Background: Periodic estimation of periodontal disease burden is essential for formulating new treatment strategies, for evaluating preventive strategies, and for framing of new policies. The previous national-level survey among adolescents was held 15 years ago. The objective of this study was to estimate the prevalence of periodontal disease among older adolescent students and to analyze its predictors as part of an oral health assessment survey conducted in Kerala. Materials and Methods: A multistage cluster sampling was employed among five districts of Kerala to examine 1065 students in the age group of 15–18 years from government and private schools of selected urban and rural areas. Sociodemographic and oral health behavioral data, modified Community Periodontal Index, Oral Hygiene Index Simplified, and Dental Aesthetic Index were taken. Descriptive statistics and bivariate and multivariate logistic regression analyses were done to identify the predictors of gingival bleeding and periodontal pockets. Results: The prevalence of gingival bleeding, periodontal pockets, and loss of attachment was 42%, 13.4%, and 2.7%, respectively. In the adjusted multivariate model for predictors of gingival bleeding, rural location of residence, studying in government schools, high mother's education and their working status, orthodontic treatment need, oral hygiene frequency, and poor oral hygiene status emerged as significant predictors of gingival bleeding. In the multivariate model for periodontal pockets, bleeding on probing emerged as the strongest predictor with an odds ratio of 12.85 when adjusted to poor oral hygiene. Conclusion: The prevalence of early periodontal disease among adolescents is significant. Sociodemographic factors, poor oral hygiene, and malocclusion are significant predictors for periodontal disease among adolescents.
Objective To develop a brief and simple, easy‐to‐administer, culturally sensitive, reliable and valid risk scoring system for early childhood caries based only on behavioural and other nonclinical risk factors. The purpose was to allow risk scoring by child care providers without clinical examination in order to guide dental referral in a community setting. Methods A cross‐sectional study using stratified multistage cluster sampling was conducted among 559 preschool children and their mothers in Anganwadi centres and Preprimary schools in Thiruvananthapuram district, Kerala, India. All steps in the development of a new tool were carried out. Exploratory factor analysis and principal component analysis with Varimax rotation were employed for item reduction. Reliability and validity assessments were also performed. Past caries experience was recorded as dmft scores and the validity hypothesis of higher dmft scores in children with higher caries risk scores was also verified as an additional measure of construct validity. Results The newly developed Caries Risk Assessment and Referral Tool (CRA‐RT) is presented as a unidimensional, 11‐item, discriminative tool which showed high test‐retest reliability (ICC = 0.8), high inter‐rater reliability (ICC = 0.8) and acceptable internal consistency (Cronbach's alpha = 0.6). Face, content and construct validity have been demonstrated. Children with higher CRA‐RT scores were having higher dmft scores, and it provided an additional evidence for the construct validity of the tool. Conclusion CRA‐RT is a simple, valid and reliable novel risk scoring system for ECC, to be used in a nondental, nonmedical setting. The proposed tool contains those behavioural risk or protective factors, the presence or absence of which could be assessed by interviewing the mother. The quick and the easy risk scoring pattern with a cut‐off score can guide the dental referral of preschool children by child care providers in a community setting.
Plasma cell gingivitis is a rare condition characterized by diffuse and massive infiltration of plasma cells into the sub-epithelial connective tissue. Clinically, it appears as a diffuse reddening and edematous swelling of the gingiva with a sharp demarcation along the mucogingival border. Though considered as a hypersensitive reaction to an allergen, the etiology of this bizarre condition is still not properly understood. Here, we present an interesting case of plasma cell gingivitis associated with an enlarged and fissured upper lip, which is quite a rarity. The condition was diagnosed based on clinical and histopathologic findings and treated by gingivectomy. The associated cheilitis has dramatically reduced after treatment of the gingival lesion.
Advanced glycation end products (AGEs) are proteins or lipids that become glycated after exposure to sugars. AGEs may modify the extracellular matrix (ECM); modify the action of hormones, cytokines, and free radicals via engagement of cell surface receptors; and impact the function of intracellular proteins..AGEs block nitric oxide activity in the endothelium and cause the production of reactive oxygen species. AGEs cause microvascular and macrovascular complications by formation of cross-links between molecules in the basement membrane of the extracellular matrix and by engaging the receptor for advanced glycation end products (RAGE). Activation of RAGE by AGEs causes upregulation of the transcription factor nuclear factor-κB and its target genes. AGEs can be formed either endogenously or exogenously. Endogenously, advanced glycation takes place in all cell types via the Maillard reaction between reducing sugars and amino residues present in proteins, lipids, and DNA, resulting in loss of protein structure and function followed in some instances by cellular apoptosis. Transition to plant based antioxidant diet with traditional Indian cooking methods seems to confer multitude of health benets.
Health related quality of life is attaining more attention and is considered as an important marker of patients’ perception of disease. The impact of oral diseases on the oral health related quality of life (OHRQL) is of immense importance, but very few studies exist on the impact of periodontitis on quality of life. : This study was aimed to find out the relationship between periodontitis and OHRQL.A cross sectional survey was conducted at the outpatient Department of Periodontics, Government Dental College, Thiruvananthapuram, Kerala among 158 patients presented with periodontitis who satisfied the inclusion criteria.Data collection was done by using a proforma for recording age, gender and socioeconomic status. Clinical periodontal parameters such as clinical attachment loss (CAL), probing pocket depth (PPD), simplified oral hygiene index (OHI-S), gingival index (GI) using UNC 15 probe were examined. OHRQL was assessed using the Malayalam version of OHIP-14.Descriptive statistics were used to describe quantitative and qualitative variables. Association between periodontitis and OHRQL was analysed using Spearman’s correlation coefficient. Severity of periodontitis and OHRQL and each domains of quality of life and was determined using Kruskal-Wallis test.There is statistically significant association of OHRQL with CAL (r=0.16; p= 0.04). Other periodontal parameters (PPD, OHIS and GI) depicted a very weak positive correlation with OHRQL but none was statistically significant (r=0.15, p=0.07; r=0.13, p=0.10 and r=0.14, p=0.08 respectively). There is no statistically significant association between severity of periodontitis and OHRQL (p=0.24). The maximum affected domains are physical pain, psychologic discomfort and physical disability among the seven domains. Periodontitis have a definite impact on the OHRQL of this selected population. The perception of OHRQL can vary with difference in cultural background and between individuals. Further long term studies with a larger sample size and comparison with a healthy periodontium is necessary to validate the results.
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