Survivors reported chewing (34.8%) and speaking difficulties (15.3%) resulting from oral health problems. More than 36% of survivors had periodontal disease and 15.9% needed dentures. In multiple logistic regression analysis, age, household income, education level, smoking status, cancer site, and current cancer status were associated with oral health status. Approximately 43.3% of cancer survivors brushed their teeth more than three times a day. In addition, 44.9% of survivors used secondary oral products, and 30.8% had been screened for oral health problems over the past year. Age, household income and education level were associated with oral health behavior. The oral health status and behavior excepting periodontal disease and the use of secondary oral products were not significantly different between cancer survivors and controls. Although oral health status of cancer survivors was not worse than that of controls, more than half of the survivors maintained unhealthy oral practices.