Periodontal Health Condition and Associated Factors among University Students, Yemen

Assessment of treatment needs, barriers, and self-perception regarding oral health among female university students: a cross-sectional study

BACKGROUND

The study aimed to compare the self-perceived oral health status measured through a self-administered questionnaire with clinically determined oral health status measured by decayed-missing-filled teeth (DMFT) and community periodontal index of treatment need (CPITN) indices in university going females. In addition, access barriers to treatment related to oral healthcare were also determined.

METHODS

A 3-month analytical cross-sectional study was designed for consenting university going females (aged 18-22 years) in Islamabad, Pakistan. The self-perceived oral health was recorded through a questionnaire requesting information regarding socio-demographics, self-perception of oral health, frequency of dental visits and barriers to seeking oral health. Seven independent examiners performed intraoral clinical examination and assessed the oral health status using globally standardized oral health assessment indices (DMFT and CPITN).

RESULTS

A total of 400 students were included in the final sample. The study revealed a significant disparity between self-perceived oral health and clinical assessment. Although perceived oral health was considered "good" by 80.0% of the respondents, clinical examination revealed moderate DMFT scores (mean 2.95 ± 1.41) and periodontal disease requiring treatment in 89.5% of the individuals. The most common barriers in seeking dental care were lack of knowledge, dental phobia, affordability issue and false self-perception.

CONCLUSION

The present study demonstrated a notable discrepancy between self-perception of oral health and clinically assessed oral health. These results emphasize the importance of focused educational programs and community outreach programs, especially directed towards this demographic. Prioritizing such initiatives will help individuals to recognize their actual oral health condition thus encouraging positive oral health behaviors and outcomes.

Factors associated with recent and regular non-use of dental services by students from a university in southeastern Brazil: a cross-sectional study

BACKGROUND

Lack of use of dental services can be a risk factor for oral health. In addition to recent visits to dental services, it is important to assess the regularity of use of these services, as well as the motivations for visiting the dentist. There is a gap in literature studies on the patterns of use of oral health services by the young university students. The goal of this study was to assess the factors associated with recent and regular non-use of dental services by young university students, using the Andersen model as a reference.

METHODS

This was a cross-sectional study with 477 university students between 18 and 24 years old, carried out as a web survey, through which predisposing, enabling and need variables were collected, according to the model proposed by Andersen, to test the factors associated with recent and regular non-use of dental services. Bivariate analyses and robust Poisson regression were performed, with estimation of crude and adjusted prevalence ratios, using confidence intervals of 95%. The variables with p < 0.05 remained in the final model.

RESULTS

The prevalence of recent non-use was of 19.5% (95% CI 16.0-23.3%), and of regular non-use, of 53.5% (95% CI 48.9-58.0%). After the adjusted analysis, the following were found to be associated with the outcome of recent non-use: type of service used (PR = 0.91; 95% CI 0.85-0.98) and perceived need for dental treatment (PR = 0.98; 95% CI 0.97-0.99); and the following variables were associated with regular non-use: father's level of education (PR = 0.86; 95% CI 0.78-0.96), area of study (PR = 1.08; 95% CI 1.02-1.15), reason for last dental appointment (PR = 0.81; 95% CI 0.75-0.88), use of dental services throughout childhood (PR = 0.92; 95% CI 0.86-0.97), self-perceived oral health (PR = 0.86; 95% CI 0.76-0.88), and toothaches over the last 2 years (PR = 0.93; 95% CI 0.87-0.99).

CONCLUSION

The motivation for young university students to use dental services are curative treatment needs, not prevention. The results point to the need to implement health prevention and promotion policies in higher education institutions and to expand access to dental services for this young population.

Living with Family Is Directly Associated with Regular Dental Checkup and Indirectly Associated with Gingival Status among Japanese University Students: A 3-Year Cohort Study

Although some studies showed that lifestyle was associated with oral health behavior, few studies investigated the association between household type and oral health behavior. The aim of this prospective cohort study was to investigate the association between household type, oral health behavior, and periodontal status among Japanese university students. Data were obtained from 377 students who received oral examinations and self-questionnaires in 2016 and 2019. We assessed periodontal status using the percentage of bleeding on probing (%BOP), probing pocket depth, oral hygiene status, oral health behaviors, and related factors. We used structural equation modeling to determine the association between household type, oral health behaviors, gingivitis, and periodontitis. At follow-up, 252 students did not live with their families. The mean ± standard deviation of %BOP was 35.5 ± 24.7 at baseline and 32.1 ± 25.3 at follow-up. In the final model, students living with their families were significantly more likely to receive regular dental checkup than those living alone. Regular checkup affected the decrease in calculus. The decrease in calculus affected the decrease in %BOP over 3 years. Living with family was directly associated with regular dental checkups and indirectly contributed to gingival status among Japanese university students.

