OBJECTIVES

A growing body of evidence points to a positive association between periodontitis and
various systemic diseases, including cardiovascular diseases (CVD), hypertension, and rheumatoid arthritis. However,
there is limited data on the prevalence and odds of having systemic conditions among Filipino periodontal patients.
Thus, this study aimed to determine the association of periodontal disease with systemic conditions among Filipino
patients at a university dental clinic.

METHODS

The periodontal and medical charts of all patients who underwent periodontal consult at a university
dental clinic within two academic years were reviewed. Periodontal diagnoses which had originally been assigned
using the 1999 classification of periodontal diseases were reclassified based on the 2018 European Federation
of Periodontology-American Academy of Periodontology classification. Listed medical conditions in the patients’
charts were self-reported. The prevalence of various systemic conditions in 715 periodontitis cases was compared
to that of 834 control patients without periodontitis. Fisher’s exact test was performed to evaluate the difference
in the prevalence of comorbidities between groups, while adjusted odds ratios (AOR) were computed using logistic
regression analysis, accounting for age, sex, educational attainment, and smoking status.

RESULTS

The prevalence of having at least one systemic condition was significantly higher among periodontitis patients
(44.5%) compared to non-periodontitis patients (36.3%). Compared to controls, a significantly higher number of
periodontitis cases had two systemic comorbidities (P=0.001). The prevalence of hypertension (18.6% versus 5.04%),
CVD including hypertension (20.42% versus 6.95%), arthritis (9.37% versus 3.0%), and diabetes mellitus (5.73% versus
0.84%) were all significantly higher in patients with periodontitis compared to non-periodontitis controls.
The odds of having CVD (AOR=1.81), hypertension (AOR=2.14) and diabetes (AOR=3.05) were higher in periodontitis cases. Meanwhile, the prevalence of asthma (9.23% versus 5.31%), respiratory diseases including asthma (12.95% versus 8.25%), and allergies (18.82% versus 13.71%) were significantly higher in non- periodontitis patients compared to periodontitis cases.

CONCLUSION

Periodontitis patients were more likely to present with CVD, hypertension, and diabetes mellitus. On the other hand, no association was found between periodontitis and respiratory diseases, as well as between periodontitis and asthma.

Human ; Male ; Female ; Adolescent: 13-18 Yrs Old ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Regression (psychology) ; Respiratory Tract Diseases ; Regression Analysis ; Periodontal Diseases ; Cardiovascular Diseases

BACKGROUND AND OBJECTIVE

The primary determinant for patient referral by general dental practitioners (GDPs) to periodontists differs based on the country of practice. Moreover, previous research has revealed that GDP preferences for managing periodontal patients, actual number of referrals, and the overall decision-making process have evolved over time. Understanding the periodontal referral pattern of Filipino GDPs could help identify factors that promote or inhibit referral to periodontists. These factors may in turn be used as basis for the formulation of periodontal referral guidelines for use by GDPs in the Philippines. Therefore, this study aimed to determine the factors that affect the referral patterns of Filipino GDPs to periodontists, with GDPs practicing in the City of Manila as the representative population.

METHODS

A descriptive cross-sectional study design with the use of a self-administered survey was utilized for this study. Participants were 75 licensed dentists practicing in the City of Manila who were members of the Philippine Dental Association-Manila Dental Chapter. The questionnaire collected information on sociodemographic characteristics of the participants, periodontal referral pattern, and the factors considered by the participants when referring patients to a periodontist. Descriptive statistics (frequency and percentage) were used to report the study’s findings.

RESULTS

Majority (92%) indicated that they regularly referred patients with periodontal disease to periodontists, with a personal estimate of up to 20 periodontal case referrals monthly by 81.3% of the participants and >20 referrals for 10.7%. The clinical factors considered as most important when referring to a periodontist were the type of periodontal disease (81.3% of the participants), periodontitis severity (74.7%), and the presence of a complex medical history 61.3%). Among the nonclinical factors, the most influential were the following: uncooperative patient (32% of the participants), perceived personal skill (24%), postgraduate training of the periodontist (21.3%), and the patient’s financial capacity (13.3%).

