Periodontal status and treatment needs of 12-15 year old institutionalized mentally handicapped school children in Ibadan, Nigeria.

Mentally handicapped children are known, to have poor periodontal health. But previous studies lack conformity due to the use of different indices by the different authors. Twenty-five institutionalized mentally handicapped school children in Ibadan, Nigeria were studied with the aim of assessing their periodontal health and per treatment needs using the CPITN which is known to be simple and has international uniformity. The result showed that none of the children had healthy periodontium and all the children will need oral hygiene care with a significant percentage (8%) requiring complex periodontal care. The need for comprehensive preventive dental program is discussed since the hallmark of management of the children is prevention.     

Assessment of periodontal status and treatment needs of a disabled population using the CPITN.

The Community Periodontal Index of Treatment Needs (CPITN) was used to assess the periodontal status of 213 handicapped persons attending seven institutions in Johannesburg. Fewer than 2% had healthy mouths, 8% had bleeding only, followed by calculus (46%), shallow pockets (40%) and deep pockets (4%). The mean number of sextants with bleeding or higher score was 5.9. Oral hygiene instruction was indicated for 98% and prophylaxis for 90% of the participants. The CPITN was easily used in the disabled population but may overestimate treatment need in view of the current understanding that periodontal disease does not automatically progress from a low CPITN level to the next. A more appropriate measure of treatment need in handicapped persons is required.     

Oral self-care and periodontal health indicators among adults with diabetes in Finland

We assessed the effects of oral self-care on periodontal health indicators among adults with diabetes. The sample consisted of 120 dentate individuals, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic in southwest Finland. Clinical periodontal examination included identification of visible plaque, the presence of calculus, and use of the Community Periodontal Index of Treatment Needs (CPITN). A questionnaire focused on self-treatment, self-prevention, and self-diagnosis of oral diseases, utilization of dental services, and patients' knowledge and attitudes towards oral health. The New Century model of oral health promotion was used as a theoretical framework for analysis of determinants of oral self-care. Although individuals aged 40 years or older were more frequent interdental cleaners, significantly better oral health indicators were found among younger patients. Women reported brushing their teeth more frequently, and differences in plaque and calculus indices were significantly lower than those of men. Self-reported good oral condition was strongly associated with frequent dental visits and less plaque and calculus. No missing teeth and age less than 40 years were predictors of lower plaque, calculus, and CPITN scores. A significant association was found only between frequent dental visits and reduced amount of calculus. Self-reported frequency of oral health habits among adults with diabetes seemed to have little effect on periodontal health indicators. Adults with diabetes should benefit from comprehensive oral selfcare, and more attention is needed for improving the quality and outcome of these habits.     

Dental health and dental care requirements for young handicapped adults in Wessex

The dental health status and treatment requirements of 195 young handicapped adults living in the Wessex Health Region are reported. These young adults, aged 25-34 years, attended adult training centres on a daily basis in each of the districts in Wessex Region. The amount of untreated caries was higher and the periodontal status worse for this group than would normally be expected in young adults in this age range. The dental care received was related to the ability of the subject to comprehend and co-operate with the operator. Nearly half the subjects could receive routine treatment in a normal surgery and about a quarter were likely to require hospitalisation and general anaesthesia to achieve any treatment. The community dental service should play an important role in organising and supervising preventive strategies, with the aim of improving oral hygiene for these young handicapped adults, which should materially improve their periodontal health.     

Handicapped and oral pathology. Clinico-statistical survey

Dental and periodontal conditions of 80 handicapped adults were examined. The epidemiological survey was made by following the WHO suggestions and showed that there are patients in great need of primary and secondary prevention. The results of the research point out a DMFT of 18.78 and extractions were practically the only dental therapy received by these specific patients. Periodontal diseases were surveyed by the use of the CPITN index, and exhibited high values of dental calculus in younger. Furthermore, as the patients increased in age, periodontal pockets appeared and edentulous patients increased.     

Influence of orthodontic anomalies on periodontal condition]

