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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 15  |  Issue : 2  |  Page : 143-146

Prevalence of chronic periodontitis among the residents of PHC in Belagavi and its association with systemic disease – A cross-sectional study


1 Department of Public Health, JNMC, KAHER, Belagavi, Karnataka, India
2 Department of Oral Medicine, VKIDS, KAHER, Belagavi, Karnataka, India

Date of Submission15-Aug-2021
Date of Acceptance23-Aug-2021
Date of Web Publication24-May-2022

Correspondence Address:
Dr. Dronesh Chettri
Department of Public Health, JNMC, KAHER, Belagavi, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_209_21

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  Abstract 


BACKGROUND: Chronic periodontitis is much more common than the general public realizes. In the US, about 80% of adults have at least one attachment loss site and about 35% of the population suffers from severe chronic periodontitis. Surprisingly, only a small portion of this population seeks periodontal care. In terms of oral health treatment, India has a lot of inequalities, and periodontitis affects 95% of the population. In rural areas, the dentist-to-population ratio of about 1:200000 necessitates the development of dental infrastructure at the primary health-care level. Periodontitis affects about 20%–50% of the global population.
METHODS: This cross-sectional analysis was done to determine the spread of chronic periodontitis and its association with systemic disease. A total number of 146 individuals comprising of both sexes ≥40 years of age were selected from two areas in Vantmuri, Belagavi. Age, sex, family history, smoking and alcohol habits, systemic disease, etc., were recorded by giving a questionnaire. The investigation was done to assess body mass index, BOP, CAL, DMFT, OHI, etc., Chronic periodontitis was assessed along with its association with systemic disease. The information collected was entered into Microsoft Excel and evaluated with the help of SPSS 26.
RESULTS: It was evident from the sample population that periodontal disease (41.78%) was highly prevalent. Periodontitis was found to be significantly correlated with age, cigarette/beedi smoking (regular), and OHI scores among study participants (P < 0.05).
CONCLUSION: More research into the underlying mechanisms and risk factors of chronic periodontitis, as well as its link to systemic diseases, is required.

Keywords: Age, chronic periodontitis, smoking, systemic diseases, type 2 diabetes


How to cite this article:
Chettri D, Bagewadi A, Angolkar M. Prevalence of chronic periodontitis among the residents of PHC in Belagavi and its association with systemic disease – A cross-sectional study. Indian J Health Sci Biomed Res 2022;15:143-6

How to cite this URL:
Chettri D, Bagewadi A, Angolkar M. Prevalence of chronic periodontitis among the residents of PHC in Belagavi and its association with systemic disease – A cross-sectional study. Indian J Health Sci Biomed Res [serial online] 2022 [cited 2022 Jun 25];15:143-6. Available from: https://www.ijournalhs.org/text.asp?2022/15/2/143/345824




  Introduction Top


Periodontal disease is a curable disease of inflammation of the periodontium, and its advanced condition is characterized by loss of periodontal bone and destruction of the surrounding alveolar ligament.[1],[2] About 800 strains of bacteria have been identified in the oral cavity and it is thought that complex interactions of bacterial infection and the retaining response, altered by behavioral factors such as smoking, can lead to periodontal disease. In addition to the effects on the oral cavity, research shows that periodontitis is responsible for chronic diseases such as heart disease and diabetes. Acute periodontitis typically affects 5%–15% of any person globally and is also responsible for loss of teeth and surrounding tissues.[3] Bacterial plaque products cause direct damage and the introduction of antibodies into inflammatory and immune responses cause indirect damage.[4] Measurement of loss of attachment of the periodontal ligament is in periodontitis according to the Canadian Health Measures Survey 2007–2009. The National Health and Nutrition Examination Survey was performed to measure periodontal disease in the U.S. which determined attachment loss and pocket depth in six areas of all teeth (excluding third particles). Chronic periodontitis, also called adult periodontitis, is a contagious disease which is caused by bacteria of plaque dentistry, which leads to further damage to the supporting tissue of teeth, namely gingival, periodontal ligament, cementum, and therefore alveolar bone. Porphyromonas gingivalis is a bacterium often associated with chronic periodontitis and is responsible for promoting inflammatory responses associated with tissue destruction in some areas.[5]

In general population, chronic periodontitis is more common and prevalent. In US, approximately 80% adults have minimum one site with loss of attachment. 35% of the US population is affected by it badly.

