The relationship between body mass index and oral health status among Saudi adults: a cross-sectional study.

OBJECTIVE: To assess the relationship between body mass index (BMI) and the sum of decayed, missing and filled teeth (DMFT), periodontal pockets, and oral soft tissue variations. BASIC RESEARCH DESIGN: A systematic sample of 250 people attending King Abdulaziz Medical City was included. The study was conducted using questionnaires and clinical examinations. Questionnaires were prepared to include socio-demographic, smoking, oral hygiene, medical and physical variables. Clinical examination included DMFT, pocket depths and soft tissues changes. BMI was calculated as kg/m² using height and weight. Analyses included descriptive statistics, ANOVA, Chi-square and logistic regression. RESULTS: Participants mean age was 35.3 years (18-83 years), and about 60% were females. The mean BMI was 28.24. Two thirds (67%) of participants were overweight (BMI=25.0-29.9kg/m²) or obese (BMI⟩30kg/m²). Mean DMFT correlated with BMI (p=0.005). However, periodontal pocket depths were not associated with increased BMI. In the bivariate analyses, there were associations between BMI and age, education, smoking, tooth brushing, hypertension, diabetes, use of medication and traumatic ulcer. Logistic regression analysis revealed a significant relationship between BMI and DMFT in people educated to less than high school, current smokers, those with any medical problem or with edematous gingiva (P=0.026). CONCLUSION: Participants higher BMI were more likely to have a higher DMFT score in the presence of low education, presence of edematous gingiva, smoking or a medical condition.

The significance of age group, gender and skin complexion in relation to the clinical distribution of developmental oral mucosal alterations in 5-13 year-old children.

INTRODUCTION: To describe the relationship and impact of age group, gender and skin complexion on the prevalence and clinical distribution of oral mucosal alterations of developmental origin (OMA-DO) among school children aged 5-13 years. METHODS: A randomized representative national survey of Jordanian school children including all Country geographic areas was performed. Cut-off age that significantly correlated with presence and distribution of OMA-DO was identified (ROC curve). Skin complexion was classified into light/fair, intermediate/tan, dark/brown based on skin complexion index. Chi square test with P value≤0.05 was used for significance of correlations. RESULTS: Two thousand two hundred and fifty one children were clinically examined. The average age that significantly correlated with prevalence and distribution of OMA-DO was 9.9 years. Female gender was significantly correlated with four OMA-DO: leukoedema (L), linea Alba (LA), Fordyce's granules (FG), commissural lip pits (CLP) and wider distribution of racial pigmentations (RP) (P<0.05, χ2 test). Older age group (9.9-13 years) was significantly correlated with 7 OMA-DO: L, LA, FG, frenal tag, CLP, mandibular and maxillary tori (MT) as well as wider clinical distribution of RP, FG, L (P<0.05 χ2 test). Dark skin complexion significantly correlated with 5 OMA-DO: L, LA, FG, RP, MT and wider clinical distribution of RP (P<0.02, χ2 test). CONCLUSIONS: Increased prevalence and wider clinical distribution of OMA-DO are significantly associated with older age group of 9.9-13 years, female gender, and dark skin complexion. Oral health care provides are encouraged to be familiar with these correlations. This knowledge is expected to improve OMA-DO diagnosis and clinical management. Continuous education programs in this field are recommended.

Quality of life and satisfaction of patients after nonsurgical primary root canal treatment provided by undergraduate students, graduate students and endodontic specialists.

AIM: (i) To assess the impact of primary root canal treatment on the perceived quality of life amongst a cohort of Jordanian patients, (ii) to assess this cohort's satisfaction of their primary root canal treatment, and (iii) to evaluate the association of the level of training and experience of clinicians with these two parameters. METHODOLOGY: A systematic random sample of 302 subjects was selected from patients who attended undergraduate, graduate and specialty clinics of Jordan University of Science and Technology. Participants were interviewed before and two weeks after completion of root canal treatment. The study instrument included the Oral Health Impact Profile questionnaire (Dugas et al. 2002) and seven semantic differential scales. Data analyses included descriptive statistics and nonparametric analyses. RESULTS: More than 90% of subjects reported improvements in the sense of taste, pain, eating, altering food temperature, self-consciousness, waking up during sleep, interruption of meals, difficulty to relax and difficulty to sleep after root canal treatment. There was no significant difference in terms of improvement amongst patients treated by specialists, graduate students or undergraduate students. The overall semantic differential score of intraoperative pain, pleasantness, chewing ability and general satisfaction was about 8. Satisfaction of root canal treatment by specialists was higher in terms of time involved, intraoperative pain, pleasantness and general satisfaction than those treatments by undergraduate students. Patients treated by specialist were least satisfied with the treatment cost compared to those patients treated by graduate or undergraduate students. CONCLUSIONS: The impact of root canal treatment on the quality of life was apparent. Satisfaction with root canal treatment approximates 8 on the semantic differential scale with preference for specialists over dental students.

