Risk indicators for periodontal problems among adult and elderly Nepalese

Objectives: To describe periodontal health of Nepalese individuals aged 33–49 and 50 and over and also to identify possible risk indicators associated with periodontal problems (PPs).

Methods: Stratified cluster sampling methodology was undertaken. Periodontal health was evaluated by five examiners using the WHO criteria, Community Periodontal Index (CPI). A structured questionnaire, pilot tested prior to the main survey, was used to collect data on socio–demographic factors and oral health behaviour. Data were analyzed using independent sample t–tests, chi–square tests and multiple logistic regressions.

Results: Eight percent of 596 subjects aged 33–49 (mean±sd, 39±4 years) and 4 percent of 614 aged 50 and over (mean±sd, 63±10 years) experienced no periodontal problems (score 0). In both age groups, score 0 was higher among those residing in urban than in rural areas (33–49yrs P<0.01, ≥50yrs P<0.05). Multivariate analysis: 33–49 age group – The probability of experiencing PPs in adults was greater among illiterates than highly educated individuals (Adjusted Odds Ratios (Adj ORs)=3.3, 95% Confidence Interval (CI):1.1–10.6). ≥50 age group – The likelihood of having PPs (CPI>0) increased among the elderly living in rural areas (Adj ORs=7.5, 95% CI:1.3–41.3) and those using non-fluoride toothpaste (Adj ORs=7.4, 95% CI:1.7–32.1) when compared with those living in urban areas and those using fluoride toothpaste. The analysis was adjusted for age, gender, oral health behavior and caries experience. The total explained variance in PPs among the 33–49 and ≥50 age groups were 12% and 30%, respectively.

Conclusion: Periodontal problems were high in the population. The risk indicator/s for individuals experiencing PPs at ages 33–49 was low education, while at ages of 50 and over were residency in rural areas and use of non–fluoride toothpaste. Knowledge of specific risk indicators is imperative in order to identify populations prone to PPs and to devise strategies for prevention.