[Effects of dental health awareness and behaviours on the glycemic metabolic characteristics and periodontal disease of patients with type 2 diabetic].

OBJECTIVE: To analyze the effects of dental health awareness and behaviours on the relationship between glycemic metabolic characteristics and periodontal disease of type 2 diabetic patients. METHODS: In the study, 83 subjects with type 2 diabetes mellitus were recruited. The clinical periodontal indexes, such as pocket probing depth (PPD), attachment loss (AL), modified bleeding index (mBI), plaque index (PLI) were obtained with a Williams type periodontal probe; Laboratory examinations including glycosylated haemoglobin A1(HbA1C) were made, glucose assay tested, and the structured questionnaire interview conducted evaluationg the knowledge, attitude and practice (KAP) about periodontal health. RESULTS: The prevalence of moderate and severe periodontitis was 67.5%, compared with mild periodontitis, whose severities were affected by the higher level of HbA1C (≥8.0%) (OR 54.1-143.1), followed by using glycemic drug (OR=12.9-44.6), stress (OR=16.9-29.6), and the dissatisfaction with diabetic therapy (OR=16.9-18.0) et al. Meanwhile the attachment loss conditions were also correlated with the poor periodontal knowledge level(OR=3.4),older age(OR=1.1),and misjudgement of gingival inflammation (OR=13.3) et al. On the other hand, individuals with moderate and severe periodontitis, having bad teeth brushing effects and knowing about dental plaque inadequately, had a significantly higher risk for the poorly controlled glycemic results (HbA1C≥8.0%), and the OR was 8.61, 8.07, and 7.49 respectively. CONCLUSION: In patients with type 2 diabetes the severity of periodontal disease and the glycemic metabolic level (HbA1C) have a definite bidirectional adverse interrelationship, which is affected by the dental health awareness and behaviours.

[Periodontal health status assessed by community periodontal index and related factors in adult population of Beijing urban community].

OBJECTIVE: To investigate the periodontal health conditions by using community periodontal index (CPI) and analyze the effects of related risk factors. METHODS: By stratified random sampling procedure, a total of 1 183 subjects aged 35-74 were recruited from 13 neighbour community and accepted structured interview and periodontal examination. RESULTS: The percentage of edentulous jaws was 2.3% (27/1 183). For the remaining 1 156 people, the percentage of subject with a highest CPI scores of 0,1,2,3,4 were 0.3%, 0.2%, 46.3%, 31.9%, 21.3%, respectively. At the sextant and tooth level, the numbers of healthy, bleeding, calculus, shallow pocket, deep pocket and missing pocket were 0.26, 0.25, 3.56, 1.06, 0.39, 0.48, and 3.32, 2.02, 15.43, 2.60, 0.70, 3.93, respectively. By multivariable logistic regression models, many risk indicators such as age, gender, smoking, the knowledge, attitudes and practices (KAP) status, etc. were demonstrated to be related to the distribution of deeper and missing pockets. CONCLUSION: The adult periodontal conditions of urban community were serious and affected by some demographic and behavior risk factors. More than half (53.2%) of the examined subjects require complex periodontal treatments.

[Effect of community periodontal care intervention on periodontal health and glycemic control in type 2 diabetic patients with chronic periodontitis].

OBJECTIVE: To evaluate the effectiveness of community periodontal care intervention in type 2 diabetic patients with chronic periodontitis who participated in community non-communicable diseases management service. METHODS: The randomized controlled and blinded community trial with a duration of six months was designed to compare effects of "periodontal initial therapy" on group I(22 cases), of "professional mechanical tooth cleaning (PMTC), i.e. coronal scaling" on group II(19 cases)and of "non-clinical therapy" on the control group(25 cases). The clinical periodontal indexes, such as probing depth (PD), attachment loss (AL), modified bleeding index (mBI), plaque index (PLI) were obtained with a Williams type periodontal probe; Laboratory examinations including glycosylated haemoglobin A1(HbA1C), glucose assay, were conducted. RESULTS: The reductions of PD in groups I and II were 0.71 and 0.70 mm, respectively, which was more significant than in control group (0.20 mm); the reductions of AL in groups I, II, and control group were 0.86, 0.57, and 0.03 mm, respectively, which showed significance in all the three groups. The subjects of groups I and II had 0.56% and 1.01% reductions of HbA1C respectively, and the significance was observed in group II. In addition, the improvement of HbA1C values in group II was highly correlated with the decrease in gingivitis (r=0.51, P=0.03). CONCLUSION: The community periodontal care approaches implemented in the community health service centers have significantly improved periodontal health as well as reduced glycemic level, which could be regarded as basic health care strategies for the patients with diabetes.