Only a small percent of these population needs regular care from time to time. India suffers from price differences in health care and 95% of Indians suffer from periodontitis. In the last 10 years, an alarming increase in the prevalence of periodontitis in India has attracted interest from various parts of the country. Dental ratio and population of approximately 1:200000 in rural areas require the construction of dental infrastructure at the primary level of a health-care facility. Only 19% increase in the risk of the disorder is probably caused by periodontitis, with this estimated risk increase reaching 44% in people aged 65 and over. Type two people with diabetes who have severe forms of periodontitis have a risk of 3.2 times more risk than people who do not have or have mild periodontitis.[6] In total, periodontitis affects about 20%–50% of people worldwide.

Objectives

  1. Find how common chronic periodontitis is
  2. To determine the parameters that enhance the risk of chronic periodontitis and their relationship
  3. To find a connection between periodontitis and systemic diseases.



  Methods Top


The study was performed to assess the prevalence of chronic periodontitis among the PHCs residents in Vantmuri, Belagavi and its association with systemic diseases. A total of 146 participants comprising of both sexes ≥40 years of age were selected from 2 areas in Vantmuri, Belagavi.

Inclusion criteria

  1. Individual ≥40 years of age
  2. Individual giving informed consent.


Exclusion criteria

  1. Physically or mentally compromised patients
  2. Pregnant women
  3. Edentulous individual.


Chronic periodontitis

  1. Localized form – ≤30% of sites affected
  2. Generalized form – 30% of sites affected.


Sample size

Sample size was calculated based on the previous study conducted by Balaji et al. in Chennai, Tamil Nadu. The study found that the prevalence of chronic periodontitis among adult population ≥40 years of age was 42.3% with 95% confidence interval (CI) and 8% of relative precision. Calculated sample size was 146.

Sampling methods: Simple random sampling

Data collection methods

In the study area, total number of 146 individuals comprising of both sexes ≥40 years of age were selected from two areas in Vantmuri, Belagavi. After obtaining informed consent information on sociodemographic details, various risk factors for periodontitis such as smoking behavior, alcohol consumption, and brushing habits were collected using predesigned questionnaire. Height was measured in centimeter and weight was measured using weighing machine in kilogram. The suggested classification for Asian populations was used to classify body mass index. Investigation for chronic periodontitis was also done which includes the presence of plague, calculus, BOP, gingival recession, CAL, DMFT score, OHI, and patient periodontal index using armamentarium as discussed below.

Data analysis

Data were entered in IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. (Armonk, NY: IBM Corp.). Descriptive statistics such as average and proportions were calculated and 95% CI was calculated appropriately. Binary logistic regression was used to find the association between one dependent and two or more independent variables. P < 0.05 was considered as statistically significant.

Ethical considerations

An informed consent was taken from each participant before the data collection. Those who were illiterate, thumb impression were taken in front of a witness. All information collected was kept confidential. All the study subjects who had severe chronic periodontitis and/or systemic disease as well as poor OHI were referred to a secondary level/tertiary level hospital for getting their further check-up and treatment. Ethical Clearance was obtained from JNMC Institutional Ethics Committee on Human Subjects Research with Ref no. MDC DOME/404 dated 17.7.2020.


  Results Top


In the present study, a total number of 146 participants comprising of both sexes ≥40 years of age were selected from 2 areas in Vantmuri, Belagavi. [Table 1] shows binary logistic regression analysis done on the sample population (with the presence/absence of periodontitis as the dependent variable) and various risk factors as independent variables. Age (P = 0.001) and OHI score (P = 0.001) possess a statistically significant association (P < 0.05) with periodontitis spread in the study population, irrespective of the other risk factors assessed. In [Table 2], it was found that cigarette/beedi smoking – regular (P = 0.027) – had an association which is statistically significant with periodontitis prevalence in the study population, irrespective of the other risk factors assessed. In [Table 3], it showed that participant aged 30–50 (P = 0.041) and 50–70 (P = 0.013) had statistically significant associations in the sample population.
Table 1: In the sample population, binary logistic regression analysis was performed (with periodontitis as the dependent variable)

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Table 2: In the sample population, binary logistic regression analysis was performed with the presence/absence of periodontitis as the dependent variable and the participant's personal habits as the independent variables

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Table 3: In the sample population, binary logistic regression analysis was performed with age stratification and the presence/absence of periodontitis as the dependent variable

