Self-assessment of dental health status, behaviours and oral health risk factors among adolescents from public schools in Maputo City-Mozambique.

Self-assessment of dental health status may have an impact on the oral health behaviour of adolescents which could impact their oral health. Oral health has been linked to various medical health conditions, thus eliminating oral health diseases can improve general health. The present study aimed to assess the association between behaviours and risk factors (oral hygiene habits, sugar intake, urban/rural status) and negative self-perception of dental health status among adolescents attending public schools in Maputo City.Method An analytic cross-sectional study, conducted in three Primary public schools from urban and peri-urban areas in Maputo City selected by convenience due to their geographic location was included. The size of the sample was 236 12-year-olds. Data was collected using a self-completion questionnaire designed by the World Health Organization (WHO). Chi-square tests or Fishers' Exact tests were used for associations. A simple and multiple logistic regression was used to determine the strength of these associations using backward elimination (p < 0.05). Results: The sample consisted of 221 adolescents, with 114 (51.6%) residing in urban areas and 107 (48.4%) in peri-urban areas. More than half of the participants (111 individuals) reported having a negative perception of their dental health. In the urban location, a higher percentage of participants had a "negative" perception of dental health (57.9%, n = 66), while in the peri-urban location, more participants perceived their dental health as "positive" (57.9%, n = 62). Participants residing in an urban setting were 82% more likely to have a negative perception of dental health (AOR = 1.82 [95% C.I.: 1.05 to 3.14]). Those who had experienced dental pain tended to report a higher proportion of negative dental perception (57.2%, n = 91), with 2.7 times more likely to report a negative perception of dental health (AOR = 2.72 [95% C.I.: 1.46 to 5.08]). The majority (n = 139; 63.2%) claimed to clean their teeth twice a day.Conclusion There was a higher negative perception of dental health in urban areas. The need to strengthen oral health promotion in urban schools is high since schools play such a significant role in oral health promotion.

Inter-rater reliability of the extended Composite Quality Score (CQS-2).

Aim: To establish the inter-rater reliability of the Composite Quality Score (CQS-2) and to test the null hypothesis that it did not differ significantly from that of the first CQS version (CQS-1). Materials and methods: Four independent raters were selected to rate 45 clinical trial reports using CQS-1 and CQS-2. The raters remained unaware of each other's participation in this study until all rating had been completed. Each rater received only one rating template at a time in a random sequence for CQS-1 and CQS-2 rating. Raters completed each template and sent these back to the principal investigator. Each rater received their next template 2 weeks after submission of the completed previous template. The inter-rater reliabilities for the overall appraisal score of the CQS-1 and the CQS-2 were established by using the Brennan-Prediger coefficient (BPC). The coefficients of both CQS versions were compared by using the two-sample z-test. During secondary analysis, the BPCs for every criterion and each corroboration level for both CQS versions were established. Results: The BPC for the CQS-1 was 0.85 (95% CI: 0.64-1.00) and for the CQS-2 it was 1.00 (95% CI: 0.94-1.00), suggesting a very high inter-rater reliability for both. The difference between the two CQS versions was statistically not significant (p = 0.17). The null hypothesis was accepted. Conclusion: The CQS-2 is still under development, This study shows that it is associated with a very high inter-rater reliability, which did not statistically significantly differ from that of the CQS-1. The promising results of this study warrant further investigation in the applicability of the CQS-2 as an appraisal tool for prospective controlled clinical therapy trials.

COVID-19 vaccine hesitancy and its drivers among dental students at University of the Western Cape, South Africa.

Background: Vaccine hesitancy has seen an uprising over the decades, even though there have been many advances regarding vaccine-preventable diseases. Of late, vaccine hesitancy has resurged towards the coronavirus disease 2019 (COVID-19) vaccine. The SARS-CoV-2 virus has major effects on the human body and has led to the development of different vaccines, which have been shown to provide immunity against the novel coronavirus. Dentists are at an increased risk to COVID-19 because of the nature of their work. It is imperative to have high vaccination coverage for this group. Aim: The aim of this study is to determine vaccine hesitancy and drivers associated with vaccine hesitancy among dental students at a university in South Africa. Setting: A dental school in South Africa was chosen as the setting for this study. Methods: An analytical cross-sectional study was conducted by means of an anonymous, online, validated questionnaire to determine vaccine hesitancy. Results: Of the 205 dental students participated, 83.9% (n = 172) students were vaccine not hesitant. The main concerns regarding the vaccines were identified as safety and efficacy of the vaccine. Pressure by family or friends and the university to get vaccinated was evident. Conclusions: Vaccine hesitancy is high despite mandatory vaccination policies in South Africa. Specific drivers contributing to vaccine hesitancy were identified as doubt in the efficacy and safety of the vaccine. Contribution: This study has highlighted the prevalence of vaccine hesitancy among dental students at University of the Western Cape, prior to compulsory vacccination implementations.