[Prevalence and related factors of periodontitis in community-dwelling Chinese with diabetes].

OBJECTIVE: To evaluate the periodontal conditions in community-dwelling Chinese with diabetes and analyze some related factors. METHODS: A total of 90 (45- to 84- year-old) patients with diabetes, participating in community-based non-communicable diseases management system, were recruited in this study. The examination items on these patients included periodontal measurements performed by pocket probing depth (PPD), attachment loss (AL), sulcus bleeding index (SBI), plaque index (PLI), and blood sugar metabolic level surveillance, as well as structured questionnaire interview. RESULTS: The prevalence of periodontitis was 100%, while 37.1% was diagnosed as having mild periodontitis, 24.4% with moderate, and 38.5% with advanced periodontitis. The AL level in male was significantly higher than that in female. The periodontal destruction was highly correlated with HbA1C value and affected by some socio-behavior factors based on multinomial logistic model. CONCLUSIONS: There is a positive correlation between AL and HbA1C level, and AL and HbA1C should be measured regularly. The patients' periodontal inflammation needs effective control. Priority should be given to the low income population and those with little periodontal knowledge for behavior interventions.

[Evaluation of the public on the psychosocial effects of fluorosis].

OBJECTIVE: To explore the attitude of the public to the psychosocial effects of fluorosis through investigating the public in different areas. METHODS: Twenty typical fluorosis photos were selected and evaluated by the public in Xingtai, Beijing and Guangzhou, which included 101 dentists, 118 dental students, 103 college students in non-dental schools, 102 clerks and 92 leaders. Each evaluator was required to answer seven five-point questions according to each photo. RESULTS: The mean of the public evaluation was going up with the increase of Dean's Index (DI) score, ranging from 2.21 to 4.74, meanwhile, the prevalence of reporting that fluorosis would affect their psychosocial status also ascended. Less than 25% people reported that very mild fluorosis (DI < or = 1) would affect the psychosocial status of patients, and mild fluorosis (DI = 2) would affect 25% - 56%, while the prevalence would increase to 48% - 97% in severe fluorosis group (DI > or = 3). "Bivariate Correlation Analysis" showed that significant correlation existed in the evaluation of the public and the degree of fluorosis. The scores of dentists were significantly lower than those of dental students, college students in non-dental schools and clerks. The evaluation scores of the public in Xingtai were generally higher than those in Beijing and Guangzhou. CONCLUSIONS: Mild or less fluorosis could lead to little psychosocial effects.

[A survey of cognition and utilization of fluoride toothpaste and associated factors].

OBJECTIVE: To survey the situation of cognition and utilization of fluoride toothpaste and associated factors amongst elementary and middle school students in Haidian district, Beijing. METHODS: Sample of students was recruited by a multistage, stratified, and probability proportional to size sampling procedure. Self-administered structured questionnaires were used to collect information concerning the knowledge of, attitudes to and utilization of fluoride toothpaste and associated factors. A total of 1 557 students completed the questionnaire effectively. RESULTS: The percent age of students who used fluoride toothpaste when brushing their teeth were 87.8%. More than 60% of students knew that fluoride toothpaste could prevent dental caries by strengthening the out layer of tooth surface. 41.6% of the students doubted about the harmless of fluoride toothpaste even to be used properly. Advertisement was the main source of information about the fluoride toothpaste. CONCLUSIONS: The percentage of students using fluoride toothpaste was high and the majority of them knew that fluoride toothpaste could prevent caries. The oral health education programme concerning the optimal use of fluoride in dental caries prevention is highly recommended.

Oral malodor-related parameters in the Chinese general population.

