Oral Hygiene Considerations in Adult Patients with Leukemia during a Cycle of Chemotherapy

The oral cavity is the place where the first symptoms of systemic diseases may appear. Leukemia is the malignancy of the hematopoietic system in which abnormal leukocytes are produced in the bone marrow and these cells spread to the peripheral blood. It is classified clinically on the basis of the duration and nature of the disease (acute or chronic), the type of cell involved (myeloid, lymphoid, or monocytes), and a rise in the number of abnormal cells in the blood. The study aimed to assess and compare the oral hygiene and periodontium status based on the indices in leukemic patients before and after one cycle of chemotherapy and whether the therapy had an impact on the change of these parameters. Dental indices used in clinical diagnostics were calculated: API (approximal plaque index), SBI (sulcus bleeding index), and CPI (community periodontal index). The research project was conducted at the Clinic of Hematooncology and Bone Marrow Transplantation of the Independent Public Clinical Hospital No. 1 in Lublin. The target population consisted of 102 adults with leukemia who were over 18 years of age. The time since diagnosis of the disease ranged from 1 to 10 years. The data were evaluated in the Statistica 12 software with the respective tests. In the majority of patients, both before and after chemotherapy, improper oral hygiene and severe generalized periodontitis were confirmed. The cycle of chemotherapy that was used did not correlate with the change of patients’ oral hygiene and periodontium state. Unsatisfactory oral hygiene and periodontal health has to be addressed with urgent dental treatment to avoid systemic complications in leukemic patients.

Comparison of Oral Health Problems in Children: A Cross Sectional Survey in Pakistan

Aim: To determine and compare the oral health, in term of oral health, community periodontal and DMFT index, of primary and elementary school children. Subjects and method: In this study 694 students were examined for oral health. 347 students were from primary school whereas other half were from elementary school. The sample population was selected via a purposive sampling technique. Data was collected using Simplified oral health index (OHI-s), community periodontal index (CPI) and decay missing Filled tooth (DMFT). Results: in the study 39(11.2%) of primary school students and 49(14.1%) of elementary school students have poor oral hygiene. Similarly among primary school students 62(17.9%) have bleeding gums and 30(8.6%) of the students have calculus teeth. Among elementary school students 74(21.3%) have bleeding gums and 40(11.5%) of the students have calculus teeth. Conclusion: In primary and elementary school students simplified oral health index and community periodontal index was satisfactory and no difference was observed whereas on the basis of decay missing Filled tooth index primary school students have low average score. Keywords: Oral health, school, children, cross sectional survey

The Periodontal Status of Pregnant and Lactating Women in Ilam Province, Iran (2018 - 2019)

Background: Gingivitis and periodontitis cause the inflammation of the soft tissue around the teeth and destroy the supporting structures of the teeth. This is highly prevalent during pregnancy and lactation. Objectives: The present study aimed to investigate the periodontal status in pregnant and lactating women in Ilam province, Iran in 2018 - 2019. Methods: This descriptive-analytical study was conducted on 100 pregnant and lactating women who were selected via cluster and stratified sampling. Data were collected using a demographic questionnaire and the community periodontal index of treatment needs (CPITN). Data analysis was performed in SPSS version 24 using independent t-test, chi-square, and one-way ANOVA at the significance level of 0.05. Results: The mean age of the pregnant and lactating women was 25.62 ± 5.52 and 29.08 ± 6.83 years, respectively. In total, 30% of the pregnant women had a healthy gingival, 18% had bleeding, 36% had a mass, and 16% had CPITN. As for the lactating women, 44% had a healthy gingival, 32% had bleeding, 20% had a mass, and 4% had an envelope. CPITN index II and III were significantly higher in the pregnant women compared to the lactating women. Among the pregnant women, there were 49 housewives and only one employee, while 50 of the lactating women were housewives. Conclusions: According to the results, the sample population had an unfavorable periodontal status, and the pregnant women needed more oral health education.

Prevalence of periodontitis in obese patients in Bahrain: a cross-sectional study

Background Adult obesity has been associated with various systemic diseases and is an increasing problem in Bahrain. Recent evidence indicates a correlation between adult obesity and periodontitis. Hence the aim of this study was to assess the prevalence of periodontitis in overweight/obese adults in Bahrain and to determine the factors associated with periodontitis in these obese adults. Method This cross-sectional study was conducted in overweight subjects attending Ministry of Health (MOH) Nutrition Clinics at primary health centers in Bahrain. After obtaining the institutional ethics approval, the demographic and anthropometric data, including Body Mass Index (BMI) and waist circumference (WC) using World Health Organization (WHO) thresholds for severity of obesity, were recorded. Periodontal status was measured using the Community Periodontal Index (CPI) and the extent and severity of periodontal disease were categorized according to the number of sextants with CPI codes 3 and 4. Results A total of 372 participated with a mean age 44.0 (± 10.5) years for males, and 42.5 (± 11.2) years for females. Periodontitis was present in 361 (97%) of participants. Hypertension and diabetes were the most prevalent co-morbidities at 23.4% and 16% respectively. Mean WC was significantly greater in males at 114 cm (± 15.6) compared to females 109.5 cm (± 12.5) (p < 0.001). BMI was not associated with severity or extent of periodontitis but WC was weakly correlated in males but not in females (Spearman rho = + 0.2, p < 0.05). In the logistic regression model using overall WC to predict the severity of periodontitis, the adjusted OR was 1.02 (95% CI 1.00–1.04) and for age it was 1.05 (95% CI 1.00–1.07). Conclusion The prevalence of periodontitis was high in this sample of overweight Bahrainis. BMI was not correlated with periodontitis but WC had a weak positive correlation. Implementation of periodontal health screening as a routine part of a nutrition clinic program is recommended.

