Periodontal treatment needs in a population of Ljubljana, Yugoslavia

Assessment of the Periodontal Status among Kota Stone Workers in Jhalawar, India

CONTEXT

Periodontal disease is one of the most prevalent dental diseases which affects the adult population of the world, varying only in degree from mild to severe. Its prevalence, which was reported in various studies which were conducted in different parts of the globe, signifies its need for a control.

AIMS

To assess the periodontal status among the Kota stone workers in Jhalawar and to provide a baseline data for the planning and evaluation of the oral health care promotion programmes.

SETTINGS AND DESIGN

A cross-sectional descriptive survey was conducted among the Kota stone workers who were working in the Kota stone factories which were located in the Ricco Industrial Area in Jhalawar.

METHOD AND MATERIALS

The study population comprised 420 subjects who were in the age group of 21 to 60 years. The data were collected by means of a close ended, self administered questionnaire and clinical examination with the use of the CPI index. Statistical analyses which were used: Chi-square, Student's t-test, One way Analysis of Variance (ANOVA), and Multiple Logistic Regression.

RESULTS

The socio-demographic characteristics, except the gender, were found to be significantly associated with the periodontal status in the study population (P≤0.05). Multivariate analysis showed high CPI scores which were associated with males (OR=1.313), the 21-40 year age group (OR=0.548), education upto 10th class (OR=4.776), oral hygiene practices other than toothbrush with toothpaste (OR=0.774) and smoking (OR=3.994).

CONCLUSION

The observations of this study indicate the need for a reorientation of the dental care services, with further emphasis on the preventive care in such a population.

Periodontal inflammatory burden correlates with C-reactive protein serum level

OBJECTIVE

The aim of study was to present a new method for evaluation of the periodontal inflammatory burden, to apply the method to the adult population and to correlate it with serum levels of C-reactive protein (CRP).

MATERIALS AND METHODS

On 515 extracted teeth was measured the neck circumferences (NC). The average values of the NC were obtained for 16 male and 16 female individual tooth types. In the clinical part of this study 238 dentate subjects were included. The subgingival area, inflamed area and periodontal wound size were calculated from NC, probing depth and BOP. The sum of the inflamed and ulcerated subgingival areas of all teeth represented the total periodontal inflammatory burden of an individual. Serum levels of CRP were measured by immunochemical method.

RESULTS

The average subgingival area in 238 subjects was calculated to be 13.11 ± 6.35 cm(2) and inflammatory burden area 9.25 ± 5.57 cm(2). The periodontal bleeding wound (p < 0.05) was significantly larger in men. The increased serum levels of CRP correlated with periodontal inflammatory burden (p < 0.05).

CONCLUSIONS

This new method quantifies the inflammatory burden caused by periodontal disease. The size of the inflammatory burden is correlated with increased serum levels of CRP.

Oral health of the elderly living in residential homes in Slovenia

OBJECTIVES

To evaluate oral health status of the elderly, living in eight randomly selected residential homes for senior citizens across the country.

BACKGROUND

The percentage of the elderly is growing worldwide. With ageing, risks of various oral diseases, including dental caries and periodontal disease, are growing.

METHODS

Altogether 296 elderly people (88 men, 208 women) of average age 79.89 ± 7.4 years were questioned about their medical condition and oral health practice and examined orally. Evaluation of clinical examination was carried out by DMFT, plaque index (Silness and Löe, 1964) and Community Periodontal Index of Treatment Need (CPITN).

RESULTS

Of 296 participants, 106 (35.8%) were edentulous, 95 (32.1%) had one to nine teeth and 95 persons (32.1%) had 10 or more teeth. The average number of teeth in an individual was small: 6.76 ± 7.47. The average number of teeth with caries lesions was 3.59 ± 4.70, filled teeth 1.94 ± 3.63 and teeth without caries or fillings 1.19 ± 2.41. The average DMFT value was 30.75. In 69.5% of participants, dental plaque was visible with the naked eye. Of 171 subjects, in whom CPITN index was appraised, 81.9% would need oral hygiene education, 56.7% would need scaling and root planning and 21.6% would need periodontal surgical treatment.

CONCLUSIONS

The results of this study indicate poor oral health of the elderly living in residential homes situated in different towns in Slovenia. It is of utmost importance to highlight the necessity of improving oral health care of this population.

Periodontal diseases: epidemiology

1. The interpretation of epidemiological data of periodontal disease is difficult, due to inconsistencies in the methodology used. It is not possible, therefore, to accurately assess if the prevalence of the periodontal diseases shows a world-wide decline. As long as the disease is assessed through accumulated clinical attachment loss, retention of the natural dentition in older ages entails increased prevalence in these cohorts. Contemporary epidemiological studies should ideally employ full-mouth examination of the periodontal tissues. Partial recording estimates are generally biased, especially when the prevalence of the disease is low. 2. Early-onset periodontitis is infrequent in all populations. Adult periodontitis is rather prevalent; however, advanced disease affects limited subfractions of the population (probably less than 10 to 15%). Although prevalence figures vary with race and geographic region, in most cases, the progression pattern of the disease seems compatible with the retention of a functional dentition throughout life. 3. Of a plethora of behavioral and environmental risk markers identified by multi-variate analysis, smoking and presence of certain subgingival microorganisms have been proven to be true risk factors. The same holds true for diabetes mellitus, a systemic condition that confers a risk for periodontal disease which is independent of the effect of other significant factors. 4. In certain cases, periodontal infections appear to have a systemic impact on the host. Most recent data indicate that periodontal disease may confer risk for coronary heart disease and pre-term low birth weight.

Significance of epidemiologic research in the understanding of periodontal disease

This review describes the development of periodontal index systems which during the last 50 yr have made it possible to gradually expand our understanding of the etiology and pathogenesis of periodontal diseases. Modern epidemiologic research on the prevalence and severity of periodontal diseases is based on a substantial amount of scientific data collected since the early 1940's. The work of a number of innovative researchers has eventually resulted in the clarification of one unsolved problem after the other. At the same time new ideas have been developed for the inclusion of public health aspects in the epidemiologic analyses. The assessment of periodontal treatment needs has become an issue of great importance in many countries of the world and has initiated a discussion and studies on the role of the possibilities for self-assessment of treatment needs. A completely new area of interest has developed when recent epidemiologic surveys demonstrated a substantial increase in the numbers of elderly people together with a substantial increase in the number of teeth per elderly person.