Differing profiles of periodontal disease in two similar South Pacific island populations

Abstract The periodontal condition of a cross-section of individuals aged between 15–59 years was characterised from clinical and radiographic observations of dental calculus, gingival inflammation, the level of the gingival attachment, alveolar bone loss, teeth missing or requiring extraction for periodontal reasons. The common characteristics of the profile in Tonga and W. Samoa were a high prevalence of the factors common to periodontal disease: calculus and gingival inflammation; a progressive apical movement of the gingival attachment; and alveolar bone Joss. All these criteria showed a positive age dependency with calculus (particularly subgingival calculus) and gingival inflammation being very commonly associated with all tooth types at an early age, less than 30 years. Tooth loss observed was presumed to be previously associated with periodontal disease because the prevalence of dental caries was very low in both populations. Substantial differences were observed in the number of missing teeth between Tongan and Samoan populations, the Tongan subjects having a high rate of tooth loss. From radiographic interpretations of the periodontal conditions fewer subjects in Tonga were assessed as having no disease, and there was a higher prevalence of progressive destructive disease in Tonga than in W. Samoa. The proportion of subjects in both countries with no disease decreased rapidly with age. There was no evident explanation of the greater severity of disease in Tonga than in W. Samoa. The prevalence of microbial plaque, calculus and gingival inflammation was very high in all subjects at all ages particularly over 30 years in both populations.     

A study of the dental health of children and young adults attending special schools in South Glamorgan.

An epidemiological study was carried out involving 677 children and young adults aged between 3 and 19 years who were attending special schools in South Glamorgan. The children and young adults were examined for caries and periodontal disease. Their dental attendance pattern and the dental service they used were recorded, and their mobility and posture, and comprehension and cooperation, were assessed. The results showed that the majority were receiving regular dental care and that the caries experience of 12- and 14-year-old children was lower than that of children of the same ages in other state schools. Five-year-old children were found to have a dmft of 4.18, which was significantly higher than that of similar-aged children attending state schools. Forty-seven per cent of the children and young adults were found to have periodontal disease; the greatest percentage (60%) was found in the young adults in the 15-19-year-old age group. Caries experience and gingival health were not related to the subjects' mobility and posture but caries experience was greater and gingival health was poorer in subjects who had reduced comprehension and cooperation. The study highlighted deficiencies in the service provided for this group, especially for pre-school children.     

Gingival recession: epidemiology and risk indicators in a representative urban Brazilian population

BACKGROUND: Gingival recession is a common manifestation of periodontal disease, but it is also associated with other risk factors. A few studies have investigated the epidemiology and risk factors of this condition. This study describes the epidemiology of gingival recession in a representative, urban Brazilian population and assesses various risk indicators. METHODS: A representative sample of 1,460 subjects was selected using a multi-stage, probability, cluster sampling strategy. The subjects were interviewed using a structured questionnaire and had a full-mouth clinical examination in a mobile examination center. RESULTS: More than half (51.6%) and 22.0% of the individuals and 17.0% and 5.8% of teeth per individual showed gingival recession > or = 3 mm and > or = 5 mm, respectively. The prevalence, extent, and severity of recession correlated with age. Recession showed a nonlinear relationship with age, with 25 to 50 year olds showing the highest level of recession. Males aged > or = 30 years showed significantly higher prevalence and extent of gingival recession than females. The percentage of teeth with recession was significantly higher in the lower socioeconomic groups irrespective of age, and in subjects > or = 30 years of age with irregular dental care than in subjects with regular care. Using a multivariable model, cigarette smoking and presence of supragingival calculus were the factors most significantly associated with localized and generalized recession, whereas gender, dental visits, and socioeconomic status were not significant risk indicators. CONCLUSIONS: The high level of gingival recession in this Brazilian population may be primarily related to destructive periodontal disease and is significantly associated with a high level of supragingival dental calculus and cigarette smoking. Population-based programs aimed at the prevention of periodontal diseases may reduce the prevalence of severe gingival recession in this and similar populations.     