CONCLUSION

Multiple factors affect the decision of general dental practitioners in the City of Manila when referring patients to a periodontist. Majority are influenced by clinical factors such as the type and severity of periodontal disease and the systemic condition of the patient. Although considered to a much lesser degree compared to clinical factors, the top nonclinical factors that Manila GDPs base their referral decisions include the assessment that a patient is uncooperative and the perceived adequacy of personal skills in managing periodontal patients.

Human ; Periodontal Diseases ; Referral And Consultation ; Dentists ; Periodontists

INTRODUCTION AND OBJECTIVE

Periodontitis is highly prevalent worldwide, and previous investigations have reported increased prevalence and severity among elderly. Regular monitoring of dental health, which includes periodontal conditions, has been recommended by the Philippine Department of Health, as basis for the development and updating of policies and laws that will address the public health problem of periodontal disease among the ageing Filipino population. Therefore, this present study aimed to determine the prevalence and severity of periodontal disease among Filipino older adults who participated in the Focused Interventions for Frail Older Adults Research and Development Program (FITforFRAIL) study.

METHODS

This study on the periodontal status of Filipino older adults is a cross-sectional substudy of the FITforFRAIL research of the Institute on Aging, National Institutes of Health, University of the Philippines Manila. Participants aged ≥ 60 years were from four identified geographical regions in the Philippines. Three hundred sixteen completed oral health assessment, which included full mouth periodontal recording, and 183 participants were eligible for inclusion in the periodontal component. Periodontal diagnoses were determined using the Centers for Disease Control-American Academy of Periodontology (CDC-AAP) case definitions for surveillance of periodontitis and the 2018 European Federation of Periodontology (EFP)/AAP classification. Descriptive statistics (frequency, percentage, and mean) were used to report the sociodemographic characteristics and periodontal diagnoses of the participants. The clinical periodontal measures used to indicate the extent and severity of periodontitis were presented as mean [standard error (SE)] or percentage (SE).

RESULTS

Using the CDC/AAP case definitions, majority (97.3%) were diagnosed with periodontitis, with 33.3% having severe periodontal destruction. On the other hand, based on the 2018 EFP/AAP classification, all participants had periodontitis and most (94.5%) presented with severe disease. Moreover, using the latter classification system, the percentage of severe periodontitis was observed to increase with age. Among the young-old, 93.1% had severe disease, while 94.1% of the middle-old and 100% of the oldest-old were found to have severe destruction.

CONCLUSION

Based on the results of the study, the prevalence of total and severe periodontitis is high among this sample of Filipino older adults. Future studies for regular monitoring of the oral health of Filipino older adults are recommended.

Human ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Geriatrics ; Aged ; Periodontal Diseases ; Prevalence ; Philippines

Background and Objective: The primary determinant for patient referral by general dental practitioners (GDPs) to periodontists differs based on the country of practice. Moreover, previous research has revealed that GDP preferences for managing periodontal patients, actual number of referrals, and the overall decision-making process have evolved over time. Understanding the periodontal referral pattern of Filipino GDPs could help identify factors that promote or inhibit referral to periodontists. These factors may in turn be used as basis for the formulation of periodontal referral guidelines for use by GDPs in the Philippines. Therefore, this study aimed to determine the factors that affect the referral patterns of Filipino GDPs to periodontists, with GDPs practicing in the City of Manila as the representative population. Methods: A descriptive cross-sectional study design with the use of a self-administered survey was utilized for this study. Participants were 75 licensed dentists practicing in the City of Manila who were members of the Philippine Dental Association-Manila Dental Chapter. The questionnaire collected information on sociodemographic characteristics of the participants, periodontal referral pattern, and the factors considered by the participants when referring patients to a periodontist. Descriptive statistics (frequency and percentage) were used to report the study’s findings. Results: Majority (92%) indicated that they regularly referred patients with periodontal disease to periodontists, with a personal estimate of up to 20 periodontal case referrals monthly by 81.3% of the participants and >20 referrals for 10.7%. The clinical factors considered as most important when referring to a periodontist were the type of periodontal disease (81.3% of the participants), periodontitis severity (74.7%), and the presence of a complex medical history 61.3%). Among the nonclinical factors, the most influential were the following: uncooperative patient (32% of the participants), perceived personal skill (24%), postgraduate training of the periodontist (21.3%), and the patient’s financial capacity (13.3%). Conclusion Multiple factors affect the decision of general dental practitioners in the City of Manila when referring patients to a periodontist. Majority are influenced by clinical factors such as the type and severity of periodontal disease and the systemic condition of the patient. Although considered to a much lesser degree compared to clinical factors, the top nonclinical factors that Manila GDPs base their referral decisions include the assessment that a patient is uncooperative and the perceived adequacy of personal skills in managing periodontal patients.
Human ; periodontal diseases ; referral and consultation ; dentists ; periodontists

