Association of dental health knowledge with periodontal conditions among regular patients

Patients' knowledge and views about the effects of smoking on their mouths and the involvement of their dentists in smoking cessation activities

BACKGROUND

Smoking is correlated with a large number of oral conditions such as tooth staining and bad breath, periodontal diseases, impaired healing of wounds, precancer and oral cancer. These effects are often visible and in the early stages they are reversible after cessation of smoking. Dentists, as part of the health profession, are frequently in contact with the general population and there is evidence that they are as effective in providing smoking cessation counselling as any other healthcare group.

AIMS AND METHODS

Patients' knowledge of the effects of smoking and their attitudes towards the role of dentists in smoking cessation activities were analysed via a self-completing questionnaire and compared depending on their smoking status (smokers and non-smokers).

RESULTS

The results show that patients hold very positive attitudes towards dentists' role in smoking cessation. The results also show that although patients have a good knowledge of the effects of smoking on general health, smokers are significantly less aware of the relationship between smoking and gum disease and on wound healing.

CONCLUSIONS

Dentists should inform their patients about the oral effects of smoking and strongly advise them not to smoke, especially in patients diagnosed with periodontal disease and requiring surgical procedures.

Improving patients' compliance with the treatment of periodontitis: a controlled study of behavioural intervention

OBJECTIVES

This clinical trial study investigates whether a behavioural educational intervention based on the autoregulation theory can improve periodontitis patients' compliance with proper dental care at a 1-month follow-up.

MATERIAL AND METHODS

Thirty patients matched for gender (20 men), age (mean age=39 years) and education were randomly assigned to a control or an experimental treatment condition. In the control condition, patients received the regular treatment based on instruction of the proper prophylactic dental care. In the experimental treatment condition, patients received information about the symptoms of periodontitis, the causes, consequences and temporal course, and the types of effective strategy and they were requested to keep daily records of the effects of applying prophylactic dental care on their periodontitis symptoms. In both groups, plaque indices (PIs) (Silness & Löe 1964) were measured prior to treatment and at a 1-month follow-up. A self-report questionnaire also assessed the representation of periodontitis in all patients.

RESULTS

A 2 (time of measurement: baseline versus follow-up) x 3 (PI localization) x 2 (experimental group) mixed-design anova computed on the PI reports a large effect of time, F(1, 28)=267.10, p<0.000, indicating that both groups improved from baseline (mean=1.73, SD=0.08) to the 1-month follow-up (mean=0.56, SD=0.06). It is important to point out that this analysis also revealed the expected Group x Time interaction, F(1, 28)=7.09, p<0.02, partial eta(2)=0.19, indicating that smaller PI were observed in the experimental group (mean=0.24, SD=0.14) than in the control group (mean=0.88, SD=0.38) at follow-up. Post hoc analyses showed that this pattern applies to the proximal and lingual PI but not to the vestibular PI.

CONCLUSIONS

The present data show that the behavioural education intervention is (a) more effective than a classical intervention based on information and training about prophylactic techniques and (b) that it is effective in bringing most patients to normal levels of PI. For clinical practice, it suggests that better results can be obtained if (a) patients are taught a correct representation about periodontitis and (b) patients' sense of self-efficacy is developed through their own direct experience, by observing the effects of their behaviour on periodontitis symptoms.

Assessment of periodontal knowledge and periodontal status of an adult population in Jordan

The aim of this study was to assess periodontal knowledge and periodontal status in 20-60-year-old adult population in northern Jordan. A convenient sample consisting of 722 adults was included in this study. A questionnaire incorporating items related to socio-demographic and periodontal knowledge questions was completed before clinical examination, using the Community Periodontal Index of Treatment Needs (CPITN). The results showed that the proportions of subjects who reported bleeding gums, gums' irritation, rough tooth surface and gum disease decreased steadily with age, there is an evident linear trend with high statistical significant difference among various age groups (P < 0.001). Furthermore, the proportions of subjects who answered correctly the periodontal knowledge questions related to plaque definition and its role in disease aetiology and prevention, decreased with age, with a high significant difference for all knowledge questions (P < 0.001). The prevalence of subjects with healthy periodontium (score 0) decreased with age, being 41.1% among 20-29-year-old group and 11.1% in 50-60-year-old group. Similar trend was seen for bleeding on probing (score 1) whilst calculus deposit (score 2) was the major problem in all age groups over 29 years. The prevalence of periodontal pockets was relatively low, with a range of 4.5-18.6% for shallow pockets (score 3) and 2.9-11.1% for deep pockets in younger and older age groups, respectively. Younger age group had more healthy sextants than older age groups. In addition, sextants with bleeding on probing were highest in 20-29-year-old age group (1.8) compared with that in 50-60-year-old age group (0.60) whilst those with calculus deposits varied slightly among different age groups (1.50-1.65). Sextants affected by shallow or deep pockets increased steadily with age. Such a finding was also noted in excluded sextants, with an increase from 0.15 at 20-29 year-old group to 0.94 at the age of 50-60 years. It is concluded that health knowledge and status related to periodontal disease is still poor in northern Jordan. Therefore, dental health education provision is necessary to improve oral health knowledge and conditions among population in general and among older population in particular.

