Oral health in Slovenia, Yugoslavia

An oral health epidemiological survey using WHO assessment forms was conducted in the Republic of Slovenia (Yugoslavia) in 1987. The study population consisted of 1623 persons aged 6, 12, 15, 18, 35-44 and over 65 yr. The survey included 10 towns in 9 geographical areas of Slovenia. The results showed the prevalence of dental caries in the Slovenian population to be very high (93.6% in 12-yr-olds). The mean decayed, missing, and filled teeth (DMFT) scores were as follows: 5.1 at age 12 yr, 10.2 at 15 yr, 12.9 at 18 yr, 20.5 at 35-44 yr, and 27.0 in persons aged over 65 yr. Assessment of the periodontal status showed calculus to be the predominant disorder in the age groups 18 and 35-44 yr, while shallow pockets prevailed in persons aged over 65 yr.     

Oral health in SFR Yugoslavia in 1986

A pilot oral health epidemiological survey using WHO assessment forms was conducted in Yugoslavia in the year 1986. The study population consisted of 2600 persons aged 6, 12, 15, 18, 35-44, and over 65 yr. The survey included 22 towns (11 developed and 11 underdeveloped) in the six Republics and two Provinces of Yugoslavia. The results showed the prevalence of dental caries in the Yugoslav population to be very high (98.7% in 12-yr-olds). The mean decayed, missing, and filled teeth (DMF) scores were as follows: 6.1 at age 12 yr, 9.6 at age 15, 10.9 at age 18, 18.0 at age 35-44, and 28.0 in persons aged over 65 yr. Assessment of the periodontal status showed calculus to be the predominant disorder in the age groups 18 and 35-44 yr, while loss of sextants prevailed in persons aged over 65 yr.     

Periodontal treatment needs in populations under 20 years of age in Espoo, Finland and Chiangmai, Thailand

The aim of this study was to assess the periodontal treatment needs at under 20 yr of age in the affluent area of Espoo, Finland, offering comprehensive public dental health care, as compared to a less advantaged area in Chiangmai, Thailand. In Espoo, 50 girls and 50 boys were examined in each age group of 7, 12 and 17 yr. In Chiangmai equal numbers of girls and boys were examined to obtain a group of 89 subjects aged 18.5 + 0.6 yr. According to the Community Periodontal Index of Treatment Needs (CPITN) the need of scaling increased in Espoo from 6% of the 7-yr-olds to 39% of the 17-yr-olds. Moderate pocketing (4-5 mm) occurred in one subject at age 12 and in three subjects at age 17. In Chiangmai, deep pockets (6 mm and over) were recorded for 1%, moderate pockets for a total of 44%, and dental calculus as the highest treatment need indicator in the remaining 55%, indicating a need for professional treatment in 100% of the group examined. The mean number of sextants requiring scaling was 0.6 per person at age 17 in Espoo as compared to 4.5 at 18.5 yr of age in Chiangmai. Three or more healthy sextants per subject were recorded for 47% of the 17-yr-olds in Espoo and for only 6% of the 18.5-yr-olds in Chiangmai. It was concluded that already at young age vast differences occur between periodontal treatment needs in industrialized and developing countries.     

The possibility of previous epidemiological data to serve as baseline for future national oral health surveys--a study in Vietnam

AIM: The purpose of this paper is to review the most recent epidemiological data (1985-2000) on dental caries and periodontal diseases in Vietnam in an attempt to obtain a 'baseline' for future national oral health surveys. METHODS: Studies on periodontal diseases and caries were included when CPITN and WHO caries criteria had been applied and when the sample size was at least n = 200 for each age group. RESULTS: Almost all subjects had calculus. The median number of sextants with calculus in the 15-19-year- and in the 35-44-year-olds was 4.2 and 5.0, respectively. Only 2-7% of the 35-44-year-olds had one or more deep periodontal pockets. The estimated DMFT of the 12-, 15- and 35-44-year-olds was 1.8, 2.0 and 5.4, respectively, in the years around 1990. CONCLUSION: This review shows that (often neglected) epidemiological studies from the past on caries and periodontal diseases can contain comprehensive data sets that provide an estimate of the past oral health status which may serve as a baseline for future national surveys.     

