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

Association of smokeless tobacco with periodontal health of patients seeking treatment at a Dental Hospital setting in Sri Lanka

Introduction

Betel chewing has indeed been an integral part of many cultures in South Asia and beyond for centuries. The practice involves the combination of various ingredients, including areca nut (also known as betel nut), slaked lime, and often tobacco, all wrapped in a betel leaf. This mixture is chewed for its stimulating and psychoactive effects. In addition to its widespread cultural significance, betel chewing has been linked to social rituals, celebrations, and even medical practices in some regions. Despite its cultural importance, it's important to note the health concerns associated with betel chewing. The use of areca nut has been linked to an increased risk of oral cancers, gum disease, and other health issues. Some studies also indicate that the combination of areca nut and tobacco significantly raises the risk of developing these conditions.

Main objective

To assess any association of smokeless tobacco (SLT) with periodontal health of patients seeking dental treatment.

Specific objectives

To assess the association of periodontal status with oral hygiene habits of patients seeking dental treatment.To assess the association between smokeless tobacco use with plaque score, bleeding score, BPE (Basic Periodontal Examination) scores and pocket depth measurements.

Materials and method

This was a cross sectional descriptive study, conducted among adult patients above the age of 18 years, randomly selected from the daily diagnostic clinic of the Dental (Teaching) Hospital, Peradeniya (DTHP), Sri Lanka. The sample size was calculated by using Lawanga and Lamshow sample size calculation method (Lwanga & Lemeshow, 1991) ensuring a 95 % confidence level and 80 % power and a systematic sampling technique. The study instrument was a check-list to obtain socio demographic information and periodontal health status.

Results

A total of 355 adult patients were included in the study, with a mean age of 38 (SD ± 15.2 years) and the age range between 18 and75 years. Out of the total study sample, 120 (34 %) were male and 235 (66 %) were female.It was identified that age is significantly associated with severe periodontal disease (p < 0.001, OR = 1.043 per year increase) and Plaque score percentile is a strong predictor (p < 0.001, OR = 1.87), indicating a higher plaque score is linked to severe periodontal destruction.The inferential statistics revealed that there was a statistically significant increase in the plaque scores (P = 0.007), bleeding scores (P = 0.007) and BPE scores (P = 0.003) in smokeless tobacco users when compared with those who do not use smokeless tobacco. Moreover, the periodontal pocket depths (PPD) of smokeless tobacco (SLT) users were significantly greater (P = 0.023) than those of tobacco nonusers (NSLT). Among the SLT users, and those who had good oral health habits which was assessed in related to their brushing frequency, showed no significant association across their periodontal (PDD) pocket depths resembling their PDD health.

Conclusion

The results indicated that smokeless tobacco is detrimental to periodontal health. Habit intervention and reduction in the consumption of smokeless tobacco may significantly reduce periodontal disease, and therefore, these preventive measures should be encouraged in SLT users.

Assessment of dental and periodontal indices and Streptococcus mutans virulence in fragile X syndrome patients

INTRODUCTION

Fragile X syndrome (FXS) is the most common cause of hereditary genetic disorder in a single gene characterised by intellectual disability. Behavioural features such as autism, hyperactivity and anxiety disorder may be present. Biofilm development and pathogenicity of Streptococcus mutans may be altered because FXS renders the dental approach and oral hygiene more complex.

OBJECTIVES

The purpose of this study was to compare the levels of transcripts for VicRK and CovR of S. mutans isolated from FXS patients with the levels of transcripts for VicRK and CovR of standard strain ATCC, using a quantitative polymerase chain reaction (qPCR).

METHODS

The caries experience index was assessed by the International Caries Detection and Assessment System (ICDAS), Periodontal Condition Index (PCI) and Invasive Dental Treatment Need Index (INI).

RESULTS

The clinical index findings revealed a high rate of caries cavities and bleeding on probing of FXS patients. When VicRK and CovR transcript levels were compared with the reference strain, Fragile X patients were found to have significantly higher values.

