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.

Association between cognitive rumination and periodontal disease, tooth loss and oral health-related quality of life in a rural Southern Brazil population.

OBJECTIVES: Rumination is a maladaptive emotion regulation strategy. It has been associated with several psychological disorders and physical problems. This cross-sectional study aimed to evaluate whether cognitive rumination is associated with periodontal disease (PD), tooth loss (TL), and oral health-related quality of life (OHRQoL). MATERIALS AND METHODS: A population-based sample from a rural area in southern Brazil was evaluated. Calibrated examiners carried out a complete periodontal examination at six sites-per-tooth. Rumination and Reflection (RRQ) and Oral Health Impact Profile (OHIP-14) questionnaires were administered. Regression modeling was used to assess the prevalence ratio (PR) between rumination and PD and to estimate the rate ratio (RR) between rumination and TL and rumination and OHIP. RESULTS: Severe periodontitis prevalence of 33% was observed in the sample. In the Poisson-adjusted model (n = 587), individuals who ruminate more have 27% more periodontal disease (PR: 1.27, 95%CI:1.02 - 1.60). Regarding TL and OHIP, negative binomial regression (n = 672) showed an association with rumination, but it was not significant (RR 1.14, 95%CI 0.99 - 1.31) and (RR 1.20, 95%CI 0.98 - 1.48), respectively. CONCLUSIONS: Cognitive rumination was independently associated with periodontal disease in individuals living in a rural area. Borderline non-significant estimates were observed regarding TL and OHRQoL. More research using different populations and focusing on individual's responses to psychological stress may confirm these results. CLINICAL RELEVANCE: Emotional regulation is crucial to deal with stress, anxiety, and depression. Since psychopathologies are among the most prevalent diseases in the world, it is critical to understand the role of these issues in dental outcomes.

Association between oral health and cognitive impairment in older adults: Insights from a Six-year prospective cohort study.

OBJECTIVE: This study aims to investigate the relationships between four baseline oral conditions (periodontal status, dental caries, tooth wear, and dentition) and repeated global cognition or domain-specific cognition (memory, executive function, attention, and verbal fluency) in non-demented older adults over time. METHODS: This prospective cohort study (2011-2019) enrolled 516 non-demented community-dwelling older adults (age ≥ 65) to explore the association between oral health and cognitive function. Global and domain-specific cognition were assessed biennially (four repeats) using a battery of neuropsychological tests. The baseline oral health conditions were examined, including periodontal status, dental caries, tooth wear, and dentition. The association of these oral conditions with cognition was evaluated by generalized linear mixed models. Stratified analyses were performed by important covariates. RESULTS: Over time, dental caries was associated with poor memory in two different logical memory tests (ß^= -0.06 and ß^= -0.04). Incomplete dentition with less than 28 teeth was associated with poor performance in attention (ß^= -0.05) and verbal fluency (ß^= -0.03). These associations became more evident in those with an elevated inflammatory marker (IL-6, ß^= -0.11 to -0.08). In contrast, tooth wear was associated with better memory in two different logical memory tests (ß^= 0.33 and ß^= 0.36) and better executive function (ß^= 0.06) over time, and this association became more evident in those with the lowest inflammatory marker (IL-6, ß^= 0.10). CONCLUSIONS: Dental caries and incomplete dentition were associated with poor memory, attention, and verbal fluency performance. Conversely, tooth wear was associated with better memory performance and executive function. CLINICAL SIGNIFICANCE: For early prevention of dementia, an evaluation of multiple dental and periodontal status in older adults helps predict the risk of dementia in the preclinical phase. Maintaining intact tooth structure without caries progression and eventually tooth loss may help prevent the worsening of memory, attention, and verbal fluency over time.

Impact of dental caries and periodontal disease on oral health-related quality of life among the Karnataka State Reserve Police Personnel in Belagavi, India.