Do Oral hygiene and Diet Favor The Development of Non-Carious Cervical Lesions? A Retrospective Study.

Purpose: The aim of this retrospective case-control study was to evaluate the influence of dental brushing factors, diet, the consumption of acidic drinks and Community Periodontal Index of Treatment Needs (CPITN) on the development of non-carious cervical lesions (NCCLs). Methods: The sample consisted of undergraduate dentistry students from different Spanish faculties (age range 18 to 29 years). NCCLs and the CPITN were diagnosed and recorded using a periodontal probe. A questionnaire was used to record different brushing factors, the consumption of extrinsic acids and the presence of intrinsic acids. The data obtained were analysed using unconditional uni- and multivariate logistic regression (significance lecel p<0.05). Results: Brushing force was a risk factor (OR=1.71). The presence of NCCLs is significantly more frequent in subjects who brush their teeth vigorously Frequent consumption of salads with vinegar or lemon increases the risk of NCCLs (OR=4.5). As the CPITN score increases, the risk of NCCLs also increases significantly (OR=1.93) for value 1 and OR=6.49 for CPITN of 3. The consumption of extrinsic acids associated with salads seasoned with vinegar or lemon, the brushing force and the CPITN were the risk factors. The model obtained has a 67.14% predictive capacity for NCCLs, a specificity of 76.43%, and a sensitivity of 57.86%. Conclusions: the results of this study show that brushing force, and acidic diet and CPITN significantly increase the risk of NCCLs. Other variables are needed to increase model prediction.

Periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults

Objective The aim of this study was to evaluate periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults. Methods A total of 1159 adults aged 65 to 80 years and diagnosed with periodontal disease and CKD (stages 1, 2, and 3) were randomly selected for a cross-sectional study. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN) and CKD was staged using the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines. Results In patients with stage 1 CKD, the odds ratios (ORs) (95% confidence intervals [CIs]) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.13 (0.83–1.55), 1.47 (1.13–1.81), 1, and 1, respectively. In patients with stage 2 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.49 (1.14–1.93), 1.37 (1.02–1.78), 3.07 (2.81–3.25), and 3.65 (3.49–3.71), respectively. In patients with stage 3 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1, 1, 4.61 (4.47–5.21), and 5.23 (5.14–5.47), respectively. Conclusion The highest CPITN values (CPITN-3 and CPITN-4) were associated with CKD stages 2 and 3. Thus, periodontal disease may be associated with progression of CKD.

Entwicklung der Zahn- und Mundgesundheit in Deutschland von 1997 bis 2014

Zusammenfassung Hintergrund Zur Veränderung der oralen Krankheitslast in der deutschen Allgemeinbevölkerung über die letzten 20 Jahre gibt es bisher keine umfassende Darstellung. Fragestellung Wie haben sich die Prävalenzen der Karies, der Parodontitis und des Zahnverlustes und deren Determinanten von 1997 bis 2014 in Deutschland verändert? Material und Methoden Ausgewertet wurden Daten von 35- bis 44- und 65- bis 74-Jährigen der Deutschen Mundgesundheitsstudien (DMS) III, IV und V sowie von 25- bis 74-Jährigen der Studies of Health in Pomerania (SHIP‑0 und SHIP-Trend-0). Der Decayed, Missing, Filled Teeth Index (DMFT), die Anzahl füllungsfreier Zähne, der Community Periodontal Index (CPI) als auch Daten zur Zahnzahl und Zahnlosigkeit wurden herangezogen. Ergebnisse In beiden Studien waren bzgl. der Determinanten eine Zunahme der Probanden mit hoher Schulbildung, eine geringfügige Abnahme der Raucher sowie eine Verbesserung der Mundhygiene zu beobachten. Bei den 35- bis 44-Jährigen stieg die Anzahl gesunder Zähne von 11,9 in DMS III auf 16,8 in DMS V, während bei den Senioren die Anzahl gesunder Zähne um 5,9 anstieg. In SHIP wurde ein ähnlicher Trend beobachtet. Die Prävalenz des höchsten CPI-Grades 4 fiel in den DMS bei den 35- bis 44-Jährigen von 9,3 % auf 3,5 %; bei den Senioren lag der Wert 2014 wieder auf dem Niveau von 1997 (10,5 % und 9,8 %). Parallel dazu hat sich der Anteil der zahnlosen Senioren in beiden Studien halbiert. Die Zahnzahl nahm über alle Altersklassen hinweg zu. Diskussion DMS und SHIP zeigten über die Jahre konsistent eine Zunahme gesunder, füllungsfreier Zähne, eine geringfügige Reduktion der Probanden mit CPI-Grad 4 sowie mehr Zahnerhalt und weniger Zahnlosigkeit. Bedingt durch den höheren Zahnerhalt und die Alterung der Gesellschaft ist in Zukunft mit einer erhöhten parodontalen Behandlungslast zu rechnen.