INTRODUCTION: Three main reasons are routinely cited to justify the provision of orthodontic treatment: improvement of facial and dental aesthetics and of dental health and function. However, association between malocclusions and periodontal condition is still controversial. The aim of the present study was to further investigate the correlation between certain orthodontic anomalies and periodontal condition. MATERIALS AND METHOD: One hundred and one subjects were included in this study. Information regarding oral hygiene habits and accessibility to professional oral health care were obtained from each subject. Malocclusions were assessed with the Indice of Orthodontc Treatment Need (IOTN) and the Index of Complexity, Outcome and Need (ICON) and periodontal with the Community Periodontal Index for Treatment Need (CPITN). Spearman Rank correlation order was used to test for any association between malocclusions and periodontal condition. Significance was set at the 5% level. RESULTS: Contact point displacements (malpositions) are positively and significantly correlated to CPITN in the mandibular arch. There was also significant negative correlation between spacing and CPITN in the maxilla. Openbite and overjet assessed by IOTN have a significant positive correlation with the periodontal condition as assessed by the CPITN. In contrast no correlation was found with dental crossbite (IOTN and ICON). At last, there was significant correlation between overbite and periodontal condition. CONCLUSION: Significant correlations were found between malocclusions and periodontal condition. Within the limitation of this study one can suggest that malocclusions are risk marker for periodontal diseases. However, this study by virtue of its protocol cannot allow us to makeany inference about a cause/effect relationship between malocclusions and periodontal condition.     

Oral self-care and periodontal health indicators among adults with diabetes in Finland

We assessed the effects of oral self-care on periodontal health indicators among adults with diabetes. The sample consisted of 120 dentate individuals, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic in southwest Finland. Clinical periodontal examination included identification of visible plaque, the presence of calculus, and use of the Community Periodontal Index of Treatment Needs (CPITN). A questionnaire focused on self-treatment, self-prevention, and self-diagnosis of oral diseases, utilization of dental services, and patients' knowledge and attitudes towards oral health. The New Century model of oral health promotion was used as a theoretical framework for analysis of determinants of oral self-care. Although individuals aged 40 years or older were more frequent interdental cleaners, significantly better oral health indicators were found among younger patients. Women reported brushing their teeth more frequently, and differences in plaque and calculus indices were significantly lower than those of men. Self-reported good oral condition was strongly associated with frequent dental visits and less plaque and calculus. No missing teeth and age less than 40 years were predictors of lower plaque, calculus, and CPITN scores. A significant association was found only between frequent dental visits and reduced amount of calculus. Self-reported frequency of oral health habits among adults with diabetes seemed to have little effect on periodontal health indicators. Adults with diabetes should benefit from comprehensive oral self-care, and more attention is needed for improving the quality and outcome of these habits.     

The oral health in different groups of adults with mental handicaps attending Birmingham (UK) adult training centres

The policies of normalisation and integration into the community of people with mental handicap have significant implications for dental care. Before dental services can be planned, the extent of the problem needs to be identified. A total of 382 people with mental handicap living in the community and attending day centres was examined; 52 of these people were edentulous. The mean age of the dentate adults was 30.9 years and the mean DMFT was 9.59. This was low in comparison with data available from national studies but when component parts of the DMF were evaluated it was apparent that far less restorative care had been received by the adults with mental handicap. There were also significant differences in the mean DMFT between mentally handicapped people who had additional handicaps; the mean DMFT for people with Down's syndrome was 10.95, whilst those mentally handicapped people who also had epilepsy had a mean DMFT of 11.19. The oral hygiene and periodontal condition was also poor and there were significant differences between the sub-groups. However, despite people with Down's syndrome having lower levels of plaque, they showed evidence of greater periodontal destruction. When resources are allocated, consideration should be given to raising the oral health of adults with mental handicap up to at least the same level as that of the rest of the population.     

Assessment of periodontal treatment needs among adults with diabetes in Finland

OBJECTIVES: People with diabetes have a high risk for periodontal disease, which can be considered one of the complications of diabetes. We evaluated periodontal treatment needs using the Community Periodontal Index of Treatment Needs (CPITN) in relation to diabetes-related factors and oral hygiene. DESIGN: The sample consisted of 120 dentate diabetics, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic. The nurses, who interviewed the patients, collected data on duration and type of diabetes, complications, and HbA1c level. Clinical periodontal examination included identification of visible plaque, the presence of calculus and use of the CPITN. RESULTS: The CPITN score 3 was the most prevalent. According to the logistic regression model, poor metabolic control was significantly related to pathologic pockets. No significant association was found between diabetes-related factors and the highest individual CPITN score of 4, which was, in turn, significantly associated with extensive calculus. CONCLUSIONS: Excessive periodontal treatment needs found, indicate that current dental care may be insufficient in adults with diabetes. Oral health among high-risk groups, especially those with poor metabolic control, should be promoted by collaboration between dental and health care professionals involved in diabetes care.     

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.     