Introduction: The Karnataka State Reserve Police (KSRP) is a state-level police force in India. Good Oral Health-Related Quality of Life (OHRQoL) among them is quintessential for the welfare of the society. The aim of the study was to assess the impact of dental caries and periodontal disease on the OHRQoL among the Karnataka State Reserve Police (KSRP) stationed in Belagavi, India. Methods: A cross-sectional design was used with a total sample size of 720. The personnel were recruited by simple random sampling. The Oral Health Impact Profile 14 (OHIP 14) was used to assess OHRQoL in 7 domains. The intra-examiner reliability for World Health Organisation (WHO) oral assessment form 2013 was assessed using Kappa statistics and was found to be 0.86. Dentition and periodontal status were recorded using the same. Statistical analysis was performed using descriptive statistics, Analysis of variance (ANOVA), Pearson's coefficient of correlation and multiple linear regression analysis. Results: Physical pain and psychological discomfort had the highest mean scores among the seven domains of OHIP-14. Constables had higher mean OHIP-14 scores among the study population. A significant positive correlation was found between oral health parameters with the domains of OHIP-14. The highest dependence on the socio-demographic and oral health predictors were found in the domains of physical pain (44.2%), psychological discomfort (38.3%), and physical disability (30.5%). Conclusions: The study revealed that dental caries and periodontal disease had a significant impact on OHRQoL among reserve police personnel and the OHRQoL was poor particularly among the lower ranked personnel.

Disparities in Preventive Oral Health Care and Periodontal Health Among Adults With Diabetes.

INTRODUCTION: People with diabetes are more vulnerable to periodontal disease than those without; thus, practicing preventive oral health care is an important part of diabetes self-care. Our objective was to examine disparities in preventive oral health care among US adults with diabetes. METHODS: We performed a secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Periodontal examinations were conducted in adults aged 30 and older. We compared the weighted prevalence of periodontal disease and the practice of preventive oral health care, including practicing dental interproximal cleaning (flossing or using other interproximal cleaning devices) and use of preventive dental services, among people with and without diabetes. Multivariable logistic regressions were performed to examine the relationship between the presence of diabetes, periodontal disease, and preventive oral health care practices. RESULTS: Weighted prevalence of periodontal disease in the US population was higher among adults with diabetes than those without (58.0% vs 37.6%). This difference persisted after controlling for sociodemographic characteristics and smoking status. People with diabetes were more likely to have periodontal disease (adjusted odds ratio [aOR] 1.39; 95% CI, 1.17-1.65), less likely to practice daily interproximal cleaning (aOR 0.85; 95% CI, 0.75-0.95), and less likely to visit a dentist for preventive care in the past year (aOR 0.86; 95% CI, 0.76-0.96) than people without diabetes. CONCLUSION: Adults with diabetes reported suboptimal preventive oral health care behaviors in use of preventive dental services and interproximal dental cleaning than people without diabetes, despite their health disparity related to periodontal disease. Educating people to improve their preventive oral health care is essential for good oral health and diabetes self-management.

Efectos psicosociales de la enfermedad periodontal en la calidad de vida de pacientes de la Facultad de Odontologia (UdelaR) Un estudio cuali-cuantitativo / Efeitos psicossociais da doença periodontal na qualidade de vida de pacientes da Faculdade de Odontologia (UdelaR). Um estudo qualitativo-quantitativo / Psychosocial impact of periodontal disease on the quality of life of patients of the school of dentistry (Udelar). A qualitative-quantitative study

Resumen Objetivos: Identificar los aspectos psicosociales de la enfermedad periodontal y su incidencia en la calidad de vida de las personas que la padecen. Métodos: Se realizó un estudio mixto cuanti-cualitativo en pacientes de la facultad de odontología UdelaR. Los instrumentos utilizados fueron: entrevista (semiestructurada) con base en la teoría fundamentada y la aplicación del cuestionario OHIP-14 (Oral Health Impact Profile) que mide el grado de afectación en la calidad de vida (modelo teórico de Locker). Resultado: Se identifican los factores psicosociales que presenta esta población, así como la afectación emocional y a nivel social que provoca el diagnóstico de enfermedad periodontal. Los resultados muestran una afectación en la calidad de vida de la población de 1,46 en una escala de 0-4, donde 4 es la máxima afectación. Las participantes femeninas mostraron mayor nivel de afectación en la calidad de vida (1,54) en comparación con los hombres (1,36). A mayor grado de instrucción más afectación en la calidad de vida. Conclusiones: Existe una limitación en el enfoque biomédico en la atención de pacientes odontológicos, y por tanto la necesidad de realizar un abordaje integral en pacientes con enfermedad periodontal. Los profesionales odontólogos deben tener un enfoque biopsicosocial en la atención debido a la complejidad que presenta la enfermedad periodontal.

