Oral hygiene practices and their socio-demographic correlates among Nepalese adult: evidence from non communicable diseases risk factors STEPS survey Nepal 2013.

BACKGROUND: Oral diseases remain a significant public health problem in Nepal, as do oral health behaviours. Socio-demographic factors play a crucial role in driving oral hygiene practices. This study aims to identify oral hygiene practices and associated socio-demographic factors in Nepalese population. METHODS: This descriptive, cross-sectional study recruited 4200 adults (15-69 years) through multistage cluster sampling. Data obtained from the WHO NCD STEPS instrument version 2.2 were analysed in STATA 13.0 using complex sample weighted analysis. RESULTS: Prevalence of cleaning teeth at least once a day was 94.9 % (95 % CI: 93.7-95.9), while that of cleaning teeth at least twice a day was 9.9 % (95 % CI: 8.2-11.9). Use of fluoridated toothpaste was seen among 71.4 % (95 % CI: 67.9-74.7) respondents. A 3.9 % (95 % CI: 3.1-5.0) made a dental visit in the last 6 months. The 45-69 years age group had lesser odds of cleaning teeth at least once a day (AOR: 0.4; 95 % CI: 0.2-0.8), in comparison to 15-29 years age group. Women had greater odds of cleaning teeth at least twice a day (AOR: 1.7; 95 % CI: 1.1-2.4) and having visited a dentist in the last 6 months (AOR: 2.2; 95 % CI: 1.2-3.8) compared to men. With reference to rural residents, urban population had higher odds of using fluoridated toothpaste (AOR: 2.3; 95 % CI: 1.4-3.4) and making a dental visit within the last 6 months (AOR: 1.9; 95 % CI:1.1-3.6). Inhabitants of the Terai had five-fold (AOR: 4.9; 95 % CI: 3.1-7.8) greater odds of cleaning teeth once per day than did hill residents. Those with higher education had greater odds than non-formal education holders of cleaning teeth at least once a day (AOR: 9.0; 95 % CI: 2.9-27.7), cleaning teeth at least twice a day (AOR: 5.6; 95 % CI: 2.9-10.6), using fluoridated toothpaste (AOR: 13.9; 95 % CI: 8.4-23.1), and having visited a dentist in the last 6 months (AOR: 2.8; 95 % CI: 1.4-5.4). CONCLUSIONS: Cleaning teeth at least once a day is widely prevalent in Nepal and a substantial number of population use fluoridated toothpaste. However, cleaning teeth twice a day and visiting a dentist is less common. Being women, Terai residents, urban residents, and educated were significantly associated with oral hygiene practices assessed in this study.

Assessment of the Knowledge of the Association between Periodontal Status and Pregnancy Outcome among Obstetricians and Gynecologists.

BACKGROUND: It has been more than two decades since a link was found between maternal oral health and adverse pregnancy outcome. Obstetricians and gynecologists play a core role in the screening, prevention and referral of the pregnant women for periodontal diseases. Thus, a study was conducted to assess the knowledge of the association between periodontal status and pregnancy outcomes. METHODS: An online survey was done by distributing self-administered questionnaire to the obstetricians and gynecologists. The survey consisted of three parts: demographic variables, consent and questionnaire. The qualitative data was recorded and analyzed. RESULTS: Out of 237 participants, 95.8% of the participants agreed that there is a relation between periodontal disease and pregnancy; 73.8% with preterm birth, 60.3% with low birth weight infants and 38.4% with pre-eclampsia. CONCLUSIONS: The knowledge of the association between periodontal status and pregnancy outcomes was found to be insufficient. The gynecologists must be provided with periodic orientation to enhance and update their knowledge on maternal periodontal health.

Oral Health Knowledge, Attitudes and Practices of People Living with Diabetes in South Asia: A Scoping Review.

Diabetes increases the risk of oral health complications. This review aimed to synthesise the current evidence on the oral health knowledge, attitudes and practices of people living with diabetes in South Asian countries and provide recommendations on possible strategies for addressing the gaps in oral health care in this population, including the role of non-dental professionals. Using a scoping review framework, six electronic databases (Ovid Medline, CINAHL, ProQuest Central, Scopus, Web of Science and Embase) were searched to identify the relevant literature published between January 2000 and December 2021. The data were extracted into three main categories based on the review's aims, and further refined into sub-categories. A total of 23 studies were included. The review identified that while people with diabetes living in South Asian countries had some level of awareness about oral health and limited care practices to maintain good oral health, there were gaps in knowledge, and there were areas where their oral health practices and attitudes could be improved. The findings suggest a need for developing targeted oral health policies as well as implementing integrated oral health care interventions involving non-dental professionals to improve the oral health outcomes of people with diabetes.

Serum Vitamin D in Patients with Chronic Periodontitis and Healthy Periodontium.