Research into actual conditions and preventive care in periodontal disease. Relationship between questionnaire results and periodontal disease in youth

The purpose of this study was to determine the prevalence of periodontal disease and the relationship between the results of questionnaire concerning periodontal disease and the actual periodontal condition in youth. The examination was carried out in three parts. In the first part, a questionnaire was conducted on 3,886 junior and senior high school students (12 to 18 years of age) living in Kawagoe, Japan. The questionnaire was composed by of items concerning habits of oral hygiene, periodontal symptoms, understanding of periodontal disease and history of diagnosis by dentist of periodontal disease. Secondary, mass intraoral examination was carried out on all objects. The examination covered gingival inflammation, periodontal probing depth, calculus, dental plaque, dental caries and malalignment. Lastly, we examined the relationship between the results of periodontal examination and questionnaire with the original periodontal classification. The following results were obtained: 1. As an example of items in questionnaire, 83.1% brushed their teeth more than two times daily. The understanding of oral hygiene concerning dental caries was improved, but concerning periodontal disease was still poor. 2. The symptom most frequently reported was gingival bleeding during tooth brushing (18.4%). 3. The percentage of persons with periodontal disease (moderate gingival inflammation and periodontal pocket 4 mm or deeper) was of the highest frequency at 13 years old. The proportion of males increased with the advanced state of periodontal disease. 4. A significant correlation was found (chi 2-test: alpha less than 0.001) between advanced state of periodontal disease and a decrease in tooth brushing time per day. 5. A significant correlation was found between the advance of periodontal disease and gingival bleeding on tooth brushing (chi 2-test: alpha less than 0.001). Similarly, a correlation was found between the advance of periodontal disease and gingival swelling (chi 2-test: alpha less than 0.001). 6. A significant correlation was found (chi 2-test: alpha less than 0.001) between the advance of periodontal disease and aggravation of condition of dental plaque, calculus, dental caries and malalignment.     

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目的    了解大连市开发区15岁学生人群恒牙龋病和牙周病患病状况及分布, 为口腔疾病防治策略提供依据。方法    于2009年10—11月,采用多阶段、等容量、随机抽样方法, 抽取大连市经济开发区 15岁学生480名, 男女各半。按照《第三次全国口腔健康流行病学调查方案》中的龋病、牙周病调查标准进行检查。以龋均、患龋率、龋齿充填率和牙石、牙龈出血、牙周袋检出率作为统计指标, 采用SPSS12.0软件包对数据的进行统计分析。 结果    大连市经济开发区15岁学生的恒牙患龋率为55.42% , 龋均为1.49, 龋齿充填率为26.19%, 龋均和患龋率男女之间差异均有统计学意义 （均 P < 0.05） ; 牙龈出血检出率和平均检出区段数分别为31.88%和0.49个 , 牙结石检出率和平均检出区段数分别为74.58%和1.57个, 牙周袋的检出率为2.50%, 牙结石检出率和平均检出区段数男女之间差异有统计学意义 （ P < 0.05）。结论    大连市开发区 15岁年龄组学生患龋较高, 龋齿充填率低, 牙周健康状况不良, 应加强口腔卫生服务, 以促进该人群口腔健康水平。     

吉林省12岁儿童龋病和牙周健康状况调查分析

目的：了解吉林省12岁儿童人群恒牙龋病和牙周病患病状况及分布,为口腔疾病防治策略提供依据。方法：根据全国第三次口腔健康流行病学调查的方法,对吉林省城乡788名12岁儿童的龋病和牙周病进行了调查。采用SPSS13．0软件包进行数据的统计分析,以龋均、患龋率和牙石、牙龈出血检出率作为统计指标,两样本均数的比较使用t检验,率的比较使用X2检验。结果：12岁儿童的恒牙患龋率43．65％,龋均为1．07,龋均和患龋率男女之间均有高度显著性差异（P〈0．01）,农村地区患龋率高于城市地区,但经检验差异无显著性意义,吉林省12儿童的显著性龋均指数为2．89;牙龈出血检出率为53．46％,牙结石检出率和平均检出区段数为76．40％和1．94。牙龈出血检出率和牙结石检出率城乡之间均有高度显著性差异（P〈0．01）。结论：12岁年龄组儿童患龋较高,牙周健康状况不良,应加强口腔卫生服务,以促进该人群口腔健康水平。     

四川省12岁儿童口腔健康状况调查报告

目的调查四川省12岁儿童口腔健康现状,监测龋病和牙周疾病患病趋势,为四川省口腔卫生保健规划和决策提供信息和依据。方法按照《第三次全国口腔健康流行病学抽样调查方案》,采用多阶段分层等容量随机抽样的方法,抽取四川省12岁城乡儿童常住人口720人,男女各半,检查恒牙龋和牙周情况。数据采用SPSS13.0软件统计。结果12岁年龄组儿童龋均0.5,患龋率25.7%。龋补充填比F/(D F)6.7%,城市高于农村(P<0.01)。窝沟封闭率0.7%,农村为0。显著性龋均指数1.47,73.40%的恒牙龋分布于12.74%的儿童中。牙龈出血检出率76.3%,牙石检出率72.0%,人均7.5颗牙齿有牙龈出血,9.9颗牙齿有牙石。农村均高于城市(P<0.01)。结论调查人群患龋率较低,但龋病预防与治疗情况差,龋病主要集中在少数高危儿童;农村儿童牙周状况差,农村口腔保健工作亟待加强。口腔卫生保健工作应趋向区域性、合理性、系统性。     

