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Assessment of Oral Hygiene Behaviors and Periodontal Status Among Dental Patients in Turkey: a Pilot Study

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Assessment of Oral Hygiene Behaviors and Periodontal Status Among Dental Patients in Turkey: a Pilot Study Original Article Assessment of oral hygiene behaviors and periodontal status among dental patients in Turkey: A pilot study Eylem Coşkun1 , Füsun Kıymet Ünlü2 1 Oral and Dental Health Center, Balıkesir, Turkey 2 Ege University, Faculty of Dentistry, Department of Periodontology, İzmir, Turkey Abstract Aim: Mechanical plaque control plays a substantial role in preventing periodontal diseases. The aim of this study was to determine the self- reported oral hygiene habits and periodontal status of dental patients in Turkey and to evaluate whether the data was consistent with the current periodontal status of the participants. Methodology: The study group consisted of 104 patients in consultation with a faculty of dentistry in Turkey. Clinical measurements included probing depth (PD), clinical attachment level (CAL), plaque index and bleeding on probing. A survey was conducted Correspondence: in order to learn participants’ oral hygiene habits and demographic Dr. Eylem COŞKUN data. Three groups of 0–3 mm, 4–6 mm, and ≥ 7 mm were assigned to Oral and Dental Health Center, all patients for PD and CAL values. Balıkesir, Turkey. Results: A total of 33.6% of the participants brushed their teeth two E-mail:[email protected] or more times per day, and 33.7% brushed one time daily. The Received: 9 June 2018 percentage of dental floss use was 11.5% and interproximal brushing Accepted: 10 July 2018 was 7.7%. The percentage of the areas with 0–3 mm PD were 89.78%, and areas with 0–3 mm CAL were 86.61%. Areas with ≥ 7 mm PD and _____________________ CAL were found to be very low (PD: 3.85%, CAL: 3.60%). The extent of dental plaque was 62.80% and bleeding on probing was 38.13% of the Access Online overall study population. Quick Response Code Conclusions: It is possible to say that oral care is insufficient in our study group. Also, poor oral hygiene and smoking are closely related to moderate and severe clinical attachment loss for the participants. Consequently, it is clear that more extensive researches need to be done across the country. DOI: 10.5577/intdentres.2018.vol8.no2.3 Keywords: Dental Public health, oral hygiene, periodontal diseases. How to cite this article: Coşkun E, Ünlü FK. Assessment of oral hygiene behaviors and periodontal status among dental patients in Turkey: A pilot study. Int Dent Res 2018;8(2):63-9. International Dental Research © 2018 63 Oral hygiene behaviours and periodonal health Coşkun and Ünlü Introduction Turkey and to evaluate whether the data collected by a survey was consistent with the current periodontal status of the participants. Periodontal diseases are infectious diseases characterized by inflammation and destruction of periodontal tissues, which develop due to complex Materials and Methods relationships between pathogenic microorganisms and the host (1). Microbial dental plaque is shown to be the Participants primary cause of periodontal diseases. Genetic and environmental factors such as age, gender, systemic The study group consisted of 104 people who diseases, drug use and smoking play an important role were obtained randomly through the patients in in the development of the disease (2, 3). consultation with the Ege University Faculty of Mechanical plaque control plays a substantial role Dentistry. The study protocol was approved by the local Committee of Ethics of the Ege University, Turkey in preventing periodontal diseases (4). Adequate oral (approval number 15-9/3), and the research was hygiene habits and regular attendance to dental visits conducted in full accordance with the World Medical are essential self-care behaviours to prevent gingival Association Declaration of Helsinki. All steps of the inflammation (5). It has been demonstrated that procedure were explained to the individuals before mechanical removal of bacterial dental plaque through they signed an informed consent form. adequate use of a toothbrush, interdental brush and The inclusion criteria were: (1) age ≥ 18 years; dental floss can reduce the prevalence of periodontal (2) uncompromised systemic health (This entailed diseases (6–8). individuals who had no risk of bacteremia during Diagnoses of periodontal diseases at early stages periodontal measurements and who did not use can be difficult due to individuals’ lack of awareness, anticoagulant drugs.); (3) no previous periodontal plus the painless and slow progression of the disease treatment before six months; (4) not pregnant or also factors in. Commonly, people need to visit a lactating. dentist when the disease progresses and serious symptoms are revealed, such as gingival bleeding, Self-Reported Oral Hygiene Habits and