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Epidemiology

Prevalence of Periodontitis and


Gingivitis
-Albandar et al assessed the prevalence of early-onset
forms of periodontitis among group of US adolescents
and reported that 0.6% of the subjects were having
juvenile periodontitis at the age of 1315, and 2.75% of
the subjects were having chronic periodontitis at the
age of 16-17.
-Adult periodontitis is rather prevalent; however,
advanced disease affects limited subfractions of the
population (probably less than 10 to 15)
-Many researchers have observed larger amount of
plaque and less inflammation in relation to the amount
of plaque in children compared to the adults.
Furthermore, experts and clinicians noted that most of
the periodontal diseases that affect children and
adolescents are reversible and cause little tissue
damage compared to the adults.
-Almost all children will have gingivitis at one time or
another (surrounding at least 1 tooth). The prevalence
of gingivitis among schoolchildren in the United States
has ranged from 40% to 60% in national surveys. The
incidence of gingivitis increases with age in adults. In
the elderly there is high incidence of gingivitis.
Prevalence is generally equal between the
sexes.Research suggests that P. gingivalis may be
contagious and transmissible after extended exposure
to an infected person norm among adults.Other factors

Prevalence - The # of cases of a disease


in a designated population at a given
point in time.
Incidence - The # of new cases in a
population over a given time period.

Epidemiology develops a variety of


models of how an event may occur,
in order to recognize and
understand those events on a
higher level.
-identify the risk factors associated
with a disease
-quantify the strength of risk factors
for a particular disease
-allows for theories of causation/
models of periodontal disease
-yield treatment protocols for
clinicians to use with their patients
-lead to interventions to prevent
further cases of the disease

INDICES

For Debris and Inflammation :

1. Quigley-Hein index : An index that evaluates the


plaque revealed on the buccal and lingual non-restored
surfaces of the teeth on a scale of 0 to 5, defined by G.
A. Quigley and J. Hein in1962.

2. Plaque Index :This index scores only the dierences


in thickness of the soft deposits in the gingival area of
the tooth surfaces by running the probe.

3. Gingival Index

4. Simplified Oral Hygiene Index

5. PMA Index :The philosophy of this index was to


count the number of gingival units aected by
inflammation.

For Loss of Attachment :

Extent and Severity Index

A periodontal index used in epidemiology to calculate


and summarize the extent and the average severity of
periodontal disease based on the degree of alveolar
bone loss within the group being studied.

> Periodontal Index

The periodontal index assumes a progression of


gingivitis to pocket formation leading to advanced
destruction with loss of masticatory function with age.

> Periodontal Disease Index

Periodontal disease index is similar to the PI but uses 6


selected teeth : 16,21,24,36,41,44

Limitations of this Study


> Descriptive Studies-These are not useful
for testing hypotheses concerning the effect
of particular exposures on particular disease
outcomes
> Analytic Studies
Cross Sectional Studies -It is limited in
terms of documenting the type and extent
of exposure of potentially exposed persons
> Ecological Studies- There is the lack of
ability to link individual exposure to
individual disease risk and to control for
possible confounders.
> Cohort Studies- It is complex and
expensive
> Case Control Studies-Difficult in minimise
bias, including the selection of appropriate
controls and the control of confounding
variables and minimising recall bias
> Experimental or intervention studies
These may not be suitable in some cases
due to ethical or cost considerations and
where subjects cannot be blinded to

Study done to show attachment loss of the


periodontal ligament and tooth loss in Sri
Lankan Laborers 14 to 46
PROGRESSION

RESULTS

RAPID

(8%) At 35 y/o mean loss of


attachment 9mm. At 45, 13 mm.
Teeth loss as early as 20, at 35,
12 teeth missing;45, all teeth
missing

MODERATE

Moderate progressing (81%), at


45 mean loss of attachment
was 7mm. Tooth loss started at
30 and by 45, mean loss was 7.

NO PROGRESSION (11%) of population, at 35 mean

loss of attachment was less


than 1mm. Tooth loss was not
noted after 40