Periodontal awareness and knowledge, and pattern of dental attendance among adults in Jordan

AIMS

To provide baseline data on periodontal awareness and health knowledge, and to assess patterns of dental attendance behaviours among 20 to 60 year-old Jordanian adults.

METHODS

A questionnaire incorporating items related to personal and socio-demographic data, periodontal awareness and health knowledge, and self-reported dental attendance behaviours. One-thousand questionnaires were distributed among adults attending dental clinics.

RESULTS

743 questionnaires were completed and statistically analysed. About one-quarter of adults reported 'gum bleeding' on brushing, but more subjects (40.4%) believed that they had periodontal disease. Also, 47% of the participants thought that they had a 'rough tooth surface', 16% had 'gum irritation' and 25% had 'bad breath'. There were no statistically significant differences between genders with regard to responses on periodontal awareness (P >0.05). The majority of adults incorrectly defined the meaning of dental plaque and did not know its role in the aetiology of gingival disease. Conversely, the majority of participants (60.8%) were aware that gingival bleeding upon brushing indicated the presence of periodontal disease that can be prevented by brushing and flossing (63.4%), mainly before going to bed (73.9%). The overwhelming majority of subjects (81.4%) were irregular attenders. 'Treatment not necessary' and 'cost' were found to be the common barriers for regular dental attendance. The most common treatment received by the subjects at their last visit was restorative therapy.

CONCLUSION

Knowledge and awareness concerning periodontal disease is still poor in Jordan, therefore, more dental health education is needed to improve oral health.

Gender differences in oral health behavior and general health habits in an adult population

This study aimed to evaluate gender differences in oral health behavior and general health habits in adults. The subjects were 207 males and 196 females aged 20-64 yrs who were public officials in the city or town administrations in Chiba Prefecture, Japan. The questionnaire survey included three items: (1) self assessment of oral health status, (2) oral health behavior and (3) general health habits. Statistical analysis was performed using the chi-square test for differences of responses between males and females. The proportion of subjects with cognition of symptoms of oral disease ranged from 14.3 to 23.0%. The percentage of those who had not visited a dentist in the last year were 52.7% for males and 36.7% for females (p < 0.01). Subjects who brushed their teeth almost every day at bed time were 60.9% of males and 88.8% of females (p < 0.01). A comparison of the numbers of positive responses regarding general health habits found no differences in the distribution of general health habits score between males and females. Examining the relationship between oral health behavior and general health habits revealed that males with general habit high scores tended to have positive oral hygiene behavior. These results support the thesis that gender specificities in oral health depend on individual attitudes to oral health and dental utilization. In addition, understanding the cognitive factors of males and females would accelerate dental approaches to modifying oral health behavior of both groups, thus contributing to lifelong health maintenance.

A comparison of patients attending general dental practices employing or not employing dental hygienists

Previous studies have shown that dental practices employing dental hygienists provide a more periodontally oriented mix of dental services. Little is known about differences in the characteristics of patients who attend these practices, and whether these reflect the orientation of service delivery. In this study, a comparison was made between patients attending private general dental practices employing hygienists and patients attending practices without hygienists in Adelaide, South Australia. A questionnaire was mailed to 2391 patients, and valid responses were received from 632 patients attending 12 practices employing hygienists, and 1052 patients attending 22 practices not employing hygienists. Bivariate analysis of the responses comparing the two groups of patients was conducted using ANOVA for continuous variables and chi-square statistics for categorical variables. A multiple logistic regression model was developed to identify characteristics of patients attending practices with hygienists. Examination of significant (p < 0.05) findings revealed that patients attending practices with hygienists had a higher socio-economic status, had a more preventive pattern of use of services, had better knowledge of periodontally related topics and it was more likely that the dental profession was their main source of information of these topics. These findings indicate that patient profiles do reflect the orientation of service delivery within dental practices and raise the question of whether the dental practice alters the patient's knowledge and behaviour or whether certain patients selectively seek care from practices with hygienists.

Relationship between CPITN and oral health behaviour in Japanese adults

Many studies on toothbrushing have concentrated on clinically diagnosing plaque and measuring periodontal status as indicators of oral health behaviour. From a behavioural point of view, however, the more important objective is the health behaviour itself. To investigate the relationship of oral health behaviour to periodontal status, 517 urban employees in Japan (249 men and 268 women aged 20-59 years) responded to a 20-item dental health behaviour questionnaire, entitled the HU-DBI, and had their periodontal conditions examined using the CPITN. Only 1 per cent were found with a healthy periodontium (Code 0), and 9 per cent had bleeding on probing (Code 1). Calculus (Code 2) was the most prevalent condition with 51 per cent of subjects having this code as the worst condition, followed by shallow pockets (Code 3) in 30 per cent, and deep pockets (Code 4) in 9 per cent of the sample. The mean HU-DBI score was 4.2 (out of 12). Females had somewhat higher scores than males (4.4 vs. 4.0, p < 0.05). CPITN had a negative relationship with the HU-DBI (r = -0.26, p < 0.001), and a positive relationship with age (r = 0.40, p < 0.001). Similar relationships were observed in each gender. These data demonstrate the relationship of age with periodontal status, and periodontal status with oral health behaviour. A two-dimensional matrix of HU-DBI score by CPITN may provide a simple and effective means of identifying low and high risk individuals.