Coronal caries experience in dentate Jordanian adults.

OBJECTIVE: To assess the coronal caries experience and associated risk indicators among a sample of Jordanian adults. PARTICIPANTS AND METHODS: A random sample of 1,096 dentate Jordanian adults in Irbid region were interviewed and clinically examined for coronal caries using the DMFS index. Descriptive summary statistics, bivariate, and regression analyses were employed. RESULTS: Findings revealed that the mean numbers of coronal decayed surfaces (DS), missing surfaces because of caries (MS), filled surfaces (FS), decayed and filled surfaces (DFS) and DMFS were 6.3, 20.6, 8.0, 14.3 and 34.9 respectively. All subjects had coronal caries experience and 93% had untreated lesions. Subjects of older age, with less education, urban residence, lower incomes, no dental insurance, a smoking habit and irregular oral hygiene practices had a significantly higher coronal caries experience (p < 0.05). Age, income, education, residence, smoking, brushing and flossing collectively explained 45% of the variance for the mean number of coronal DMFS. CONCLUSIONS: This study provided useful information on the coronal caries status of Jordanian adults. Modifications of several social factors could potentially reduce coronal DMFS, to improve oral health status and function in adults.

Periodontal treatment need of the 6th-grade Jordanian pupils.

AIM: The purpose of this study was to assess the periodontal treatment needs of 6th-grade Jordanian pupils aged 12 years old. METHODS: Forty-eight classes teaching 6th-grade pupils were randomly selected from the six education zones in Irbid region, Jordan. The data were collected during interviews and clinical examinations using the Community Periodontal Index of Treatment Needs (CPITN) criteria. RESULTS: The findings revealed that 27.5% of the examined pupils had healthy periodontium, 22.9% showed gingival bleeding on probing but no calculus, and 31.4% had calculus deposits. Pockets in the 4-5 mm range were found in 17.6% and those in the>6 mm range in 0.6% of the pupils. Healthy periodontium was found in 2.9 sextants, whereas 2.7 sextants showed gingival bleeding and calculus. Periodontal pockets were demonstrated in less than 0.4 sextants. Periodontal therapy was not required for 27.5% of the pupils. The rest of the pupils (72.5%), however, needed oral hygiene improvement, and of these 50% required professional calculus removal. CONCLUSION: This study indicated that about 73% of the sample needed oral hygiene instructions and motivation, 50% needed professional scaling, and 0.6% needed periodontal therapy. The data of this study establish a baseline data, which may help in planning dental services and initiating further research.

Prevalence of dens invaginatus in Jordanian adults.

AIM: To assess the prevalence of dens invaginatus in a sample of Jordanian dental patients. METHODOLOGY: The data were collected from examination of 3024 radiographs from a random sample of 1660 patients showing 9377 teeth. A tooth was considered having dens invaginatus if an infolding of a radiopaque ribbon-like structure equal in density to enamel was seen extending from the cingulum into the root canal. RESULTS: Teeth with dens invaginatus were found in 49 subjects out of 1660 subjects examined; thus, the person prevalence was 2.95%. Bilateral dens invaginatus was seen in 12 patients, whereas unilateral dens invaginatus was demonstrated in 37 patients. Dens invaginatus was detected in 61 teeth out of a total of 9377 for a tooth prevalence of 0.65%. Maxillary lateral incisors were the most common teeth affected with the condition (90% of cases). CONCLUSIONS: Dens invaginatus is not common, but it is an important anomaly. The availability of such data may alert the dental practitioner to anticipate the percentage of teeth having difficulties during endodontic treatment.

Prevalence of dilaceration in Jordanian adults.

AIM: The purpose of this study was to determine the prevalence of dilaceration in a sample of Jordanian dental patients. METHODOLOGY: The data were collected from examination of radiographs from a random sample of periapical films. In all, 4655 teeth from 814 dental records at the Faculty of Dentistry, Irbid, Jordan were evaluated. The films were viewed using a magnifying lens and an X-ray viewer. A tooth was recorded as having a dilaceration towards the mesial or distal direction if there was a 90 angle or greater along its long axis using a small ruler aligned along the pulp of the tooth. Dilacerated roots towards the buccal or lingual directions were determined by evaluating the appearance of a round opaque area with a dark shadow in its central region, cast by the apical foramen in which the root canal gave a 'bulls-eye' appearance. RESULTS: Dilacerations were recorded in 3.78% of the teeth examined. Mandibular third molar teeth were the most commonly affected (19.2%) followed by mandibular first molars (5.6%). The maxillary anterior teeth and mandibular incisors were least affected exhibiting dilaceration in approximately 1% of teeth. Two-thirds of the dilacerations were in the mandible and approximately 5% were in anterior teeth. CONCLUSION: Dilaceration is not common, but it is an important dental anomaly that affects all teeth. Recognizing the condition will facilitate endodontic, orthodontic and surgical treatment.