Resumo Objetivos: Identificar os aspectos psicossociais da doença periodontal e sua incidência na qualidade de vida das pessoas que sofrem com a doença. Métodos: Foi realizado um estudo quantitativo e qualitativo misto. Os instrumentos utilizados foram: entrevista (semiestruturada), fundamentada na teoria fundamentada em dados, e aplicação do questionário OHIP-14 (Perfil de Impacto na Saúde Oral), que mede o grau de comprometimento da qualidade de vida (modelo teórico de Locker). Resultado: são identificados os fatores psicossociais que essa população apresenta, bem como a afetação emocional e social que causa o diagnóstico de doença periodontal. Os resultados mostram uma afetação na qualidade de vida da população de 1,46 em uma escala de 0-4, onde 4 é a afetação máxima. As participantes do sexo feminino apresentaram maior nível de comprometimento da qualidade de vida (1,54) em comparação aos homens (1,36). Quanto maior o grau de escolaridade, mais a qualidade de vida será afetada. Conclusões: A limitação da abordagem biomédica no cuidado de pacientes odontológicos e a necessidade de realizar uma abordagem abrangente em pacientes com doença periodontal são evidentes. Os profissionais de odontologia devem ter uma abordagem biopsicossocial ao atendimento devido à complexidade da doença periodontal.

Abstract Objectives: To identify the psychosocial factors of periodontal disease and their impact on the quality of life of patients. Methods: A mixed quantitative and qualitative study was conducted at the School of Dentistry, UdelaR. The instruments used were a semi-structured interview based on grounded theory and the application of the OHIP-14 (Oral Health Impact Profile) questionnaire that measures the degree of impairment of quality of life (Locker's theoretical model). Results: This population's psychosocial factors are identified, as well as the emotional and social effects of periodontal disease diagnosis. The results show a 1.46 impact on people's quality of life on a scale of 0-4, where 4 is the maximum impact. Women showed a higher level of impairment in quality of life (1.54) than men (1.36). The higher the educational level, the more the quality of life is affected. Conclusions The limitations of the biomedical approach to dental patient care and the need for a comprehensive approach in periodontal disease patients are clear. Dental professionals need a biopsychosocial care approach given the complexity of periodontal disease.

The oral health and periodontal diseases awareness and knowledge in the Iraqi population: Online-based survey.

OBJECTIVES: This study aimed to evaluate oral health (OH) and periodontal diseases (PD) awareness in the Iraqi population. MATERIAL AND METHODS: This study was a questionnaire-based online survey of two weeks duration. The questionnaire was built using a Google platform and was distributed randomly via social media (Facebook and Telegram). The questionnaire consisted of a demographic data section and two other main sections for the evaluation of OH and PD awareness. Each response was marked with "1" for a positive answer and "0" for the other answers. For each respondent, answers were summed to give an overall score. The frequency of positive responses was used to determine the association of awareness with demographic data and the level of awareness into low, moderate, and high levels. RESULTS: A total of 1,465 were included in the final analysis after application of exclusion criteria. The respondents showed significantly higher levels of awareness about PD (mean ± SD = 3.66 ± 1.42) than OH awareness (mean ± SD = 2.19 ± 1.29). Analysis of data showed that OH awareness was mainly associated with high degree holders (OR 1.851) and age > 45 years (OR 1.730). However, PD awareness did not show any evident association with demographic variables investigated. In general, the respondents exhibited low levels of OH knowledge and low to moderate level of PD knowledge. CONCLUSIONS: Despite limitations, this study revealed inappropriate levels of OH and PD awareness and knowledge in the Iraqi population and provided the baseline data necessary for the development of Governmental educational programs and health awareness campaigns which are highly suggested particularly focusing on the primary and high schools, in an attempt to improve the levels of awareness.

A cohort study of factors that influence oral health-related quality of life from age 12 to 18 in Hong Kong.