Maternal and infant risk factors and risk indicators associated with early childhood caries in South Africa: a systematic review.

OBJECTIVES: To evaluate the risk factors and risk indicators associated with early childhood caries in South Africa. DESIGN: A systematic review of aetiology was performed. From 1366 papers found, 23 studies met the eligibility criteria and were included. All study designs were included. Healthy children under six who live in South Africa were eligible for the study. The study was registered with PROSPERO, registration number CRD42020216455. DATA EXTRACTION: Eligible studies were selected, and data extracted independently by two reviewers. Published data on socio-economic status, dietary factors, oral hygiene knowledge and practices, breastfeeding and bottle-feeding practices, oral bacterial flora and other risk indicators were collected. Two authors appraised the studies independently using the Joanna Briggs Critical Appraisal tools. DATA ANALYSIS: Heterogeneity was assessed using the I2 statistics, and due to heterogeneity, extracted data were mostly presented narratively. RESULTS: Meta-analysis was performed using random-effects models and concluded that parents of children who had a tertiary education had a 1.77 [1.22-2.57] odds of experiencing dental caries compared to the children of parents with a secondary education. However, the unclear risk of bias of most included cross-sectional studies precluded definitive conclusions. CONCLUSIONS: More high-quality cohort studies need to be performed to evaluate actual risk factors for ECC in a South African setting. Parental/caregiver oral educational knowledge needs promoting before the emergence of their children's teeth. The social determinants of health need to be incorporated in future studies, and suitable targeted interventions need to be developed and implemented to mitigate early childhood caries in South Africa.

Perspectives on academic mentorship, research collaborations, career advice and work-life balance: a masterclass conversation with Professor Salim Abdool Karim.

Mentorship and collaboration are fundamental to ensure success in research, particularly health research. In this article, we summarise a conversation between the Master's in Biostatistics students at Stellenbosch University and Professor Salim Abdool Karim, the head of the Centre for the AIDS Programme of Research in South Africa. In May 2021, Professor Abdool Karim was invited to share some of his expertise and knowledge on successful mentorship and collaboration with researchers in the early stages of their careers. Passion, hard work and always trying one's best were some of the key values he highlighted as what a young researcher would need to succeed in today's world. In this candid and open discussion, Professor Abdool Karim provides valuable insight pertaining to the intricacies of a career in research, in terms of collaboration, mentorship and personal lessons drawn from his own life experience.

Patient-reported outcome measures of digitally versus conventionally constructed removable dentures: a systematic review protocol.

OBJECTIVE: This review will evaluate patient-reported outcome measures of treatment with digitally fabricated versus conventionally manufactured removable dental prostheses in partially or completely edentate adults. INTRODUCTION: Compared with conventionally manufactured dental prostheses, digitally fabricated prostheses may simplify and reduce the number of clinical steps and minimize errors in the production of prostheses without compromising occlusal accuracy and fit. This may, in turn, improve patient satisfaction, ability to speak, esthetics, stability, and oral health status. Determining evidence of patient-reported outcomes will assist the dental practitioner when communicating patient expectations. INCLUSION CRITERIA: This review will consider experimental and quasi-experimental study designs, including randomized and non-randomized controlled trials, comparative clinical studies, prospective or retrospective trials, longitudinal clinical studies, clinical reports, and technique articles. The review will include patient-reported outcome measures from fully or partially edentulous adult participants who received either conventionally or digitally fabricated dental prostheses. METHODS: The following databases will be searched for scientific, peer-reviewed literature: Academic Search Complete, CINAHL, Dentistry and Oral Sciences (all via EBSCO), MEDLINE (PubMed), ScienceDirect, and Cochrane Central Register of Controlled Trials. The search strategy will include terms relevant to the intervention, which will be adapted for each bibliographic database, in combination with database-specific filters, where available. The language restriction will be English and Dutch. All included studies will be critically appraised and data will be extracted for synthesis. If possible, a meta-analysis will be conducted. The Grading of Recommendations, Assessment, Development and Evaluation approach will be followed to evaluate the certainty of evidence. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42018094357.