Radiographic evidence of enamel pearls in jordanian dental patients.

OBJECTIVE: An "enamel pearl" is an ectopic globule of enamel that is adherent to the tooth root surface. Such an anomaly may facilitate the progression of periodontal breakdown. Information on the prevalence of enamel pearls is sparse, and ethnic variations are thought to occur. Our objective was to assess the prevalence of enamel pearls in a group of Jordanian dental patients. STUDY DESIGN: A random sample of 819 dental records were selected, and a total of 1032 periapical radiographs were interpreted for the presence of enamel pearls. RESULTS: Enamel pearls were detected in 4.76% of the subjects and on 1.6% of the molars. No significant difference between sexes was observed. First molar teeth were the most commonly affected, whereas the third molars were the least affected with the condition. CONCLUSIONS: Enamel pearls are not uncommon among Jordanian dental patients, and their early detection could be important in prevention of periodontal disease.

Risk indicators associated with tooth loss in Jordanian adults.

OBJECTIVES: The purpose of this study was to evaluate the risk indicators of tooth loss in Jordanian adults. METHODS: A sample of 509 Jordanian adults was randomly selected. The subjects were interviewed regarding demographics, social economic status, smoking habits, and oral hygiene practices and then clinically examined by a single examiner. Multiple regression analysis was performed to estimate the simultaneous impact of risk indicators on tooth loss. RESULTS: The subjects' mean age was 42.6 years with an average of 20.9 teeth remaining per person. The overall educational level of the subjects was low. More than 40% reported not brushing their teeth regularly and 56% had had no professional teeth cleaning during the last year. Monthly family income averaged JOD 231, and about a third of the subjects were smokers. The mean number of remaining teeth decreased significantly with age. Smokers, those who brushed irregularly, and those who had not had professional teeth cleaning in the last year had significantly fewer remaining teeth. Men also had significantly fewer remaining teeth. Education and income were also significantly associated with the number of remaining teeth. Age, income, brushing, prophylaxis, and gender collectively explain 75.1% of the variance in the number of remaining teeth. CONCLUSION: Modification of non-disease independent factors could reduce tooth loss and improve oral health in Jordanians.

Prevalence of taurodontism in Jordanian dental patients.

OBJECTIVES: To assess the prevalence of taurodontism in a group of Jordanian adult dental patients. METHODS: Posterior periapical radiographs of 875 unselected dental patients were examined for the presence of taurodontism defined as the presence of an apically displaced pulp chamber without the usual constriction at the cemento-enamel junction. RESULTS: Taurodontism was detected in 8% of subjects and 4.4% of the teeth examined. The maxillary second molar was the most commonly affected tooth. It was equally distributed between males and females (7.9% compared with 8.1% respectively, P > 0.05). 26.7% of the taurodont teeth also had pulp stones or calcifications. CONCLUSION: Taurodontism is not uncommon in Jordan but further larger scale studies are required to assess its prevalence in the general population to compare it with other ethnic groups.

Medical conditions associated with missing teeth and edentulism in the institutionalized elderly.

Several studies have reported the prevalence of medical conditions or investigated the relationships between the oral health status and general health conditions in the elderly. However, the relationship between medical conditions and oral health among the elderly is not well-described. Previous studies have not clearly identified a consistent association between medical conditions and oral health, specifically edentulism and tooth loss. The purpose of this study was to investigate the relationships between medical conditions and oral health, as assessed by edentulism and missing teeth, in an institutionalized elderly population. A systematic sample (n = 175), stratified by age and sex, was drawn from nursing home patients treated by the University of low' as Geriatric Mobile Unit (GMU) team. Data were extracted from GMU dental records, regarding history of medical conditions, medications, dental history, dentate status, and tooth-by-tooth conditions. Mean numbers of missing teeth were significantly higher among those who had a history of atherosclerotic vascular disease, heart failure, ischemic heart disease, and joint disease. Subjects who had a history of atherosclerotic vascular disease, heart failure, ischemic heart disease, and joint disease were more likely to be edentulous than subjects who did not have a history of those diseases. The biological basis for these relationships between dentate status and systemic medical conditions is unclear and warrants further study.