Background and Objective: The University of the Philippines Manila (UPM) subcommittee on students in distress was convened during the COVID-19 pandemic to develop “plans, programs and mechanisms” to deal with students experiencing distress and mental health concerns. This study was conducted as one of the activities of the Subcommittee to inform policy to address the following research objective: to describe the experiences, perceptions, and knowledge of both students and faculty members of UP Manila regarding distress. Methods: An online survey tool was created using the results from seven online focus group discussions among 20 faculty of UP Manila. The survey was conducted for one month among faculty and students sampled from the seven colleges of UP Manila and the three extension campuses of the Schools of Health Sciences. The different categories which were consistently perceived as important by both faculty and students as well as those with disparity in the perceptions between faculty and students were described and discussed. Results: A total of 136 faculty (F) and 290 students (S) participated in the study, representing 39% vs 98% (F vs S) of the target sample, respectively. Results showed that among the effects of stressors for students, avoidance of schoolwork (F79 vs S70.3%) and sleep disturbance (F79.4 vs S72.4%), were perceived by both faculty and students as the most frequently perceived response of students to stress.Among the causes of stress, unclear boundaries between school and home (F73.5 vs S63.1%), family duties (F76.5 vs S50.7%), lack of socialization (F89 vs S57.6%), limited recreational activity (F76.5 vs S64.8%), adapting to new ways of socialization (F67.6 vs S53.8%), and internet signal (F99.3 vs S88.3%) were perceived by both faculty and students as the most frequently perceived causes of stress. Among the coping mechanisms, connecting with friends online (F86.8 vs S69.7%), listening to music (F72.8 vs S78.3%), browsing social media (F82.4 vs S81%), viewing movies (F84.6 vs S74.5%), and sleeping or resting (F67.6 vs S84.1%) were perceived by both faculty and students as the most employed by students to cope with stress.Results also show that there were marked disparities in the perceptions of faculty and students. Among the effects of stressors, the largest disparities were in non-performance in academics (F86 vs S51.7%) and academic failure (F76.5 vs S53.8%). Of the causative factors, the largest disparities were in the areas of death (F94.1 vs S14.5%) or sickness in the family (F66.9 vs S0%), family issues (F82.4 vs S24.5%), financial concerns (F89 vs S36.9%), absence of physical connectedness and interaction, (F94.9 vs S23.8%) lack of socialization (F89 vs S57.6%), owning a gadget (F73.5 vs S22.1%), and lack of funds for the internet (F79.4 vs S22.4%).Among the support systems available in the university (psychosocial, academic and wellness activities of the colleges), 70% of the faculty perceived that the students were aware of the support process offered by the university. In contrast, 28% of students were aware of the support services offered to them. Conclusion This study shows that UP Manila faculty and students perceived stress due to the effects of COVID-19 on teaching, learning, and everyday living. Distress among student respondents was commonly perceived to be caused by family concerns, environmental restrictions, connectivity issues, and experiencing a sense of lack. While support services and mental health programs have been in place within the university, only 28% of students perceive that students in distress were aware of the process in receiving support.
Adaptation, Psychological ; Mental Health ; COVID-19 ; Education

Objective. Second-generation force-controlled periodontal probes were developed to address examiner-related factors in the application of standard forces while probing. However, previous researches comparing the accuracy of first and second-generation probes have failed to yield unequivocal results. This study aimed to determine the accuracy and reproducibility of a first-generation UNC-15 probe and force-controlled Gram probe #2, used by senior and junior dental students in measuring probing pocket depths (PPD).

Methods. Eight senior and eight junior dental students participated in the study. A periodontal model was positioned on a digital balance. Each participant performed probing four times, twice using a UNC-15 and twice employing a Gram probe #2. The order of probe usage was randomly assigned. The PPD and probing forces employed were recorded initially and after a 15-minute interval. Data were analyzed using a t-test at a 0.05 significance level.

