Dataset Information

Socio-demographic factors related to periodontal status and tooth loss of pregnant women in Mbale district, Uganda.

ABSTRACT: Information on the socio-behavioral distribution of periodontal status and tooth loss in pregnancy emanating from sub Saharan Africa is sparse. This study examined periodontal status and tooth loss in pregnant Ugandan women and assessed the relationship with socio-demographics factors, parity, dental care and oral hygiene.Mothers were participants of a multicentre cluster-randomized behavioral intervention study (PROMISE-EBF Safety and Efficacy of Exclusive Breast feeding Promotion in the Era of HIV in Sub-Saharan Africa). In Uganda, these were pregnant women resident in Mbale district, recruited into the PROMISE EBF study between January 2006 and June 2008. A total of 886 women were eligible to participate of whom information became available for 877 (participation rate 98.9%, mean age 25.6) women who participated in the recruitment interview and 713 (mean age 25.5) women who got a clinical oral examination. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN).The prevalence of tooth loss was 35.7%, 0.6% presented with pockets shallow pockets (4-5 mm), whereas 3.3% and 63.4% displayed bleeding and calculus, respectively. A total of 32.7% were without any sign of periodontal disease. Binary logistic regression analyses revealed that older women, women from larger households and those presenting with microbial plaque were respectively, 3.4, 1.4 and 2.5 times more likely to have CPI score >0. Rural (OR = 0.9), nulliparous (OR = 0.4) and women who never visited a dentist (OR = 0.04) were less likely, whereas women from larger households (OR = 1.5) were more likely to have lost at least one tooth.The results revealed moderate prevalence of bleeding and tooth loss, high prevalence of calculus, low frequency of pockets 4-5 mm. Disparity in pregnant women's oral health related to parity suggests that education of maternity care providers concerning oral health in pregnancy is warranted.ClinicalTrials.gov Identifier NCT00397150.

SUBMITTER: Wandera M

PROVIDER: S-EPMC2722607 | biostudies-literature | 2009 Jul

REPOSITORIES: biostudies-literature

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Socio-demographic factors related to periodontal status and tooth loss of pregnant women in Mbale district, Uganda.

Wandera Margaret M Engebretsen Ingunn M S IM Okullo Isaac I Tumwine James K JK Astrøm Anne N AN

BMC oral health 20090718

<h4>Background</h4>Information on the socio-behavioral distribution of periodontal status and tooth loss in pregnancy emanating from sub Saharan Africa is sparse. This study examined periodontal status and tooth loss in pregnant Ugandan women and assessed the relationship with socio-demographics factors, parity, dental care and oral hygiene.<h4>Methods</h4>Mothers were participants of a multicentre cluster-randomized behavioral intervention study (PROMISE-EBF Safety and Efficacy of Exclusive Bre ...[more]

PMID: 19615094

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Project description:BACKGROUND:Current periodontal disease taxonomies have limited utility for predicting disease progression and tooth loss; in fact, tooth loss itself can undermine precise person-level periodontal disease classifications. To overcome this limitation, the current group recently introduced a novel patient stratification system using latent class analyses of clinical parameters, including patterns of missing teeth. This investigation sought to determine the clinical utility of the Periodontal Profile Classes and Tooth Profile Classes (PPC/TPC) taxonomy for risk assessment, specifically for predicting periodontal disease progression and incident tooth loss. METHODS:The analytic sample comprised 4,682 adult participants of two prospective cohort studies (Dental Atherosclerosis Risk in Communities Study and Piedmont Dental Study) with information on periodontal disease progression and incident tooth loss. The PPC/TPC taxonomy includes seven distinct PPCs (person-level disease pattern and severity) and seven TPCs (tooth-level disease). Logistic regression modeling was used to estimate relative risks (RR) and 95% confidence intervals (CI) for the association of these latent classes with disease progression and incident tooth loss, adjusting for examination center, race, sex, age, diabetes, and smoking. To obtain personalized outcome propensities, risk estimates associated with each participant's PPC and TPC were combined into person-level composite risk scores (Index of Periodontal Risk [IPR]). RESULTS:Individuals in two PPCs (PPC-G: Severe Disease and PPC-D: Tooth Loss) had the highest tooth loss risk (RR = 3.6; 95% CI = 2.6 to 5.0 and RR = 3.8; 95% CI = 2.9 to 5.1, respectively). PPC-G also had the highest risk for periodontitis progression (RR = 5.7; 95% CI = 2.2 to 14.7). Personalized IPR scores were positively associated with both periodontitis progression and tooth loss. CONCLUSIONS:These findings, upon additional validation, suggest that the periodontal/tooth profile classes and the derived personalized propensity scores provide clinical periodontal definitions that reflect disease patterns in the population and offer a useful system for patient stratification that is predictive for disease progression and tooth loss.

Project description:BACKGROUND:Vitamin D is hypothesized to reduce risk for tooth loss via its influence on bone health, inflammation, and the immune response. The association between plasma 25-hydroxyvitamin D [25(OH)D] concentrations and prevalence and 5-year incidence of tooth loss in a cohort of postmenopausal females was examined. METHODS:Participants underwent oral examinations at study baseline (1997 to 2000) and follow-up (2002 to 2005) to determine the number of missing teeth and 5-year incidence of tooth loss, respectively. At both visits, females self-reported reasons for each missing tooth. At baseline, 152 females reported no history of tooth loss, and 628 were categorized as reporting a history of tooth loss as a result of periodontal disease (n = 70) or caries (n = 558) (total n = 780). At follow-up, 96, 376, 48, and 328 females were categorized into the aforementioned categories related to tooth loss (total n = 472). Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for tooth loss by category of baseline 25(OH)D (nmol/L) concentrations. Models were adjusted for age, income, smoking status, frequency of dental visits, waist circumference, and recreational physical activity. P value for trend was estimated using continuous concentrations of 25(OH)D. RESULTS:Among females with 25(OH)D ?50 (adequate vitamin D status) compared to <50 nmol/L (deficient/inadequate), the adjusted ORs were 1.24 (95% CI = 0.82 to 1.87), P-trend = <0.05 for the history (prevalence) of tooth loss resulting from periodontal disease or caries and 1.07 (95% CI = 0.62 to 1.85), P-trend = 0.11 for the incidence of tooth loss resulting from periodontal disease or caries. No statistically significant association was observed between 25(OH)D and the history or incidence of tooth loss caused by periodontal disease. An increased odds of the history of tooth loss attributable to caries was observed with increasing concentrations of 25(OH)D (P-trend = <0.05) but was not confirmed in prospective analyses. CONCLUSION:In this cohort of postmenopausal females, the data do not support an association between vitamin D status and tooth loss.

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Dataset Information

Socio-demographic factors related to periodontal status and tooth loss of pregnant women in Mbale district, Uganda.

Publications

Socio-demographic factors related to periodontal status and tooth loss of pregnant women in Mbale district, Uganda.

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