BACKGROUND: There is a lack of cohort studies on the influence factors of oral health-related quality of life (OHRQoL). This study aimed to follow subjects from age 12 to 18 to analyse the sociodemographic and clinical factors that may influence OHRQoL. METHODS: This cohort study selected a representative sample from Hong Kong. Periodontal status and caries were examined according to WHO criteria. Four orthodontic indices were used to assess malocclusion. Child Perceptions Questionnaires (CPQ11-14) with 8 items (CPQ11-14-ISF: 8) and 37 items were used to assess OHRQoL at age 12 and age 15, respectively; Oral Health Impact Profile (OHIP-14) was used to assess OHRQoL at age 18. Wilcoxon signed ranks test and Friedman's test were used to analyse the age-related change of OHRQoL and malocclusion from age 12 to 18. Generalized estimating equations were used to analyse the influence factors of OHRQoL and to calculate adjusted risk ratio (RR). RESULTS: Subjects recruited in this study were 589 (305 females, 284 males), 364 (186 females, 178 males) and 300 (165 females, 135 males) at age 12, 15 and 18, respectively. Among them, 331 subjects (172 females, 159 males) were followed from age 12 to 15, and 118 subjects (106 females, 82 males) were followed from age 12 to 18. Subjects had less severe malocclusion at age 12 than at ages 15 and 18 (p = 0.000, measured by Dental Aesthetic Index). Age, periodontal status, and malocclusion had an effect on OHRQoL. When compared with OHRQoL at age 12, worse OHRQoL was observed at age 15 (adjusted RR = 1.06, 95%CI = 1.01-1.12, p = 0.032), but not at age 18 (adjusted RR = 1.01, 95%CI = 0.95-1.08, p = 0.759). Unhealthy periodontal conditions had a negative effect on OHRQoL (adjusted RR = 1.14, 95%CI = 1.04-1.25, p = 0.007). Only severe malocclusions had a negative effect on OHRQoL; a more severe malocclusion was associated with a higher effect on OHRQoL (adjusted RR = 1.09, 95%CI = 1.01-1.18, p = 0.032 for severe malocclusion, and adjusted RR = 1.17, 95%CI = 1.07-1.28, p = 0.001 for very severe malocclusion measured by Dental Aesthetic Index). CONCLUSION: Age, periodontal status, and malocclusion had an influence on OHRQoL from age 12 to 18. When clinicians attempt to improve subjects' OHRQoL, it is necessary to consider these factors.

Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis.

BACKGROUND: The aim of our study was to perform a systematic review of the literature and meta-analysis in order to investigate relationship between drug use and oral health. METHODS: We searched for studies in English published before July 1, 2019 on PsycINFO, PubMed, SciELO, Scopus, and Web of Science. We assessed the relationship between drug use (methamphetamines, heroin; opiates; crack, cocaine and cannabis as dependent variables) and reported tooth loss, periodontal disease, or decayed, missing, and filled teeth index as an independent variable. The data were analyzed using Stata 12.0 software. RESULTS: We initially identified 1836 potential articles (with 1100 duplicates) and screened the remaining 736 titles and abstracts, comprising 54 studies. In the next step, we evaluated the full-texts; 44 studies were excluded, accordingly. In total, we included 10 publications in the meta-analysis. Drug type was associated with periodontal disease (OR 1.44; 95% CI 0.8-2.6) and pooled estimates showed that type of drug used increased the odds of the number of decayed, missed and filled teeth (DMFT) (OR 4.11; 95% CI 2.07-8.15) respectively. CONCLUSIONS: The analytical challenges of segregating the impact of individual drug types on oral health diseases mean that investigations on the direct relationship between oral health status and drug use are limited. Developing programs to improve potential confounding with various substances and addressing the dental health needs of people who use drugs is vital if we are to improve their overall quality of life.

Self-reported stress, coping ability, mental status, and periodontal diseases among police recruits.

