Periodontal status of a given population of West Bengal: An epidemiological study

Comparison of clinical indices with halitosis grading in chronic periodontitis: A randomized control trial

Background

Oral malodor is a major periodontal complaint, but the best method for assessing the halitosis grade is still undefined. The primary objective of the study was to detect the halitosis grade in the exhaled breath using the three distinct techniques and to compare the readings with different clinical indices to find out the best method of halitosis grading.

Materials and Methods

A total of 90 patients with chronic periodontitis having oral malodor were included in the study. The subjective assessment of the exhaled breath (halitosis grading) was done by three different methods; using a handheld portable Tanita FitScan sulfide monitor, by Halitox toxin assay, and by organoleptic (Sniff test) method. The findings were then compared with the clinical parameters of poor oral hygiene like plaque index (PI), gingival index (GI), gingival bleeding index (BI), and pocket depth (PD) to detect the best method of halitosis grading.

Results

The mean age of the patients included was 38.23 ± 8.83 (mean ± standard deviation) years. The median value of halitosis grading as obtained by Tanita FitScan was 3.0 (95% confidence interval as 2 and 4) which was then compared with clinical indices (PI, GI, BI, and PD) and the results were statistically significant (P < 0.05), whereas the other two techniques of halitosis grading gave insignificant results.

Conclusion

The results confirmed that the halitosis grading done using Tanita FitScan sulfide monitor is more appropriate with respect to clinical indices when compared with the other two techniques.

Prevalence of Periodontal Disease and Oral Hygiene Practices in Kancheepuram District Population: An Epidemiological Study

BACKGROUND AND OBJECTIVES

The purpose of the study was to evaluate the prevalence of periodontal disease status and oral hygiene practices in urban and rural population of Kancheepuram District, Tamil Nadu, India.

METHODS

This epidemiological survey was carried out on 1650 participants taken from both urban and rural areas of Kancheepuram District. The study groups will belong to rural and urban areas in the ratio of 1:2, respectively. Every individual was assessed with the oral hygiene index-simplified, community periodontal index of treatment needs and periodontal disease index. In addition, the oral hygiene practices were also studied and recorded in a specially designed pro forma. Data were subjected to statistical analysis using SPSS 19.0 software.

RESULTS

The study showed that 50% and 36% of the study participants have gingivitis and periodontitis, respectively, while only 14% of the study participants did not present with any form of periodontal disease. The study also showed that 16.63% of the study subjects among urban and 7.63% of them among rural do not have any type of periodontal disease. About 57.09% of the study participants among urban and 36.54% of the study participants among rural areas have gingivitis. The remaining 26.3% of the study participants in urban areas and 55.8% of the study participants in rural areas have periodontitis. It was observed that majority of participants brush once a day using Medium bristle tooth brush and toothpaste as dentifrice.

CONCLUSION

Periodontal disease is widely spread among population of Kancheepuram District, with greater prevalence in rural population than in urban population. This could be mainly due to the lack of awareness and limited availability of resources. These estimates are vital for the future planning of dental services in Kancheepuram District, Tamil Nadu, India.

Periodontal Disease in Patients Visiting a Tertiary Care Dental Hospital: A Descriptive Cross-sectional Study

Introduction:

Periodontitis is chronic disease leading to tooth loss. Oral hygiene practices combined with regular dental examinations keep oral cavity disease free and maintain periodontal health. The primary objective was to find out the prevalence of periodontal disease of patients measured by the Simplified Oral Hygiene Index and Community Periodontal Index.

Methods:

This descriptive cross-sectional study was conducted in department of Periodontics of a tertiary care dental hospital from April to June 2019 after obtaining ethical clearance and informed consent. Participants were recruited by convenience sampling and 183 sample size was calculated. Proforma included demographics, Simplified Oral Hygiene Index, Community Periodontal Index, body mass index, and smoking status. Data were entered in Statistical Package for Social Sciences version 23 and descriptive statistics were presented as frequency, percentage, mean, and standard deviation.

