Epidemiology of periodontal diseases
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Transcript of Epidemiology of periodontal diseases
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EPIDEMIOLOGY OF PERIODONTAL
DISEASE
3rd year postgraduate Public health dentistry
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INTRODUCTIONThe periodontium, defined as those tissues
supporting and investing the tooth,comprises of
CementumPdlAlveolar bone Dentogingival junction
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EPIDEMIOLOGY Epi = upon
Demos = people
Ology = science
Epidemiology = the science which deals with what falls upon
people…..
Epidemiology has been defined by John M. last in 1988
as:-‘The study of the distribution and determinants of health-
related states or events in specified populations and the
application of this study to the control of health problems.’
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CLASSIFICATION OF EPIDEMIOLOGY
It can be classified into 2 types :- [1] observational studies [2] Experimental or intervention • Descriptive studies studies
• Analytical studies – {a} randomized controlled trials
{a} ecological or correlational or clinical trials
{b} cross-sectional or prevalence {b} field trials
{c} case – control or case- reference {c} community trials or community
{d} cohort or follow-up intervention studies
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PERIODONTAL DISEASE Periodontal disease is a term which includes all
pathological conditions of the periodontium
(gingiva, alveolar bone, cementum and periodontal
ligament).
Traditionally periodontal disease were classified
into gingival diseases and periodontal diseases.
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EPIDEMIOLOGICAL TRIAD
[1] HOST FACTORS
[2] AGENT FACTORS
[3] ENVIRONMENTAL FACTORS
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HOST FACTORS
1. AGE - More with older age groups (40 YEARS)
2. SEX – More in males
3. RACE – Blacks are more affected than whites
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HOST FACTORS
4. INTRAORAL VARIATIONS- Gingivitis is more seen
on the interproximal areas than buccal and lingual.
5. SEVERITY OF BONE LOSS – incisor and molar
areas are more severely involved than canine and
premolars.
Maxillary teeth experience more bone loss compared
to mandible.
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HOST FACTORS6. ENDOCRINE CHANGES – chances are more in puberty, menstruation and pregnancy, hyper – thyroidism, hyper – parathyroidism.7. TRAUMATIC OCCLUSION – sharp cusp acts as plungers and lead to periodontitis.9. TOOTH POSITION – irregular alignment unclean areas
pocket formation
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HOST FACTORS
10. OCCUPATIONAL HABITS – thread biting, holding
nails between teeth etc.
11.NEUROSIS – bruxism, lip, cheek and nail biting
12. USE OF TOBACCO – components present in tobacco
lower the tissue resistance
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HOST FACTORS
13. MISUSE OF TOOTHBRUSH
14. CONCOMITANT DISEASE – there is tendency towards
alveolar bone destruction in patients with uncontrolled diabetes.
15. INCOME – pdl diseases increases with decrease in income
16. EDUCATION – pdl diseases and education is also
inversely related
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AGENT FACTORS[A] PLAQUE[B] CALCULUS
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DENTAL PLAQUE
Primary etiologic factor for PDL disease.
It is defined as soft deposits that form the bio – film
adhering to the tooth surface or other hard surfaces in the
oral cavity including removable and fixed dentures.
Disruption of balance between plaque bacteria and host
results in PDL diseases.
Dental plaque is divided into : - [1] supragingival
[2] subgingival
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DENTAL PLAQUE
Marginal plaque responsible for –gingivitis
Supragingival and tooth associated subgingival plaque –
calculus and root caries
Tissue associated subgingival plaque – periodontitis
1 gram of plaque contains 2 ×10¹¹ bacteria
It also contains epithelial cells and macrophages
embedded in an organic and inorganic matrix.
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DENTAL PLAQUE
Organic and inorganic materials are derived from
bacterial products.
Accumulation of plaque is found to be more on gingival
1/3rd of the tooth surface, cracks, pits and fissures,
overhanging restorations and around mal-aligned teeth.
The rate of formation and location vary according to the
oral hygiene practices, diet, salivary composition and
rate of flow.
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DENTAL CALCULUS
Calculus is an adherent calcified mass that forms on the
surface of natural teeth and dental prosthesis.
It consists of mineralized plaque.
Calculus would be divided into :- [1] supragingival
[2] subgingival
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SUPRAGINGIVAL CALCULUS
It is white or whitish yellow in color.
It is found to be maximum in the upper 1st molars,
followed by the lower central and laterals and least in
upper anteriors.
It can be easily detached.
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SUBGINGIVAL CALCULUS
It is dark brown or greenish black in color.
It is found to be maximum in lower centrals and laterals
and followed by upper 1st molar, upper anteriors and
upper 2nd molars.
It is found to be least in lower 1st and 2nd premolars and
lower 3rd molars.
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ENVIRONMENTAL FACTORS
[1] GEOGRAPHIC VARIATIONS – high in Chile,
Jordan, India, Malasiya, Ceylon; intermediate in
US(blacks), Columbia, Ethiopia and Ecuador and low in
US (whites), dentist deprived areas.
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ENVIRONMENTAL FACTORS
[2] NUTRITION – high in Niacin deficiency and
Avitaminosis C.
ICNND (International Committee On Nutrition for
National Defence) said that there is no consistent
association between periodontal diseases and nutrition
items.
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ENVIRONMENTAL FACTORS
Severity of periodontal diseases were found in areas with
protein energy malnutrition and vitamin A deficiency.
[3] DEGREE OF URBANIZATION – rural population
seems to suffer more from periodontal diseases compared to
urban population.
.
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ENVIRONMENTAL FACTORS
[4] STRESS- is said to predispose to ANUG and is often
seen in exam going students.
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CONCLUSION
Periodontal disease accounts for a majority of
missing teeth in adults and result in tremendous
economic and social burdens both to the individual
and society.
Periodontal disease is so prevalent that the only
possible solution is the “prevention”
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THANK U…