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  Discussion Top


Chronic periodontitis was found to be very common in the current research (41.78%). Former/occasional cigarette/beedi smokers were found in 61.64% of the participants in this sample. This means that a large number of them have minimized or stopped smoking. The present cigarette smoking was found to have the highest incidence of moderate to extreme periodontitis (25.7%), whereas previous cigarette smokers and nonsmokers have 20.2% and 10.1%, respectively, in related studies (13.1%).[7] The current study found no connection between respiratory disease and chronic periodontitis, but a systematic analysis found very little evidence which depicted a weak link (OR: 2.0) between COPD and oral health.[8] The prevalence of periodontitis in a Brazilian rural population ranged from 24.4% to 83%.[9] A total of 15.8% of the 146 participants in the current study had systemic diseases. Cigarette/beedi smoking (regular), ages 30–50 and 50–70, general age, and OHI score were found to be significantly correlated with periodontitis among the participants. 19 out of 423 chronic periodontitis participants (4.5%) were suffering from hypertension, and out of 423 chronic periodontitis participants, 25 (5.9%) suffered from type 2 diabetes in previous studies. Periodontitis was found to be significantly correlated with pan chewing, DMFT scores, cigarette smoking, OHI scores, age, and PISA scores among urban participants.[10] A similar study was conducted in a representative sample from both urban and rural districts of Tamil Nadu, and it was found that the rural population had 59.8% prevalence rates and the 42.35% group had the highest number of cases of chronic in the urban population. Female participants were found to be more prevalent than male participants in this study and the 50–70 age periodontitis. Females, too, had higher chronic periodontitis than males.

Limitations

The study's main drawback was that since it did not use the PISA classification system, it was unable to find an association between periodontitis and systemic disease. This index provides an indirect clinical marker of the inflammation due to chronic periodontitis by quantifying the inflamed surface present in periodontal tissues. The procedure is complicated, and it necessitates a significant amount of time, experience, and ability. Only a few studies have been done on this topic.


  Conclusion Top


Even though we found out from the study that periodontal disease was highly prevalent (41.78%); more research into the underlying mechanisms and risk factors of chronic periodontitis, as well as its link to systemic diseases, is required.

Acknowledgments

We thank all the other faculty members, paramedical staff of health centers, participants, colleagues, and family for their guidance and support in conducting this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
de Pablo P, Chapple IL, Buckley CD, Dietrich T. Periodontitis in systemic rheumatic diseases. Nat Rev Rheumatol 2009;5:218-24.  Back to cited text no. 1
    
2.
Benjamin RM. Oral health: The silent epidemic. Public Health Rep 2010;125:158-9.  Back to cited text no. 2
    
3.
Ashby MT, Kreth J, Soundarajan M, Sivuilu LS. Influence of a model human defensive peroxidase system on oral streptococcal antagonism. Microbiology (Reading) 2009;155:3691-700.  Back to cited text no. 3
    
4.
Newman MG. Classification and epidemiology of periodontal diseases. In: Newman MG, Takei H, Carranza FA, editors. Carraza's Clinical Periodontology. 10th ed. Philadelphia: WB Saunders Company; 2007. p. 100-29.  Back to cited text no. 4
    
5.
van Winkelhoff AJ, Loos BG, van der Reijden WA, van der Velden U. Porphyromonas gingivalis, Bacteroides forsythus and other putative periodontal pathogens in subjects with and without periodontal destruction. J Clin Periodontol 2002;29:1023-8.  Back to cited text no. 5
    
6.
Chandra A, Yadav OP, Narula S, Dutta A. Epidemiology of periodontal diseases in Indian population since last decade. J Int Soc Prev Community Dent 2016;6:91-6.  Back to cited text no. 6
    
7.
Albandar JM, Streckfus CF, Adesanya MR, Winn DM. Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss. J Periodontol 2000;71:1874-81.  Back to cited text no. 7
    
8.
Azarpazhooh A, Leake JL. Systematic review of the association between respiratory diseases and oral health. J Periodontol 2006;77:1465-82.  Back to cited text no. 8
    
9.
Corraini P, Baelum V, Pannuti CM, Pustiglioni AN, Romito GA, Pustiglioni FE. Risk indicators for increased probing depth in an isolated population in Brazil. J Periodontol 2008;79:1726-34.  Back to cited text no. 9
    
10.
Dowsett SA, Archila L, Kowolik MJ. Oral health status of an indigenous adult population of Central America. Community Dent Health 2001;18:162-6.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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