Occurence of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in subgingival plaque among patients with periodontal disease at the University of Nairobi Dental Hospital

Objectives: To determine the occurrence of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in patients with periodontal disease using polymerase Chain Reaction.Design: A descriptive cross-sectional study.Setting: The University of Nairobi Dental Hospital.Subjects: Patients presenting at the Oral Diagnosis and Periodontology clinics during the period of the study. The patients had periodontal examination done followed by subgingival plaque collection from selected teeth. DNA extraction from the plaque samples was then done followed by PCR based on Taqman probes using commercially available kits.Results: A total of 92 participants were recruited in the study. Aggregatibacter actinomycetemcomitans (A.a) was found in 14 (15.20%) while Porphyromonas gingivalis (P.g) was present in 16 (17.40%) of the study participants. Based on independent sample t-test, statistically significant positive associations were found between detection frequency of Porphyromonas gingivalis and plaque score (t= 2.47, p= 0.015), gingival index (t= 3.24, p= 0.022), but not with clinical attachment loss (t= 1.90, p= 0.061). Chi square test revealed a positive association between detection rate of P.g and periodontal disease severity (X2= 6.34, p= 0.042). Similar association was also found between detection rate of Aggregatibacter actinomycetemcomitans and increasing age (t=2.19, p= 0.031), clinical attachment loss (t= 4.61, p<0.001) and periodontal disease severity (X2=11.23, p= 0.004).Conclusion: The multiplex polymerase chain reaction technique utilised in this study enabled detection of target bacteria in the same reaction mixture as opposed to other periodontal microbiological techniques that require each bacteria to be investigated individually therefore PCR should be considered as an alternative to other methods of periodontal microbiology investigation. The association between periopathogenic microorganisms, A.a and P.g with occurrence and severity of periodontal disease were also confirmed in this study

Oral hygiene practices and risk of oral leukoplakia

Objective: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. Design: Case control study. Setting: Githongo sublocation in Meru District. Subjects: Eighty five cases and 141 controls identified in a house-to-house screening.Results: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the “don't brush” group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1 .4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). Conclusion: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes. East African Medical Journal Vol. 83(4) 2006: 73-7

Nutritional and oral health status of an elderly population in Nairobi

Objective: To determine the nutrition and oral health status of elderly persons in Nairobi, Kenya. Design: A cross-sectional study. Setting: Households in Dagoretti Division of Nairobi. Subjects: Two hundred and eighty nine persons (29.8% males and 70.2% females) aged 45 years and above were assessed. Results: The level of malnutrition using the mid upper arm circumference was 18.8% while by body mass index was 11.4%. Of the population assessed, 46.4% had normal nutritional status while 40.9% were overweight, with more females (48.0%) than males (25.9%) being overweight. The study established that many of the elderly persons suffered from dental problems, especially periodontitis with 89.9% having dental plaque, calculus 85.6%, gingival recession 82.5% and bleeding gums 77.4%. The decayed index missing and filled teeth, was 7.173 with 19.7% caries free, 51.9% reported tooth mobility and edentulousness was common. Conclusions: Under-nutrition, obesity and dental problems are issues of concern among the elderly. There is need to develop policies that will look into the nutrition and dental health of the elderly in order to improve their welfare.East African Medical Journal Vol. 85 (8) 2008: pp. 378-38