Periodontal disease prevalence in different age groups in Japan as assessed according to the CPITN

A CPITN survey was conducted involving 12,832 Japanese subjects from 7 to 64 years of age. Subjects under 18 were schoolchildren, and 18-year-old and older subjects represented various social backgrounds, having been randomly selected from both urban and rural Japan. Fifty percent of the 7-yr-old children had signs of periodontal disease, and this percentage increased with increasing age. In those under 14, this increase in periodontal disease was mainly due to an increase in the proportion of children developing dental calculus. Subjects with 6 mm or deeper pockets were observed starting from the 20-29-yr-old age group. In subjects over this age, the prevalence of periodontal disease was higher in men than in women. The percentages of subjects having pathologic pockets had increased remarkably in the 30-44-yr-olds. In the 45-64-yr-old group, almost all subjects had some sign of periodontal disease, and the percentage of those with 4 or 5 mm pockets and 6 mm or deeper pockets were 37% and 21%, respectively.     

Periodontal treatment needs, by CPITN, among employees of a Jerusalem hospital.

A survey, employing the Community Periodontal Index of Treatment Needs (CPITN), was conducted among 344 employees of a Jerusalem hospital. Of the population surveyed, 2.2 per cent demonstrated totally healthy mouths, 1.5 per cent had, at the worst, bleeding symptoms, 13.3 per cent had calculus, 53.4 per cent had 4-5 mm ('shallow' according to WHO) pockets and 29.6 per cent had deep pockets (6 mm or more) as their worst CPITN scores. Results revealed an average of 0.55 edentulous sextants, 0.68 healthy sextants, 0.87 sextants with bleeding symptoms, 1.36 with calculus, 1.95 with 4-5 mm pockets and 0.61 sextants with deep pockets. In general, females were healthier than males, had a significantly greater number of healthy sextants, less sextants with calculus and less sextants with deep pockets. A deterioration in periodontal health with age was evident, according to mean number of sextants per person by CPITN scores. Associations were also analysed between CPITN and demographic variables. Few significant associations were revealed. Based on FDI and WHO estimates, the calculated periodontal treatment needs for the hospital employees was found to be about 2 hours per person. Compared with data for other countries, as reported by the WHO, this status demands serious efforts to be made towards periodontal health promotion.     

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     

Periodontal treatment needs in 12 and 15 to 19-year-old school children in the Caribbean island of Antigua, 1990

A national survey was undertaken in 1990 to investigate the periodontal treatment needs in 12 and 15 to 19-year-olds residing in urban and rural areas of Antigua. Using the CPITN procedure, examination of 246 12 year-old children and 456 adolescents (15–19 years) revealed that the CPITN scores of healthy, gingival bleeding, calculus, 4 or 5 mm and ≥6 mm periodontal pockets were distributed similarly in urban and rural areas. Calculus was the most commonly recorded score, with a prevalence of 46% in 12-year-olds and 56% in 15–19 year-olds. 4 or 5 mm pockets were found in 14% of adolescents, affecting on average less than one sextant per subject, but deep pockets were uncommon, 26% of 12-year-olds and 14% of adolescents had periodontally healthy mouths. Scaling and oral hygiene instruction were the predominant treatment needs in both age groups, but the requirement for complex periodontal care in adolescents was low – 3% only.     

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.     

Periodontal status of a subject sample of Yemen

Abstract From August to October 1991, the periodontal status of 1001 Yemenis representing the age groups 12-14, 15-19, 20-24 and 35-44 years was recorded and evaluated with preference to the CPITN, the calculus index and clinical attachment levels. The impact of chewing khat, the leaves of a cultivated, alkaloid shrub, and of using the traditional miswak chewing stick for oral hygiene purposes were investigated. The results show that 6.9% of the juvenile probands (15-19 years) had healthy periodontal tissue (CPITN 0). whereas bleeding on probing and calculus (CPITN 1+2) were registered in 86.2%. In the 35-44 year age group. 1.7% were periodontally healthy, whereas 84.5% displayed plaque retention or shallow pocketing (CPITN 2-3) and 12.5% deep pocketing (CPITN 4). The treatment needs in all age groups are confined primarily to calculus removal and instruction in oral hygiene. The clinical attachment level and the calculus index revealed age-related attachment loss and calculus formation, primarily among male probands. The higher khat consumption among the male population is reflected in its detrimental effect on the periodontal tissue, especially among younger probands. Oral hygiene aids have also an influence on periodontal status, with a toothbrush proving more efficient than the miswak. WHO efforts directed towards prophylactic programs need to be intensified but can be staffed by dental hygienists.     

