Socio-demographic factors related to periodontal status and tooth loss of pregnant women in Mbale district, Uganda

Margaret Wandera, Ingunn M S Engebretsen, Isaac Okullo, James K Tumwine, Anne N Astrøm, PROMISE-EBF Study Group, Thorkild Tylleskär, Philippe Van de Perre, Eva-Charlotte Ekström, Nicolas Meda, Chipepo Kankasa, Debra Jackson, Thorkild Tylleskär, Lars Thore Fadnes, Eli Fjeld, Knut Fylkesnes, Jørn Klungsøyr, Øystein Evjen Olsen, Bjarne Robberstad, Halvor Sommerfelt, Philippe Van de Perr, Eva-Charlotte Ekström, Nicolas Meda, Hama Diallo, Thomas Ouedrago, Jeremi Rouamba, Bernadette Traoré Germain Traoré, Emmanuel Zabsonré, Caleb Bwengye, Charles Karamagi, Victoria Nankabirwa, Jolly Nankunda, Grace Ndeezi, Chipepo Kankasa, Mary Katepa-Bwalya, Chafye Siuluta, Seter Siziya, Debra Jackson, Mickey Chopra, Mark Colvin, Tanya Doherty, Ameena E Googa, Lyness Matizirofa, Lungiswa Nkonki, David Sanders, Wanga Zembe, Margaret Wandera, Ingunn M S Engebretsen, Isaac Okullo, James K Tumwine, Anne N Astrøm, PROMISE-EBF Study Group, Thorkild Tylleskär, Philippe Van de Perre, Eva-Charlotte Ekström, Nicolas Meda, Chipepo Kankasa, Debra Jackson, Thorkild Tylleskär, Lars Thore Fadnes, Eli Fjeld, Knut Fylkesnes, Jørn Klungsøyr, Øystein Evjen Olsen, Bjarne Robberstad, Halvor Sommerfelt, Philippe Van de Perr, Eva-Charlotte Ekström, Nicolas Meda, Hama Diallo, Thomas Ouedrago, Jeremi Rouamba, Bernadette Traoré Germain Traoré, Emmanuel Zabsonré, Caleb Bwengye, Charles Karamagi, Victoria Nankabirwa, Jolly Nankunda, Grace Ndeezi, Chipepo Kankasa, Mary Katepa-Bwalya, Chafye Siuluta, Seter Siziya, Debra Jackson, Mickey Chopra, Mark Colvin, Tanya Doherty, Ameena E Googa, Lyness Matizirofa, Lungiswa Nkonki, David Sanders, Wanga Zembe

Abstract

Background: Information on the socio-behavioral distribution of periodontal status and tooth loss in pregnancy emanating from sub Saharan Africa is sparse. This study examined periodontal status and tooth loss in pregnant Ugandan women and assessed the relationship with socio-demographics factors, parity, dental care and oral hygiene.

Methods: Mothers were participants of a multicentre cluster-randomized behavioral intervention study (PROMISE-EBF Safety and Efficacy of Exclusive Breast feeding Promotion in the Era of HIV in Sub-Saharan Africa). In Uganda, these were pregnant women resident in Mbale district, recruited into the PROMISE EBF study between January 2006 and June 2008. A total of 886 women were eligible to participate of whom information became available for 877 (participation rate 98.9%, mean age 25.6) women who participated in the recruitment interview and 713 (mean age 25.5) women who got a clinical oral examination. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN).

Results: The prevalence of tooth loss was 35.7%, 0.6% presented with pockets shallow pockets (4-5 mm), whereas 3.3% and 63.4% displayed bleeding and calculus, respectively. A total of 32.7% were without any sign of periodontal disease. Binary logistic regression analyses revealed that older women, women from larger households and those presenting with microbial plaque were respectively, 3.4, 1.4 and 2.5 times more likely to have CPI score >0. Rural (OR = 0.9), nulliparous (OR = 0.4) and women who never visited a dentist (OR = 0.04) were less likely, whereas women from larger households (OR = 1.5) were more likely to have lost at least one tooth.

Conclusion: The results revealed moderate prevalence of bleeding and tooth loss, high prevalence of calculus, low frequency of pockets 4-5 mm. Disparity in pregnant women's oral health related to parity suggests that education of maternity care providers concerning oral health in pregnancy is warranted.

Trial registration: ClinicalTrials.gov Identifier NCT00397150.

Figures

Figure 1
Figure 1
Percentage of tooth loss by tooth type and age group. Tooth number illustration: 1: Central Incisor, 2: Lateral Incisor, 3: Canine, 4: First premolar, 5: Second premolar, 6: First Molar, 7: Second molar.