Body mass index and periodontal health status among young Saudi adults: a cross-sectional study

BACKGROUND

Obesity has been suggested as a risk factor for periodontal disease. Despite the high prevalence of obesity and over-weight among Saudi population, no study has assessed whether there is an association between periodontal health status and body mass index (BMI).

OBJECTIVES

Assess the association between BMI and other variables with periodontal health status among young Saudi adults.

DESIGN

Analytical, hospital-based cross-sectional study.

SETTING

University dental hospital, Riyadh.

PATIENTS AND METHODS

All dental students aged 21-35 years who met inclusion criteria were invited to participate in the study. Periodontal health status was assessed by the plaque index (PI), gingival index (GI) and community periodontal index (CPI) scores. Biometric measurements included weight, height and BMI. Multiple logistic regression was used to assess the association of independent variables with periodontal disease (CPI>2 vs CPI ≤2) and multiple linear regression models to assess associations with PI and GI.

MAIN OUTCOME MEASURES

Periodontal health by BMI and other variables.

SAMPLE SIZE

308.

RESULTS

Of 700 participants invited, 380 participated for a response rate of 54.2%. Slightly more than half of the obese subjects 54 (52%) did not brush their teeth regularly. The mean (standard deviation) PI and GI scores were significantly higher among the obese (PI score: 1.54 [0.45]); GI score: 1.52 [0.51]) and overweight (PI score: 1.36 [0.47]) and (GI score: 1.42 [0.57]) subjects when compared with subjects with normal weight (PI score: 1.27 [0.51]); (GI score: 1.31 [0.48]); ( P<.05). No significant differences were seen between BMI groups in CPI scores. There were also no significant differences in the mean number and percentage of sextants between different BMI groups. The only signficant factor for periodontal disease in the multivariable analysis was toothbrushing.

CONCLUSION

The present study shows a significant positive correlation between BMI and PI and GI scores. However, no statistically significant association was found between BMI and periodontal health status.

LIMITATION

Cross-sectional, so not possible to assess the association of oral health and BMI over time.

CONFLICT OF INTEREST

None.

Effect of Khat Chewing on the Salivary pH before and after Using Mouthwashes

BACKGROUND

Saliva is a biological fluid that has multiple protective functions. These functions can be attained only if the saliva keeps certain physo-chemical properties such as pH. The main purpose of the current study was to compare the salivary pH among khat chewers and non-khat chewers before and after specific intervals (15, 30, and 60 minutes) of using three commercially available mouthwashes (MWs).

METHODS

In this cross sectional study, thirty pharmacy student volunteers were divided into three groups of 10 for the three MWs. Each group was then subdivided into 5 volunteers as khat chewer and non-khat chewer. The statistical evaluation was carried out by using paired t-test and analysis of variance (ANOVA) for in vivo study of salivary pH.

FINDINGS

Low salivary pH in all khat-user volunteers before and after using MWs was indicated. There was an increase in the salivary pH after 15 minutes of rinsing with the three selected MWs for both groups of volunteers, after that there was a gradual decrease to the initial pH. The difference between the three groups was not significant at baseline and after 15 minutes, but there was a significant difference after 30 and 60 minutes for the non-khat-chewing and khat-chewing volunteers.

CONCLUSION

It can be concluded that using MWs results in altering salivary pH and continuous khat chewing lowers the baseline pH of saliva and ability to compensate the change of salivary pH.

Epidemiology of khat (Catha edulis) consumption among university students: a meta-analysis

BACKGROUND

Khat is amphetamine-like substance commonly consumed by students when they wish to study for long hours especially during examination periods. Khat consumption is associated with increased rates of cardiovascular problems, stroke, myocardial infarction, cardiomyopathy, periodontal disease, gastritis, poor oral hygiene, psychosis, decreased quality of life, and poor academic performance.

