Periodontal health in a group of industrial employees

Association between the interval of worksite dental check-ups and dental and medical expenditures: a single-site, 12-year follow-up study in Japan

OBJECTIVES

The purpose of this study was to identify the effective intervals of worksite dental check-ups to reduce cumulative dental expenditures (CDEs) and cumulative medical expenditures (CMEs), based on 12 years of follow-up dental check-ups.

SETTING, DESIGN AND PARTICIPANTS

A longitudinal study was conducted between 2002 and 2014 fiscal years. A total of 2691 full-time employees (2099 males and 592 females) aged 20-59 years in a manufacturing company in Japan were recruited.

PRIMARY AND SECONDARY OUTCOME MEASURES

Based on the follow-up of 12-year dental check-ups, the interval of dental check-ups visits was classified into the following categories: 'Once per year' as the regular group, 'At least once per 2 years' as the subregular group and others as the irregular group. CDEs and CMEs per capita were examined by the three groups of dental check-ups interval after adjustment for sex, age, occupation and total CMEs at baseline. For sensitivity analysis, decayed teeth, missing teeth and Community Periodontal Index were added as adjustment factors.

RESULTS

Compared with the irregular group, the pooled CDEs (including dental check-ups fee) per capita in the subregular group (OR 0.91, 95% CI 0.85 to 0.98) and regular group (OR 0.87, 95% CI 0.81 to 0.93) were significantly lower overall. The younger adults in the subregular group and younger-aged and middle-aged adults in the regular group had significantly lower CDEs. Sensitivity analysis confirmed these findings.

CONCLUSIONS

Our findings suggest that regular and subregular worksite dental check-ups were related to reduction of CDEs. It is important to promote a yearly interval between dental check-ups.

Appraisal of Periodontal Condition amongst Leather Manufacturing Plant Workers in Central India: A Prevalence Survey

Objective

To assess the periodontal status among the leather factory workers in Dewas and to provide a baseline data for the oral health care and promotion programs.

Materials and Methods

A total of 850 study population was considered for examination, and the age ranged from 20 to 60 years. All those factory workers with low socioeconomic status and poor background were considered. The data were collected by means modified World Health Organization (WHO) Oral Health Assessment 1997 Performa and clinical examination with the use of the Community Periodontal Index (CPI). Statistical analyses were used: chi-squared test, Mann-Whitney U test, and Kruskal-Wallis test.

Results

The sociodemographic characteristics were found to be significantly associated with the periodontal status in the study population (p ≤ 0.05). Mean number of loss of attachment (LOA) 0 sextants was 3.55 ± 2.35, LOA 1 was 0.935 ± 1.3, LOA 2 was 0.414 ± 0.8, LOA 3 was 0.529 ± 0.94, and LOA 4 was 1.24 ± 0.04; all the parameters showed statistically significant difference (p=0.001) except LOA 1 and LOA 2.

Conclusion

The periodontal health status of the factory workers is poor. Factors associated with high prevalence of periodontal disease could be the following: a high rate of tobacco consumption and not cleaning their teeth at all along with other associated factors like stress, poor oral hygiene, etc.

Prevalence and risk factors of non-carious cervical lesions related to occupational exposure to acid mists

This study evaluates the prevalence and risk factors of non-carious cervical lesions (NCCLs) in a Brazilian population of workers exposed and non-exposed to acid mists and chemical products. One hundred workers (46 exposed and 54 non-exposed) were evaluated in a Centro de Referência em Saúde do Trabalhador - CEREST (Worker's Health Reference Center). The workers responded to questionnaires regarding their personal information and about alcohol consumption and tobacco use. A clinical examination was conducted to evaluate the presence of NCCLs, according to WHO parameters. Statistical analyses were performed by unconditional logistic regression and multiple linear regression, with the critical level of p < 0.05. NCCLs were significantly associated with age groups (18-34, 35-44, 45-68 years). The unconditional logistic regression showed that the presence of NCCLs was better explained by age group (OR = 4.04; CI 95% 1.77-9.22) and occupational exposure to acid mists and chemical products (OR = 3.84; CI 95% 1.10-13.49), whereas the linear multiple regression revealed that NCCLs were better explained by years of smoking (p = 0.01) and age group (p = 0.04). The prevalence of NCCLs in the study population was particularly high (76.84%), and the risk factors for NCCLs were age, exposure to acid mists and smoking habit. Controlling risk factors through preventive and educative measures, allied to the use of personal protective equipment to prevent the occupational exposure to acid mists, may contribute to minimizing the prevalence of NCCLs.