Periodontal conditions in 35–44-year-old factory workers in Shanghai

Abstract A periodontal survey applying CPITN was carried out in almost 500 male and female factory workers, 35–44 yr of age, in Shanghai, P.R. China. Calculus and shallow pockets were most frequent. Deep pockets of 6 mm and over were seldom found. The mean number of missing teeth was only 2.7 (out of 32). Problems associated with third molars seem to provide the largest immediate oral health problem     

National oral health survey Zimbabwe 1995: periodontal conditions

Ten years after completion of the first national oral health survey, a second national oral health survey was carried out in 1995. Application of a multi-stage sampling procedure resulted in 3,709 persons being examined. WHO's oral health assessment form and CPITN index was used. The background variables studied were age (15-19, and 35-44-year olds), gender, type of location, socio-economic status and level of education. Results suggest that the periodontal health of adolescents was better in 1985 than in 1995. Overall, the prevalence of periodontal conditions in both age groups was high but its severity was low. The need for complex periodontal treatment was only 4 per cent for adults. The survey has shown that the vast majority of Zimbabweans are not receiving and/or are not seeking periodontal care.     

Periodontal conditions in 65-74 year old adults in France, 1995

In 1995, a study was undertaken in France to assess the periodontal health status of 603 noninstitutionalized elderly subjects aged 65-74 years. Thirty areas were identified in the Rh?ne-Alpes region, with a sampling method based on stratified quotas according to sex, place of residence and socio-economic group (S-EG). The CPITN index was used. The total prevalence of healthy dentate adults (n = 483) was 16.5 per cent, whilst 16.3 per cent of the adults were edentulous. The prevalence of CPITN code 1 + 2 (low) was 50.7. The higher S-EG having fewer codes 1 and 2 (45.8 per cent) than the lower S-EG (49.7 per cent) and the medium S-EG (55.7 per cent). The total prevalence of periodontal disease (code 3 + 4) was 31.5. The prevalence of periodontal disease was lower in adults of medium socio-economic status and was also lower in adults living in urban residences. Overall, 66.9 per cent of the entire population needed oral hygiene instruction, 56.6 per cent scaling and 2.3 per cent complex periodontal treatment.     

Periodontal treatment needs in a native island community in Colombia determined with CPITN

AIMS: To identify the prevalence and different degrees of periodontal disease in an isolated community (Isla Grande, Colombia) with no dental services and low educational level with the use of CPITN, and to establish periodontal treatment needs in different age groups. RESULTS: Of 116 people examined, 0.9% were in periodontal health (CPITN value 0), 18.1% had gingival bleeding (CPITN value 1), 51.7% had supra or subgingival calculus (CPITN value 2), 18.1% presented pockets 3.5-5.0 mm deep (CPITN value 3), and 11.2% had pathological pockets of 5.5mm or deeper (CPITN value 4). No clear differences were observed between sexes. CONCLUSIONS: This study shows that 81% of the sample has some type of periodontal treatment need, with 69.8% of them requiring periodontal treatment that may be supplied by a hygienist and 11.2% requiring specialised treatment. Implementation of oral health education and oral prevention programmes was recommended to the authorities for this community.     

Oral Hygiene Measures and Promotion: Review and Considerations

Current mechanical and chemotherapeutic approaches to oral hygiene aim to modify the oral microflora to promote healthy periodontal and dental tissues. Current oral hygiene measures, appropriately used and in conjunction with regular professional care, are capable of virtually preventing caries and most periodontal disease and maintaining oral health. Toothbrushing and flossing are most commonly used, although interdental brushes and wooden sticks can offer advantages in periodontally involved dentitions. Chewing sugar-free gums as a salivary stimulant is a promising caries-preventive measure. Despite new products and design modifications, mechanical measures require manual dexterity and cognitive ability. Chemotherapeutic supplementation of mechanical measures using dentifrices, mouthrinses, gels and chewing gums as delivery vehicles can improve oral hygiene. The list includes anticalculus, antibacterial and cariostatic agents. For the population at large to make effective use of these oral hygiene measures, oral hygiene promotion needs to be implemented. Considerations include the role of parents, school and the media for children and the workplace, social environments. nursing homes and trained carers for adults and the elderly. Community oral hygiene promotion must attempt to maximise opportunities for oral health for all and reduce inequalities by removing financial and other barriers. Oral health approaches should be tailored to lifestyles and abilities of children, adults and the elderly in order to enable them to make decisions to improve personal oral hygiene and oral health.     

Oral health promotion among adults with diabetes in Finland

OBJECTIVES: In the present community trial, changes in oral health among adults with diabetes in Finland were assessed in three differing intervention groups and in a control group. The goal of intervention was to promote periodontal health. METHODS: The study population comprised of 120 adults with diabetes, who were regular patients at the Salo Regional Hospital Diabetes Clinic in Salo, Finland. All underwent periodontal examination in 1999 and 2001. The percentage of dropouts was 4%. Outcome measures were visible plaque, presence of calculus, and the Community Periodontal Index of Treatment Needs (CPITN) index calculated for each tooth separately. Oral-health-related factors were determined by a questionnaire. Intervention based on the recommended treatment interval was carried out in the following groups: diabetes nurse-letter-reminder group (n = 26), diabetes nurse-reminder group (n = 31), letter-reminder group (n = 30), and a control group (n = 28). RESULTS: A significant decrease occurred in the visible plaque index between 1999 and 2001 in all groups, and in calculus index in the diabetes-nurse-reminder group and in the letter-reminder group. During the study period, only in the control group, the CPITN index codes 3 and 4, calculated for each tooth separately, increased. CONCLUSION: These positive results emphasize the potential of existing health-care actions for promoting periodontal health. With minimal recourse demands, it was possible to increase oral health behaviors and periodontal health among patients with diabetes.     