BACKGROUND: Periodontitis is inflammatory disorder resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation, recession, or both. Vitamin D has a benefit in bone metabolism and anti-inflammatory activity involving T-cell homeostasis. The objective of this study was to compare the vitamin D level in patient with chronic periodontitis and healthy periodontium and evaluate its correlation. METHODS: A comparative cross-sectional study was done in 80 patients (40 with healthy periodontium and 40 with chronic periodontitis) visiting to Department of Dental Surgery (Periodontology and Oral Implantology Section) of Bir Hospital. Parameters measured were plaque index, gingival index, clinical attachment level and pocket depth for the evaluation of healthy periodontium and chronic periodontitis. RESULTS: The result showed 16.58±6.65ng/mL and 19.06±11.52ng/mL level of vitamin D in female and male respectively (p-value 0.230) and 16.85±13.30 ng/mL and 19.78±5.87 ng/mL level of vitamin D in healthy and chronic periodontitis groups respectively (p-value 0.209). CONCLUSIONS: There are no differences in the level of serum vitamin D between healthy and chronic periodontitis groups. No association was seen between vitamin D level and chronic periodontitis.

Effect of Oral Health Promotion on Caries Experience and Oral Cleanliness of School Children in Kerung, Nepal: A Prospective 6-month Follow-Up Study.

BACKGROUND: A longitudinal oral health promotion project on caries experience and oral cleanliness was performed in a remote village in Nepal. The aim of this 6-month prospective survey was to investigate the impact of an oral health promotion project on caries experience, oral health-related behaviour, and general knowledge about oral health in Kerung, a remote village in Nepal. METHODS: A prospective study was conducted in a convenience sample of children from the local school in Kerung. At baseline and after six months, dental plaque scores and caries experience scores were measured by calibrated examiners. Validated questionnaires on oral health habits and knowledge on oral health were taken. In addition, an oral health promotion program was developed. RESULTS: At baseline, 359 children were included, of which 266 could be surveyed after six months. A statistically significant decrease in the mean plaque score was found at after six months with a higher reduction for boys. A significant decrease in caries prevalence, as well as a significant increase in knowledge about oral health, was observed. Furthermore, after six months there were significantly more children reporting that they brushed their teeth for at least two minutes. CONCLUSIONS: Dental screenings and a comprehensive educational program resulted in a significant improvement of oral health.

Prevalence of Periodontitis among Rheumatoid Arthritis Patients Attending Tertiary Hospital in Nepal.

BACKGROUND: Rheumatoid arthritis and Periodontitis both are chronic destructive inflammatory disorders characterized by dysregulation of the host inflammatory response and increase in localized and systemically circulating pro-inflammatory cytokines. The objective of this study was to determine prevalence of periodontitis among Rheumatoid Arthritis patients in our setup. METHODS: A crossectional study was done in 43 cases of diagnosed Rheumatoid Arthritis patients visiting to department of Orthopedics of Bir Hospital during the period of July 2016 to January 2017 were examined for presence of periodontitis and its severity. A descriptive questionnaire was also prepared concerning age, sex, personal history. Parameters to be measured were Plaque Index, Gingival Index, Pocket Depth and Clinical Attachment Level. RESULTS: Prevalence of periodontitis among Rheumatoid Arthritis patients was found to be 86.04% (37) with Mild periodontitis in 9%(4), Moderate periodontitis 56% (24)and severe periodontitis in 21% (9). The commonest age group was 50.41±9. with male to female ratio of 1:3 Conclusions: Periodontitis was common in Rheumatoid Arthritis in our set up. Moderate periodontitis was more frequent. Periodic oral examination of patients with Rheumatoid Arthritis is required to improve periodontal health.

Effects of nonsurgical periodontal therapy in patients with moderately controlled type 2 diabetes mellitus and chronic periodontitis in Nepalese population.

OBJECTIVES: Despite several investigations, evidence is still controversial regarding the effect of periodontal treatment on diabetes. This study evaluates and compares the effect on glycemic control and periodontal status with or without nonsurgical periodontal therapy in patients with type 2 diabetes mellitus and chronic periodontitis in a Nepalese population. MATERIALS AND METHODS: A total of 82 patients attending the diabetes clinic and fulfilling enrollment criteria with moderate to severe periodontitis were selected. They were assigned in an alternative sequence, into test and control group. Both groups were instructed to continue with their medical treatment without modifications. Scaling and root surface debridement were performed in the test group whereas the control group received oral hygiene instructions with no treatment during the 3-month study period. RESULTS: There were 41 participants in each group with the mean age of 50.66±7.70 and 53.80±9.16 years, average diabetes duration of 6.32±4.21 and 6.24±4.00 years, mean body mass index of 24.78±1.85 and 24.6±1.79 kg/m2, and glycated hemoglobin (HbA1c) level of 6.71±0.50% and 6.80±0.45%, in the test and control group, respectively. After 3 months, there was significant reduction in HbA1c levels in the test group compared to the control group (p=0.029). Clinical periodontal parameters of gingival index, probing depth (PD), and clinical attachment level (CAL) significantly improved in the test group (p<0.001) with PD reduction by 0.9 mm and gain in CAL by 0.3 mm compared to the control group (p>0.001) who showed an increase by 0.05 mm. CONCLUSION: This study showed that nonsurgical periodontal therapy may have a beneficial effect on HbA1c level in moderately controlled type 2 diabetic patients.