Oral health status of the elderly in Lahore district of Pakistan

Poor oral health among old aged people is an important public health issue and a growing burden to countries worldwide. In Pakistan, there is paucity of data available regarding the oral health status of the elderly. This study was aimed to describe oral health status of the elderly in Lahore district, by assessing the dental disease prevalence in the 60+ age group. The current study was conducted in Lahore district. The results of the study are based on 470 valid examination proformas. The mean age of the total sample was 66.71+6.39 falling in the range of 60-91 years. Extra and intra oral examination were carried out. All clinical findings were recorded on the standard World Health Organization [WHO] oral health assessment form. Prevalence of periodontal disease as observed by Community Periodontal Index [CPI] was almost 70% in the study population. Calculus, most frequent findings, was observed in 28% subjects, shallow pocketing in 23.25% whereas deep pocketing was reported in 18.75%. Mean Decayed Missing Filled [DMF] score for the sample was 16.3 with females scoring higher than males. Missing component constituted 86.5% of the DMF score. 80% of the subjects did not wear any prosthesis, while almost 11.85% wore either a bridge or a partial denture or both; and another 8.5% wore a complete denture. Temporomandibular joint [TMJ] symptoms were reported by 11.25% of the subjects whereas TMJ clicking was the most common sign observed in 38%. TMJ tenderness and reduced jaw mobility was observed in 11.1% and 1.4% of the subjects respectively. Results of the current study clearly indicate poor oral health status of the elderly in the study population of Lahore. The level of unmet needs is very high hence; more attention needs to be given towards is improving and maintaining the oral health status of the elderly

Prevalence of dental caries among 5-14 years old poor locality school children of Lahore

The aim of study was to investigate the Prevalence of dental caries among 5-14 years old poor locality school children of Lahore Pakistan. Sixteen hundred and seventy three poor locality school children aged 5-14 years: 1113,5-11 years old and 560, 12-14 years old were examined for dental caries and oral hygiene status using the World Health Organization criteria for diagnosis of caries and oral hygiene status. The overall caries prevalence among the study group was 71%. The mean df [decayed and filled primary teeth] score in the 5-11 years age group was 2.98. The mean DMFT [decayed, missing and filled teeth] score among 12-14 years old age group it was 3.70. Only 14% of the poor locality school children had good oral hygiene with corresponding mean df of 1.33 and mean DMFT score of 1.97, followed by 31% having fairly good oral hygiene, 26% having poor oral hygiene. 29% of children had a very poor oral hygiene with corresponding mean of score of 2.96 and mean DMFT score of 3.31. The results of the study emphasize the need for re-orientation of oral health services and programs to a more preventive approach. Serious efforts need to be made by focusing on this neglected group of population

Improving quality of life of diabetic patients through non-surgical periodontal treatment

Improving the periodontal health leads to better glycemic control in type 2 diabetic patients. [6,7] The study included known type II diabetic patients registered with the Diabetic Out Patient Department of Shaikh Zayed Hospital Lahore and Oral examinations were carried out in the Department of Oral Health Sciences of Shaikh Zayed Medical Institute. 61 subjects, 31 treatment group 30 control group. All the patients were non smokers with at least 14 teeth and showed wild to severe level of periodontal disease. Age ranged from 45-65 years. HbA1c values varied from 5-8%. No history of systemic antibiotic administration in the past 3 months. Subjects with any change in oral glycemic drug or its dose altered renal medication or any antibiotics were not included in the study. Treatment group showed a statistically and clinical significant improvement of 16.25% in HbA1c values. The periodontal therapy improves quality of life of diabetic person by improving glycemic control and decreasing the patients' dosage of oral glycemic drugs. In review of this advantage periodontal therapy should be made an integral part of the regime to improve glycemic control

Oral health attitudes, knowledge, and behavior amongst high and low socioeconomic school going children in Lahore, Pakistan

This study was carried out to evaluate the knowledge, attitude and behavior of low and high socioeconomic school going children and the type of food available and consumed at school premises, as well as the dental health care facilities available at schools. It was a multi-centric study which analysed school going children [n=281] from grade 1 to grade 10 who attended private schools of both high and low income groups in Lahore, Pakistan. A questionnaire adapted from Peterson and Stenberg et al designed to assess children's behavior, knowledge and perception of their oral health and dental treatment along with the availability of healthy food in the school was used. Results showed that 54% of HSES students bought food from cafeteria as compared to only 11% of LSES School. 41% LSES children's parents did not observe their child while brushing. 54% of LSES and 41% of HSES visited the dentist only in pain. 39% of HSES but only 12%of LSES went for regular checkups. Reason for not visiting the dentist among HSES students was fear of drilling [40.3%] and 9.3% in LSES. It was concluded that there was a dire need of health education programs especially for low socio economic school children. This study provides baseline information about children's knowledge, their attitudes and behavior towards eating habits, maintaining oral hygiene, seeking dental treatment of low socio economic and high socio economic school children in Lahore

University curriculum and perceived tobacco control policies amongst staff and students of university college of dentistry, Lahore