Dental caries in Namibia – the first national survey

Abstract This paper reports findings on dental caries in the first national survey in Namibia, the second largest country on the Southern African subcontinent. In 1991. a total of 208l individuals, representing 0.15% of the Namibian population, 764 12-yr-olds, 736 15-yr-olds and 581 35–44-yr-olds were examined to determine their oral health. Caries was diagnosed using WHO criteria by a single calibrated dentist. At 12 yr between 37% and 81% of the subjects examined were caries-free, at 15 yr between 25% and 66%, and in the age class 35–44 yr 6–44% were caries-free. Mean DMFT at 12 yr was 0.40–1.74 and at 15 yr 0.92–3.05; mean DFT at 35–44 yr was 1.36–3.93. Females had significantly more caries than males and there were significant differences between urban, peri-urban and rural areas. The caries prevalence and experience is nevertheless low and within the WHO target for the year 2000 at 12 yr of age.     

Periodontal conditions in Hesse, Federal Republic of Germany, measured by CPITN

The periodontal status and the need for treatment were investigated among 3140 inhabitants of the Federal German state of Hesse, using the CPITN index. The male and female subjects forming the case material were divided into 6 age categories (I up to 19 yr, II 20-24 yr, III 25-29 yr, IV 30-34 yr, V 35-44 yr, VI 45 yr or more). The dentitions of 1.3% of those examined were healthy from the periodontal aspects (CPITN 0). 3.3% of examined persons displayed an increased tendency towards bleeding on probing as the sole pathologic manifestation (CPITN 1); calculus and bleeding on probing (CPITN 2) were recorded in 35.5% of patients. Shallow pocketing (CPITN 3) was observed in 49.3, and deep pocketing (CPITN 4) in 10.6% of the examined subjects. There was a marked increase in scores 3 and 4 among patients from age group V. In addition, the posterior teeth were more susceptible to disease than those in the anterior segments, with slightly higher figures being recorded among female than among male individuals. 98.7% of the patients were in need of periodontal treatment. Application of the PTNS index yielded a treatment requirement of 6841.0 hours for the examined population. 2323 hours of this time were allocated to oral hygiene instruction, 4148 hours to scaling and 370 hours to surgical intervention.     

A review of the oral health status in Syria

AIM: To estimate the prevalence and severity of dental caries and periodontal diseases in Syria and to determine possible secular changes in the last two decades. METHODS: Epidemiological studies performed between 1980-1999, using the WHO criteria for dental caries and the CPITN criteria for periodontal diseases in Syria were retrieved and reviewed. RESULTS: The caries experience of 5-year-old children was high (dmft of 4.7-5.2). The estimated DMFT score of 12-year-old Syrian children was 1.9-2.3. A secular change of the caries experience in the last two decades was not apparent. The amount of untreated caries lesions was high and had not changed substantially in the last two decades. The D component comprised 72-90% of the DMFT of 12-15-year-old children and 26-30% of the DMFT of 35-44-year-old Syrians. The majority of 15-24-year-olds, and more than 80% of the 35-44-year-olds had calculus. Despite the widespread and chronic existence of calculus, only 3-11% of the 35-44-year-old persons had one or more deep periodontal pockets. CONCLUSION: The caries experience in Syria is moderately low and does not seem to have changed in the last two decades. The increased output of graduate dentists in the last decade has not changed the large amount of untreated caries lesions. In Syria, where the prevalence of unmet (caries) treatment needs is high, regular removal of calculus (scaling) for the sake of preventing periodontal pockets should not have a high priority in the oral health services.     