References

    1. Mumghamba EG, Manji KP. Maternal oral health status and preterm low birth weight at Muhimbili National Hospital, Tanzania: a case-control study. BMC Oral Health. 2007;7:8. doi: 10.1186/1472-6831-7-8.
    1. Baelum V, Scheutz F. Periodontal diseases in Africa. Periodontol 2000. 2002;29:79–103. doi: 10.1034/j.1600-0757.2002.290105.x.
    1. Baelum V, Manji F, Fejerskov O, Wanzala P. Validity of CPITN's assumptions of hierarchical occurrence of periodontal conditions in a Kenyan population aged 15–65 years. Community dentistry and oral epidemiology. 1993;21:347–353. doi: 10.1111/j.1600-0528.1993.tb01097.x.
    1. Baelum V, Chen X, Manji F, Luan WM, Fejerskov O. Profiles of destructive periodontal disease in different populations. J Periodontal Res. 1996;31:17–26. doi: 10.1111/j.1600-0765.1996.tb00459.x.
    1. Albandar JM, Tinoco EM. Global epidemiology of periodontal diseases in children and young persons. Periodontol 2000. 2002;29:153–176. doi: 10.1034/j.1600-0757.2002.290108.x.
    1. Hyman JJ, Reid BC. Epidemiologic risk factors for periodontal attachment loss among adults in the United States. J Clin Periodontol. 2003;30:230–237. doi: 10.1034/j.1600-051X.2003.00157.x.
    1. Craig RG, Boylan R, Yip J, Bamgboye P, Koutsoukos J, Mijares D, Ferrer J, Imam M, Socransky SS, Haffajee AD. Prevalence and risk indicators for destructive periodontal diseases in 3 urban American minority populations. J Clin Periodontol. 2001;28:524–535. doi: 10.1034/j.1600-051x.2001.028006524.x.
    1. Borrell LN, Crawford ND. Social disparities in periodontitis among United States adults 1999–2004. Community dentistry and oral epidemiology. 2008;36:383–391. doi: 10.1111/j.1600-0528.2007.00406.x.
    1. Sanya BO, Ng'ang'a PM, Ng'ang'a RN. Causes and pattern of missing permanent teeth among Kenyans. East Afr Med J. 2004;81:322–325.
    1. Kida IA, Astrom AN, Strand GV, Masalu JR. Clinical and socio-behavioral correlates of tooth loss: a study of older adults in Tanzania. BMC Oral Health. 2006;6:5. doi: 10.1186/1472-6831-6-5.
    1. Russell SL, Mayberry LJ. Pregnancy and oral health: a review and recommendations to reduce gaps in practice and research. Am J Maternal Child Nurs. 2008;33:32–37. doi: 10.1097/01.NMC.0000305655.86495.39.
    1. Hugoson A. Gingivitis in pregnant women. A longitudinal clinical study. Odontol Revy. 1971;22:65–84.
    1. Laine MA. Effect of pregnancy on periodontal and dental health. Acta odontologica Scandinavica. 2002;60:257–264. doi: 10.1080/00016350260248210.
    1. Lopez NJ, Smith PC, Guiterrez J. Periodontontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomised controlled trial. Journal of periodontology. 2002;73:911–924. doi: 10.1902/jop.2002.73.8.911.
    1. Gursoy M, Pajukanta R, Sorsa T, Kononen E. Clinical changes in periodontium during pregnancy and post-partum. J Clin Periodontol. 2008;35:576–583. doi: 10.1111/j.1600-051X.2008.01236.x.
    1. Boggess KA. Maternal oral health in pregnancy. Obstetrics and gynecology. 2008;111:976–986.
    1. Offenbacher S, Bogess KA, Murtha AP, Jared HL, Lieff S, McKaig RG, Mauriello SM, Moss KL, Beck JD. Progressive periodontal disease and risk of very preterm delivery. Obstet Gynecol . 2006;107:29–36.
    1. Tilakaratne A, Soory M, Ranasinghe AW, Corea SM, Ekanayake SL, de Silva M. Periodontal disease status during pregnancy and 3 months post-partum, in a rural population of Sri-Lankan women. J Clin Periodontol. 2000;27:787–792. doi: 10.1034/j.1600-051x.2000.027010787.x.
    1. Scheutz F, Baelum V, Mecky IM, Mwangosi I. Motherhood and dental disease. Community dental health. 2002;19:67–72.
    1. Nuamah I, Annan BD. Periodontal status and oral hygiene practices of pregnant and non-pregnant women. East Afr Med J. 1998;75:712–714.
    1. Ainamo JJ, Barmes DD, Beagrie GG, Cutress TT, Martin JJ, Sardo-Infirri JJ. Development of the World Health Organization (WHO) community periodontal index of treatment needs (CPITN) International Dental Journal. 1982;32:281–291.
    1. W.H.O . Oral Health Surveys Basic Methods Geneva. 4 1997.