Prevalence of early childhood caries in South Africa: a systematic review.

BACKGROUND: The prevalence of Early Childhood Caries (ECC) in South Africa was last determined in 2002 in a national survey. Since then only few scattered studies were conducted across pocketed communities in the country. There appears to be an increasing trend in dental caries prevalence in South Africa. Since South Africa has one of the highest burden of HIV in the world, less focus was spent on Non-Communicable Diseases (NCDs), it was only when HIV patients developed NCD's did the government start evaluating NCDs. However, oral health is still not given enough attention within the health sphere. It is the hope of this systematic review to showcase the extent of dental caries amongst the future leaders of our country. OBJECTIVES: The systematic review presents the prevalence and severity of early childhood caries between age groups and provinces in South Africa from 1975 to 2014. DESIGN: A systematic review of prevalence was performed. SETTINGS AND PARTICIPANTS: All studies performed on children under the age of six who lived in South Africa were eligible to be included. PRIMARY AND SECONDARY OUTCOME MEASURES: The prevalence of ECC and the dmft scores were the primary and secondary outcome measures. RESULTS: Twenty-one studies were included in the present review. The overall prevalence was 44.94% (95% confidence interval (C.I.) 39.73-50.15%) and the overall dmft score was 2.422 (95% C.I. 2.148-2.696). CONCLUSIONS: The dmft score was the lowest in the Limpopo Province and highest in the Eastern Cape. ECC prevalence increased post-apartheid possibly on account of lifestyle changes due to the exodus from rural to urban and peri-urban areas. Registration The protocol of this systematic review was registered with PROSPERO, CRD42018112161, in November 2018.

Prevalence of Early Childhood Caries in South Africa: Protocol for a Systematic Review.

BACKGROUND: Young children are at the highest risk of developing dental caries as they have a lack of autonomy over their diet and oral hygiene practices. Dental caries develops over time due to demineralization of tooth substance (enamel), which results from acid production during sugar metabolism by bacteria. Early onset of dental caries often results in asymptomatic presentation, but if left untreated, it can result in severe pain, infection, and dentoalveolar abscesses. Early childhood caries (ECC) is defined as dental caries in children aged 6 years and younger and is a significant public health problem in South Africa. According to the Global Burden of Disease study, untreated dental caries of primary teeth affects 532 million children. Untreated dental caries has many detrimental effects which can affect the physical development and reduce the quality of life of affected children. Furthermore, long-term untreated dental caries can result in school absenteeism, low BMI, and poor educational outcomes. OBJECTIVE: The purpose of this study was to determine the prevalence and severity of ECC in South Africa in children under the age of 6 years. METHODS: All cross-sectional studies documenting the prevalence and severity of dental disease (decayed, missing, and filled teeth scores) will be included. Various databases will be searched for eligible studies. Only studies conducted on South African children aged 6 years and under will be included. There will be no restriction on the time or language of publication. The quality of all eligible studies will be analyzed by a risk of bias tool developed by the Joanna Briggs Institute. The results will be presented narratively, and if possible, a meta-analysis will be conducted. RESULTS: The protocol is registered with PROSPERO. The literature search was initially conducted in November 2018 and was repeated in November 2020. CONCLUSIONS: The results of this study will be used to advise stakeholders of the prevalence and severity of dental disease in children under 6 years of age in South Africa. TRIAL REGISTRATION: PROSPERO CRD42018112161. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/25795.

The Effect of Periodontal Disease on Metabolic Control in Patients With Diabetes Mellitus in South Africa: Protocol for a Systematic Review.