Dental and periodontal health status in Campanian children and relation between caries experience and socio-economic behavioural factors.

AIM: Our aim was to record oral health situation through mean value of DMFT/dmft, Significant Caries Index (SiC) and CPITN values in a young-population sample in Campania (Italy) and to determine the possible relationship between oral health behaviour, socioeconomic factors and caries experience. STUDY DESIGN: Observational study. METHODS: 101 children (age range 5-18 years) were randomly selected from 10 public schools of the Regional Campanian district and visited at the Paediatric Dentistry Department of Federico II University of Naples (Italy). Clinical examinations were conducted, under standard light, using a plane buccal mirror, a dental probe and air drying to evaluate caries experience and a WHO CPITN ball-point probe to record the periodontal health of each child. A questionnaire (investigating demographic and oral health behaviour data) was filled. X-ray bitewing were also taken. The comparison of quantitative variables among groups was carried out using the one-way analysis of variance (ANOVA). RESULTS AND STATISTICS: The caries prevalence was 81%; the sample mean values were 3.5 (SD=3.79) for DMFT and 3.8 (SD=3.39) for dmft. The variables influencing statistically DMFT/dmft values in the sample are the following: family socio-economic level, level of educational attainment of children mothers and use of the school canteen service. Most of the examined children show CPITN levels between 0 and 1. CONCLUSION: Our results confirm a high caries prevalence and also a need for preventive and educational programmes to obtain caries decrease.     

Behavioral dental science. Part VIII. The dentist's rating and adolescents' perceptions of oral health

The purpose of this study was twofold. The first objective was to measure the periodontal status and perceptions of oral health in adolescents. The second objective was to determine the effects that a program of dental health education would have on their periodontal status and perceptions of oral health. The dental health education with a 90-minute lecture had been given to eleventh-grade students (352) in the previous year. The dental health education program was not carried out in tenth-grade students (442) yet. The oral examination was performed by a dentist for both grades. The examination time was about ten seconds per person. The students' periodontal status was scored as "excellent (+2)," "good (+1)," "questionable (0)," "poor (-1)," or "very poor (-2)" according to the criteria of an Oral Rating Index (ORI) System proposed by the present authors. The level of students' perceptions was assessed by the cognition score of our dental health test (10 items concerning dental attitudes and behavior). Main results were as follows: 1. Only 6% of the 10-th grade students were judged as having "excellent (+2)" oral health. Thirty-six percent were "very poor (-2)" or "poor (-1)" periodontal status. 2. The mean cognition score and the mean ORI score of the 11-th grade students were significantly greater for each sex group than those of the 10-th grade students. 3. The cognition score showed a clear relationship to the ORI score in each grade and in all. The behavioral component of the cognition score was more closely related to the ORI score. These findings suggest that the dental health education contributes to the improvement of periodontal status as well as that of perceptions. Furthermore, the ORI may be utilized for a screening system to evaluate adolescents' periodontal status quickly and effectively.     

Comparison of the Periodontal Index (PI) and Community Periodontal Index of Treatment Needs (CPITN)

692 dental adults in the age ranges, 15-19, 20-29, and 35-44 yr, were assessed for their periodontal conditions and treatment needs using the Periodontal Index (PI) and Community Periodontal Index of Treatment Needs (CPITN). The relative advantages and disadvantages of the two indices were evaluated as epidemiological screening procedures. The CPITN (which calls for examination of only 10 selected teeth) identified higher proportions of adults and teeth with a healthy periodontal condition and also those with periodontitis than the PI (which requires examination of all teeth). The proportion of adults and teeth with gingivitis as the worst condition was greater than when assessed by the PI. Evaluation of individual adult scores by PI and CPITN suggested that the CPITN, despite being a partial recording index only, is more sensitive in identifying existing periodontal conditions and treatment needs than the PI. This is explained by the clinical criteria and periodontal probe utilized in the CPITN. Although the original purposes of the PI and CPITN differ, it is proposed that as a epidemiological screening procedure for assessing periodontal treatment needs the CPITN is to be preferred to the PI.