بسم الله الرحمن الرحيم dr. k. jawad

of periodontal disease Epidemiology of periodontal disease dr. k. jawad

Advantages of epidemiology 1- to identify the causative (etiological) factor of a disease. 2- to identify the prevalence and severity of a specific disease or condition. 3- help in the development of methods of control and prevention. 4- to define the problems that may be associated with that disease. 5- help in planning of treatment and estimation of manpower required and resources through the analysis and interpretation of the collected data.. 6- help in identification of high risk groups. So the priorities in the conducted treatment can be determined. 7- it is provide a base line data for the future studies and treatment planning. dr. k. jawad

1- the pathologic changes of dental The studying of epidemiology of periodontal disease is slower in progression than that of caries because of the following: 1- the pathologic changes of dental caries involve hard calcified tissues, where as periodontal disease involve soft and hard tissues. 2- periodontal disease does not tend itself easily to objective measurements. dr. k. jawad

Definitions: dr. k. jawad

Epidemiological index: Prevalence: Incidence: Severity: Dental epidemiology: Pattern: Base line data: Epidemiological index: Prevalence: Incidence: Severity: dr. k. jawad

Requirement of an epidemiological index : dr. k. jawad

2. permit the examination of many people in a short time . 1. easy to use. 2. permit the examination of many people in a short time . 3. define the clinical conditions objectively. 4. can be reproducible in assessing a clinical condition when used by one or more than one examiners. 5. can be analyzed statistically. dr. k. jawad

Types of indices: 1- reversible indices: it measures the disease in which no damage occur and the condition is reversible. 2- irreversible indices: measure destructive disease and damaging conditions. Ex. Periodontitis. 3- we have other indices that shows both reversible and irreversible indices. Ex. Periodontal index (PI) by Russell 1956. dr. k. jawad

Some indices used in Periodontology dr. k. jawad

A – Indices used to assess the gingival inflammation dr. k. jawad

1- PMA index (Schour & Massler). P = dental papilla. M = gingival margin. A = attached gingiva. Score ( 0 ) is given when there is no inflammation. Score ( 1 ) is given when the site is inflamed. This index was confined to the labial aspects of incisors, canines and premolars only. dr. k. jawad

2- Periodontal index of Russell ( PI ). 0- No inflammation no loss of function . 1- Mild gingivitis the inflammation doesn't encircle the tooth . 2- Gingivitis, the inflammation encircle the tooth. 4- Notch like alveolar bone resorption ( on radiograph) 6- True pocket formation and horizontal bone resorption. 8- Advanced bone destruction and loss of function. dr. k. jawad

3- Periodontal disease index of Ramfjord ( PDI ) It is similar to Russell PI with the following scores 0- healthy periodonteum. 1- mild to moderate gingivitis. 2- Sever gingivitis. Component measures the periodontal destruction, GCF and even calculus were included in this index. dr. k. jawad

4- Gingival index ( Loe & Silness ) dr. k. jawad

B – Indices used to assess the gingival bleeding dr. k. jawad

1- Sulcular bleeding index ( SBI ). 2- Papillary bleeding index ( PBI ). 3- Gingival index used by national institute of dental research (NIDR) dr. k. jawad

C – Indices used to assess the plaque accumulation dr. k. jawad

1- Plaque index (Silness & Loe) 2- Simplified oral hygiene index Green & vermillion (OHI-S) it composed of Depris index (DI )and Calculus index ( CI ). dr. k. jawad

D – Indices used to assess the calculus accumulation: dr. k. jawad

1- Calculus index of OHI-S. 2- Calculus component of PDI . 3- Calculus surface index CSI . 4- Probe method index . direct measurements. dr. k. jawad

E – Indices used to assess the treatment needs: dr. k. jawad

Periodontal Treatment Need System ( PTNS ). This system depend on assessment of treatment need on basis of time required and type of treatment needed . this system permit the calculation of the manpower, resources, facilities and time required to face a certain situation. dr. k. jawad

Community Periodontal Index for Treatment Needs ( CPITN ) Code Condition Treatment need Code 0 healthy No Code 1 Plaque + bleeding on gentle probing OHI + S Code 2 Plaque + calculus Code 3 Plaque + calculus + pocket of 4-5 mm OHI + S + RP Code 4 Plaque + calculus + pocket more than 5 mm OHI + S + RP +PS dr. k. jawad

Factors affecting the prevalence and severity of periodontal disease dr. k. jawad

1- Oral hygiene: periodontal disease increased as the oral hygiene is impaired. 2- Age: periodontal disease increased with advancing in age. 3- Sex: more in females than males. 4- Race: more in Negroid than Caucasian. 5- Place of residence: more in rural than urban areas. 6- Level of education: decreased as the level of education is increased. 7- Occupation: can be affected by certain occupations as wind instrument players. 8- income: decreased as the financial level is increased. dr. k. jawad

Thank You dr. k. jawad