BACKGROUND: The increase in the prevalence of type 2 diabetes mellitus (T2DM) and its associated complications is burdensome to the South African health system. Understanding the role of comorbid diseases, such as periodontal disease (PD), and their effect on metabolic control in patients with DM in South Africa will raise awareness about the importance of periodontal interventions among patients with DM in South Africa. OBJECTIVE: The review will aim to determine the effect of PD on the metabolic control of T2DM in a South African population. METHODS: A systematic review of the relationship between PD and metabolic control in patients with T2DM in a South African population will be conducted. Cohort, cross-sectional, and case-controlled studies will be considered in which the outcome of interest is diabetic control. A search will be done in the following sources: EBSCOhost (academic search complete; dentistry and oral sciences), PubMed, ScienceDirect, and the South African National ETD Portal for articles published in English. There will be no limit placed on the date of the publication. The reference list of articles will be reviewed for further inclusion of critical articles. Two independent reviewers (AJ and FK-D) will do study selection, data extraction, and quality analysis. All disputes will be resolved by discussion, and the entire team will verify final decisions. RESULTS: The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO). A preliminary search was conducted using the keywords ((perio*) AND (diabet*)) AND ("South Africa"). The review process should be completed by December 2021. CONCLUSIONS: The review will determine the effect of PD on metabolic control in patients with T2DM in South Africa. The outcome would inform health policy to highlight the need to include periodontal care into treatment protocols in patients with T2DM. In this process, the feasibility for future research in this area of interest will also be defined. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020221064; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=221064. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/27471.

Career Development of Academic Staff in Faculties of Dentistry by Means of Mentorship Programs: Protocol for a Scoping Review.

BACKGROUND: Globally, the demands on dental educators continue to diversify and expand. Due to their importance and value, mentoring programs have been acknowledged as a means of recruiting, developing, and retaining academics in dental education. OBJECTIVE: This protocol is for a scoping review that aims to identify the goals of mentoring programs for academic staff in dental faculties and determine how these programs were structured, delivered, and evaluated. METHODS: The review will be performed in accordance with the Joanna Briggs Institute's methodology for scoping reviews, which covers both qualitative and quantitative scientific literature as well as grey literature written in English and published between 2000 and 2020. The databases will include PubMed, Ovid, the Educational Resources Information Center database, Science Direct, Scopus, Google Scholar, Trove, Web of Science, Openthesis.org, and the website of the American Dental Education Association. A manual search will also be conducted by using the reference lists of included studies to identify additional articles. Working independently, the authors will participate iteratively in literature screening, paper selection, and data extraction. Disagreements between the reviewers will be resolved by discussion until a consensus is reached or after consultation with the research team. Key information that is relevant to the review questions will be extracted from the selected articles and imported into a Microsoft Excel file. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) will be used to guide the reporting of this protocol. RESULTS: The search for appropriate literature has commenced, and we aim to present the results before the end of the 2021 academic year. CONCLUSIONS: The development of formal mentorship programs for academics in dental education will enhance the retention of academic staff. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/27239.

Prevalence and distribution of HPV infection and subtypes in oral squamous cell carcinoma in Africa: a systematic review protocol.

INTRODUCTION: Human papillomavirus (HPV) is an established risk factor for oropharyngeal squamous cell carcinoma, regardless of a history of other known risk factors such as alcohol and tobacco. While cases of HPV-related oral squamous cell carcinoma (OSSC) are increasing in the USA, Europe and South Central Asian countries, little is known about the impact of the disease on the African continent. METHODS AND ANALYSIS: We describe a protocol for a systematic review to synthesise the best current evidence to assess the disease burden in Africa. Electronic databases including EBSCOhost, MEDLINE, CINAHL, ACADEMIC SEARCH COMPLETE, ScienceDirect, Web of Science, Scopus, SciCENTRAL, Cochrane Library, International Prospective Register of Systematic Reviews) and WorldCAT will be comprehensively searched for studies reporting on the defined outcomes, in Africa, published from 1985 (when HPV was first reported) to the latest current entries, with no language restriction. Supplemental handsearching of grey literature, conference abstract proceedings, reference lists of included studies and citations in Google Scholar will be conducted. Authors will be contacted, where necessary, to assist with missing data. A customised data extraction form, with specified criteria, will be used for data extraction. Overall study quality assessment will be done using an appropriate risk of bias tool suited to the study design. Where available, qualitative data from studies reporting on the outcomes will be captured on the data extraction form. Using Stata software, we will apply the random-effects meta-analysis model to aggregate prevalence estimates with 95% CI, incorporating the Freeman-Tukey transformation to account for between-study variability. A narrative report of the findings will be presented where data are insufficient in terms of the outcome/s. Subgroup analysis will be done subject to sufficient available data. ETHICS AND DISSEMINATION: Ethics approval or written consent is not required as the review will be conducted using published data. The findings will be distributed through a peer-review publication and conference presentation.