Results:

Prevalence of periodontal disease corresponding to loss of attachment 1, 2, 3, and 4 was found to in 104 (56.83%) participants. Simplified Oral Hygiene Index score was 1.67±0.89 with “fair” status in majority 114 (62.30%). Gingivitis (Community Periodontal Index 1, 2) was seen in 136 (74.32%). The mean age was 36.37±14.43 years of which 92 (50.27%) were female but smoking was more in males.

Conclusions:

This study suggests deteriorating periodontal health related to age, sex, oral hygiene, smoking, and BMI. As updated information on oral and periodontal health in Nepal is limited, this assessment would help the national policy makers on oral health intervention measures to prevent periodontitis and develop future programs to improve oral health.

Prevalence of periodontal disease among adults in India: A systematic review and meta-analysis

Objective

We designed this systematic review of the available literature to measure the pooled prevalence of periodontal disease among Indian adults.

Methods

An electronic search was conducted for studies assessing the prevalence of periodontal disease (gingivitis and periodontitis) in India. The search yielded forty studies, of which thirty eligible cross-sectional studies assessing the prevalence among those 18 years and above were included. The methodological quality of the included studies was assessed. Meta-analyses were conducted for periodontitis outcomes, stratified for different covariates like age groups, gender, geographic region, population group, type of index and study quality. Pooled prevalence was used to estimate overall effect, with 95% confidence intervals (CI).

Results

A total of 92,219 adults participated in 30 studies included for qualitative analysis. Studies utilizing convenience sampling were excluded from quantitative analysis. Pooled prevalence estimates of periodontitis and gingivitis were assessed on from 24 to 21 studies respectively. We found that overall prevalence of periodontal disease was 51% (CI: 41.9-60.1) and gingivitis was 46.6% (CI: 37.8-55.5). Prevalence of mild to moderate periodontitis was 26.2% (CI: 21.1-31.6), while for severe periodontitis it was 19% (CI: 14.3-24.2). Participants 65 years or above had highest proportion of severe periodontitis (32.7%, CI: 23.7-42.5). Urban population showed the highest prevalence of mild to moderate periodontitis 22.7% (CI: 17.3-28.5). Females had lower prevalence (34.4%) of the periodontitis than males (42.2%). The methodological heterogeneity of included studies was low.

Conclusion

Half of Indian adults suffer from some form of periodontal disease. There is need to adopt uniform and accurate measurement tools for recording periodontal condition.

Plaque-induced gingivitis: Case definition and diagnostic considerations

OBJECTIVE

Clinical gingival inflammation is a well-defined site-specific condition for which several measurement systems have been proposed and validated, and epidemiological studies consistently indicate its high prevalence globally. However, it is clear that defining and grading a gingival inflammatory condition at a site level (i.e. a "gingivitis site") is completely different from defining and grading a "gingivitis case" (GC) (i.e. a patient affected by gingivitis), and that a "gingivitis site" does not necessarily mean a "GC". The purpose of the present review is to summarize the evidence on clinical, biochemical, microbiologic, genetic markers as well as symptoms associated with plaque-induced gingivitis and to propose a set of criteria to define GC.

IMPORTANCE

A universally accepted case definition for gingivitis would provide the necessary information to enable oral health professionals to assess the effectiveness of their prevention strategies and treatment regimens; help set priorities for therapeutic actions/programs by health care providers; and undertake surveillance.

FINDINGS

Based on available methods to assess gingival inflammation, GC could be simply, objectively and accurately identified and graded using bleeding on probing score (BOP%) CONCLUSIONS: A patient with intact periodontium would be diagnosed as a GC according to a BOP score ≥ 10%, further classified as localized (BOP score ≥ 10% and ≤30%) or generalized (BOP score > 30%). The proposed classification may also apply to patients with a reduced periodontium, where a GC would characterize a patient with attachment loss and BOP score ≥ 10%, but without BOP in any site probing ≥4 mm in depth.

Oral hygiene status, oral hygiene practices and periodontal health of brick kiln workers of Odisha

Aim and Objective:

The aim of this study was to assess the oral hygiene status, oral hygiene practices, and periodontal health among brick kiln workers of Odisha.

Materials and Methods:

Four hundred and eight subjects (300 males and 108 females) between the ages of 22 and 65 years with mean age of 33.44 ± 2.34 years working in various brick kilns in the district of Khordha, Odisha, participated in the survey. Data were collected through personal interview and clinical examinations.