OBJECTIVE: This cross-sectional study aimed to investigate self-reported stress level and coping ability as well as mental status (anxiety and depression) via the 12-item General Health Questionnaire (GHQ-12) questionnaire and periodontal status among police academy recruits during their 8 months of training. METHODS: Eighty-five consenting police recruits were examined at baseline during the first month of training and again during the last month of training. Full mouth plaque score (FMPS), full mouth bleeding score, basic periodontal examination, self-reported stress level (scale of 1-10) and GHQ-12 questionnaire (mental status) were recorded at both visits. Ability to cope (yes/no) with stress was recorded at the final visit. Periodontal diagnosis was derived based on clinical examination. t test and regression analyses (p < .05) were performed. RESULTS: High stress (odds ratio: 1.25) and inability to cope with stress (odds ratio: 1.31) were statistically significant (p < .05) predictors of high FMPS. Inability to cope with stress (odds ratio: 1.45) was also a statistically significant (p < .05) predictor for periodontitis compared to gingivitis. Mental status (anxiety and depression) may play a greater role in gingivitis (mean 1.75) as opposed to periodontitis (mean 1.00) as reflected by the higher mean GHQ-12 (t test, p = .04). CONCLUSIONS: In this study, both self-reporting of stress level and ability to cope with stress were statistically significant predictors of higher plaque score (FMPS). Ability to cope with stress was also a statistically significant predictor of periodontitis compared to gingivitis. Recording of both self-reported stress level and ability to cope may be valuable variables to note in the management of plaque and periodontal diseases.

Impact of sense of coherence on oral health-related quality of life among Brazilian adults.

It has been postulated that oral health-related quality of life (OHRQoL) may be affected by the sense of coherence (SOC), but there are no epidemiological studies investigating this association in Brazilian adults. The present study was conducted among adults of a mid-sized Brazilian city, with the aim of looking into this association. The probability sampling consisted of 342 adults aged 35-44 years old, from a mid-sized Brazilian city, who were examined at their homes for caries (Decayed, Missing and Filled Teeth [DMFT] Index) and periodontal disease (Community Periodontal Index - CPI), according to WHO criteria. The questionnaire applied included demographic factors, socioeconomic information, use of dental services, behavior, SOC and the Oral Health Impact Profile (OHIP). The OHIP outcome, measured by prevalence of the impact, was analyzed by binary logistic regression using a hierarchical approach, a conceptual model, and a 5% significance level. A total of 67.9% of the respondents had one or more impacts on OHRQoL, and 54.4% showed a high SOC. The impact on OHRQoL was more prevalent in adults who had a manual occupation (PR = 2.47, 95%CI 1.24-4.93), those who perceived the need for dental treatment (PR = 2.93, 95%CI 1.67-5.14), and those who had untreated caries (PR = 1.93, 95%CI 1.07-3.47). Those with a low SOC had a twofold higher prevalence of impact on OHRQoL (PR = 2.19, 95%CI 1.29-3.71). This impact on OHRQoL was associated with a low SOC, even after adjusted by socioeconomic, behavioral and clinical factors. Future studies should consider the SOC in determining the oral health impact on quality of life.

Childhood IQ predicts age-38 oral disease experience and service-use.

OBJECTIVES: Given that people with higher intelligence have been shown to live longer, enjoy better health and have more favourable health behaviours, we investigated the association between childhood IQ and a range of important dental health and service-use indicators at age 38. METHODS: Long-standing prospective study of a complete birth cohort, with childhood IQ (assessed at ages 7, 9, 11 and 13 years) used to allocate participants (N = 818) to one of four ordinal categories of childhood IQ. RESULTS: There were distinct and consistent gradients by childhood IQ in almost all of the dental caries experience measures (with the exception of filled teeth) whereby each was most severe in the lowest child IQ category and least severe in the highest; the exception was the mean FT score, for which there was no discernible gradient. Indicators of self-care and periodontal disease experience showed similar gradients, and multivariate modelling using the continuous IQ score confirmed the observed patterns. CONCLUSIONS: Childhood cognitive function is a key determinant of oral health and dental service-use by midlife, with those of lower cognitive capacity as children likely to have poorer oral health, less favourable oral health-related beliefs, and more detrimental self-care and dental visiting practices by age 38. There is a need to shape dental clinical services and public health interventions so that people with the poorest cognitive function do not continue to be disadvantaged.

Progressive muscle relaxation therapy to relieve dental anxiety: a randomized controlled trial.

