Natural history of periodontitis: Disease progression and tooth loss over 40 years.

OBJECTIVES: To assess long-term attachment and periodontitis-related tooth loss (PTL) in untreated periodontal disease over 40 years. MATERIAL AND METHODS: Data originated from the natural history of periodontitis study in Sri Lankan tea labourers first examined in 1970. In 2010, 75 subjects (15.6%) of the original cohort were re-examined. RESULTS: PTL over 40 years varied between 0 and 28 teeth (mean 13.1). Four subjects presented with no PTL, while 12 were edentulous. Logistic regression revealed attachment loss as a statistically significant covariate for PTL (p < .004). Markov chain analysis showed that smoking and calculus were associated with disease initiation and that calculus, plaque, and gingivitis were associated with loss of attachment and progression to advanced disease. Mean attachment loss <1.81 mm at the age of 30 yielded highest sensitivity and specificity (0.71) to allocate subjects into a cohort with a dentition of at least 20 teeth at 60 years of age. CONCLUSIONS: These results highlight the importance of treating early periodontitis along with smoking cessation, in those under 30 years of age. They further show that calculus removal, plaque control, and the control of gingivitis are essential in preventing disease progression, further loss of attachment and ultimately tooth loss.

[The relationship between gingival condition and socio-demographic factors of adolescents living in a Brazilian region]. / Relação entre condição gengival e fatores sociodemográficos de adolescentes residentes em uma região brasileira.

The scope of this study is to correlate the gingival condition and sociodemographic status of adolescents living in an economically disadvantaged Brazilian region. The survey was conducted with a random sample of 450 adolescents in 13 cities selected in the Jequitinhonha Valley (State of Minas Gerais). The gingival condition was evaluated using a calibrated examiner (Kappa ≥ 0.85). The oral exam was based on the Community Periodontal Index (CPI). The frequencies of individuals were calculated and sextants subsequently assessed using Multiple Correspondence Analysis (ANACOR) to reveal the relationship between CPI and sociodemographic characteristics. The results showed that: 16 (3.6%) were healthy; 235 (52.2%) had gingival bleeding; 36 (8%) had dental calculus and 163 (36.2%) had both bleeding and calculus. ANACOR identified two groups with similarities in relation to periodontal disease. Group one featured 19-year-olds with healthy CPI who work and have higher family income. Group two included 15- and 16-year-olds of both sexes with CPI and gingival bleeding in elementary school with lower family income, who declared themselves to be of mixed or Afro-descendant race. The presence of gingivitis was related to the socioeconomic and demographic characteristics of adolescents in the region.

Relação entre condição gengival e fatores sociodemográficos de adolescentes residentes em uma região brasileira / The relationship between gingival condition and socio-demographic factors of adolescents living in a Brazilian region

O objetivo deste artigo é relacionar as condições gengival e socioeconômica e distribuição demográfica de adolescentes residentes em uma região desfavorecida brasileira. O estudo transversal foi realizado com amostra probabilística de 450 adolescentes (15-19 anos) em 13 municípios sorteados no Vale do Jequitinhonha (MG). A condição gengival foi avaliada por um examinador calibrado (Kappa ≥ 0,85) e baseado Índice Periodontal Comunitário (CPI). Foram calculadas as frequências para indivíduos e sextantes com posterior Análise de Correspondência Múltipla (Anacor) que explorou relações entre o CPI e as características sociodemográficas. Como resultados: 16 (3,6%) apresentaram-se sem alterações gengivais, 235 (52,2%) com sangramento, 36 (8,0%) com cálculo dental e 163 (36,2%) com sangramento e cálculo. A Anacor identificou dois grupos que guardavam semelhanças entre si em relação à doença periodontal. O grupo 1 reuniu os adolescentes com CPI sadio, 19 anos de idade, que trabalham e têm maior renda familiar. No grupo de CPI com sangramento, tem-se os adolescentes com 15 e 16 anos de idade, de ambos os sexos, cursando o ensino fundamental, menor renda familiar e que se autodeclararam pardos ou negros. A gengivite foi relacionada às condições socioeconômicas e demográficas de adolescentes da região.