CONCLUSION

The present study demonstrated that FXS patients have more adverse clinical conditions, with increased biofilm accumulation and virulence. When combined with behavioural abnormalities, these patients become even more vulnerable to dental caries.

Assessment of oral health status amongst postal employees of Bhubaneswar city: A cross-sectional study

Introduction

Upholding good dental health has wider effects on productivity and performance at work in addition to being crucial for individual well-being. Because it can affect both their personal well-being and productivity at work, post office workers' oral health is therefore a critical issue of concern. Hence, evaluating Bhubaneswar city post office workers' dental health is the study's aim.

Materials and Methodology

With the aid of the WHO 2013 oral health assessment form, a cross-sectional study involving 171 regular post office workers was undertaken. Using the Chi-square test and an ANOVA for pertinent variables, the data were analysed using SPSS statistical software version 27.0. Potential confounding variables were adjusted using multiple logistic regression analysis.

Results

The survey included a total of 171 post office personnel, of which 76.6% were men and 23.4% were women. The participants' periodontal health revealed that 67.7% had deep periodontal pockets, 18.7% had shallow ones, and 95.3% had bleeding gums. The mean DMFT of the study participants was 4.10 ± 3.149.

Conclusion

Among post office workers, tobacco use and oral health conditions represent a crucial junction of variables that call for caution and preventative action.

Case Series of HIV-Associated Oral Lesions Across Different Clinical Stages in People Living with HIV

Introduction

Human immunodeficiency virus (HIV) impairs immune function leading to oral mucosal lesions. While highly active antiretroviral therapy (HAART) has reduced the incidence of HIV-associated oral lesions (HIV-OLs), these lesions can still manifest across all HIV stages due to various patient-related factors.

Purpose

To evaluate the occurrence of HIV-OLs and clinical characteristics across all HIV stages in people living with HIV (PLWH).

Patients and Methods

Five patients aged 7 to 60 with canker sores visited the Oral Medicine Clinic. One newly diagnosed patient with stage II HIV had not yet started ART, while others in stages I, III, and IV were already receiving ART. Diagnosed oral lesions included recurrent intraoral herpes (RIH) in patients with stages I, II, and III; linear gingival erythema (LGE) in stages I; acute pseudomembranous candidiasis (APC) and oral hairy leukoplakia (OHL) in stages II; traumatic ulcers in stages III; erythema multiforme (EM) and angular cheilitis (AC) in stages IV. Potential risk factors for these oral lesions included poor oral hygiene, low CD4+ T-cell counts, detectable viral load, non-adherence to ART, smoking, medication use for systemic diseases, nutritional deficiency, and comorbidities.

Results

Treatment included antiviral for RIH; antifungal for APC and AC; topical corticosteroid and antiseptic mouthwash for oral ulcers and improving oral hygiene; application of normal saline-soaked gauze dressing followed by topical steroid for EM; petroleum jelly for dry lips; and multivitamins. Lesions improved over 5-15 days. Addressing risk factors involved improving oral hygiene, treating comorbidities, promoting weight gain, smoking cessation, and starting ART for those untreated.

Conclusion

Oral lesions are prevalent throughout the stages of HIV and are influenced by immune status, medication adherence, and overall health, underscoring the need for holistic care to enhance the quality of life, potentially alter HIV progression, and reduce morbidity through integrated oral health assessments in routine care.

Oral Health and Lifestyle Factors in Rural Adults of Jharkhand, India

Background

There is a lack of health care facilities and poor oral health awareness among the rural adult population of Jharkhand which may significantly influence oral health status and lifestyle scores.

Aim

To assess the oral hygiene status, lifestyle factors, and various risk factors associated with poor lifestyle scores in the rural adult population of Jharkhand.