METHODS

PubMed, EMBASE, and SCOPUS were systematically searched without restriction by publication status. Publications were screened according to predefined inclusion criteria. Twenty-five articles were included. Random effect model was used to calculate weighted prevalence, odds ratio (OR) and corresponding 95% confidence interval (CI). We assessed the risk of publication bias by using funnel plot and Eggers's regression tests.

RESULTS

The pooled prevalence of current khat use among university students was 14.16% (95% CI; 11.87-16.81). The pooled prevalence of current khat use was highest in Saudi Arabia 18.85% and it was 13.59% in Ethiopia and 13.04% in Yemen. In addition, the current pooled prevalence of khat use was higher in men at 19.26% than in women 6.41%. Regarding lifetime khat use, in this study, the pooled prevalence of lifetime khat use was 27.31%. The lifetime prevalence was higher in men at 31.47% than in women 11.79%. Moreover, the lifetime prevalence of khat use was 43.27% in Yemen, 37.32% in Saudi Arabia, and 24.82% in Ethiopia. We found significantly increased odds of current (OR 3.59; 95%CI 2.01-6.41) as well as lifetime (OR 3.48; 95%CI 2.09-5.78) khat chewing in men as compared to women.

CONCLUSION

The pooled prevalence of current and lifetime khat consumption was 14.16 and 27.31%, respectively. Both the current and lifetime prevalence of khat use was higher in men than in women. In addition, both the current and lifetime prevalence estimates of khat consumption were low in Ethiopia than in Saudi Arabia. Moreover, the odds of both current and lifetime khat consumption were higher in male students than in female students. Programmes that specifically aim at increasing awareness and that most motivate reduced khat consumption among university students were recommended.

Is Khat (Catha edulis) chewing a risk factor for periodontal diseases? A systematic review

Background

Khat (Catha edulis) chewing is a highly prevalent habit in the Arabian Peninsula and East Africa, and has recently spread to Western countries. The association between khat chewing and oral mucosal lesions is well documented in the literature. However, there is no concrete evidence on the association between khat chewing and periodontal disease. The purpose of this systematic review was to analyze the influence of khat chewing on periodontal health.

Material and Methods

A literature search of PubMed, Scopus and Web of Sciences databases was carried out to identify relevant articles published from 1990 to May 2017. The inclusion criteria were all clinical studies that assessed the relationship between khat chewing and periodontal disease.

Results

The search yielded 122 articles, of which 10 were included in this systematic review. Most of the studies exhibited a positive correlation between khat chewing and periodontal disease.

Conclusions

Altogether, the analysis of the current evidence reveals that khat chewing is destructive to the periodontium and enhances the risk of periodontal disease progression. However, due to variability of studies, more longitudinal case-controlled studies are highly warranted to establish a causal relation between khat chewing and periodontal disease.

Key words:Khat chewing, periodontal health, periodontal disease, risk factor.

Oral hygiene and periodontal health status among khat chewers. A case-control study

Background

Habitual khat chewing is a widespread male habit in Southern Arabia and East Africa. The aim of this study was to assess the effect of Khat chewing on oral hygiene and periodontal health status among Yemeni male khat chewers.

Material and Methods

This case- control study included 310 khat chewers, aged 20-65 years, and 72 age- and gender- matched non-chewers as controls. Periodontal examination included recording of dental plaque index (PI), gingival index (GI), probing pocket depth (PPD), attachment level (AL) and gingival recession (GR). Demographic data, oral hygiene practices, and duration, frequency and site of khat chewing were obtained using questionnaires. SPSS was used for data analysis. ANOVA and t- tests were used to compare groups.

Results

Khat chewers had significantly higher mean PI, AL, GR scores than non-chewers (P < 0.05). However, no significant differences in the GI and PPD mean scores were observed between both groups (p > 0.05). Interestingly, the results showed that the chewing side had less PI, GI and PPD than non-chewing side. However, gingival recession was significantly higher in the chewing side. The duration of chewing showed a significant effect on PI, PPD, AL, and GR but had no effect on the gingival condition. Likewise, the frequency of chewing showed a significant effect on PPD, AL, and GR, but had no effect on other indices (PI and GI).

Conclusions

The results of this study indicate that khat chewing have a detrimental effect on the periodontium.

Key words:Khat chewing, periodontal health, oral hygiene.