Results. Both junior and senior students used significantly higher probing forces (35.3 ± 1.4 and 29.9 ± 2.1 g, respectively) than the standard 25 g when using the UNC-15 probe. The junior students employed accurate forces using the Gram probe while probing both anterior (25.6 ± 1.2 g) and posterior teeth (25.1 ± 0.7 g). In comparison, the seniors used accurate forces (26.0 ± 1.3 g) only while examining anterior teeth. The PPD values obtained by both student groups were comparable to the actual PPD, except for significantly higher measurements (P=0.0003) obtained by juniors when examining posterior teeth using the Gram probe. When assessing the reproducibility of PPD measurements obtained from two examinations, values were reproducible for both juniors and seniors when using the Gram probe and during an inspection of posterior teeth using the UNC-15 probe.

Conclusions. The Gram probe #2 had better reproducibility and yielded forces closer to the standard 25 g. However, more accurate PPD values were obtained with the UNC-15 probe.

Periodontal Pocket ; Diagnosis ; Calibration

Objective: The association between periodontitis and diabetes mellitus varies based on geographical location, and there are limited investigations on the relationship of the two chronic diseases among Philippine subjects. This study aimed to determine the association between periodontitis and diabetes among Filipino dental school patients. Methods: In this retrospective case-control study, the periodontal conditions and diabetic statuses of all patients who sought treatment at the Dental College’s Oral Medicine clinic within two academic years were reviewed. The prevalence of diabetes among 715 cases of periodontitis was compared to the prevalence among 834 control patients without periodontitis. Odds ratios (OR) were computed using logistic regression analysis, adjusting for age, sex, educational attainment, and smoking status. Results: The overall prevalence of diabetes mellitus for all patients was 3.10%. Patients with periodontitis had a significantly higher prevalence of diabetes at 5.73% compared to control subjects without periodontitis, whose diabetes prevalence was recorded at 0.84% (P<0.001). A significant association was observed between periodontitis and diabetes, with an unadjusted OR=7.19. After logistic regression analysis to control confounding variables, the adjusted OR was found to be 3.05 (95% confidence interval = 1.27 to 7.31; P=0.012). Conclusion The prevalence and odds of having diabetes are significantly higher among Filipino dental school patients with periodontitis, compared to patients without periodontitis. These results provide evidence to support an association between periodontitis and diabetes mellitus in this representative sample of the Filipino population.
Periodontitis ; Diabetes Mellitus ; Association ; Prevalence

BACKGROUND AND OBJECTIVE: The role of dental plaque as the etiology of caries and periodontal diseases has long been established. Therefore, plaque control is central to the prevention and management of these oral diseases. Among the different means of self-performed plaque control, brushing is the most essential. Moreover, toothpaste is a common adjunct during tooth brushing, as its abrasive contents are believed to enhance plaque removal. This study aimed to compare the effectiveness of plaque removal when brushing with a sodium bicarbonate abrasive-containing toothpaste, compared to brushing using an abrasive-free toothpaste.

METHODS: Twelve students from the University of the Philippines College of Dentistry participated in the study. The subjects discontinued all oral hygiene measures for a minimum of 48 hours. Using the Modified Bass technique, they performed tooth brushing for two minutes, using either an abrasive-free or abrasive containing toothpaste. Toothpaste allocation was randomized via fishbowl method. Pre-brushing and post brushing plaque scores were recorded using the Turesky modification of Quigley-Hein plaque index. A washout period of 11 days was implemented before crossover to the second round, wherein employed toothpastes were switched. The difference in plaque reduction between the two kinds of toothpaste was analyzed using Wilcoxon signed rank test.

RESULTS AND CONCLUSION: Overall plaque reductions were 75% for the abrasive-free toothpaste and 73% for the abrasive-containing toothpaste. The difference between the toothpaste was statistically insignificant (p=0.48). Therefore, based on the study, brushing with a sodium bicarbonate abrasive-containing toothpaste resulted in similar levels of plaque removal, compared to brushing with an abrasive-free toothpaste. There is insufficient evidence that abrasives in toothpaste result in more effective dental plaque removal. 

Dental Plaque ; Oral Health