Oral Health Status of Pregnant and Non Pregnant Women

spontaneous wellness office of Pregnant and Non Pregnant WomenORAL HEALTH STATUS AMONG expectant AND nonpregnant WOMEN OF AGRA CITY A HOSPITAL BASED STUDYABSTRACTINTRODUCTIONPregnancy is often thought to be a time of happiness for the expectant mothers but it does not only influence her experience vocal wellness status but also may increase her risk of other indispositions.OBJECTIVETo compare the oral health status among with child(predicate) and non big(predicate) women of Agra city.MATRIALS AND METHODA cross sectional acquire was carried knocked give away(p) among 425 heavy(predicate) and 425 non significant women of 18-45 years attending the hospital. A pretested proforma designed in local langu succession for lay in all the pertinent information was used which included questions regarding personal information, oral hygienics practices, frequency of alveolar consonant visits, education, occupation, gravid status along with a self-reported oral health status questio ns. The investigator was calibrated in the world-class place the start of the hire in order to limit the intra-examiner variability.RESULTSA perfect of 850 subjects with a mean age of 29.303.30 years were examined. The mean DMFT was found to be 3.021.79 and 1.791.90 in pregnant and nonpregnant respectively.CONCLUSIONThe results of this study channeliseed that maternity had effect on the gumwood and on periodontic attachment levels. Overall oral health was brusqueer among pregnant women than nonpregnant women.KEY WORDSGravid status, Oral wellness Status, Oral hygiene.INTRODUCTIONPregnancy brings intimately physical, physiological and psychological changes in women. It affects almost all systems and parts of the body including the oral endocarp. Due to changes in the hormones, numerous opportunistic organisms gain access to various parts of the body in the absence of neat disquiet1. Pregnancy constitutes a special physiological state characterized by a series of temporar y adjustive changes in body structure, as a result of an increased production of estrogen, progestron, gonadotropins and relaxin among other hormones. The oral cavity is also affected by such endocrine actions and may position both transient and permanent changes as well as modifications that are considered pathological2.Pregnancy related oral changes are most mark and frequent in gingival tissue. gingival tinder and pregnancy have now been linked for many years as early as 1978, Vermeeran discussed toothpains in Pregnancy. In 1818, Pitcarin described gingival hyperplasia in pregnancy3. Pinard first described this situation in 1877 characterized with erythema, hyperplasia and increased bleeding4. Womens pregnancy experience not only influences her own oral health status but also may increase her risk of other diseases. superior levels of oral diseases may also have an impact on the Oral Health Related tint of Life. Although some studies on pregnant women have been reported, t hey have been limited to exploring the impact of certain factors, such as pain, on the Oral Health Related Quality of Life4.Pregnancy gingivitis marked by the gingival inflammation is the most common condition seen during the pregnancy due to hormonal changes particularly during the second trimester of gestation. The signs and symptoms of pregnancy gingivitis, further do not differ from the gingivitis seen in non pregnant women5. It has been noted that the gingivitis in pregnancy is related to the accruement of dental plaque and maintenance of proper oral hygiene in pregnant women can bunk an important role in preventing this condition and maintaining a well-informed gingival state6.There is a ripening acceptance of the fact that oral disorders too can have a significant impact on physical, social and mental well-being during pregnancy. No study has been conducted on Oral Health Related Status of pregnant and non pregnant women in Agra city. Keeping the above facts in mind, an attempt was made to carry out a comparative hospital based study on Oral Health Status of pregnant and nonpregnant women attending selected hospitals in Agra city.MATERIALS AND METHODA cross sectional study was carried out among 425 pregnant and 425 nonpregnant women of 18-45 years attending the hospital. A pilot study was conducted on 100 (n=50) pregnant and nonpregnant women separately with OHRQoL as a main parameter. The prevalence of Oral Impact on Daily execution of instrument was 76%. The estimated sample size for the study based on prevalence of Oral Impact on Daily Performance was calculated