Relative influence of calculus and overhangs of fillings on the frequency of score 2 of the CPITN

Periodontal treatment needs of 895 dentate subjects aged 25, 35, 50 and 65 yr were studied according to the Community Periodontal Index of Treatment Needs (CPITN). The relative influence of calculus and overhanging margins of restorations on the need for professional debridement of shallow (less than or equal to 3 mm) pockets was calculated. The mean number of sextants per person scoring CPITN Code 2 decreased from 2.6 in the 25-yr group to 1.1 in the 65-yr group. Overhangs of fillings alone were detected in 0.8 sextants of the 25-yr-olds and in 0.1 sextants of the 65-yr-olds. The mean number of sextants containing calculus with or without overhangs decreased from 1.8 in the 25-yr group to 1.0 in the 65-yr group. The relative influence of calculus was higher in the aged than in the young population. The recording of overhangs is important for accurate assessment of periodontal treatment needs in populations with a high caries experience.     

Assessment of periodontal disease in an adult population survey in Taipei city using CPITN and GPM/T indices

The community periodontal index of treatment needs (CPITN) has been recommended for epidemiological surveys of periodontal status and treatment needs. The prevalence of gingivitis, periodontitis and missing teeth in a study population has been determined using the CPITN and GPM/T (gingivitis: periodontitis: missing teeth) indices. In this study, a survey of periodontal disease was performed among the adult population of Taipei City using the CPITN index. A total of 673 dentated persons (male 339, 50.4%; female 334, 49.6%) were examined and surveyed. Data were then divided into five age groups, 15-19, 20-29, 30-44, 45-64 and 64+. The prevalence of periodontal disease was analyzed using the percentage or sextant from all teeth. Treatment needs were determined by the worst periodontal score per sextant. It was found that about 91% of subjects suffered from various degrees of periodontal disease in at least one tooth. Gingivitis and periodontitis were 86.9% and 33%, respectively. Among them 48.9% had missing teeth. The prevalence of periodontitis and missing teeth increased with age. Most of them involved oral hygiene instruction and scaling. About 11.0% of the subjects needed periodontal surgery. Higher proportions of attachment loss with gingival recession caused by destructive periodontal disease were found in older persons who did not require periodontal surgery. It was concluded that endemic gingivitis and calculus, a moderate prevalence of shallow pockets and a low prevalence of deep pockets were observed among adults in this group in Taipei City and that the CPITN is a practical epidemiological and public health method for screening the periodontal status and treatment needs of a population.     

Periodontal treatment needs in a population of Ljubljana, Yugoslavia

1692 citizens of Ljubljana in the age range from 15 to 65 yr participated in a survey to assess their periodontal treatment needs. Eighty-three of the participants (4.9%) were edentulous and excluded from the study. Of the 1609 dentate subjects only 2.4% were free of any signs of periodontal disease. According to the Community Periodontal Index of Treatment Needs, (CPITN), reversible gingivitis was present in 19.9% of the population, calculus and shallow pockets (4-5 mm) in 57.4%, and deep pockets (greater than or equal to 6 mm) in 20.3% of the examined participants. Bleeding on probing was the most common finding in a group of 15-yr-old subjects, calculus was most frequently found in 25- and 35-yr-old groups, and shallow and deep pockets in 45-, 55- and 65-yr-old adults. Complex treatment needs increased with age, reaching 42.9% in the 65-yr-old population. However, deep pocketing was in 60% limited to one sextant of the participants with complex treatment needs.     

Periodontal status by CPITN, and associated variables in an Israeli permanent force military population

AIMS: The objectives were to determine periodontal treatment needs using the CPITN index, of Israeli permanent force military personnel. METHODS: The study population consisted of 1300 military personnel aged 25-44 years (mean age 33.8 +/- 5.4), who attended obligatory routine medical and dental examinations. Clinical examinations were conducted by 3 calibrated examiners, employing flat dental mirrors, the specially designed WHO periodontal probes (FDI probes) and following CPITN criteria. The frequency distributions were studied with regard to age groups, gender and education, as well as differences in the severity of the disease. Also, the mean number of sextants affected per person by age was assessed. RESULTS: Only 1.19% of the subjects demonstrated healthy periodontal tissue. Shallow pockets were similarly found among all age groups, and the number of persons with deep pockets increased with age. Deep pockets were found almost 3 x more among males (18.66%) in comparison with females (6.19%). Persons with higher education (> 12 years), had less deep pockets and bleeding than individuals with less than 12 years of education (p<0.05). CONCLUSIONS: Compared with data from other countries reported by the WHO, this periodontal status indicates a relatively high level of treatment needs. This survey provides a substantial contribution to the national oral health data bank concerning the adult working population in Israel.     