The aim of this study was to investigate the university curriculum and perceived tobacco control policies amongst staff and students of University College of Dentistry, Lahore, Pakistan. A modified self reported validated standardized global youth tobacco survey [GYTS] was used amongst two hundred and fifty five staff members and students of faculty of dentistry, the university of Lahore, Pakistan. Of all the participants 59.3% demonstrated below median level of activity in any tobacco related teaching or learning in last one year. Staff [68.7%] members were significantly less likely to have been participated in tobacco related activities over the last one year compared to students [54.7%] p=<0.05. Only 12.3% of all the participants perceived that their institute had all three tobacco control policies [i.e. a policy preventing students to use tobacco in campus, a policy preventing University personnel from using tobacco in campus and / or a policy declaring the campus [Tobacco Free]] out of which at least one was enforced in the campus. Males [19.6%] perceived that their institute was 'Tobacco free'and prevents students and university personnel from in campus tobacco use compared to females [6.4%] p=<0.05. University staff was 2.42 [95% Confidence Interval= 1.05-5.57] times significantly more likely to perceive that their institute had all three tobacco control policies compared to students p=<0.05. The results of the study emphasize the need to amend the curriculum at health care institution / university level towards tobacco control. Stricter policies and better implementation is necessary to meet the international tobacco free campus initiative

Periodontal infection: a potential risk factor for pre-term delivery of low birth weight [PLBW] babies

Pre-term delivery of low-birth-weight [PLBW] babies is considered a major peri-natal problem in many countries and is contributing substantially to infant mortality and to childhood handicap. There is a reported incidence of pre-term delivery of low-birth-weight [PLBW] babies of 37% of all live births in Pakistan, which has a tremendous impact on health care system in this community. The prevalence of periodontal disease in Pakistan is also very high in all age groups and women of child bearing age [18-34 years] are no exception.Recent studies indicate periodontal infection as a potential independent risk factor for PLBW, and is considered to be 7 times more likely to be associated than any other risk factors. Several postulated mechanisms have been reviewed, including the virulence effects and role of asymptomatic bacteraemia, focusing on the bacterial load in periodontium facilitating its transmission from oral cavity to the uterus.The indication that periodontal disease is a potential risk factor for the delivery of PLBW; a high level of periodontal disease in women of child bearing age and similar high level of PLBW babies in country, calls for further longitudinal investigations that validate a causal relationship between periodontal infection and pre-term delivery of LBW babies in Pakistan. A review of literature and preliminary communication for a planned study is presented

Periodontal infection: a potential risk factor for p re-term delivery of Low birth weight [PLBW] babies

Pre-term delivery of low-birth-weight [PLBW] babies is considered a major peri-natal problem in many countries and is contributing substantially to infant mortality and to childhood handicap. There is a reported incidence of pre-term delivery of low-birth-weight [PLBW] babies of 37% of all live births in Pakistan, which has a tremendous impact on health care system in this community. The prevalence of periodontal disease in Pakistan is also very high in all age groups and women of child bearing age [18-34 years] are no exception. Recent studies indicate periodontal infection as a potential independent risk factor for PLBW, and is considered to be 7 times more likely to be associated than any other risk factors. Several postulated mechanisms have been reviewed, including the virulence effects and role of asymptomatic bacteraemia, focusing on the bacterial load in periodontium facilitating its transmission from oral cavity to the uterus. The indication that periodontal disease is a potential risk factor for the delivery of PLBW; a high level of periodontal disease in women of child bearing age and similar high level of PLBW babies in country, calls for further longitudinal investigations that validate a causal relationship between periodontal infection and pre-term delivery of LBW babies in Pakistan. A review of literature and preliminary communication for a planned study is presented

Evaluation of problems related to malpractice and professionalism in islamabad area - a study

In many developing countries of the world where dental health care facilities by college I university trained personnel are limited, or very expensive the poor segments of the society go to unqualified persons [known as quacks] to get dental treatment

Quack is an untrained person who has learnt dentistry either by assisting a dental surgeon or inherited it from his family and later on adopted it as a profession. The treatment provided by them is often far below the normal set standards for sterilization and therefore the chances of a patient being exposed to life threatening conditions such as Hepatitis B, C and AIDS at their end is far more than at the hands of a qualified dental practitioner

The following questionnaire based survey maps the current situation of dental quacks in the urban [65%] and rural [35%] sectors of Federal Area [Islamabad], in terms of their methods of sterilization adopted and their treatment modalities. The main aim was to evaluate problems related to malpractice and professionalism. A diverse range of sterilization methods ranging from autoclaving to the use of plain water irrigation was observed. The opinion of the general public was also sought for, revealing varied ideas from suggesting courses for quacks in order to improve their quality of work to completely banning quackery

This malpractice [Quackery] is harming the public confidence in dentistry and also causing degeneration in professional ethics. Health regulatory authorities should be concerned about the increasing number of complaints about the unconventional health care issues

Tea as a source of dietary fluoride in Pakistan

OBJECTIVE: Exposure to fluoride in the modern world has expanded far beyond the degree envisaged by the fluoride pioneers of 60 years ago, who dealt exclusively with fluoride in drinking water. Given that increasing numbers of people are consuming beverages instead of water, fluoride intake should also consider the different beverages consumed and their fluoride content. This study was conducted to assess the levels of fluoride in 11 different varieties of tea available in Pakistan. Materials and This study was conducted with ten different brands and an unbranded variety of tea. Samples were prepared for each brand of tea and were subdivided into 4 groups comprising tea brewed for I min and 3 min. and boiled for 1 min and 3 min. A total of 44 tea infusion samples comprising of 4 samples of each brand were evaluated for their fluoride content. To measure fluoride concentration, a dual range fluoride ion selective tester was used. Leaching of fluoride on brewing ranged from 1.6 ppm to 4.3. A concentration range of 2.8 and 10.7 ppm was observed when the tea leaves were boiled in water. The results of this preliminary study indicate that tea can be considered as an effective vehicle for fluoride delivery and an additional source of dietary fluoride in Pakistan