Results:

Overall prevalence of periodontal diseases among brick kiln workers was 86.27%. There was a statistically significant difference in the distribution of Community periodontal index (CPI) (P < 0.001) and loss of attachment score scores (P < 0.001). Periodontal disease was significantly associated with age, oral hygiene status, practices, and tissues abuse habits. Most of the workers were males (59%), in the age group of 30–40 years (40.69%), having only a primary level of education (75.98%) and were married (80.88%). Majority of the workers brushed their teeth once daily (78.9%) with toothbrush (51.5%) and used toothpaste (41.2%). Most of them were found to be consuming paan or gutkha as compared to cigarette or beedi smoking. Among the subjects with a CPI >2, higher prevalence of periodontal disease was seen in subjects older than 50 years of age (86.7%), those brushing once daily only (75.2%), brushing with finger (82.8%), with higher frequency and duration of consumption of tobacco and alcohol, and having a poor oral hygiene (85.5%).

Conclusion:

The survey among brick kiln workers revealed that the oral hygiene status was poor, they had ill-informed oral hygiene practices and most of them were suffering from periodontal disease.

Dental Infection and Resistance-Global Health Consequences

Antibiotics are widely used in dental caries and another dental related issues, both for therapeutic and prophylactic reasons. Unfortunately, in recent years the use of antibiotics has been accompanied by the rapid emergence antimicrobial resistance. Dental caries and periodontal diseases are historically known as the top oral health burden in both developing and developed nations affecting around 20⁻50% of the population of this planet and the uppermost reason for tooth loss. Dental surgeons and family practitioners frequently prescribed antimicrobials for their patients as outpatient care. Several studies reported that antibiotics are often irrationally- and overprescribed in dental diseases which is the basis of antimicrobial resistance. The aim of this review is to evaluate the use of antibiotics in dental diseases. Almost certainly the promotion of primary oral health care (POHC) in primary health care program especially among the least and middle-income countries (LMIC) may be the answer to ensure and promote rational dental care.

Prevalence of Periodontal Disease in the General Population of India-A Systematic Review

INTRODUCTION

Periodontal disease is a chronic inflammatory disease resulting in destruction of tissues and structures surrounding the teeth thus, if left untreated causes loss of teeth and ultimately results in edentulism, posing a great negative impact on individuals' quality of life. Hence the global epidemiological data suggests periodontal disease to be one of a major burden on oral diseases. To reduce this burden it is necessary to know the true prevalence of the disease according to which proper initiatives can be formulated. India being home to nearly 1.2 billion people and one amongst the rapidly developing country, its population requires being systemically as well as orally healthy to lead a good quality of life. However due to large heterogenecity amongst its residing population in terms of geographical area, culture, education, socioeconomic status, a variety of oral diseases like periodontal diseases are prevalent here. Even though the early studies suggested that the population is highly susceptible to the disease, the true prevalence of periodontal disease has not been found yet due to paucity in literature available.

AIM

To systematically review the available literature taken from various parts of India and find the prevalence rate of periodontal disease amongst the general population of India.

MATERIALS AND METHODS

A literature search was performed using PUB MED, COCHRANE and EMBASE databases on August 6, 2015. Following full text assessment a thorough references search was made and potential studies were included. A Quality assessment of retrieved articles from 2(nd) round was done using a self designed questionnaire and only field survey studies were included in the systematic review.

RESULTS

The literature search yielded six studies which had performed field surveys to find the prevalence of periodontal disease in their respective areas. These studies have observed different sets of age groups and the same has been accomplished by using Community Periodontal Index (CPI) or Community Periodontal Index of Treatment Needs (CPITN). It was also found that no prevalence studies have been carried out in few North and North Eastern states and Union Territories of India.

CONCLUSION

Due to non-availability of same age groups in selected studies an overall prevalence rate could not be obtained. However, it was observed that few areas of states like West Bengal, Uttar Pradesh and Assam have reported a prevalence rate of periodontal disease of more than 85% in their general population. The data from the present systematic review calls for a combined initiative from the Government of India and Dental council of India to have a nationwide multicentric prevalence studies to obtain the true prevalence rate of periodontal disease in India and interventions should be provided for the same to maintain the oral health and quality of life of the affected population.