The second national survey of oral health status of children and adults in China

OBJECTIVES: To describe the oral health status of Chinese children and adults at national level in relation to location and province and to highlight changes in dental caries experience. DESIGN: Cross-sectional study, oral epidemiological survey based on WHO methodology, clinical examinations. SETTING: National survey by National Committee for Oral Health. SUBJECTS: Representative samples of provinces, districts, townships; cluster sampling including subjects aged 5,12,15,18, 35-44 and 65-74. Each age group consisted of 23,452 participants, i.e. total of 140,712 individuals. RESULTS: At age 5, 76.6% were affected by dental caries and mean dmft was 4.5. Mean DMFT varied from 1.0 in 12-year-olds, 1.4 in 15-year-olds, 1.6 in 18-year-olds, 2.1 in 35-44-year-olds to 12.4 in 65-74-year-olds. In adults, caries experience was higher in females than in males. The effect of urbanisation on caries prevalence in children varied by province and age. Among adolescents and young adults caries levels were high in urban areas while caries experience was high for old-age people of rural areas. At national level, changes in dental caries prevalence of 12- and 15-year-olds were small. However, some provinces with extensive oral health programmes (e.g. Love Teeth Day) showed declining caries experience whereas provinces with limited preventive activities had increasing levels of caries. For all age groups, gingival bleeding and calculus were most frequent. Severe periodontal conditions were relatively rare. CONCLUSION: The systematic implementation of preventive oral care and community-oriented health programmes are needed for the continuous promotion of oral health in China.     

龋病患牙牙周健康状况调查分析

目的：检查龋病患牙的牙周健康状况,探讨龋病对牙周健康状况的影响。方法：在武汉大学口腔医学院牙体牙髓科和牙周黏膜科就诊的患者中,选择一侧牙有龋,而对侧同名牙无龋的牙齿86对,每对牙齿依次检查牙体龋坏情况（包括冠龋和根龋）及牙周状况（包括探诊深度、探诊出血、牙石指数、牙龈退缩程度、松动度）,并进行统计学分析,研究龋病患牙的牙周健康状况。结果：86对牙齿比较结果显示,有龋组的牙周探诊深度、牙石指数、牙龈退缩程度、松动度均显著高于无龋组（P〈0.05）。对有龋组牙仅有冠龋的71对牙齿做比较,结果显示有龋组患牙的牙周探诊深度、牙石指数、牙龈退缩程度均高于无龋组,有显著性差异,且探诊深度、牙石指数有非常显著的差异（P〈0.01）。对有龋组中既有冠龋又有根龋的15对牙齿牙周情况做比较,结果显示有龋组牙龈退缩、松动度均高于无龋组且有显著性差异（P〈0.05）。结论：在同一口腔环境中龋病的发生和牙周炎症程度呈正相关,两者的微生态联系和相互影响有待深入的研究。     

北京市12岁儿童口腔健康调查及影响因素分析

目的 了解北京市12岁儿童龋病患病率和牙周健康状况，并分析其影响因素。方法 随机抽取西城区616名12岁儿童进行患龋状况调查，对其中二分之一的样本做问卷调查，收回有效问卷206份，统计分析龋齿和牙石栓出率与影响因素间的关系。结果 患龋率43％龋均0．95，62％的儿童牙面清洁，10．6的牙周健康。结论 与第二次全国口腔健康流行病学调查结果相比，患龋率，龋均和需治疗牙数有所下降，但牙周健康状况较差。有晚上刷牙习惯的儿童患龋率较低，从未发现自己牙龈出血的儿童牙石少。     

Periodontal status of individuals in early stages of human immunodeficiency virus infection