The oral health status and the treatment needs of salt workers at sambhar lake, jaipur, India

BACKGROUND

Salt workers are exposed to the adversities of environmental conditions such as direct sunlight, salt dust and contact with brine, which have an impact on the health of workers. Since oral health is an integral part of the general health, we planned to determine its effect on the oral cavity.

OBJECTIVES

To assess the oral health status and the treatment needs among the workers of Sambhar Salts Limited at Sambhar Lake, Jaipur, India.

MATERIAL AND METHODS

A cross sectional, descriptive survey was conducted among 979 subjects (509 males; 470 females) who were aged between 19-68 years, who were the workers of Sambhar Salts Limited, Sambhar Lake, Jaipur, India. An interview on the demographic profile followed a clinical examination for recording the oral health status, based on the World Health Organization guidelines. The Chi-square test, t-test, One way Analysis of Variance and a Stepwise multiple linear regression analysis were used for the statistical analysis.

RESULTS

Females had a significantly greater prevalence of dental fluorosis (71.7%) and periodontal disease (96.4%) as compared to males (p= 0.001). The mean number of healthy sextants (0.71 ± 0.09) and the mean DMFT (5.19 ± 4.11) were also significantly higher in females as compared to those in males (p=0.001). One surface filling (78.2%), followed by pulp care and restoration (76.1%) were the most prevalent treatment needs. The gender and oral hygiene practices for dental caries and periodontal disease were respectively identified as the best predictors.

CONCLUSION

Considerable percentages of salt workers have demonstrated a higher prevalence of oral diseases. Higher unmet treatment needs suggest a poor accessibility and availability of oral health care, in addition to a low utilization of preventive or therapeutic oral health services.

Occupational exposure to acid mists and periodontal attachment loss

This study investigated the hypotheses that occupational exposure to acid mists is positively associated with periodontal disease, assessed by periodontal attachment loss. The study sample included 530 male workers at a metal processing factory. Data were obtained from interviews and oral examinations. Periodontal attachment loss was defined as >or= 4mm at probing, in at least one tooth. A job exposure matrix was utilized for exposure evaluation. Exposure to acid mists was positively associated with periodontal attachment loss >or= 4mm at any time (prevalence ratio, PR(adjusted) = 2.17), past (PR(adjusted) = 2.11), and over 6 years of exposure (PR(adjusted) = 1.77), independently of age, alcohol consumption, and smoking, and these results were limited to workers who did not use dental floss. Exposure to acid mists is a potential risk factor for periodontal attachment loss, and further studies are needed, using longitudinal designs and more accurate exposure measures.

Cost-benefit analysis of a worksite oral-health promotion program

This study was conducted to examine whether oral-health promotion programs provided as an occupational health service for employees were cost-beneficial for employers. The subjects were composed of 357 male workers (20-59 yr of age) who participated in oral-health promotion programs conducted at their workplaces between 1992 and 1997. The design of this study was a quasi-experimental study design in which the three programs (light: 1 visit; medium: 2-4 visits; and heavy: 5-6 visits) were compared through cost-benefit analysis conducted from the viewpoint of the employers. The programs consisted of oral-health checkups by dentists and oral-health education, including that on the proper brushing method, by dental hygienists. The costs of the program included direct costs for the payment of oral-health-care staff and for teaching materials, and indirect costs for the time for employee participation in the program (20 min/employee per visit). The accumulated dental expenses for the seven years were used to calculate benefits, which were determined, based on the differences between 0 visits and each program. The benefit/cost ratios of the three programs were -2.45, 1.46, and 0.73, respectively. These results suggest that a worksite oral-health promotion program of medium frequency is cost-beneficial for employers.