The scope of this study is to correlate the gingival condition and sociodemographic status of adolescents living in an economically disadvantaged Brazilian region. The survey was conducted with a random sample of 450 adolescents in 13 cities selected in the Jequitinhonha Valley (State of Minas Gerais). The gingival condition was evaluated using a calibrated examiner (Kappa ≥ 0.85). The oral exam was based on the Community Periodontal Index (CPI). The frequencies of individuals were calculated and sextants subsequently assessed using Multiple Correspondence Analysis (ANACOR) to reveal the relationship between CPI and sociodemographic characteristics. The results showed that: 16 (3.6%) were healthy; 235 (52.2%) had gingival bleeding; 36 (8%) had dental calculus and 163 (36.2%) had both bleeding and calculus. ANACOR identified two groups with similarities in relation to periodontal disease. Group one featured 19-year-olds with healthy CPI who work and have higher family income. Group two included 15- and 16-year-olds of both sexes with CPI and gingival bleeding in elementary school with lower family income, who declared themselves to be of mixed or Afro-descendant race. The presence of gingivitis was related to the socioeconomic and demographic characteristics of adolescents in the region.

Estimates and multivariable risk assessment of gingival recession in the population of adults from Porto Alegre, Brazil.

AIM: To describe estimates and determine risk indicators of gingival recession in the urban population of Porto Alegre, Brazil. MATERIALS AND METHODS: A representative sample of 1023 adults 35 years and older was obtained using a multistage probability sampling strategy. A structured questionnaire was applied and a clinical examination was performed at four sites of all teeth present. Complex survey commands were used for the estimation of gingival recession (GR) and during risk assessment. RESULTS: GR ≥1 mm affected 99.7% of subjects. The percentage of subjects with ≥1 tooth with GR ≥3 mm and ≥5 mm was 75.4% and 40.7%, respectively. 67.6%, 27.8% and 9.5% of teeth per subject showed GR ≥1 mm, ≥3 mm and ≥5 mm, respectively. Older age, male gender, smoking exposure, poor self-reported oral hygiene, history of periodontal treatment and high percentage of calculus were significant risk indicators for GR found after multivariable risk assessment. When buccal GR was analysed separately, only gender, age, smoking and high education were significant risk indicators for GR, whereas variables related to oral hygiene were not associated. CONCLUSION: GR is highly prevalent in this Brazilian population. Preventive strategies for GR may target a variety of socio-demographic, behavioural and clinical risk indicators.

Risk factors for oral diseases among workers with and without dental insurance in a national social security scheme in India.

OBJECTIVES: The target population for this cross sectional study comprises subjects with and without social security in a national social security scheme. The study aimed to compare and assess the risk factors for oral diseases among insured (organised sector) and non-insured workers (unorganised sector) in New Delhi, India. METHODS: The sample comprised a total of 2,752 subjects. Of these, 960 workers belonged to the formal or organised sector with a social security and dental health insurance and 1,792 had no social security or dental insurance from the informal or unorganised sector. RESULTS: Significant differences were noted between the two groups for literacy levels, between-meal sugar consumption, tobacco-related habits and utilisation of dental care. Bleeding/calculus and periodontal pockets were present among 25% and 65.4% of insured workers, respectively. Similarly, 13.6% and 84.5% of non-insured workers had bleeding/calculus and periodontal pockets, respectively. The mean DMFT (decayed, missing, filled teeth) value among the insured workers and non-insured workers was 3.27 ± 1.98 and 3.75 ± 1.80, respectively. The association between absence of health insurance and dental caries was evident with an odds ratio (OR) of 1.94. Subjects with below graduate education were more prone to dental caries (OR = 1.62). Subjects who cleaned their teeth two or more times a day were less likely to have dental caries (OR = 1.47). Utilisation of dental care was inversely related to dental caries (OR = 1.25). CONCLUSION: The major risk factors for oral diseases in both the groups with similar socio-economic status were the lack of social security and health insurance, low literacy levels, high tobacco consumption and low levels of dental care utilisation.