Dental anxiety causes patients to refuse or delay treatment, which may exacerbate oral diseases. The aim of the current randomized controlled trial was to determine whether progressive muscle relaxation therapy could relieve dental anxiety. The trial included 68 periodontal patients with dental anxiety scores of ≥13 who were randomly assigned to either an intervention group or a control group (n = 34 per group). The intervention group was administered progressive muscle relaxation therapy for 20 min and oral health education for 15 min before periodontal treatment once per week for 4 wk. The control group was provided with oral health education only, for the same duration. Changes in dental anxiety, depression symptoms, blood pressure, heart rate, and salivary cortisol were evaluated 4 wk and 3 months after the intervention. The intervention group exhibited statistically significantly greater reductions in dental anxiety scores than did the control group at the 4-wk (-3.82 vs. -0.89) and 3-month (-4.22 vs. -0.28) assessments. They also exhibited significantly greater reductions in depression symptoms, systolic and diastolic blood pressure, pulse rate, and salivary cortisol levels at both time-points. Progressive muscle relaxation therapy relieves tension and anxiety in dental patients.

Impact of sense of coherence on oral health-related quality of life among Brazilian adults

Abstract It has been postulated that oral health-related quality of life (OHRQoL) may be affected by the sense of coherence (SOC), but there are no epidemiological studies investigating this association in Brazilian adults. The present study was conducted among adults of a mid-sized Brazilian city, with the aim of looking into this association. The probability sampling consisted of 342 adults aged 35-44 years old, from a mid-sized Brazilian city, who were examined at their homes for caries (Decayed, Missing and Filled Teeth [DMFT] Index) and periodontal disease (Community Periodontal Index - CPI), according to WHO criteria. The questionnaire applied included demographic factors, socioeconomic information, use of dental services, behavior, SOC and the Oral Health Impact Profile (OHIP). The OHIP outcome, measured by prevalence of the impact, was analyzed by binary logistic regression using a hierarchical approach, a conceptual model, and a 5% significance level. A total of 67.9% of the respondents had one or more impacts on OHRQoL, and 54.4% showed a high SOC. The impact on OHRQoL was more prevalent in adults who had a manual occupation (PR = 2.47, 95%CI 1.24-4.93), those who perceived the need for dental treatment (PR = 2.93, 95%CI 1.67-5.14), and those who had untreated caries (PR = 1.93, 95%CI 1.07-3.47). Those with a low SOC had a twofold higher prevalence of impact on OHRQoL (PR = 2.19, 95%CI 1.29-3.71). This impact on OHRQoL was associated with a low SOC, even after adjusted by socioeconomic, behavioral and clinical factors. Future studies should consider the SOC in determining the oral health impact on quality of life.

Diabetes mellitus and periodontal disease: awareness and practice among doctors working in public general out-patient clinics in Kowloon West Cluster of Hong Kong.

BACKGROUND: Diabetes mellitus (DM) and periodontitis are very common and they interact with each other bidirectionally. This survey studied public primary care doctors on their awareness of this bidirectional relationship and their corresponding practice. METHODS: All Family Medicine doctors in Kowloon West Cluster, Hospital Authority were invited to a cross-sectional questionnaire survey. Results were analyzed statistically. RESULTS: One hundred sixty-eight questionnaires were sent out, 143 were returned (response rate 85.1%). One hundred forty valid questionnaires were analyzed. Ninety-two percent of participants were aware of a relationship between DM and periodontal disease and this awareness was not associated with their years of experience, training status and personal oral health behavior. Ninety percent knew the effect of poor DM control on periodontal disease but only 76% were aware of the reverse effect of periodontal disease on DM. The difference was statistically significant (p = 0.002, Related-samples Sign Test). In clinical practice on DM patients, only 5.7% asked dental history often (defined as 50% patients or above), 7.1% examined their mouths often and 12.1% recommended them to see dentist often. Logistic regression showed that awareness factors had no association with periodontology related clinical practice whereas clinical experience, being a Family Medicine specialist and personal interdental cleaning habit were linked with more positive practice. CONCLUSIONS: A high proportion of doctors in the study were aware of the relationship between DM and periodontal disease. However, this did not appear to influence their practice. Further measures among doctors and patients to promote comprehensive management of DM and periodontal disease should be explored.

Is COPD associated with periodontal disease? A population-based study in Spain.