Materials and Methods

This cross-sectional study included 400 rural adults (35-44 years) populations. Face-to-face interviews were used to collect sociodemographic data and data on oral hygiene practices. Lifestyle factors were assessed using Health Practice Index (HPI). Oral health status was assessed using the oral health assessment proforma provided by the World Health Organization (WHO).

Results

A significantly higher (p value < 0.0001) prevalence of tobacco consumption was reported by males (94.0%) compared to females (4.0%). The males (54.0%) reported significantly higher (p value < 0.0001) poor lifestyle scores compared to females (38.0%). A significantly higher (p value < 0.0001) number of oromucosal lesions (13.0%) was found in males compared to females (1.0%). There was a significant difference (p value < 0.0001) in the oral hygiene status between males and females with majority of males (60.0%) having poor oral hygiene. A bivariate analysis was performed, and unadjusted odds ratio was computed. The factors that became significant were then entered into logistic regression model (enter method). The results of logistic regression analysis showed that education (OR = 0.3, p value = 0.003), systemic diseases/long-term medication (OR = 2.9, p value = 0.004), tobacco consumption (OR = 2.9, p value = 0.006), oral hygiene status (OR = 2.4, p value = 0.007), and dental caries (OR = 2.9, p value = 0.004) were significant predictors of poor lifestyle scores.

Conclusion

The rural adult population in Jharkhand has poor oral hygiene status and poor lifestyle scores. It is important to raise awareness regarding good oral hygiene and the negative effects of tobacco consumption. The dental visit should be encouraged, and the concept of preventive care needs to be instilled.

Impact of an Educational Intervention on Oral Health Knowledge and Bacterial Plaque Control in Male Secondary School Students in a Peruvian Province: A Quasi-Experimental Study

Background

The purpose of this study was to evaluate the effect of an educational intervention on oral health knowledge and bacterial plaque control in male secondary school students in a Peruvian province.

Methods

This quasi-experimental study evaluated 294 male secondary school students in southern Peru. Oral health knowledge was measured with a validated 20-item questionnaire. Bacterial plaque was measured with the Simplified Oral Hygiene Index (OHI-S). This was rated as Excellent: 0, Good: 0.1-1.2, Fair: 1.3-3.0 and Poor: 3.1-6.0, before receiving the educational intervention and after four weeks of receiving it. Variables such as age, area of residence, having health professionals as family members, educational level of mother and father, and living with parents were considered. A significance level of p<0.05 was considered.

Results

The comparison between the level of oral health knowledge and the OHI-S, before and after 4 weeks of receiving the educational intervention, showed a significant improvement (p<0.05) in all the categories of the variables studied. Likewise, before the educational intervention, there were significant differences in global knowledge about oral health among the categories of the following variables: age group (p=0.040), area of residence (p<0.001), educational level (father) (p=0.011) and living with parents (p<0.001). However, after four weeks of receiving the educational intervention, no significant differences were observed in all the variables studied (p>0.05). Regarding the OHI-S, no significant differences were observed in any of the variables studied, both before (p>0.05) and after four weeks (p>0.05) of receiving the educational intervention.

Conclusion

After four weeks, the educational intervention significantly improved oral health knowledge and significantly reduced plaque bacterial plaque in male secondary school students in a Peruvian province, regardless of age, area of residence, having health professional family members, educational level of mother and father, and living with parents.

Assessment of oral health status amongst the Sevayats of Shree Jagannath Temple, Puri, Odisha: A cross sectional study

Aim

To assess the oral health status amongst the Sevayats of Shree Jagannath temple, Puri, Odisha.

Methodology

A cross-sectional study was conducted to evaluate the oral health status among 488 Sevayats of Shree Jagannath Temple, Puri, using a simple random sampling technique. Data were obtained by utilizing the WHO oral health assessment form for adults-2013. The documented data were assembled, entered into an MS Excel spreadsheet, and analyzed using SPSS version 26. The statistical tests applied for the analysis were one-way analysis of variance and the Chi-square test. The P value of < 0.05 was considered statistically significant.