Determinantes individuais e contextuais da carie em criancas brasileiras de 12 anos em 2010 / Determinantes individuales y contextuales de la caries en ninos brasilenos de 12 anos en 2010 / Individual and contextual determinants of dental caries in Brazilian 12-year-olds in 2010

OBJETIVO: Estimar a prevalência e gravidade de cárie em crianças brasileiras e sua associação com fatores individuais e contextuais. MÉTODOS: Foram utilizados os dados da Pesquisa Nacional de Saúde Bucal (SBBrasil 2010), em uma amostra de 7.247 crianças de 12 anos. Os dados foram coletados por meio de exames clínicos e entrevistas. As variáveis dependentes foram as prevalências de cárie (dentes permanentes cariados, perdidos ou obturados [CPOD] ≥ 1 e CPOD ≥ 4). Foram realizadas análises bivariadas (teste de Rao-Scott) e multinível (regressão de Poisson). As variáveis individuais foram sociodemográficas, condição periodontal e relato de incômodo ao escovar os dentes. Os fatores contextuais foram a presença de água fluoretada, a porcentagem de domicílios ligados à rede de abastecimento de água e a renda mediana do município. RESULTADOS: A prevalência de CPOD ≥ 1 foi 56,0%. O CPOD médio foi igual a 2,04 (IC95% 1,76;2,31) e 22,2% das crianças tinham CPOD ≥ 4. A experiência de cárie foi significantemente mais elevada em crianças de cor de pele preta, parda e amarela; em famílias com renda mais baixa; em crianças com cálculo dentário ou sangramento gengival; e naquelas que relataram incômodo ao escovar. Viver em cidades sem água fluoretada, com menor cobertura da rede de abastecimento de água e com renda mediana baixa foram fatores contextuais associados à doença. CONCLUSÕES: A prevalência de cárie em crianças brasileiras de 12 anos foi baixa, de acordo com os critérios da Organização Mundial da Saúde. Houve significantes desigualdades geográficas e socioeconômicas nos níveis da doença. .

OBJETIVO: Estimar la prevalencia y gravedad de la caries en niños brasileños y su asociación con factores individuales y contextuales. MÉTODOS: Se utilizaron los datos de la Investigación Nacional de Salud Bucal (SBBrasil2010), en una muestra de 7.247 niños de 12 años. Los datos fueron colectados por medio de exámenes clínicos y entrevistas. Las variables dependientes fueron las prevalencias de caries (dientes permanentes cariados, perdidos u obturados [CPOD] ≥1 y CPOD ≥4). Se realizaron análisis bivariados (prueba de Rao-Scott) y multinivel (regresión de Poisson). Las variables individuales fueron sociodemográficas, condición periodontal y relato de incomodidad al cepillarse los dientes. Los factores contextuales fueron la presencia de agua con flúor, el porcentaje de domicilios unidos a la red de abastecimiento de agua, y la renta mediana del municipio. RESULTADOS: La prevalencia de CPOD≥1 fue 56,0%. El CPOD promedio fue igual a 2,04 (IC95% 1,76;2,31) y 22,2% de los niños tenían CPOD≥4. La experiencia de caries fue significativamente más elevada en niños de color de piel negra, parda y amarilla; en familias con renta más baja, en niños con cálculo dentario o sangramiento de las encías y en aquellas que relataron incomodidad al cepillarse. Vivir en ciudades sin agua con flúor, con menor cobertura de la red de abastecimiento de agua y con renta mediana baja fueron factores contextuales asociados a la enfermedad. CONCLUSIONES: La prevalencia de caries en niños brasileños de 12 años fue baja, de acuerdo con los criterios de la Organización Mundial de la Salud. Hubo desigualdades geográficas y socioeconómicas significativas en los niveles de la enfermedad. .