OBJECTIVES: To estimate the prevalence of halitosis in the Chinese population and to assess the relationships between halitosis and oral health, social and behavioural factors. METHODS: The correlation between the incidence of oral malodor and oral health was surveyed in a sample of 2000 individuals (1000 males and 1000 females) aged 15-64 years residing in urban and rural areas. Malodor was measured with both organoleptic measurements and with a portable sulphide monitor. Assessment of oral health included decayed, missing and filled teeth (DMFT), periodontal status, dental plaque, and tongue coating. Behavioural and social factors related with oral health or halitosis were also investigated. RESULTS: The prevalence of halitosis was 27.5% according to the organoleptic score. The level of volatile sulphur compounds (VSCs) in mouth air was significantly lower in males and in some of the age groups after lunch. Age and location of residence (rural or urban areas) did not influence the VSCs concentration in mouth air. The amount of tongue coating played the most important role in increasing VSCs concentration in mouth air, followed by periodontal status and plaque index values. DMFT, social, and behavioural factors did not contribute to halitosis. CONCLUSIONS: Tongue coating score, modified sulcus bleeding index and calculus index were factors significantly related to oral malodor in this study.

[Evaluation of the psychosocial status of fluorosis patients in fluorosis epidemic areas].

OBJECTIVE: To explore the psychosocial effect of fluorosis on patients in fluorosis epidemic areas. METHODS: Multistage, stratified, clustered and random sampling method was used in this survey. Totally 416 inhabitants of 12, 15 and 35-44 years of age from rural fluorosis epidemic areas in Hebei province were selected. Dental fluorosis was classified by Dean's index (DI). A total of 178 patients with different types of fluorosis were involved in a psychosocial questionnaire investigation which included six five-point subscales, including attitude to teeth, subjective well-being, life satisfaction, interpersonal or social anxiety, effect of self-esteem, impact on behavior. RESULTS: Fluorosis prevalence in fluorosis epidemic areas of Xingtai in Hebei province was 71.20%, and significant difference existed among three age groups (Pearson Chi-square value = 167.51, P < 0.01). With the increase of DI score, the average value of subscale "attitude to teeth" rising, ranging from 2.58 to 3.51, and value of "subjective well-being" was also increasing, ranging from 2.35 to 2.9. Statistical difference of subscale average value was found only in these two subscales ("attitude to teeth": F = 4.787, P < 0.01; "subjective well-being": F = 2.538, P < 0.05). "Attitude to teeth" was significantly different between control group and moderate group (F = 0.52, P < 0.01) and between control group and severe group (F = 0.72, P < 0.01). While significant difference of "subjective well-being" could only be found between control group and severe group (F = 0.56, P < 0.01). According to the bivariate correlation analysis, strong correlation could be found between the degree of fluorosis and the average value of sub-scales. CONCLUSIONS: The psychosocial impact of fluorosis on patients in fluorosis epidemic areas mainly appeared in two aspects, i.e. attitude to teeth and the perception of well-being, especially in severe group.

Oral health knowledge, attitudes and behaviour of adults in China.

OBJECTIVES: To describe oral health behaviour, illness behaviour, oral health knowledge and attitudes among 35-44 and 65-74-year-old Chinese; to analyse the oral health behaviour profile of the two age groups in relation to province and urbanisation, and to assess the relative effect of socio-behavioural risk factors on dental caries experience. METHODS: A total number of 4,398 35-44-year-olds and 4,399 65-74-year-olds were selected by multistage stratified cluster random sampling which involved 11 provinces in China. Data were collected by self-administered structured questionnaires and clinical examinations (WHO criteria). RESULTS: 32% of the 35-44-year-olds and 23% of the 65-74-year-olds brushed at least twice a day but only 5% used fluoridated toothpaste; 30% and 17% respectively performed 'Love-Teeth-Day' recommended methods of tooth brushing. A dental visit within the previous 12 months was reported by 25% of all participants and 6% had a dental check-up during the past two years. Nearly 15% of the subjects would visit a dentist if they experienced bleeding from gums; about 60% of the subjects paid no attention to signs of caries if there was no pain. Two thirds of the urban residents and one fifth of the rural participants had economic support for their dental treatment from a third party, either totally or partially. Significant variations in oral health practices were found according to urbanisation and province. At age 35-44 years 43% of participants had daily consumption of sweets against 28% at age 65-74 years. Dental caries experience was affected by urbanisation, gender, frequency, time spent on and method of tooth brushing. Knowledge of causes and prevention of dental diseases was low with somewhat negative attitudes to prevention observed. CONCLUSION: Systematic community-based oral health promotion should be strengthened and preventive-oriented oral health care systems are needed, including promotion of further self-care practices and the use of fluoridated toothpaste.

[A study of multi-factors on the utilization of dental services in Chinese residents].