The purpose of this study was to evaluate the association of periodontal health and human immunodeficiency virus infection among individuals in the early stages of disease who were participating in randomized placebo-controlled clinical trials of zidovudine. Previous reports have described a rapidly progressive periodontitis and atypical gigivitis associated with late stages of infection by the human immunodeficiency virus. A health history was completed by each subject. Baseline oral examinations were completed on 97 asymptomatic patients and nine with AIDS-related complex (ARC) during their regular clinic visit. Follow-up examinations were conducted at 3-month intervals throughout the 48 weeks of the oral study. Evaluations of plaque, calculus, gingival abnormalities, caries, and periodontal disease were conducted. Periodontal measurements included plaque index (PI), gingival index (GI), bleeding index (BI), probing depth (PD), and observation for cratering, necrosis, and tooth mobility on six teeth in each patient. More than half of the subjects had visited their dentist during the previous year and had had an oral prophylaxis; less than 25% of them had had either restorative work or extractions. The mean scores for periodontal indices averaged over the course of the study in asymptomatic and ARC respectively were: PI: 0.9 (SE 0.04) and 0.9 (SE 0.08), 0.818; GI: 1.0 (SE 0.04) and 0.9 (SE 0.07), P = 0.412; BI: 0.6 (SE 0.04) and 0.4 (SE 0.07), P = 0.278; PD: 2.9 (SE 0.05) and 2.6 (SE 0.10), P = 0.140. There was no evidence of cratering, necrosis, or tooth mobility in either group. Few had calculus or dental caries. There were no clinically significant differences detected between ARC versus asymptomatic patients. Dental histories and oral examinations showed that two groups of patients in early stages of HIV-disease were in good periodontal health.     

Oral health in adolescents with immigrant background in Stockholm

Dental caries and periodontal health was studied in 225 18- and 19-year-old adolescents with different ethnic background. The results showed that immigrant adolescents exhibit an increased prevalence of periodontal disease compared to the Swedish control group whereas no differences were found concerning the prevalence of dental caries. Alveolar bone loss was diagnosed on one or more surfaces in 4.3% of the Swedish adolescents compared to 16.2% in the immigrant group. Subgingival calculus was found among 5.3% of the Swedish adolescents compared to 35.1% in the immigrant group. This study shows that immigrant adolescents must be considered at high risk to develop periodontal disease during adolescents while dental caries can be managed.     

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.     

Association of dental health knowledge with periodontal conditions among regular patients

Although routine patient education concerning periodontal disease is recommended as a means of improving oral health, strong associations between oral health knowledge and plaque or gingival inflammation scores have not been demonstrated. This study examined associations between four knowledge scales (likelihood of keeping teeth, signs of disease, role of diet, role of oral hygiene measures) and six periodontal status measures (plaque, gingivitis, calculus, probing depth, attachment loss, missing teeth) among 1088 regularly attending dental patients. In bivariate correlation analyses, there was a weak, direct association between stronger expectations of keeping teeth and better levels of periodontal health, while an inverse association between knowledge of signs of periodontal disease and better periodontal health was noted. Level of knowledge of the role of oral hygiene or of diet in periodontal disease was not associated with level of disease. When effects associated with age, sex, race, and different dental practices were held constant, these patient knowledge scales did not explain substantial proportions of variance in the periodontal disease measures. Among regular utilizers, the effects of receipt of dental care may be more determinative than level of patient knowledge.     

The relationship of initial clinical parameters to the long-term response in 112 cases of periodontal disease

The purpose of the present study was to determine whether any of the clinical parameters recorded during an initial periodontal examination would relate to the course of periodontal cases maintained for long periods of time. Based on available documentation, cases which had a downhill course were assembled from a population previously studied. In addition, long-term cases currently under maintenance care were drawn from our private practice. On average, the patients had been under care for 23 years. The study population was heavily weighted toward downhill cases to better compare these cases with those usually found in periodontal practice. Positive statistical correlations were found between the amount of subgingival calculus and the degree of gingival inflammation at initial examination. Disease severity initially was positively correlated to long-term course of disease. The amount of subgingival calculus did not relate to the long-term result. There was a strong correlation between inflammatory gingival hyperplasia initially and good long-term maintenance. The results suggest that, in combination, initial characteristics of periodontal cases coupled with long-term results of treatment may aid in further subclassifying the periodontal diseases.     