OBJECTIVE: To estimate the prevalence and severity of dental caries in Brazilian children and the association with individual and contextual factors. METHODS: Data were taken from the Brazilian Oral Health Survey (SBBrasil 2010) a sample of 7,247 12-year-olds. The data were collected using clinical examinations and interviews. The dependent variables were the prevalence of dental caries (decayed, missing and filled teeth [DMFT] ≥ 1 and DMFT ≥ 4). Bivariate (Rao Scott test) and multivariate (Poisson regression) analyses were carried out. The individual variables were sociodemographic variables, periodontal health and reporting discomfort while brushing. Contextual factors were the presence of water fluoridation, the percentage of residences connected to the water supply and median income of the municipality. RESULTS: The prevalence of DMFT ≥ 1 was 56.0%. Mean DMFT was 2.04 (95%CI 1.76;2.31) and 22.2% of children had DMFT ≥ 4. Caries experience was significantly more common in children with black, brown or yellow skin; in low-income families; in children with dental calculus or bleeding gums and in those who reported discomfort while brushing. Living in towns with fluoridated tap water, with low coverage of water supply and with low median income were contextual factors associated with the disease. CONCLUSIONS: The prevalence of dental caries in Brazilian 12-year-olds was low, according to World Health Organization criteria. There were significant geographical and socioeconomic inequalities in levels of the disease. .

Socio-behavioral variables effecting oral hygiene and periodontal status of 12 year-old schoolchildren of Udaipur district.

AIM: To assess the effect of various socio-demographic in addition to oral hygiene variables on the oral hygiene and periodontal status. METHODS: A combination of multi stage and cluster sampling procedure was followed to collect a representative population of 831, 12 year-old schoolchildren of Udiapur district. Oral Hygiene Index Simplified (OHI-S) and Community Periodontal Index (CPI) were used to evaluate oral hygiene and periodontal status respectively. Along with the clinical examination, each subject was interviewed to collect the socio-demographic information and oral hygiene practices. RESULTS: The overall mean OHI-S was 1.42 and debris component of the oral hygiene index was dominant. Unpaired 't' test showed significantly higher DI-S (p = 0.0001) and OHI-S (p = 0.007) among boys than girls. The overall prevalence of periodontal disease was 89.9% and gingival bleeding was widespread. Chi square test demonstrated significant differences (p = 0.0001) with 14.6% urban children having healthy periodontium in comparison to 5.6% rural residents. Oral hygiene scores were dependent on the father's occupation (p = 0.046), father's (p = 0.002) and mother's level of education (p = 0.0001). CONCLUSIONS: Oral hygiene status was poor, more among boys with debris contributing a major part for oral hygiene index. Periodontal status was poor with bleeding being most prevalent indicator. The multivariate analysis of oral hygiene status confirmed the existence of socio-behavioural determinants for oral hygiene.

[Individual and contextual determinants of dental caries in Brazilian 12-year-olds in 2010]. / Determinantes individuais e contextuais da cárie em crianças brasileiras de 12 anos em 2010.

OBJECTIVE: To estimate the prevalence and severity of dental caries in Brazilian children and the association with individual and contextual factors. METHODS: Data were taken from the Brazilian Oral Health Survey (SBBrasil 2010) a sample of 7,247 12-year-olds. The data were collected using clinical examinations and interviews. The dependent variables were the prevalence of dental caries (decayed, missing and filled teeth [DMFT] ≥ 1 and DMFT ≥ 4). Bivariate (Rao Scott test) and multivariate (Poisson regression) analyses were carried out. The individual variables were sociodemographic variables, periodontal health and reporting discomfort while brushing. Contextual factors were the presence of water fluoridation, the percentage of residences connected to the water supply and median income of the municipality. RESULTS: The prevalence of DMFT ≥ 1 was 56.0%. Mean DMFT was 2.04 (95%CI 1.76;2.31) and 22.2% of children had DMFT ≥ 4. Caries experience was significantly more common in children with black, brown or yellow skin; in low-income families; in children with dental calculus or bleeding gums and in those who reported discomfort while brushing. Living in towns with fluoridated tap water, with low coverage of water supply and with low median income were contextual factors associated with the disease. CONCLUSIONS: The prevalence of dental caries in Brazilian 12-year-olds was low, according to World Health Organization criteria. There were significant geographical and socioeconomic inequalities in levels of the disease.

The impacts of gingivitis and calculus on Thai children's quality of life.