Inequalities in Periodontal Disease According to Insurance Schemes in Thailand

Few studies have considered the effects of insurance on periodontal disease. We aimed to investigate the association between insurance schemes and periodontal disease among adults, using Thailand’s National Oral Health Survey (2017) data. A modified Community Periodontal Index was used to measure periodontal disease. Insurance schemes were categorized into the Universal Coverage Scheme (UCS), Civil Servant Medical Benefit Scheme (CSMBS), Social Security Scheme (SSS), and “others”. Poisson regression was applied to estimate the prevalence ratios (PRs) of insurance schemes for periodontal disease, with adjustment for age, gender, residential location, education attainment, and income. The data of 4534 participants (mean age, 39.6 ± 2.9 years; 2194 men, 2340 women) were analyzed. The proportions of participants with gingivitis or periodontitis were 87.6% and 25.9%, respectively. In covariate adjusted models, lowest education (PRs, 1.03; 95% CI, 1.01–1.06) and UCS (PRs, 1.05; 95% CI, 1.02–1.08) yielded significantly higher PRs for gingivitis, whereas lowest education (PRs, 1.20; 95% CI, 1.05–1.37) and UCS (PRs, 1.17; 95% CI, 1.02–1.34) yielded substantially higher PRs for periodontitis. Insurance schemes may be social predictors of periodontal disease. For better oral health, reduced insurance inequalities are required to increase access to regular dental visits and utilization in Thailand.

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.

Pengalaman karies, penyakit periodontal dan tingkat risiko karies ibu hamilCaries experience, periodontal disease, and caries risk level of pregnant women

Pendahuluan: Perempuan yang sedang hamil merupakan golongan yang rentan terhadap penyakit gigi dan mulut. Kesehatan gigi dan mulut yang tidak dijaga dengan baik dapat menjadi sumber terjadinya penyakit gigi dan mulut seperti infeksi gigi dan jaringan periodontal. Tujuan dari penelitian ini adalah untuk mengetahui pengalaman karies, penyakit periodontal, dan tingkat risiko karies ibu hamil. Metode: Jenis penelitian ini bersifat deskriptif dengan teknik pengumpulan data melalui survei yang melibatkan 50 orang ibu hamil di Puskesmas Pagarsih. Pengumpulan data diperoleh melalui pemeriksaan indeks DMF-T, Community Periodontal Index of Treatment Needs (CPITN) dan Caries Risk Assessment Form ADA usia >6 tahun. Hasil: Nilai indeks DMF-T ibu hamil 7,84 termasuk kriteria rendah. Hasil CPITN yaitu periodontal sehat 0%; BOP 4%; kalkulus 64%; poket 4-5 mm 32%; poket 6 mm 0%. Sejumlah 4% ibu hamil membutuhkan perawatan periodontal instruksi oral hygiene, 96% lainnya membutuhkan perawatan instruksi oral hygiene, scaling dan menghilangkan faktor retentif plak. Persentase risiko karies ibu hamil dengan kategori sedang sebanyak 34% dan tinggi sebanyak 66%. Simpulan: Pengalaman karies ibu hamil termasuk ke dalam kriteria rendah, penyakit periodontal yang paling sering dijumpai adalah gingivitis, sedangkan tingkat risiko karies ibu hamil masuk ke dalam kategori tinggi.Kata kunci: Ibu hamil, indeks DMF-T, indeks CPITN, karies, tingkat risiko karies. ABSTRACTIntroduction: Pregnant women are the susceptible group to oral diseases. Negligence of oral health care can be a source of oral diseases such as dental and periodontal tissue infections. The purpose of this study was to determine the caries experience, periodontal disease, and caries risk level of pregnant women. Methods: This research was descriptive with data collection techniques through a survey involving 50 pregnant women at Pagarsih Community Health Centre (Puskesmas). Data collection was obtained by examining the DMF-T index, Community Periodontal Index of Treatment Needs (CPITN), and the ADA Caries Risk Assessment Form aged >6 years. Results: The DMF-T index value for pregnant women was 7.84, which included the low criteria. The result of the CPITN was 0% healthy periodontal; BOP 4%; 64% calculus; pocket 4-5 mm 32%; pocket 6 mm 0%. Some 4% of pregnant women need periodontal treatment with oral hygiene instructions; the other 96% need oral hygiene instructions, scaling and removing plaque retentive factors. The percentage of caries risk for pregnant women in the moderate category was 34%, and 66% were in the high category. Conclusion: The caries experience of pregnant women is included in the low criteria. The most common periodontal disease is gingivitis, while the caries risk level of pregnant women is in the high category.Keywords: Pregnant women, DMF-T index, CPITN index, caries, caries risk level.