Oral disease burden and utilization of dental care patterns among pediatric solid organ transplant recipients

Objectives: We conducted a study among pediatric renal (RTRs) and liver transplant recipients (LTRs) to determine: a) the overall burden of oral disease; and b) the frequency with which this population utilizes dental care services in relation to sociodemographic factors and oral disease burden. Methods: In this cross-sectional survey, study procedures included the completion of a standardized questionnaire (by parents/guardians), oral mucosal examination, assessment of caries, gingival enlargement, and plaque index. Results: The 142 children (82 RTRs and 60 LTRs) enrolled from April 2002 to November 2005 were predominantly Latino (41 percent) and Caucasian (34 percent). Forty-three percent had at least one carious surface (in either a deciduous or permanent tooth), 19 percent had five or more carious surfaces, and 25 percent had gingival enlargement. We found only one case of oral candidiasis. Even though 72 percent of parents/guardians reported their child had a regular source of dental care, only 49 percent had a dental cleaning and 44 percent had dental radiographs in the past year, reflecting a low prevalence of preventive dental care. Among children with no regular source of dental care, there were statistically significantly higher proportions of Latinos, younger children, and families with an annual household income < $35,000. Conclusion: While the prevalence of oral mucosal disease and gingival enlargement was low, the prevalence of children with caries was high, and there was low use of preventive dental care. Strategies to improve this population's utilization of preventive dental care are needed.     

Socioeconomic status and self-reported periodontal symptoms in community-dwelling individuals: data from the Korea Community Health Surveys of 2011 and 2013

Objectives: This study aimed to evaluate the association between socioeconomic status and self-reported periodontal symptoms. Materials and methods: In this cross-sectional study, data were used from the 2011 and 2013 Community Health Surveys. The 210,432 (weighted n = 36,294,413) and 220,396 (weighted n = 39,067,134) subjects, respectively, were aged 19 years or older. Proportional and systematic sampling was performed. Surveys were conducted by trained interviewers using computer-assisted personal interviewing. The proportions of subjects with tooth mobility, gingival swelling, calculus and gingival bleeding were calculated. Independent variables included sex, age and socioeconomic status measures (education, occupation and income). Differences in the self-reported periodontal symptoms rates according to socioeconomic status were determined using independent t-tests and one-way analysis of variance. Logistic regression analysis was used to identify the association of periodontal symptoms with socioeconomic status. Results: Approximately 30% of the subjects reported at least one symptom of periodontal disease; 11.3% and 9.6% reported gingival bleeding and gingival swelling, respectively, while 5.6% and 3.5% reported dental calculus and tooth mobility, respectively. There were significant associations with self-reported periodontal symptoms according to occupation, education and income (P < 0.01). Conclusions: The severity of self-reported periodontal symptoms differed according to socioeconomic status. Subjects with lower socioeconomic status reported more advanced periodontal disease symptoms, such as gingival swelling, while those with higher socioeconomic status reported more incipient periodontal symptoms, such as gingival bleeding. Socioeconomic status remains a factor affecting self-reported periodontal symptoms in community-dwelling individuals in Korea.Key words: Community health, health survey, periodontal diseases, self-report, signs and symptoms     

Study on oral health status and health behavior of workers at government office]

The purpose of this study was to investigate the oral health status and health behavior of the adult population in the workplace. In 1998, oral health examination of 388 workers (male: 287, female: 101) at a government office was performed. A questionnaire was administered to obtain data regarding oral symptoms and health behavior. The results were as follows: Overall, 48% needed treatment for dental caries, 44% needed calculus removal, and 23% needed treatment for periodontal disease. Although there were no oral health complaints, 20% had early caries, 40% had dental calculus, and 19% had periodontitis. Compared to males, more females brushed their teeth, had home dentists (44%) and received more regular dental health check-ups at least once a year (48%). For males, those with home dentists had higher FT and DMFT in the twenties and thirties. There was no relationship between oral health status and regular check-ups in both males and females. The results revealed that receiving regular dental check-ups from home dentists was not popular in Japan. Further, the role of home dentists is not preventive oriented. It was concluded that it is necessary to provide regular oral health examination and health promotion programs for adult population at the workplace in Japan.     

影响牙周健康的相关因素分析

目的：利用第二次全国口腔健康流行病学调查的部分资料，对影响牙龈出血和牙结石的部分社会和行为因素进行分析，探讨影响牙龈出血和牙结石的相关因素，为牙周病的预防提供科学依据和防治对策。方法：对17598个样本的基本特征、口腔卫生习惯、就医行为、知识态度、社会经济状况和生活习惯6类指标与牙龄出血、牙石的关系进行了单因素和多因素分析。结果：我国人群的牙龈出血和牙石的患病率很高，而且患病情况较严重。结论：6类指标都对牙周健康有不同程度的影响，其中不良口腔卫生状况是最重要的影响因素。