AIM: To assess associations of socio-demographic, behavioural and the extent of gingivitis and calculus with oral health-related quality of life (OHRQoL) in nationally representative samples of 12- and 15-year-old Thai children. MATERIAL AND METHODS: In the Thailand National Oral Health Survey, 1,063 twelve-year olds and 811 fifteen-year olds were clinically examined and interviewed for OHRQoL using the Child-OIDP and OIDP indices, respectively, and completed a behavioural questionnaire. We assessed associations of condition-specific impacts (CS-impacts) with gingivitis and calculus, adjusted for socio-demographic and behavioural factors. RESULTS: Gingivitis and calculus were highly prevalent: 79.3% in 12-year and 81.5% in 15-year olds. CS-impacts relating to calculus and/or gingivitis were reported by 26.0% of 12-year and 29.6% of 15-year olds. Except for calculus without gingivitis, calculus and/or gingivitis in any form was significantly related to any level of CS-impacts. At a moderate or higher level of CS-impacts, there were significant relationships with extensive calculus and/or gingivitis in 12-year olds and for extensive gingivitis and gingivitis without calculus in 15-year olds. CONCLUSIONS: Gingivitis was generally associated with any level of CS-impacts attributed to calculus and/or gingivitis. CS-impacts were related more to gingivitis than to calculus.

Assessment of periodontal status and treatment needs among 12 and 15 years old school children in Udaipur, India.

AIM: To assess and compare the periodontal status and treatment needs among school children aged 12 and 15 years in public and private schools of Udaipur, India and to provide baseline data for planning and evaluation of oral health care promotion programmes. STUDY DESIGN: A cross-sectional descriptive survey. METHODS: A survey was conducted on 900 school children aged 12 and 15 years in Udaipur. The data were collected by means of clinical examination using the CPITN index. STATISTICS: Data was analysed using Pearson's Chi-square and student's t-test. RESULTS: Children aged 15 years had higher scores of healthy gingiva compared with 12 years old. Gender difference of females having better gingival health than males was seen in both age groups. Amongst the schools, children in private schools had good periodontal status in comparison to public schools. A statistically significant association between frequency of tooth brushing and CPITN scores was found among children of the 15 year old group. CONCLUSION: There is a need for a long term school oral health promotion program to sustain the healthy tissues of this growing Indian population.

Caries experience in 14-year-olds from Northeast Italy. Is socioeconomic-status (SES) still a risk factor?

AIM: Prevalence and severity of dental caries in 14-year-olds of Northeast Italy were estimated, evaluating the dependence to SES. MATERIALS AND METHODS: An epidemiological survey was performed among a randomised cluster sample of 560 (290 M and 270 F) 14-year-olds attending secondary schools, to evaluate DMFS following WHO indications. Association between caries occurrence and SES was evaluated in a logistic regression model. To account for high proportion of zero scores (DMFS and DS distribution highly positively skewed) data was moreover modelled with negative binomial regression and zero-inflated models. RESULTS: Caries prevalence was 63.4% with a mean DMFS of 3.0 ± 3.8. A significant trend between means was observed regarding DS in the different SES levels: z = 2.22 p = 0.03 (occupational level) and z = 3.45 p<0.01 when SES was based on educational level. The Negative Binomial Regression model resulted more appropriate than the Poisson model because the dispersion parameter was significantly different from zero (alpha=1.5, 95% CI=1.3-1.8). Working class status showed significant association with DMFS (p=0.04) while using DS as dependent variable, working class subjects and subjects with medium-low and low educational level, showed a statistically significant association. CONCLUSION: Socioeconomic status is still a predictor for dental decay in the Italian 14-year-olds.

Validity of partial protocols to assess the prevalence of periodontal outcomes and associated sociodemographic and behavior factors in adolescents and young adults.

