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Norma Samanta Romero Castro

Title: Periodontal disease, a public health problem

Norma Samanta Romero Castro

Universidad Autonoma de Guerrero, Mexico

Biography

Graduated from the National Autonomous University of Mexico with Honorable Mention.
Full time professor at the School of Dentistry of Universidad Autónoma de Guerrero México (UAGro).
Specialist in periodontics, with master in Public Health. Currently pursuing Ph.D.  in biomedical sciences with line of periodontal research.
Coordinator of the Educational Program of the School of Dentistry of UAGro.
 

Abstract

Periodontal disease is an inflammatory, multifactorial, destructive entity considered as a public health problem, due to its high global prevalence, ranging from 35 to 51% depending on  factors of the study population.

Currently, the study of this disease and the control of risk factors retakes importance, because several studies have shown that the  dysbiotic inflammation of periodontitis, has an adverse impact on systemic health. Oral microbial communities can mediate inflammatory pathology both locally and at distant sites.
Efforts for its treatment has   been directed to perform surgeries, with different types of grafts and biomaterials to gain a few millimeters of insertion; However, these procedures are not indicated in all patients or at all sites; usually performed on intraosseous defects.
Non-surgical periodontal treatment, which includes health education with motivational techniques, instruction in correct brushing techniques, and the use of hygiene additives, have shown good results in patients with improvement, in the dental hygiene they practice. With non-surgical treatment, better periodontal conditions have also been seen in patients, with the evaluation of clinical parameters such as: decrease in pocket depth and gain of clinical insertion. 
The aim of this research were to show periodontal disease as a public health problem presenting high distribution in the study population. To know the risk factors of  disease, in a population in Guerrero México; State with communities where there is social, cultural backwardness and extreme poverty. Finally, assess whether health education and conservative treatment can improve clinical parameters.
A convenience sample of 161 patients was obtained, including those who met the inclusion criteria and distributed as follows: healthy 29 (18.01%), gingivitis 34 (21.12%), mild chronic periodontitis 21 (13.04%), moderate 32 (19.88%); and severe  45 (27.95%).
Patients were divided into two groups: healthy and with periodontal disease (gingivitis and periodontitis). The Mann Whitney test was performed on the numerical variables, and for the categorical X2 test. Significant differences (p <.05) were found in the factors: age, scholarship , glucose level, plaque index and calculus, presence of root rests and poorly adjusted dental restoration.
A multinomial logistic regression was performed according to the degree of periodontal affection, with plaque as the main associated factor. Plaque was the main factor associated with gingivitis (OR 1.21, p <.05), mild periodontitis (OR 1.17, P <.05), moderate (OR 1.22, p <.05); and severe (OR 1.30, p <.05), adjusting for age and scholarship.
In those patients with gingival and periodontal disease there was a reduction of all clinical parameters, 6 months after the periodontal treatment was performed. Wilcoxon test for paired data shows the follow (Median, 25th and 75th percentile).
Depth gingival sulcus mean  in millimeters (mm). Before treatment 1.932 (1.66-2.27), after treatment 1.53 (1.31-1.89) p <0.001. Depth of periodontal pocket mean in mm, before  4.60 (4-5.6), after treatment 3.63 (3-4.1) p <0.001. Number of periodontal pockets mean before treatment 7 (3-18), after 3.5 (1-11) p <0.001. Mean of teeths with bleeding on probing, before treatment 11.5 (7-16), after treatment 5 (3-11) p <0.001.
Mean degree of mobility before treatment 1.17 (.5-1.8), after treatment .5(0-1) p <0.001.