18. Epidiemiology Of Periodontal Disease Flashcards
LOs
What is epidemiology
• ‘Epi’ – Among / Against
• ‘Demos’ – People
• ‘Ology’ – Study
• ‘The study of distribution of disease or a physiological condition in human populations and the factors that influence this distribution’ (Lilenfeld 1978)
What is descriptive epidemiology?
- Description of the distribution of the disease in different populations
Variations on types of epidemiology?
- Etiologic epidemiology
- Consider the aetiology of a disease from the combination of the descriptive epidemiological data along with other information e.g. genetics, microbiology, sociology, etc
(EG periodontitis in population, look at genetics, and put this info together and whether genetics has an effect)
- Analytical epidemiology
- Evaluate the consistency of epidemiologic data with hypotheses developed clinically or experimentally
(EG have a hypothesis in place, do a study to see if it fits with population)
- Experimental epidemiology
- Provides a basis for developing and evaluating preventative programmes and public health practices
(EG Look at population and tailor advice to them)
Why is epidemiology important? Why study it?
- The knowledge of the epidemiology of Periodontitis helps us to determine;
• The impact of the disease
• Any aetiological factors
• Treatment needs
• Treatment effects
Why is the epidemiology of periodontal disease complicated?
- The epidemiology of periodontal disease is complicated by the fact that the disease has a gradual onset and varies widely in severity, there are no universally agreed standards for defining the various stages of the disease
- all patients vary a lot, EG some patients show a high level of bone loss at a lower age
- we do have a classification system
Incidence and prevalence definition
• Incidence
- The number of new cases / year
• Prevalence
- The total number of cases within a population
Issues for the periodontal epidemiologist
• What to measure?
• How to measure?
• What to measure?
- No set, defined parameters which should be measured
- Results in variations in national and international studies - Makes the analysis of data more difficult (harder to compare data)
• How to measure?
- The ideal would be a full assessment for a large data set but not possible to assess everyone
- This is not practical, so alternatives are used e.g. partial recording (eg. Only LL quadrant used as indication for rest of mouth but this might not be an accurate representation), cross sections
- all of these Particularly difficult in a community setting
Issues for the periodontal epidemiologist – EXTENT & SEVERITY
Prevalence is based on the person
• But periodontal disease is ‘site specific’
• We need to assess the SEVERITY of the disease – the amount of attachment loss in a tooth
• And importantly the NUMBER of teeth affected - EXTENT
How does the uk assess the prevalence of disease in terms of periodontology
The Adult Dental Health Survey (ADH)
• In the UK, dental disease is measured by the DoH via the ADH approx. every 10 years.
- this looks at a number of dental diseases EG. Caries, periodontitis within a pop
Problems with the way the ADH measures/ collects data
• ADH probably significantly underestimates the amount of disease
- Partial mouth recording (so increases data as larger data set can be assessed BUT may not be accurate representation of whole mouth)
- Not completed in the dental clinic (might not have important equipment)
EG of names of dental disease surveys in other countries
- NHANES – National Health and Nutrition Examination Survey - USA
- KNHANES – Korea National Health and Nutrition Examination Survey
- SHIP – Study of Health in Pomerania - Germany
PD studies - trends to know
UK dental health survey trends
PD studies - trends to know
Swedish study over 30 years trends
PD studies - trends to know
Basic periodontal epidemiology trends
• Gingivitis is highly prevalent in the adult population (60% +)
• Associated with levels of plaque
• Mild – moderate periodontitis has a prevalence of between 20 – 35%
• Severe Periodontitis is relatively infrequent (10 – 15%)
PD studies - trends to know
Global Prevalence of Severe Periodontitis Worldwide in 2010 trends
PD studies - trends to know
Natural history of disease study (Norway VS Sri Lanka comparison)
Features of HIGH / NORMAL / LOW PD RISK GROUPS
Current classification of periodontitis suggests?