O Papel da epidemiologia no planejamento das ações de saúde bucal do trabalhador

Este é um estudo de revisão que sistematiza achados de pesquisas sobre exposições ocupacionais e seus efeitos na saúde bucal, destacando a importância dos dados epidemiológicos no planejamento de programas de saúde bucal do trabalhador. Existem relatos de associação potencial entre exposições ocupacionais e alterações bucais; entretanto, são escassos os estudos sobre as condições de saúde bucal dos trabalhadores em países em desenvolvimento como o Brasil. Entre as exposições ocupacionais presentes na literatura odontológica, observa-se uma predominância de estudos sobre substâncias ácidas e também exposições relacionadas com o açúcar, como a poeira de açúcar. As alterações bucais podem manifestar-se tanto nos tecidos duros (cárie, erosão dental, etc.) como nos tecidos moles (lesões da mucosa oral, doenças periodontais, etc). Por outro lado, observa-se que os programas de saúde bucal do trabalhador, quando existem, muitas vezes não consideram as especificidades dessa parcela da população que, além de exposta aos fatores de risco mais conhecidos das principais doenças bucais, está submetida a outros fatores relacionados ao ambiente de trabalho. Assim, considera-se relevante a discussão sobre a necessidade de maior produção de conhecimento nessa área, de capacitação de recursos humanos e de implementação de programas mais efetivos, baseados nos princípios da vigilância em saúde do trabalhador.

Periodontal health and oral mucosal lesions as related to occupational exposure to acid mists

OBJECTIVES

The association between exposure to acid mists and periodontal changes and oral mucosal lesions was measured using data from an Oral Health Promotion Program in a large metal plant. The role of sociodemographic factors, lifestyle, and oral health behavior in relation to these outcomes was also examined.

METHODS

This is a cross-sectional study of 665 active male workers who volunteered to participate in the oral health program. A job exposure matrix was constructed with industrial hygienist scores and job titles to estimate years of exposure to acid mists. Oral health outcomes were identified during standardized dental examinations. Unconditional logistic regression models were utilized in the analysis.

RESULTS

Duration of exposure to acid mists exposure was positively associated with oral mucosal lesions among workers without lip sealing. Only age, low salaries and oral hygiene-related variables were associated with periodontal changes, and estimates varied according to lip sealing.

CONCLUSIONS

Results suggest that long-term occupational exposure to acid mists is associated with oral mucosal lesions, and that absence of lip sealing may increase the intensity of exposure.

Exposição ocupacional a névoas ácidas e alterações bucais: uma revisão

Neste estudo de revisão, sistematizam-se os achados de pesquisas sobre os efeitos das exposições ocupacionais a névoas ácidas na saúde bucal. Utilizaram-se como bases de dados MEDLINE, LILACS, SciELO, BBO e DEDALUS, das quais foram selecionados oito artigos e uma tese de doutorado, que focalizavam as associações de interesse. Os achados são consistentes em torno de uma associação positiva entre exposição a névoas ácidas e erosão dental, confirmando os dados de pesquisas conduzidas desde 1919. Estudos sobre a associação entre névoas ácidas e a doença periodontal ou lesões da mucosa oral são mais recentes e raros, e os achados, controversos. Muitos estudos apresentam limites metodológicos, especialmente tamanho insuficiente da população de estudo, e análise apenas descritiva, ou sem a consideração de variáveis de confusão. A importância deste tema revela-se no grande número de trabalhadores potencialmente expostos e na necessidade da incorporação de aspectos da saúde bucal no campo da saúde do trabalhador, a fim de que programas de prevenção efetivos possam ser implementados.

The periodontal disease problem. A comparison between industrialised and developing countries

There is no reason to believe that periodontal diseases in industrialised and developing countries are in principle different. That is, not in the sense that the problem is caused by a different set of periodontal diseases, with different micro-organisms and a different natural history, needing a different approach towards prevention and treatment. Indeed, from a public health perspective the relative similarities in periodontal conditions around the world are far more striking than the differences. The view that periodontal diseases are a much more prevalent and a severe problem in the developing countries seems to be true only in terms of poorer oral hygiene and considerably greater calculus retention, already at a young age, but not so clear for periodontal destruction in adults.