Oral health care needs among the middle-aged and the elderly in Hong Kong

Abstract A sample of 372 35–44-yr-olds and 537 noninstitutionalized 65–74-yr-olds were clinically examined in an oral health survey of Hong Kong Chinese conducted in 1991. The examination procedures and diagnostic criteria for assessing restorative and extraction treatment need followed those recommended by the World Health Organization. The Community Periodontal Index-based periodontal treatment needs involving index teeth or their replacements were computed from separate clinic scores for maximum probing depth, presence of calculus, and bleeding after probing. A set of criteria for assessing prosthodontic treatment need was specially laid down for this survey. Examiners were calibrated before the survey, and the interexaminer reliability was found to be generally good. Besides reporting the various individual normative treatment need items in the traditional way, the present analysis used some holistic treatment-need categories which may have manpower-requirement implications for the classification of subjects. All dentate subjects surveyed required some treatment. Only 6% of the elderly, all edentulous, required denture work only. Of the 35–44-yr-olds, 42% needed scaling and oral hygiene instruction only, which could be provided by dental hygienists. The treatment needs of the vast majority of the middle-aged and the elderly (mainly scaling; simple fillings; and extractions, dentures, or both) could be easily handled by general dentists. Only about one-fifth of the subjects in both age groups required some complex care such as endodontics, crowns, and advanced periodontal treatment, which could be delivered by senior dentists or dentists with specialist training.     

Oral health status of children and adults in urban and rural areas of Burkina Faso, Africa

OBJECTIVES: To analyse the oral health status of children and adults in rural and urban areas of Burkina Faso; to provide epidemiological data for planning and evaluation of oral health care programmes. DESIGN: Cross-sectional survey including different ethnic and socio-economic groups. SAMPLE AND METHODS: Multistage cluster sampling of households in urban areas and random samples of participants selected based on the recent population census in rural areas. The final study population covered four age groups: 6 years (n = 424), 12 years (n = 505), 18 years (n = 492) and 35-44 years (n = 493). Clinical oral health data collected according to WHO methodology and criteria. RESULTS: At age 6, 38% of children had caries, with prevalence higher in urban than rural areas. At age 12, the mean DMFT was 0.7 with prevalence significantly higher among urban than rural children. Mean DMFT was 1.9 in 18-year-olds and 6.3 in 35-44-year-olds and figures were higher for women than men. In adults, no differences in caries experience were found by location whereas the caries index was significantly affected by ethnic group and occupation. CPI score 2 (gingivitis and calculus) was dominant for all ages: 6 years (58%), 12 years (57%), 18 years (58%), 35-44 years (49%). In addition, 10% of 35-44-year-olds had CPI score 4. Rural participants had more severe periodontal scores than did urban individuals. CONCLUSIONS: Health authorities should strengthen the implementation of community-based oral disease prevention and health promotion programmes rather than traditional curative care.     

A national survey of periodontal treatment needs of adults in the Philippines

2,400 dentate adults (15 to 65 yr), representative of rural and urban areas of all twelve regions of the Philippines, were screened for their periodontal treatment needs using the Community Periodontal Index of Treatment Needs (CPITN). The distribution pattern of CPITN scores for the criteria, healthy, gingival bleeding (on probing), calculus, 4-5 mm and 6 mm or deeper periodontal pockets was similar for adult populations in each of the twelve regions. Calculus predominated as the most frequently recorded score, with a prevalence exceeding 70% in young adults but decreasing to about 40% in older adults. The decrease in prevalence of calculus with age was associated with an increase in 4-5 mm pocketing, 4% in young adults and about 60% in older adults. Periodontally healthy mouths and cases of deep pocketing were relatively uncommon. The assessed treatment need was predominantly Type 2 (scaling and improved oral hygiene). Need for complex treatment (Treatment Need Type 3) was low involving only 4% of older adults. The pattern of assessed periodontal treatment needs of adults in the Philippines was indicative of endemic gingivitis and calculus and moderate to low prevalence of pocketing.