Impacts of Tooth Loss on OHRQoL in an Adult Population in Cape Town, South Africa.

(1) Background: Tooth loss is an important component of the global burden of oral disease, greatly reducing the quality of life of those affected. Tooth loss can also affect diet and subsequent incidences of lifestyle diseases, such as hypertension and metabolic syndromes. This study aimed to evaluate the oral health-related quality of life (OHRQoL) score using the oral impacts on daily performance (OIDP) index in relation to tooth loss patterns among adults. (2) Methods: From 2014 to 2016, a cross-sectional study was conducted on adults living in Bellville South, Cape Town, South Africa. The OHRQoL measure was used to evaluate the impact of tooth loss. (3) Results: A total of 1615 participants were included, and 143 (8.85%) had at least one impact (OIDP > 0). Males were less likely to experience at least one impact compared to the females, OR=0.6, 95% C.I.: 0.385 to 0.942, p = 0.026. Those participants who did not seek dental help due to financial constraints were 6.54 (4.49 to 9.54) times more likely to experience at least one impact, p < 0.001. (4) Conclusions: Tooth loss did not impact the OHRQoL of these subjects. There was no difference in the reported odds for participants experiencing at least one oral impact with the loss of their four anterior teeth, the loss of their posterior occlusal pairs, or the loss of their other teeth.

Risk Indicators for Early Childhood Caries in South Africa: Protocol for a Systematic Review.

BACKGROUND: Early childhood caries (ECC) is a common disorder characterized by the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces of primary teeth in children 71 months old or younger. South Africa has a diverse population in terms of culture, education, income, and occupation. This diversity is due to the consequences of historical racial discrimination, poverty, unemployment, lack of accessibility to health services, and quality of education. These factors make South Africa unique, and the disease and risk profiles for this country differ from those of other countries at similar stages of development. For these reasons, it is important to identify the unique maternal and infant risk factors for ECC in the South African context. OBJECTIVE: The purpose of this study is to determine the risk factors associated with the incidence and prevalence of ECC in South Africa in children under the age of 6 years. METHODS: All cross-sectional and cohort studies documenting risk factors associated with the prevalence and incidence of dental disease and severity (decayed, missing, and filled scores) will be included. We will search 7 databases for eligible studies, and those included will be based on prespecified inclusion criteria. Only studies conducted with South African children who are aged 6 years and younger in which dental caries risk factors are documented will be included. There is no restriction on the time or language of publication. Included articles will be scrutinized for quality by using a risk of bias tool developed by the Joanna Briggs Institute. The results will be presented narratively, and if possible, a meta-analysis will be performed. RESULTS: The literature search was conducted in November 2020. CONCLUSIONS: The results of this study will provide a framework to inform medical and dental personnel to highlight mothers and infants at risk of developing ECC. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020216455; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216455. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/26701.

Prevalence of Denture-Related Stomatitis in Edentulous Patients at a Tertiary Dental Teaching Hospital.

Oral mucosal lesions can be uncomfortable and can result in a poorer oral health related quality of life. This can be seen especially in edentulous patients who are mostly elderly and have comorbid diseases such as Diabetes Mellitus, which can impair their ability to withstand oral infections. In South Africa, one of the most unequal countries in the world, almost 50% of the population is edentulous and this prevalence increases as age increases. The aim of this cross-sectional study was to determine the prevalence of denture-related stomatitis in subjects who presented to a tertiary institution in Cape Town, South Africa for new complete dentures and to determine the risk indicators associated with it. Three hundred and ninety-six folders of participants who received complete dentures during the period 2014-2019 were included in this study. Categorical data was displayed as frequencies and percentages and a multiple adjusted logistic regression was used to determine associations between Candida and certain risk indicators. The prevalence of denture-related stomatitis was 25.76% (n = 102). Almost 75% (n = 225) females and 72.63% (n = 69) males had no denture-related stomatitis. The most common site for candidiasis in this population was the palate and tonsillar area (40.2%, n = 41) and the least common site was the upper ridge (2.94%, n = 3). Candidiasis, in edentulous patients are highly prevalent in this population and more needs to be done to prevent it.

