Although the majority of dentists in our study report performing periodontal examinations of their patients, only a small portion report recording complete probing depth measurements or using appropriate radiographs in their examinations. These practices could lead to an underestimation of diagnosis and treatment of periodontal disease.

Background and Objective Visible – near infrared (optical) spectroscopy can be used to measure regional tissue hemodynamics and edema and, therefore, may represent an ideal tool with which to non-invasively study periodontal inflammation. The study objective was to evaluate the ability of optical spectroscopy to simultaneously determine multiple inflammatory indices (tissue oxygenation, total tissue hemoglobin, deoxyhemoglobin, oxygenated hemoglobin, and tissue edema) in periodontal tissues in vivo. Material and Methods Spectra were obtained, processed, and evaluated from healthy, gingivitis, and periodontitis sites (n = 133) using a portable optical – near infrared spectrometer. A modified Beer-Lambert unmixing model that incorporates a nonparametric scattering loss function was used to determine the relative contribution of each inflammatory component to the overall spectrum. Results Optical spectroscopy was harnessed to successfully generate complex inflammatory profiles in periodontal tissues. Tissue oxygenation at periodontitis sites was significantly decreased (p<0.05) compared to gingivitis and healthy controls. This is largely due to an increase in deoxyhemoglobin in the periodontitis sites compared to healthy (p<0.01) and gingivitis (p=0.05) sites. Tissue water content per se showed no significant difference between the sites but a water index associated with tissue electrolyte levels and temperature differed was significantly between periodontitis sites when compared to both healthy and gingivitis sites (p<0.03). Conclusion This study establishes that optical spectroscopy can simultaneously determine multiple inflammatory indices directly in the periodontal tissues in vivo. Visible - near infrared spectroscopy has the potential to be developed into a simple, reagent-free, user friendly, chair-side, site-specific, diagnostic and prognostic test for periodontitis.

There are no published reports on the oral health status of adult immigrants and refugees in Canada. An oral health interview and clinical oral examination were conducted on 45 recent immigrants and 41 recent Bhutanese refugees, aged 18-67, in Nova Scotia, Canada. Over half (53%) of the immigrants and 85% of the refugees had untreated decay. Most (89% of immigrants; 98% of refugees) had moderate to severe gingivitis and the majority (73% of immigrants; 85% of refugees) had moderate to severe periodontitis. Despite these, 64% of immigrants and 49% of refugees rated their oral health as good, very good or excellent, and most believed they did not need fillings or periodontal treatment. Oral disease among the study sample was higher than the Canadian average and there was a striking discrepancy between self-reported and clinically determined need for dental care.

Background and Objective Periodontitis is currently diagnosed almost entirely on gross clinical manifestations that have been in situ for more than 50 years without significant improvement. The general objective of this study was, therefore, to evaluate whether mid-infrared spectroscopy can be used to identify disease-specific molecular alterations to the overall biochemical profile of tissues and body fluids. Material and Methods A total of 190 gingival crevicular fluid samples were obtained from periodontitis (n = 64), gingivitis (n = 61) and normal sites (n = 65). Corresponding infrared absorption spectra of gingival crevicular fluid samples were acquired and processed, and the relative contributions of key functional groups in the infrared spectra were analysed. The qualitative assessment of clinical relevance of these gingival crevicular fluid spectra was interpreted with the multivariate statistical analysis-linear discriminant analysis. Results Using infrared spectroscopy, we have been able to identify four molecular signatures (representing vibrations in amide I, amide II/tyrosine rings and symmetric and asymmetric stretching vibrations of phosphodiester groups in DNA) in the gingival crevicular fluid of subjects with periodontitis or gingivitis and healthy control subjects that clearly demarcate healthy and diseased periodontal tissues. Furthermore, the diagnostic accuracy for distinction between periodontally healthy and periodontitis sites revealed by multivariate classification of gingival crevicular fluid spectra was 98.4% for a training set of samples and 93.1% for a validation set. Conclusion We have established that mid-infrared spectroscopy can be used to identify periodontitis-specific molecular signatures in gingival crevicular fluid and to confirm clinical diagnoses. Future longitudinal studies will assess whether mid-infrared spectroscopy represents a potential prognostic tool, recognized as key to advancement of periodontics.

Objectives. To determine the distribution and determinants of periodontal health in adult members of the Sandy Bay First Nation in Manitoba, Canada. Study design. Cross-sectional study based on face-to-face interviews and oral examinations. Methods. Face-to-face interviews and oral examinations were performed on a convenience sample of 07 individuals to assess Debris Index, Calculus Index, Gingival Index and clinical attachment loss (CAL). Chi-square, Fisher's exact, Mann-Whitney and Kruskal-Wallis tests were used to find variables significantly associated with 2 outcome variables: dichotomous mean CAL (≤2.5mm and >2.5mm) and dichotomous severe periodontitis. Variables found to be significantly associated with either of the outcome variables were entered into logistic regression analysis to look for significant independent effects (P<0.05). Results. The mean age for the sample was 6. (SD .6). The mean CAL for the group was 1.44mm (SD 1.14), with age-specific CAL (SD) values of 1.08 (0.69), 1.18 (0.97), 2.05 (1.57) and .0 (0.95) for subjects aged 8-7, 8-7, 8-47 and 48 years or above, respectively. Of the individuals studied, 4.6% suffered from moderate periodontitis, whereas .4% suffered from either localized or generalized severe periodontitis. Of the variables tested, tooth brushing frequency (p<0.05), flossing (p=0.001), Calculus Index (p=0.001), Gingival Index (p<0.05), age (p<0.05), diabetes (p<0.05) and DMFS (p<0.05) were found to be significantly associated with mean CAL, whereas, sex (p<0.05), tooth brushing frequency (p<0.05), Calculus Index (p<0.005), age (p<0.005) and DMFS (p<0.05) were found to be significantly associated with severe periodontitis. Age, tooth brushing frequency and flossing were found to have significant independent effects on mean CAL and severe periodontitis using logistic regression analysis. Conclusions. Considering the high prevalence of periodontitis in this population, expanded availability of community-based dental services is urgently needed.