    1. Adler NE, Boyce WT, Chesney MA, Folkman S, Syme SL. Socioeconomic inequalities in health. No easy solution. JAMA. 1993;269:3140–3145. doi: 10.1001/jama.269.24.3140.
    1. Russell SL, Ickovics JR, Yaffee RA. Exploring potential pathways between parity and tooth loss among American women. Am J Public Health. 2008;98:1263–1270. doi: 10.2105/AJPH.2007.124735.
    1. PROMISE-EBF: Safety and Efficacy of Exclusive Breastfeeding Promotion in the Era of HIV in Sub-Saharan Africa
    1. Schellenberg JA, Victora CG, Mushi A, de Savigny D, Schellenberg D, Mshinda H, Bryce J. Inequities among the very poor: health care for children in rural southern Tanzania. Lancet. 2003;361:561–566. doi: 10.1016/S0140-6736(03)12515-9.
    1. Michie C, Lockie F, Lynn W. The challenge of mastitis. Arch Dis Child. 2003;88:818–821. doi: 10.1136/adc.88.9.818.
    1. Greene JC, Vermillion JR. The Simplified Oral Hygiene Index. Journal of the American Dental Association (1939) 1964;68:7–13.
    1. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174. doi: 10.2307/2529310.
    1. Gjermo PE. Impact of periodontal preventive programmes on the data from epidemiologic studies. J Clin Periodontol. 2005;32:294–300. doi: 10.1111/j.1600-051X.2005.00796.x.
    1. Benigeri M, Brodeur JM, Payette M, Charbonneau A, Ismail AI. Community periodontal index of treatment needs and prevalence of periodontal conditions. J Clin Periodontol. 2000;27:308–312. doi: 10.1034/j.1600-051x.2000.027005308.x.
    1. Lewis JM, Morgan MV, Wright FA. The validity of the CPITN scoring and presentation method for measuring periodontal conditions. J Clin Periodontol. 1994;21:1–6. doi: 10.1111/j.1600-051X.1994.tb00268.x.
    1. Borrell LN, Papapanou PN. Analytical epidemiology of periodontitis. J Clin Periodontol. 2005;32:132–158. doi: 10.1111/j.1600-051X.2005.00799.x.
    1. Grytten J, Holst D, Gjermo P. Validity of CPITN's hierarchical scoring method for describing the prevalence of periodontal conditions. Community Dent Oral Epidemiol . 1989;17:300–303. doi: 10.1111/j.1600-0528.1989.tb00641.x.
    1. Davenport ES, Williams CE, Sterne JA, Murad S, Sivapathasundram V, Curtis MA. Maternal periodontal disease and preterm low birth weight: case-control study. Journal of dental research. 2002;81:313–318. doi: 10.1177/154405910208100505.
    1. Miyazaki H, Yamashita Y, Shirahama R, Goto-Kimura K, Shimada N, Sogame A, Takehara T. Periodontal condition of pregnant women assessed by CPITN. J Clin Periodontol. 1991;18:751–754. doi: 10.1111/j.1600-051X.1991.tb00067.x.
    1. Nuwaha F. Factors influencing the use of bed nets in Mbarara municipality of Uganda. Am J Trop Med Hyg. 2001;65:877–882.
    1. Albandar JM, Muranga MB, Rams TE. Prevalence of aggressive periodontitis in school attendees in Uganda. J Clin Periodontol. 2002;29:823–831. doi: 10.1034/j.1600-051X.2002.290906.x.
    1. Borrell LN, Burt BA, Taylor GW. Prevalence and trends in periodontitis in the USA: the [corrected] NHANES, 1988 to 2000. Journal of dental research. 2005;84:924–930. doi: 10.1177/154405910508401010.
    1. Taani DQ, Habashneh R, Hammad MM, Batieha A. The periodontal status of pregnant women and its relationship with socio-demographic and clinical variables. J Oral Rehabil. 2003;30:440–445. doi: 10.1046/j.1365-2842.2003.01058.x.
    1. Hullah E, Turok Y, Nauta M, Yoong W. Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London. Archives of gynecology and obstetrics. 2007;277:405–9. doi: 10.1007/s00404-007-0480-8.
    1. Amarasena N, Ekanayaka AN, Herath L, Miyazaki H. Tobacco use and oral hygiene as risk indicators for periodontitis. Community Dent Oral Epidemiol . 2002;30:115–123. doi: 10.1034/j.1600-0528.2002.300205.x.
    1. Timothe P, Eke PI, Presson SM, Malvitz DM. Dental care use among pregnant women in the United States reported in 1999 and 2002. Prev Chronic Dis. 2005;2:A10.
    1. Christensen K, Gaist D, Jeune B, Vaupel JW. A tooth per child? The Lancet. 1998;352:204. doi: 10.1016/S0140-6736(05)77810-7.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner