Periodontal Treatment Practice and Referral Profile of General Dentists – A Cross-sectional Questionnaire Survey

BACKGROUND: Because of medical advancement, the mean age of the general population is increasing gradually. This increase in the mean age of patients has led to its implications on oral health. Hence, it is logical to assume an increase in the figure of referrals to specialists and the complexity of treatments provided. AIM: The aim of the survey was to assess the current status of periodontal treatment provided, awareness of referral profile, and criteria taken into consideration for the referral to the periodontist by general dentists. MATERIALS AND METHODS: This cross-sectional questionnaire study was conducted among 318 general dentists. The relevant work related to the status of periodontal procedures provided by dentists and their referral relationships were studied. The questionnaire consisting of six questions was designed. Descriptive statistics, including frequency distributions and measures of central tendency and Chi-square test, were used. RESULTS: The study showed that majority of the general dentists do non-surgical procedures by their own. However, around 85% of respondents did not provide surgical periodontal treatment by themselves. About 25% of the responding general dentists thought that they had inadequate education and experience in the field of periodontics which was a major reason for the referral to specialists. CONCLUSION: It was concluded that the general dentists are comfortable in carrying out the non-surgical procedures, but they had some reservations about the periodontal surgical procedures. Inadequate experience and facilities were the major reasons for the referral to periodontists. More of this type of study should be conducted to know the basic level of periodontal practices carried out among the general dentists and about the referral to the specialists

Pemphigus vulgaris presenting as gingival involvement

Pemphigus vulgaris (PV) is an autoimmune blistering disease affecting the mucous membrane and skin. Typically, oral lesions appear before skin lesions, and in a majority of the cases only oral lesions are present. The dentist may then be the first to recognize and diagnose this disease. It is unusual for PV to present over the gingiva as a primary site of involvement. Diagnosis is based on clinical presentation and confirmed by histopathological study. Early diagnosis and management can prevent the uneven life- threatening effects of this potentially chronic mucocutaneous disorder. The case serves to enhance our awareness of the gingiva as a site at which systemic disease can manifest itself

Periodontal disease as the initial oral manifestation of abdominal tuberculosis

Tuberculosis is a chronic, specific granulomatous disease and a major cause of death in developing countries. We report a case of tuberculosis presenting first as periodontal loss of tooth support leading to loose teeth and gingival enlargement affecting a 17-year-old female patient without any pulmonary lesion. Diagnosis was based on histopathological examination and positive adenosine deaminase activity Mycobacterium tuberculosis test. The clinical presentation of tuberculosis may take many forms. However, with the decline in numbers, tuberculosis lesions of the oral cavity have become so rare that they are frequently overlooked in the differential diagnosis of oral lesions. Also, this case report emphasizes the need for dental clinicians to be aware of the possibility of tuberculosis presenting first in the oral cavity, and contribute in control of tuberculosis through early detection and referring the patients to physicians for proper treatment

Spectrophotometric Analysis of Dental Enamel Staining to Antiseptic and Dietary Agents: In Vitro Study

Background/Objectives. Use of antiseptics as an adjunct to a traditional mechanical tooth brushing method has limited their application for long duration because of their side effects such as staining and calculus formation. The objective of this in vitro study is to analyse the staining effects of antiseptic mouthwashes on dental enamel and compare it with those containing nanoparticles, dietary agents, and distilled water (control). Material and Methods. 105 intact premolars extracted for orthodontic reasons and without any caries or anatomical defects were selected for analysis. The samples were randomly divided into 7 different groups of fifteen teeth each for different solutions. A spectrophotometer was used to assess the colorimeter analysis of buccal dental enamel surface at R1 (baseline examination), R2 (24 hours after immersion in different solutions), and R3 (after brushing). Statistical analysis was done using the Kolmogorov–Smirnov test and Levene’s test (p<0.05), respectively. One-way ANOVA was used to compare the difference in color (∆E) between the readings, R1, R2, and R3. Results. The mouthwash containing titanium dioxide (TiO2) nanoparticles produced the greater enamel discoloration compared to that of chlorhexidine. Brushing had little effect on removal of stains induced by all mouthwashes except for dietary solutions (lemon with sodium bicarbonate and olive with laurel) and distilled water (control). Conclusion. The results from this study show that mouthwashes containing TiO2 nanoparticles and other antiseptic mouthwashes cause change in color of the teeth and lead to poor esthetic appearance when compared to dietary and control solutions. Thus, future in vivo studies have to be conducted to confirm these findings as in vitro studies may not provide a reliable simulation of the clinical situations

Awareness of the bidirectional relationship between diabetes, periodontal diseases, and its risk factors among diabetic patients in the Asir region, Saudi Arabia

Introduction: Bidirectional relationship between diabetes and periodontal diseases has been recognized and accepted in the literature for a long time and shown to influence each other in both development and disease progression. Age, obesity, stress, smoking, and genetic predisposition are considered risk factors for diabetes and periodontal diseases. Aims: The objective of this questionnaire study was to assess the awareness of diabetic patients regarding the bidirectional relationship between diabetes, periodontal diseases, and risk factors. Materials and Methods: A cross-sectional questionnaire study was conducted on diabetic patients in the Asir region of Saudi Arabia between 18 and 70 years-age group individuals. A self-administrated questionnaire, which contained four sections of close-ended questions, was used. The sections included demographic characteristics, knowledge, and awareness regarding the relationship between diabetics and periodontal disease and knowledge and understanding of oral hygiene. SPSS version 20 was used to analyze the collected data, and descriptive statistical analysis was done. Results and Discussion: This study included 221 diabetic patients. The overall knowledge regarding the bidirectional relationship was high among 43%, whereas the knowledge regarding oral hygiene was high among 58.8%. The duration of diabetes (P = 0.006), medication for controlling blood sugar (P = 0.03), type of medication (P = 0.004), and the state of diabetes (P = 0.01) significantly affected the knowledge regarding the bidirectional relationship. There was a significant correlation between the understanding of oral hygiene and the knowledge of the bidirectional relationship (P = 0.0001). Conclusions: The study participants had low knowledge and awareness regarding the bidirectional relationship between diabetes and periodontal disease. However, those who had a high knowledge of oral hygiene also had an increased knowledge regarding the bidirectional correlation. Medical and dental professionals must create awareness about the importance of maintaining good oral health and influencing overall general health in diabetic patients, regardless of the presence or absence of the recognized risk factors