BACKGROUND: Most studies comparing prevalence of periodontal disease and risk factors by using partial protocols were performed in adult populations, with several studies being conducted in clinical settings. The aim of this study is to assess the accuracy of partial protocols in estimating the prevalence of periodontal outcomes in adolescents and young adults from two population-based birth cohorts from Pelotas, Brazil, and to assess differences in the estimation and strength of the effect measures when partial protocols are adopted compared to full-mouth examination. METHODS: Gingival bleeding at probing among adolescents (n = 339) and young adults (n = 720) and dental calculus and periodontal probing depth among young adults were assessed using full-mouth examinations and four partial protocols: Ramfjord teeth (RT), community periodontal index (CPI), and two random diagonal quadrants (1 and 3, 2 and 4). Socioeconomic, demographic, and periodontal health-related variables were also collected. Sensitivity, absolute and relative bias, and inflation factors were calculated. Prevalence ratio for each periodontal outcome for the risk factors was estimated. RESULTS: Two diagonal quadrants showed better accuracy; RT had the worst, whereas CPI presented an intermediate pattern when compared to full-mouth examination. For bleeding assessment in adolescence, RT and CPI underestimated by 18.4% and 16.2%, respectively, the true outcome prevalence, whereas among young adults, all partial protocols underestimated the prevalence. All partial protocols presented similar magnitude of association measures for all investigated periodontal potential risk factors. CONCLUSION: Two diagonal quadrants protocol may be effective in identifying the risk factors for the most relevant periodontal outcomes in adolescence and in young adulthood.

A preliminary assessment of the periodontal status of elderly pensioners in Benin City, Nigeria.

AIM: This study was to assess the periodontal status of pensioners in Benin City and obtain baseline data. MATERIALS AND METHODS: The cross-sectional descriptive study involved 250 subjects selected by systematic random sampling from three clusters of general, university and teaching hospital pensioners examined using the Community Periodontal Index index in four locations within Benin City. RESULTS: The percentages of the dentate subjects with healthy gingiva, bleeding on probing, calculus, shallow pockets and deep pockets were 2.4, 5.2, 46.8, 38.8 and 6.8%, respectively. Only 2% needed no periodontal treatment; those requiring oral hygiene instructions, scaling and polishing and complex treatment were 52, 39 and 7%, respectively. There were no significant differences in the periodontal status of the pensioners by gender, age or tooth brushing habits. CONCLUSION: The presence of calculus accounted for the most prevalent periodontal condition among the elderly pensioners followed by shallow periodontal pocketing apparently owing to poor dental attendance or lack of access to care. A comprehensive pensioner's oral health programme is recommended.

Assessment of periodontal status among dental fluorosis subjects using community periodontal index of treatment needs.

AIM: To determine the periodontal status and treatment needs among dental fluorosis subjects residing in Ennore, Chennai, using Community Periodontal Index of Treatment Needs (CPITN). MATERIALS AND METHODS: All the subjects with dental fluorosis above 15 years of age, permanent residents of Ennore, were included in the study. Subjects with known systemic diseases and subjects with other intrinsic dental stains were excluded from the study. Periodontal status was estimated using CPITN and Dental fluorosis was recorded using Dean's Dental Fluorosis Index. RESULTS: The total number of study subjects was 1075, of which 489 were males and 586 were females. Males were predominantly affected with periodontal disease than females. This was found to be statistically significant (P=0.000). The association between Degree of Fluorosis and Periodontal Status is statistically significant (P=0.000). There was statistically significant difference in mean number of sextants between the degree of fluorosis in each of the periodontal status (P=0.000). CONCLUSION: The finding that the lower prevalence of shallow pockets in the study area, where the fluoride level in the drinking water ranges from 1.83 to 2.01 ppm, indicates that the use of fluoride in water is beneficial to the periodontal tissues.

Prevalence and risk indicators for chronic periodontitis in adolescents and young adults in south Brazil.