Dental plaque and calculus: risk indicators for their formation

The aim of this study was to determine the levels of plaque and subgingival calculus accumulation and to evaluate their correlations with periodontal disease, as well as to evaluate the correlations with race, age, and gender in an attempt to identify risk indicators for plaque and calculus formation. A total of 508 adults 25-73 years of age was examined, and plaque assessment, gingival bleeding assessment, probing pocket depth, and attachment levels were determined. The mean percent visible plaque was 73.5% (range, 8.3-100%), mean percent of bleeding surfaces 38.5% (range, 0-100%), and the mean percent teeth with subgingival calculus 39.6% (range, 0-100%). The mean probing pocket depth in the group was 2.5 +/- 0.6 mm (SD), and mean clinical attachment loss was 2.1 +/- 1.1 mm. The majority (63%) were classified as having "Moderate" periodontal disease, 7% were "Healthy", and the remaining 30% had "Established" periodontal disease. Plaque and calculus showed statistically significant relationships to the three disease categories (p less than 0.001). Multiple step-wise regression analyses on the correlations between plaque and periodontal disease, race, age, and gender resulted in an overall correlation coefficient of r = 0.25 (p less than 0.001). Disease status ("Established") contributed most (p = 0.003), followed by race (Blacks; p = 0.015), gender (Males; p = 0.022), and age (55-73 yr; p = 0.022), to the correlation with plaque. For subgingival calculus, the overall correlation coefficient was r = 0.44 (p less than 0.001). However, only two of the variables--namely, disease status (p less than 0.001) followed by race (p = 0.017)--showed statistically significant correlations.(ABSTRACT TRUNCATED AT 250 WORDS)

Periodontal treatment needs assessed by the use of clinical and radiographic criteria

The aim of the present study was to use a decision making model in order to assess the periodontal treatment needs of a random sample of employees in a large Swedish industrial corporation. The model used provided data on critical bone loss limits for different tooth types and ages, beyond which treatment must be initiated, in order to fulfill the goal of maintaining all teeth in a functional state throughout life. A sample comprising 192 subjects belonging to four age strata (31-35 yr, 41-45 yr, 51-55 yr, and 61-65 yr) was involved. From each subject, a full mouth series of intra-oral radiographs were available. The radiographic bone height was assessed at the mesial and distal aspect of all teeth by measuring the distance between the cementoenamel junction and the bone crest. The clinical examination included assessments of plaque, gingivitis, probing pocket depth, and probing attachment level. The results revealed that (i) only 3.1% of all approximal tooth sites exhibited radiographic bone loss exceeding the critical limit, (ii) all individuals and 70% of the approximal tooth sites were in need periodontal treatment when presence of gingival inflammation (bleeding on probing) was employed as the single criterion for therapeutic intervention, (iii) the proportion of individuals and tooth sites requiring treatment amounted to 98% and 27%. respectively, when a probing pocket depth of at least 4 mm was included as an additional criterion, and 54% and 4.1%, respectively, if a probing depth threshold of 6mm was used, while (iv) the use of bleeding on probing in combination with radiographic bone loss beyond the critical limits disclosed a need of treatment in 40% of the subjects and 2.5% of the approximal tooth sites.

Periodontal awareness, health, and treatment need in dental school patients. II. Periodontal conditions

The present study aimed to evaluate the periodontal conditions in a group of randomly selected patients scheduled for periodontal treatment in a dental school. The patients' age, sex, and responses to interview questions were used as predictors. About 64% of the lateral tooth surfaces had visible plaque after disclosure with erythrosine, and males had significantly more plaque-covered surfaces than females. All subjects had some areas showing 'bleeding on probing', and a total of 58% of the gingival units bled. About 99% of the subjects, 61% of the teeth, and 33% of the gingival sites had probing depths greater than or equal to 4 mm, whereas 70% of the subjects, 19% of the teeth, and 8% of the gingival sites had probing depths greater than or equal to 6 mm. Mean individual bone score for the 'Ramfjord teeth' was 5.60. Yearly dental visitors tended to keep their teeth to a greater extent than patients with a less regular treatment pattern. This is probably because irregular and emergency patients more often ask for extraction instead of restorative treatment. Since periodontal treatment usually is not offered, the periodontal conditions in the three regularity groups were not considerably different.