Results

The majority of the participants, around 30.3%, had an educational qualification of higher secondary, followed by high school, 26.2%. A total of 84.4% of participants cleaned their teeth with a toothbrush. Around 48.0% of participants were consuming paan and 11.7% were gutkha. The majority, 77.8% of the participants had periodontal pockets, and 79.09% of them had 4-5 mm of periodontal loss of attachment. The mean DMFT of all the participants was 5.23 ± 4.71. In the 25-44 and 45-60 years of age groups, 34.2% and 31.4% of the participants had tobacco pouch keratosis. About 72% of the subjects had bleeding gums.

Conclusion

There was a higher prevalence of dental caries and periodontal disease among the subjects. The majority of the servitors who had a history of consuming paan were diagnosed with oral mucosal lesions.

Clinical Assessment of the Hyperbaric Oxygen Therapy Efficacy in Mild to Moderate Periodontal Affections: A Simple Randomised Trial

Background and Objectives: Gum disease represents the condition due to the dental plaque and dental calculus deposition on the surfaces of the teeth, followed by ulterior destruction of the periodontal tissues through the host reaction to the pathogenic microorganisms. The aim of study was to present aspects regarding the efficacy of hyperbaric oxygen therapy (HBOT) as an adjuvant therapy for the treatment of periodontal disease, started from the already certified benefits of HBOT in the general medicine specialties. Materials and Methods: The participant patients in this study (71) required and benefited from specific periodontal disease treatments. All patients included in the trial benefited from the conventional therapy of full-mouth scaling and root planing (SRP) within 24 h. HBOT was performed on the patients of the first group (31), in 20 sessions, of one hour. The patients of the control group (40) did not benefit from HBO therapy. Results: At the end of study, the included patients in HBOT group presented significantly better values of oral health index (OHI-S), sulcus bleeding index (SBI), dental mobility (DM), and periodontal pocket depth (PD) than the patients of the control group. Conclusions: HBOT had beneficial effects on the oral and general health of all patients, because in addition to the positive results in periodontal therapy, some individual symptoms of the patients diminished or disappeared upon completion of this adjuvant therapy.

Association between Smokeless Tobacco Use and Risk of Periodontitis in Asian Countries: A Systematic Review and Meta-Analysis

BACKGROUND

Individual studies conducted in Asian countries have reported higher risk of periodontitis among smokeless tobacco (SLT) users in comparison to non-users. Therefore, a systematic review was conducted to summarize the available evidence on this topic.

METHODS

Prominent electronic databases were searched using pre-decided MeSH terms and keywords. Screening of titles and abstracts, full text reading, quality assessment and data extraction was done by two investigators independently. The Newcastle-Ottawa scale was used for risk of bias assessment of eligible studies. Meta-analysis was performed for four periodontal outcomes (periodontal pocket depth, loss of attachment, clinical attachment level and gingival recession). A sensitivity analysis was also performed.

RESULTS

Of the 546 citations, 367 were screened for eligibility. Finally, 89 studies were shortlisted for full text reading, of which, 36 were found eligible for qualitative analysis. Most of the studies were conducted in India (n=22), were of cross-sectional design (n=33), utilized purposive sampling and 24 studies were included for meta-analysis (n=28) and done on hospital-based population (n=26). Only 13 (37.1%) studies achieved a score of more than 50% (5/10 stars) on quality assessment scale. SLT users had higher odds of greater periodontal pocket depth greater than 4 mm (OR=3.64), gingival recession (OR=1.71) and loss of attachment 4-5 mm (OR=2.83) and mean difference of 1.7 mm for Clinical Attachment Level compared to non-users.

CONCLUSION

The studies included in this review suggests that SLT users have poorer periodontal health in comparison to non-users. But most of this evidence comes from cross-sectional studies. Longitudinal studies with rigorous methodology are required to support this elucidation. Registration: This systematic review protocol has been registered in PROSPERO (CRD42019122964).

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.