BACKGROUND: Periodontal disease is more prevalent and more severe among men and women suffering from chronic obstructive pulmonary disease (COPD) compared with healthy adults. The objectives of this paper were to assess the association between periodontal disease and COPD, controlling the effect of sociodemographic characteristics, oral health status, lifestyle variables, and comorbidities. Second, we identified which of the variables analyzed were independently associated with periodontal disease among COPD sufferers. METHODS: This descriptive study was done with data from the National/European Health Interview Surveys, conducted in years 2006, 2011/12, and 2014 in Spain. We included subjects ≥40 years of age. COPD status was self-reported. One non-COPD patient was matched by age, gender, and the year of survey for each COPD case. The presence of periodontal disease was defined using the answers "my teeth bleed spontaneously or while brushing" or/and "my teeth move" to the question: "Do you suffer of any of these dental and oral disorders or diseases?" Independent variables included demographic, socioeconomic, and health care-related variables, oral health status, and presence of comorbidities. RESULTS: The prevalence of periodontal disease was higher among COPD patients than their matched non-COPD controls (26.5% vs 22.2%; P<0.001). Adjusted odds ratio (AOR) of periodontal disease for subjects with COPD was 1.21 (95% CI: 1.12-1.30). Suffering mental disorders (AOR: 1.61; 95% CI: 1.32-1.97) was positively associated with higher risk of periodontal disease. Older age, having a private dental health insurance, and university education were variables associated with lower rates of periodontal disease. CONCLUSION: Prevalence of periodontal disease was higher among those with COPD compared to non-COPD controls. Dentists and physicians should increase their awareness with their COPD patients, especially those who are younger, with lower education, and suffer depression and/or anxiety.

Periodontal health knowledge and awareness among subjects with fixed orthodontic appliance.

OBJECTIVE: To report on periodontal health knowledge and awareness among orthodontic patients and to investigate the effect of age, attitude and duration of orthodontic treatment on periodontal health awareness among orthodontic patients. METHODS: A total of 297 orthodontics patient (90 males, 207 females) with mean age of 17.7 ± 5.0 years (older then 18 years = 119, 18 years or younger = 178) were included in this study. Subjects were currently wearing upper and lower fixed orthodontic appliances for an mean period of 12.55 ± 10.86 months (less than or equal to 18 months = 231, more than 18 months = 66). Data was collected through a self-administered questionnaire (demographic characteristics, subjects' awareness toward their periodontal health, periodontal knowledge among orthodontic patient and patients' attitude toward orthodontic treatment regarding periodontal health) and clinical periodontal examination. RESULTS: Periodontal knowledge was poor among orthodontic patients in relation to dental plaque. Only 24 subjects (8%) correctly answered knowledge-related questions. Adult orthodontic patients reported negative attitude toward fixed orthodontic treatment in respect to periodontal health (p<0.001). Duration of orthodontic treatment negatively affected subjects' attitude toward fixed orthodontic treatment (p<0.01). The majority of subjects were in the high level of awareness group (64%). Orthodontic patients' awareness toward their periodontal health during fixed orthodontic treatment was affected by attitude scores (p=0.005), number of teeth with gingival recession (p=0.041), Gingival Index (p=0.000), duration of treatment (p=0.047) and age (p=0.008). CONCLUSIONS: Periodontal health knowledge among orthodontic patients was poor. Orthodontic patients' awareness of their periodontal health was moderate and was affected by age, attitude and duration of orthodontic treatment.

Periodontal health knowledge and awareness among subjects with fixed orthodontic appliance

Abstract Objective: To report on periodontal health knowledge and awareness among orthodontic patients and to investigate the effect of age, attitude and duration of orthodontic treatment on periodontal health awareness among orthodontic patients. Methods: A total of 297 orthodontics patient (90 males, 207 females) with mean age of 17.7 ± 5.0 years (older then 18 years = 119, 18 years or younger = 178) were included in this study. Subjects were currently wearing upper and lower fixed orthodontic appliances for an mean period of 12.55 ± 10.86 months (less than or equal to 18 months = 231, more than 18 months = 66). Data was collected through a self-administered questionnaire (demographic characteristics, subjects' awareness toward their periodontal health, periodontal knowledge among orthodontic patient and patients' attitude toward orthodontic treatment regarding periodontal health) and clinical periodontal examination. Results: Periodontal knowledge was poor among orthodontic patients in relation to dental plaque. Only 24 subjects (8%) correctly answered knowledge-related questions. Adult orthodontic patients reported negative attitude toward fixed orthodontic treatment in respect to periodontal health (p<0.001). Duration of orthodontic treatment negatively affected subjects' attitude toward fixed orthodontic treatment (p<0.01). The majority of subjects were in the high level of awareness group (64%). Orthodontic patients' awareness toward their periodontal health during fixed orthodontic treatment was affected by attitude scores (p=0.005), number of teeth with gingival recession (p=0.041), Gingival Index (p=0.000), duration of treatment (p=0.047) and age (p=0.008). Conclusions: Periodontal health knowledge among orthodontic patients was poor. Orthodontic patients' awareness of their periodontal health was moderate and was affected by age, attitude and duration of orthodontic treatment.