Comparison of various risk indicators among patients with chronic and aggressive periodontitis in davangere population

Background:

The aim of the present study was to compare various risk indicators of chronic periodontitis (CP) and aggressive periodontitis (AP) among patients of Davangere population.

Materials and Methods:

Totally, 89 CP and 90 AP patients were selected from outpatient Department of Periodontics, College of Dental Sciences, Davangere. Various clinical parameters proven to be risk indicators were determined for each patient such as age, gender, occupation, oral hygiene habits, personal habits, income, level of education, place of residence, frequency of dental visits, various oral hygiene indices, gingival status, wasting diseases, malocclusion, laboratory investigations, and the results were subjected to statistical analysis.

Results:

This study demonstrated that AP is manifested early in life in susceptible individuals. Proven risk indicators for AP and CP in the present study population included young age, place of residence, income and education levels, frequency of dental visits. Patients with AP had better oral hygiene habits and oral hygiene index results than patients with CP. Paan chewing and smoking could be considered as risk factors, both in CP and AP cases. The similar association of plaque scores but higher bleeding tendency in AP patients supported the fact of higher susceptibility of AP patients to periodontal breakdown. Malocclusion being present in the majority of cases could also be put forth as a risk factor for AP and CP.

Conclusion:

This study identifies the different risk indicators for CP and AP and demonstrates the need for constructing nationwide oral health promotion programs to improve the level of oral health awareness and standards in Indian population.

Periodontal health status of transport workers of a union territory in India: A cross-sectional study

Background:

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. Transport industry is considered an important pillar for socioeconomic development of any nation. The present study was carried out to assess the periodontal health status of transport workers working in Chandigarh Transport Undertaking (CTU) buses, Chandigarh (Union territory).

Materials and Methods:

A cross-sectional study was conducted on all available CTU workers at all three bus depots. The data were recorded on a modified WHO format (1997). A total of 998 subjects were included for community periodontal index (CPI) and attachment loss computations after doing necessary exclusions. Periodontal status was evaluated using CPI.

Results:

About 8.13% of the subjects had healthy periodontium while maximum subjects (73.2%) had a score 2 (calculus) as evaluated by CPI. 3.4% (12) of the subjects belonging to upper middle class had deep pockets as compared to 1.9% (10) of the subjects in the lower middle class. None of the subjects in the upper high, high, and upper middle socioeconomic status (SES) category had a loss of attachment score 4. 25.9% of the postgraduates had a CPI score of 0 whereas 0.7% high school subjects had a loss of attachment score 4.

Conclusion:

Advanced periodontal disease (CPI score, 4) affected small number of subjects with maximum subjects (73%) having a CPI score of 2. There was statistically significant association of SES and education level with the CPI score and loss of attachment level.

Prevalence of periodontal disease and characterization of its extent and severity in an adult population - an observational study

INTRODUCTION

Present study was undertaken to determine the prevalence of periodontal disease in an adult population and to further characterize the extent and severity of the disease.

MATERIALS AND METHODS

The study population consisted of 700 randomly selected individuals reporting to out patient department of dental college and hospital. Demographic details and lifestyle characteristics of the all the subjects were recorded and a thorough oral examination was performed. In order to evaluate the periodontal status of subjects, five indices (CAL, PD, OHI, PI and GI) were assessed and subjects having at least one site with clinical attachment loss (CAL) ≥3mm were diagnosed as having periodontitis. Further, to analyse the extent of disease, subjects having periodontitis were divided into two groups as having at least one site with CAL ≥5mm and having at least three sites with CAL ≥5mm.

RESULTS

RESULTS showed that there was a high prevalence of periodontitis amongst population with almost 72% of the individuals having at least one site with CAL ≥3mm. A trend was noted in which periodontal status worsened as the age increased. Analysing the extent and severity of disease amongst the population, results revealed that almost 41% of population had at least one site with CAL ≥5mm whereas almost 21% of individuals had at least three sites with CAL ≥5mm.

CONCLUSION

Present study provides with evidence of high prevalence of periodontal disease amongst the population. Importantly, this study also unveils the lack of awareness for dental health amidst the population.