AIM: To describe the distribution of clinical attachment loss (CAL) and to study risk indicators for chronic periodontitis in a large population-based sample of adolescents and young adults from south Brazil. MATERIAL AND METHODS: This cross-sectional study used a subset of data from a larger survey representative of Porto Alegre, Brazil. The sample consisted of 612 individuals (291 males/321 females) aged 14-29 years. Full-mouth, six sites per tooth clinical examinations were performed by calibrated periodontists. Chronic periodontitis was defined as CAL 3mm affecting two or more teeth. Aggressive periodontitis cases were excluded from the analysis. RESULTS: CAL 3 and 5mm affected 50.4% and 17.4% of subjects and 9.7% and 1.1% of teeth, respectively. Prevalence of chronic periodontitis ranged between 18.2% and 72.0% among subjects 14-19 and 24-29 years old, respectively. In the multivariable logistic regression analysis, older age [odds ratio (OR)=2.6, 95% confidence interval (CI)=1.7-3.9 and OR=7.2, 95% CI=3.7-14.0 for 20-24 and 25-29 years old, respectively], low socioeconomic status (OR=1.9, 95% CI=1.4-2.7), heavy smoking (OR=1.7, 95% CI=1.1-2.7) and larger amounts of calculus (OR=2.0, 95% CI=1.2-3.2) were significantly associated with chronic periodontitis. CONCLUSION: This population of adolescents and young adults had a high prevalence of chronic periodontitis, and its presence was associated with age, socioeconomic status, smoking and calculus.

Periodontal status and associated factors in 15-year-old Sri Lankans.

AIM: The aim of the present study was to determine the periodontal status and associated factors in 15-year-old Sri Lankans. METHODS: This was a cross-sectional study where the data were collected by means of a self-administered questionnaire and a clinical examination. A total of 400 15 year olds were selected using a two-stage cluster sampling technique from schools in the Nattandiya education division of the Puttalam district of Sri Lanka. RESULTS: The prevalence of gingival inflammation was 86%, and nearly 7% of the adolescents had chronic periodontitis. The mean gingival index, debris index, calculus index, and oral hygiene index scores of the sample were 0.47±0.3, 0.31±0.2, 0.46±0.3, and 0.78±0.5, respectively. A multiple logistic regression analysis revealed that the debris level, calculus level, frequency of toothbrushing, and the level of education of the mother were significantly associated with gingival status. CONCLUSION: The prevalence of gingival inflammation was high, and both the debris and calculus levels were strongly associated with gingival status in these adolescents.

Oral health and the postcontact adaptive transition: A contextual reconstruction of diet in Mórrope, Peru.

This work explores the effects of European contact on Andean foodways in the Lambayeque Valley Complex, north coast Peru. We test the hypothesis that Spanish colonization negatively impacted indigenous diet. Diachronic relationships of oral health were examined from the dentitions of 203 late-pre-Hispanic and 175 colonial-period Mochica individuals from Mórrope, Lambayeque, to include observations of dental caries, antemortem tooth loss, alveolar inflammation, dental calculus, periodontitis, and dental wear. G-tests and odds ratio analyses across six age classes indicate a range of statistically significant postcontact increases in dental caries, antemortem tooth loss, and dental calculus prevalence. These findings are associated with ethnohistoric contexts that point to colonial-era economic reorganization which restricted access to multiple traditional food sources. We infer that oral health changes reflect creative Mochica cultural adjustments to dietary shortfalls through the consumption of a greater proportion of dietary carbohydrates. Simultaneously, independent skeletal indicators of biological stress suggest that these adjustments bore a cost in increased nutritional stress. Oral health appears to have been systematically worse among colonial women. We rule out an underlying biological cause (female fertility variation) and suggest that the establishment of European gender ideologies and divisions of labor possibly exposed colonial Mochica women to a more cariogenic diet. Overall, dietary change in Mórrope appears shaped by local responses to a convergence of colonial Spanish economic agendas, landscape transformation, and social changes during the postcontact transition in northern Peru. These findings also further the understandings of dietary and biocultural histories of the Western Hemisphere.

Oral health status and practices of dentate Bhil adult tribes of southern Rajasthan, India.