Resumo Objetivo: relatar sobre o conhecimento e a conscientização quanto à saúde periodontal dos pacientes ortodônticos e investigar os efeitos da idade, atitude e duração do tratamento sobre a conscientização da saúde periodontal entre esses pacientes. Métodos: um total de 297 pacientes foi incluído nesse estudo (90 homens e 207 mulheres), com idade média de 17,7±5,0 anos (maiores de 18 anos = 119, iguais ou menores de 18 anos = 178). Os indivíduos estavam usando aparelhos ortodônticos fixos nas arcadas superior e inferior por um período médio de 12,55±10,86 meses (18 meses ou menos = 231, mais de 18 meses = 66). Os dados foram coletados por meio de um questionário autoaplicável (características demográficas, conscientização com relação à saúde periodontal, conhecimento periodontal entre os pacientes ortodônticos e a atitude dos pacientes com relação ao tratamento ortodôntico com relação à saúde periodontal) e exame clínico periodontal. Resultados: o conhecimento periodontal entre os pacientes ortodônticos foi pequeno com relação à placa bacteriana. Somente 24 indivíduos (8%) responderam corretamente às questões relacionadas ao conhecimento. Os pacientes ortodônticos adultos relataram uma atitude negativa quanto ao tratamento com aparelhos fixos, com relação à saúde periodontal (p<0,001). A duração do tratamento afetou negativamente a atitude dos indivíduos com relação ao tratamento com aparelhos fixos (p<0,01). A maioria dos indivíduos estava no nível mais alto do grupo conscientização (64%). A conscientização dos pacientes ortodônticos com relação à sua saúde periodontal durante o tratamento ortodôntico com aparelhos fixos foi afetada pelos escores da atitude (p=0,005), pelo número de dentes com retração gengival (p=0.041), Índice Gengival (p=0,000), duração do tratamento (p=0,047) e idade (p=0,008). Conclusões: o conhecimento sobre a saúde periodontal entre os pacientes foi pequeno. A conscientização dos pacientes quanto à sua saúde periodontal foi moderada e foi afetada pela idade, atitude e duração do tratamento ortodôntico.

Behavioral models for periodontal health and disease.

The oral health-related behavior of patients with periodontal disease is a critical determinant of their health. Psychological models of behavior provide a framework for the design of interventions to enhance oral health-related behavior. This article reviews published manuscripts on interventions to enhance oral health-related behavior, classifying the nature of the interventions according to current psychological models of behavior. Fifteen manuscripts reporting the findings of 14 studies were identified and reviewed. The present article concludes that, based on current evidence, the key elements of effective interventions are: goal setting, planning the behavior change, and self-monitoring.

Personalized periodontal treatment for the tobacco- and alcohol-using patient.

The use of various forms of tobacco is one of the most important preventable risk factors for the incidence and progression of periodontal disease. Tobacco use negatively affects treatment outcomes for both periodontal diseases and conditions, and for dental implants. Tobacco-cessation programs can mitigate these adverse dental treatment outcomes and may be the most effective component of a personalized periodontal treatment approach. In addition, heavy alcohol consumption may exacerbate the adverse effects of tobacco use. In this review, the microbiology, host/inflammatory responses and genetic characteristics of the tobacco-using patient are presented as a framework to aid the practitioner in developing personalized treatment strategies for these patients. These personalized approaches can be used for patients who use a variety of tobacco products, including cigarettes, cigars, pipes, smokeless tobacco products, e-cigarettes and other tobacco forms, as well as patients who consume large amounts of alcohol. In addition, principles for developing personalized tobacco-cessation programs, using both traditional and newer motivational and pharmacological approaches, are presented.