Socio- mobility and tooth loss. Because of these, regular dental visits and maintenance care have become Demographic Data of Participants important for the prevention and early diagnosis of periodontal diseases (9). Before being examined, participants were then Consequently, oral hygiene habits vary according asked to fill out a short questionnaire giving details to culture and geographic region. For example, a study about oral hygiene habits, self-perceived oral health status, dental attendance patterns, smoking habits as completed in 1993–1994 in 22 European countries well as demographic information (age, place of birth, showed 83–73% of 11-year-old schoolchildren brushed educational status, medical history). An example of the twice a day in Sweden, Denmark, Germany, Austria and questionnaire is shown in Table 1. Norway, but only 26–33% of boys brushed their teeth more than once a day in Finland, Lithuania, Russia, Clinical Periodontal Examinations Estonia and Latvia. The incidence of using dental floss was very low (10). Also, according to the results of a Clinical measurements were achieved by two Korean study conducted in both 2010 and 2012, 51.9% periodontists. Prior to the study, the examiners were of Korean adults brushed their teeth three or more well trained and calibrated in the assessment of times per day, 28.2% flossed their teeth and 22.1% used probing depths and clinical attachment levels using a an interdental brush (11). probing pressure of approximately 25 gr. During clinical Collecting basic information about oral hygiene periodontal examination, missing teeth were detected habits and periodontal status is essential for evaluating and clinical periodontal measurements including probing depth (mm), clinical attachment level (mm), public oral health, providing data on the prevalence of gingival recession (mm), plaque index and bleeding on periodontal diseases, determining the population at- probing (yes/no) were assessed at four sites risk and planning how to maintain periodontal health. (mesiobuccal, midbuccal, distobuccal and midlingual) In our country, only a few comprehensive studies have of each tooth. A manual William’s periodontal probe evaluated oral hygiene habits and periodontal status of from Hu-Friedy was used for these assessments, and the individuals (12―14). So we planned a prospective cross- measurements were rounded to the lowest whole millimeter. Microbial dental plaque was scored as sectional study based on the lack of data. The aim of yes/no and the Ainamo–Bay 1975 gingival index was the study was to determine self-reported oral hygiene used to assess a full mouth bleeding score. habits and the periodontal status of dental patients in 64 IDR — Volume 8, Number 2, 2018 Coşkun and Ünlü Oral hygiene behaviours and periodonal health Statistical Analysis day or more in males. The difference in the brushing frequency between males and females was statistically After the measurements were completed, three significant (p<0.05). In addition, there was no groups of 0–3 mm, 4–6 mm, ≥ 7 mm were assigned for statistically significant difference in the use of all patients according to probing depth and clinical toothbrushing frequency, dental floss and attachment level values. All statistical analyses were interproximal brush among age groups (P<0.05). The made on these groups. Statistical analysis was relationship between oral hygiene habits and age, performed using SPSS software version 20.0. For all gender and educational levels is shown in Table 2. statistical analyses, the level of significance was The participants were also asked about their accepted as p<0.05. The relationship between PD, CAL, periodontal treatment backgrounds. Only 8.7% have dental plaque, bleeding on probing and single variables had periodontal treatment regularly, and 26.9% had (flossing, interdental brush use, gender, smoking) was never been treated periodontally before. There was no analyzed with the nonparametric Mann–Whitney U Test, statistically significant relationship between gender, and multiple variables (toothbrushing, educational educational status or smoking habits and periodontal status, self-assessment of periodontal health) were treatment backgrounds. The general opinion of the analyzed with the nonparametric Kruskall–Wallis Test. participants in the study was that their oral health was poor. Only 36.5% assessed their oral health as well, but nobody assessed their oral health as perfect. Results 3. Periodontal status and its relation with self- Before their detailed periodontal examination, the reported oral hygiene habits, socio-demographic 104 participants were asked to respond to a short data and smoking status of participants questionnaire about their oral hygiene habits, self- According to probing depth and clinical perceived oral health status, periodontal treatment attachment level measurements, areas were separated backgrounds,
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