to be 827. Keeping in mind the non-response rate in each hospital, sample size of 850 subjects was taken. To obtain the total sample size of 850, 85 pregnant and 85 nonpregnant women from each of the five zone were randomly selected.INCLUSION CRITERASubjects reporting in the hospitalsSubjects willing to participate in the study.Subjects of 18-45 years age pigeonholing.EXCLUSION CRITE RIASubjects suffering from any systemic diseaseSubjects in critical condition. honourable clearance for the study was obtained by the Ethical Committee of K.D. Dental College and Hospital, Mathura. Also informed consent was taken from the women prior to the examination. A pretested Questionnaire and proforma designed in local language for collecting all the required and relevant information was used. The questionnaire included questions regarding name, age, socioeconomic status, oral hygiene practices, frequency of dental visits, education, occupation, gravid status along with a self-reported oral health status questions.clinical examination included Oral Hygiene Index-Simplified (OHI-S), Gingival Index, connection Periodontal Index and DMFT/DMFS. Oral examination was done using mouth mirror, probe and internal light. Self-reported oral health status was assessed by asking eight questions that collected information about periodontal health and dental health. The eight questions we re Do you have bleeding gums? burning gums? swollen gums? loose teeth? decayed teeth? tooth pain? food lodgment between teeth? sensitive teeth?. These questions were dichotomized into present and absent.The data obtained was compiled systematically from a pre-coded proforma in computer and a master table was prepared. The statistical synopsis was done using SPSS version 16.0 Statistical Analysis Software. Results on continuous measurement were presented in pie-eyedSD (Min-Max) and results on categorical measurements were presented in Number (%). Significance was assessed at 5% level of significance.RESULTSA total of 850 study subjects were selected out of which 61(7.17%) were of the age group 20-25 years with mean age observed 29.303.30. Among pregnant women, 204(48%) had poor OHI-S pee-pees(Table.1), 198(46.58%) had moderate gingivitis(Table.2), 61(14.35%) had CPI score 4 (Table.3) and 37(8.71%) had LOA score 2 (Table.4). The mean number of decayed, missing and change teeth wer e 3.422.66, 2.912.01 and 3.011.98 respectively among pregnant group. The mean scores for self reported oral health status, among pregnant group was 64.385.59 for decayed teeth and among nonpregnant group was 65.815.36 for burning gums (Table.5). put off.1 DISTRIBUTION OF STUDY SUBJECTS ACCORDING TO OHI-S heaps AMONG PREGNANT AND nonpregnant GROUPTABLE.2 DISTRIBUTION OF STUDY SUBJECTS ACCORDING TO GINGIVAL INDEX SCORES AMONG PREGNANT AND NONPREGNANT GROUPTABLE. 3 DISTRIBUTION OF STUDY SUBJECTS ACCORDING TO CPI SCORES AMONG PREGNANT AND NONPREGNANT GROUPTABLE. 4 DISTRIBUTION OF STUDY SUBJECTS ACCORDING TO LOA SCORES AMONG PREGNANT AND NONPREGNANT GROUPTABLE 5 DISTRIBUTION OF STUDY SUBJECTS ACCORDING TO SELF- REPORTED ORAL HEALTH STATUS AMONG PREGNANT AND NONPREGNANT GROUP DISCUSSIONIn our study, out of the total study population of 850 pregnant and nonpregnant women, 359(42.23%) women were downstairs the age of 30 years, which was in accordance to the studies conducted by Ingrida Va siliauskiene et al7 and Gaffeid M et al8. On the contrary, in the study conducted by Nuamah and Annan9 20% of pregnant women and 21.4% of nonpregnant group belonged to the age group of 30-35 years.In the present study, among the total study population, 29.303.30 was the mean age. The results of our study were similar to the study conducted by Machuca et al10, in which the mean age was 30.11.90. On the contrary, studies conducted by Yalcin et al11 and Tilakarante et al12 showed the mean age pattern of 18.623.01 and 192.90 respectively. Among pregnant population 204(48%) had poor oral hygiene. On the contrary, in the study conducted by Santosh Kumar et al13 among total study population only 25% had poor oral hygiene. In our study, among the total study subjects, mean OHI-S score was 2.650.85. On the contrary, in the study conducted by Ingrida Vasiliauskiene et al7 mean OHI-S score among total study subjects was 1.791.13. The reason behind this is that during pregnancy, gums are more susceptible to the damaging personal effects of plaque, gingiva become more edematous and fragile due to which during brushing it bleeds quickly. The problem is compounded if women have daybreak sickness nausea and vomiting which make it