Smoking and Periodontal Disease in Vietnamese Middle-Aged Population
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(Front matter)
(Chapter 1)
(Chapter 2)
(Chapter 3)
(Chapter 4)
Date
2001
Authors
Do, Loc Giang
Editors
Advisors
Spencer, Andrew John
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Thesis
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Abstract
Current understanding of periodontal disease derives from studies mostly conducted in
developed countries. However, the disease process among those studied populations
may be confounded by the professional dental care. There have been few attempts to
investigate factors related to the disease among populations of developing countries
where the natural history of the disease is minimally confounded by care. This
imbalance is evident in risk assessment research on the associations between
periodontal disease and smoking-one of the most significant risk factors for the disease.
Also, most studies on smoking used convenience or purposive samples, which may bias
the findings. Therefore, there is a need for research conducted among a representative
sample of a developing country.
The present study aimed to describe the prevalence, extent and severity of chronic adult
periodontitis among representative Vietnamese middle-aged adults. Also, it aimed to
investigate smoking, which is highly prevalent in Vietnam, as a risk indicator for
periodontal disease in a population with minimal access to dental care.
The study was designed as a cross-sectional population-based study with a multistage,
stratified random sample with probability of selection proportional to population size.
The US National Institute of Dental Research (NIDR) protocol was used to assess loss
of periodontal attachment among 575 dentate subjects in two randomly selected
provinces. Assessment was made at mesial and buccal sites of every present tooth,
excluding third molars. A parallel social survey collected socio-demographic
information and smoking history, which were assessed for possible association with the
disease status.
Periodontal disease was highly prevalent among the sample. The patterns of the disease
were similar to those reported from other populations. Virtually all subjects expressed
some levels of disease, whereas only a few subjects or sites had severe disease.
Bivariate analyses revealed significant associations between smoking and lower socio-economic
status with more severe expression of the disease. Smoking was consistently
associated with poorer periodontal status irrespective of outcome measure investigated.
Multivariate models showed that smoking was the most predictive factor for the disease.
The Odds Ratio of having severe periodontitis (that is, having 2+sites with loss of
attachment more than or equal to 5 mm and 1+sites with pocket depth more than or
equal to 4 mm) was 7.93 for heavy smokers compared to non-smokers. A dose-response
effect of the association between smoking and the outcomes of the disease was also
evident.
The study provided a picture of the periodontal status of the representative sample from
Vietnamese middle-aged adult population where the disease was less confounded by
dental care. Furthermore, the study contributes consistency, strength and dose-response
effect to the association of smoking as a risk indicator for periodontal destruction. The
study should be used to assist the public health agencies in planning appropriate policies
for Vietnam to address smoking and periodontal disease.
School/Discipline
Dental School
Dissertation Note
Thesis (M.Sc.)--Dental School, 2001.