PURPOSE: In this article, multi-factors on the utilization of dental services was assessed in Chinese residents by Logistic regression model. METHODS: A household oral health interview survey was conducted among Chinese residents. A study of multi-factors on the utilization of dental services in Chinese residents was analyzed by Logistic regression model. RESULTS: The data 1558 residents in 587 houses had been collected from 6 sampling spots by the household oral health interview survey. Significant difference was found in three hypothesis test of Logistic regression model over 15 year old of residents. CONCLUSIONS: The utilization of dental services was decided by multi-factors in Chinese residents. The main factors to influence residents visiting dentist were dental price, living area and dental caries.

Oral health knowledge, attitudes and behaviour of children and adolescents in China.

OBJECTIVES: A national representative study to describe oral health behaviour, illness behaviour, oral health knowledge and attitudes among 12-year-old and 18-year-old Chinese, to analyse the oral health behaviour profile of the two age groups in relation to province and urbanisation, and to assess the relative effect of socio-behavioural risk factors on dental caries experience. METHODS: The total number of 4,400 of each age group were selected and data were collected by clinical examinations (WHO criteria) and self-administered structured questionnaires. RESULTS: 44.4% of the respondents brushed their teeth at least twice a day but only 17% used fluoridated toothpaste. Subjects who saw a dentist during the previous 12 months or two years were 31.3% and 35.3% for 12-year-olds and 22.5% and 20.2% for 18-year-olds, respectively. Nearly one third (29%) of 12 year-olds and 40.5% of 18-year-olds would visit a dentist in case of signs of caries but only when in pain. Nearly half of the participants (47.2%) had never received any oral health care instruction. Significant variations in oral health practices were found according to province and regular dental care habits were more frequent in urban than in rural areas. The risk of dental caries was high in the case of frequent consumption of sweets and dental caries risk was low for participants with use of fluoridated toothpaste. CONCLUSION: Systematic community-oriented oral health promotion programmes are needed to target lifestyles and the needs of children, particularly for those living in rural areas. A prevention-oriented oral health care policy would seem more advantageous than the present curative approach.

[Effect of IgY solution on dental plaque].

OBJECTIVE: To observe the effect of the IgY solution on dental plaque and mutans Streptococci in plaque and in saliva. METHODS: A double-blind study was used. 44 school children at the third grade in test group used the IgY solution for 21 days; 41 children in control group used the placebo. The plaque index, the plaque weight, the level of mutans streptococci in saliva and in plaque were tested for all children. RESULTS: The plaque weight in test group was (46.4 +/- 31.2) mg at baseline, and (36.6 +/- 25.6) mg at the end of the study (P = 0.007). The IgY solution reduced 21.1% plaque weight. Statistically significant differences for other indices were not shown in this study. CONCLUSION: The 0.1% IgY solution reduces the mass of plaque on the tooth surfaces.

The second national survey of oral health status of children and adults in China.

OBJECTIVES: To describe the oral health status of Chinese children and adults at national level in relation to location and province and to highlight changes in dental caries experience. DESIGN: Cross-sectional study, oral epidemiological survey based on WHO methodology, clinical examinations. SETTING: National survey by National Committee for Oral Health. SUBJECTS: Representative samples of provinces, districts, townships; cluster sampling including subjects aged 5,12,15,18, 35-44 and 65-74. Each age group consisted of 23,452 participants, i.e. total of 140,712 individuals. RESULTS: At age 5, 76.6% were affected by dental caries and mean dmft was 4.5. Mean DMFT varied from 1.0 in 12-year-olds, 1.4 in 15-year-olds, 1.6 in 18-year-olds, 2.1 in 35-44-year-olds to 12.4 in 65-74-year-olds. In adults, caries experience was higher in females than in males. The effect of urbanisation on caries prevalence in children varied by province and age. Among adolescents and young adults caries levels were high in urban areas while caries experience was high for old-age people of rural areas. At national level, changes in dental caries prevalence of 12- and 15-year-olds were small. However, some provinces with extensive oral health programmes (e.g. Love Teeth Day) showed declining caries experience whereas provinces with limited preventive activities had increasing levels of caries. For all age groups, gingival bleeding and calculus were most frequent. Severe periodontal conditions were relatively rare. CONCLUSION: The systematic implementation of preventive oral care and community-oriented health programmes are needed for the continuous promotion of oral health in China.