hard to brush teeth regularly resulting in more plaque accumulation. Among pregnant group, about one-half of the total study subjects i.e 46.58% had moderate gingivitis. Results of our study were similar to the studies conducted by Yalcin et al11 and Tilakarante et al12. In our study, among the total study subjects, it was found that 98(11.52%) had healthy periodontium On the contrary, studies conducted by Santosh Kumar et al13 and Ingrida Vasiliauskiene et al7 found that approximately half of the total study population i.e 49.8% had healthy periodontium whereas, among pregnant group 36.6% and among nonpregnant group 61% had healthy periodontium. While the study conducted by Miyazaki et al14 utter that 82% of the pregnant study population had 4 o r 5mm pocket which is much higher in comparison to our study.In our study, the mean scores among pregnant group and non pregnant group was 64.385.59 for decayed teeth and 65.815.36 for burning gums respectively. No earlier studies have been carried out that show distribution of study subjects according to self- reported oral health status among pregnant and non pregnant groups.In conclusion, results of the study showed that oral health status among pregnant and nonpregnant group of Agra city was not good. The study also drew attention towards the need for highlighting the importance of maintaining oral health during pregnancy. Regular dental care is a key component to good oral and general health. It can be stated that there is a need for the health care professionals to ac intimacy the importance of good oral health in ensuring a safe and successful pregnancy and overcome misconceptions regarding rendering of essential dental care during this vital period in a womans life.REFERENCE SShashidhar Acharya and Parvati V. Bhat. Oral health related forest of life during pregnancy. American Association of Public Health Dentistry 2009697477.Tracy M. Dellinger and H. Mark Livingston. Pregnancyphysiologic changes and considerations for dental patients. British ledger of Obstetric and Gynaecology 20065677-697.Ojanotko-Harri AO, Harri M.P, Hurltia H.M and Sewon L.A. Altered tissue metabolism of progesterone in pregnancy gingivitis and granuloma. ledger of Clinical Periodontalogy 199118262-266.Steinberg B.J. Womans oral health issues. daybook of Dental Education 199963271-275.Miyagi M., Aoyama H., Moroshita M and Iwamoto Y. Effects of sex hormones on chemotaxis of human peripheral polymorphonuclear leukocytes and monocytes. daybook of Clinical Periodontology 1992632832.Laine M.A. Effect of pregnancy on periodontal and dental health. Acta Odontologica Scandinavica Journal 200260257-264.Ingrida Vasiliauskiene. Oral health status of pregnant women. Stomatologia, Baltic De ntal and Maxillofacial Journal 2003557-61.Gaffield M., Brenda J.,Gilbert C., Malvitz D.M. and Romaguera R. Oral Health during Pregnancy. Journal of American Dental Association 200132189-194. Nuamah I and Annan B.D. Periodontal status and oral hygiene practices of pregnant and non-pregnant women. East African Medical Journal 199875712714.Machuca G., Khoshfeiz O., Lacalle R.J., Machuca C. and Bullon P. The influence of general health and socio pagan variables on the periodontal condition of pregnant women. Journal of Clinical Periodontology 199970779785.Yalcin F., Eskinazi E., Soydinc M., Basegmez C., Issever H. and Isik G. The effect of socio cultural effects on periodontal condition in pregnancy. Journal of Clinical Periodontology 200274178-182.Tilakaratne A., Soory M., Ranasinghe AW., Corea SMX., Ekanayake S L. and Desilva M. Periodontal disease status during pregnancy and 3 months post partum, in a rural population of Sri-Lankan women. Journal of Clinical Periodontalogy 2000277 87-792.Santosh Kumar Tadakamadla, Prachi Agarwal and Preksha Jain. Dental status and its socio-demographic influences among pregnant women attending a maternity hospital in India. Journal of Clinical Express in Dentistry 20073183-192.Miyazaki H, Yamashita Y and Shirahama R. Periodontal conditions of pregnant women assessed by CPITN. Journal of Clinical Periodontology 199118751-4.Manau C, Echeverria A, Agueda A, Guerrero A and Echeverria JJ. Periodontal disease definition may determine the association between periodontitis and pregnancy outcomes. Journal of Clinical Periodontology 2008 35 385-397.Navin Anand Ingle, Akila Ganesh, Preetha Elizabeth Chaley and V. Chandrasekhara Reddy. A survey on dental knowledge and gingival health of pregnant women attending government maternity hospital, Chennai. Journal of Oral Health and Community Dentistry 2011524-30.