AIMS: To assess the oral health status of the Bhil tribal population of Southern Rajasthan and to investigate the association of age, oral hygiene and dental visiting practices with oral health status. DESIGN: A cross sectional study of Bhil tribal adults chosen by a multi stage stratified random sampling procedure. PARTICIPANTS: The total sample size was 1590 male tribal dentate subjects aged 15-54 years. METHODS: Clinical recordings of oral hygiene status (OHI-S), caries status (DMFT and DMFS) and treatment needs, and periodontal status (CPI). The Chi square test was applied to discrete data and one way ANOVA for continuous data. Multivariate analyses were carried out to test the association of age, frequency of cleaning teeth, material used for cleaning teeth and dental visiting habits with caries and periodontal status. RESULTS: Debris, calculus and oral hygiene index scores increased with age. The overall mean DMFT and DMFS scores were 5.34 +/- 6.48 and 18.94 +/- 35.87 respectively. Extraction was the most required treatment (1.74 +/- 3.66 teeth) followed by one surface fillings (1.34 +/- 1.65 teeth). Shallow periodontal pockets were prevalent (40%) among the 35-44 years age group whereas deep pockets were most common (11.6%) in the oldest age group. More than half the sextants (3.15) were excluded amongst the oldest study group. All the independent variables namely age, frequency of cleaning teeth, substance used for cleaning teeth and visiting habits were statistically significantly related to caries and periodontal status. CONCLUSIONS: The study population was characterised by a lack of previous dental care, high treatment needs, high prevalence of periodontal disease and poor oral hygiene. Under these circumstances, the implementation of a basic oral health care programme for the Bhil population is a high priority.

Periodontal health of older men: the MrOS dental study.

OBJECTIVE: The purpose of this study was to evaluate the prevalence and severity of periodontitis in men of 65+ years and identify demographic and lifestyle factors associated with its presence. METHODS: Participants were recruited from the Osteoporotic Fractures in Men Study, a longitudinal study of risk factors for fractures in older men. Dental measures included clinical attachment loss (CAL), pocket depth (PD), calculus, plaque and bleeding on a random half-mouth, plus a questionnaire regarding access to care, symptoms and previous diagnosis. RESULTS: 1210 dentate men completed the dental visit. Average age was 75 years, 39% reported some graduate school education, 32% smoked 20 + pack years and 88% reported their overall health as excellent/good. In terms of periodontal health, 38% had sub-gingival calculus, 53% gingival bleeding, 82% CAL > or =5 mm and 34% PD > or =6 mm. The prevalence of severe periodontitis was 38%. Significant demographic and lifestyle factors associated with severe periodontitis in multivariate analyses included age > or =75 (OR 1.4, 95% CI 1.1-1.7) non-white race (OR 1.9, 95% CI 1.3-2.8), less than an annual dental visit (OR 1.5, 95% CI 1.1-2.0), and 20 + pack years (OR 2.1, 95% CI 1.6-2.7). CONCLUSION: A high proportion of healthy older men have evidence of periodontal destruction which could, given the growing ageing population, have a significant impact on the dental profession's ability to provide preventive and therapeutic care. The population at highest risk of periodontitis in MrOS is older minority men who smoke and do not have annual dental visits.

Periodontal treatment needs and prevalence of localized aggressive periodontitis in a young Turkish population.

BACKGROUND: The purpose of this study was to investigate the prevalence of localized aggressive periodontitis (LAgP) among students aged 13 to 19 years at public schools in Ankara. METHODS: A total of 3,056 students (1,563 females and 1,493 males) participated in the study. All students were examined at their schools and their mouths coded according to the recommendations of the Community Periodontal Index of Treatment Needs (CPITN) using a mirror, a World Health Organization 621 ball-tip probe, and daylight for illumination. Among the students examined, 170 had two or more sextants or teeth with code 3 or one sextant with code 4 and were scheduled for radiographs and a full clinical examination. The additional criteria for the diagnosis of LAgP were good general health, radiographically determined bone loss around the first molars bilaterally, and the bone loss must be unproportionally extensive with respect to the low levels of plaque and calculus, contrary to what is usually observed in chronic periodontitis. RESULTS: Among the 3,056 students screened, 170 were scheduled for further examination, and 18 (10 females and eight males) were diagnosed with LAgP. Of 18,336 sextants examined, 6,575 required scaling, and 63 required scaling and further complex treatment. CONCLUSION: The prevalence of LAgP was 0.6%, with a female/male ratio of 1.25:1.