Prevalence of Oral Mucosal Lesions and Relation to Serum Cotinine Levels-Findings from a Cross-Sectional Study in South Africa.

Oral mucosal lesions (OML) can decrease oral health-related quality of life and some have the potential to become malignant. The aim of the present study was to report the prevalence of OML in relation to age, sex, and serum cotinine levels in a population with mixed ancestry from South Africa. This study is part of the Cape Town Vascular and Metabolic Health (VHM) study, conducted between 2014-2016. Trained dental examiners assessed the oral mucosa for the presence of OML according to WHO criteria. In total, 1976 individuals were included in the study, being 1496 females (75.7%) and 480 males (24.3%) with average age of 49.5 years (SD = 15.3). In total, 262 lesions were detected in 252 participants (overall prevalence of 13%). Males had higher prevalence than females (14% vs. 9%, p = 0.008). Participants aged 25-34 had the highest prevalence rates (21%). Participants who had cotinine ≥15 ng/mL had higher prevalence of OML as compared to those with <15 ng/mL (15% vs. 5%, p < 0.001). Most common lesions were nicotine stomatitis (33%) and leukoplakia (19%). Age, male sex, and higher cotinine levels were associated with increased prevalence of OML.

Dental caries in a South African adult population: findings from the Cape Town Vascular and Metabolic Health Study.

OBJECTIVES: Caries is a ubiquitous non-communicable disease worldwide. There is a paucity of literature on adult caries in Africa, with the last epidemiological caries study in South Africa conducted in 1988/1989. This article reports on the decayed, missing and filled teeth (DMFT) scores in relation to demographic characteristics for a mixed-ancestry South African population. METHODS: This cross-sectional epidemiological study was part of the ongoing Cape Town Bellville South Vascular and Metabolic Health Study. Each participant signed an informed consent form prior to enrolling in the study. During a clinical examination, DMFT score and components were recorded for each participant. Data analysis was performed with the statistical Package STATA 15. RESULTS: A sample of 1,885 participants was included in the study. Sixty-eight percent of the population experienced high DMFT scores. Mean DMFT score increased with age from 5 (≤ 24-year-old group) to 32 (≥ 75-year-old group, P < 0.001). It was higher in women than in men (28.5 vs. 18, respectively, P < 0.001). The missing component contributed 83% to DMFT score, followed by decayed (14%) and filled (3%) scores. Males had a higher average number of teeth present than females (18 vs. 6.5, P < 0.001). CONCLUSIONS: Dental caries experience was very high, with high levels of tooth loss in this community. These findings highlight limited access to preventive oral healthcare and a high rate of tooth extraction. Females presented higher levels of oral disease than males, indicating the need for preventive oral healthcare programmes in Cape Town, South Africa.

Periodontal Disease Status among Adults from South Africa-Prevalence and Effect of Smoking.

Periodontal diseases are among the six most prevalent non-communicable diseases (NCDs) worldwide, constituting a burden for oral and general health. There is a shortage of epidemiological data on periodontal diseases in Africa. The aim of the present cross-sectional study was to present the periodontal status and cotinine levels of a South African population of adults. This study included individuals living in the Belville South area. Bleeding on probing (BOP) and pocket depth were recorded for each tooth, and clinical attachment loss (CAL) was recorded as the highest score per sextant. Cotinine levels were measured in ng/mL. A total of 951 individuals were included. More than one third of all subjects had BOP. Regarding pocket depth, over 50% of the subjects had shallow pockets (4-5 mm), and almost 6% had deep pockets. CAL ≥ 4 mm was present in 40.1% of the subjects. Males presented worse periodontal conditions than females. In total, 52.7% of the participants had serum cotinine levels of ≥15 ng/mL. Cotinine levels had no effect on periodontal variables. Periodontal diseases were highly prevalent, and periodontal conditions were worse in males. Preventive and restorative public health programs are required to improve oral health in this population.