Patient-reported understanding and dentist-reported management of periodontal diseases – a survey: do you know what gum disease is?

This study explores periodontal disease from different perspectives, including the severity of periodontal disease as perceived by the public and dentists, and the tools available to help patients comply with OHA to manage periodontal disease/improve periodontal health.

Similar numbers of female and male participants participated in the patient survey, and all age groups were well represented, although those aged 65 and older were the largest group of participants, reflecting the demographics of the clinic's patients.

Based on clinical judgment, only 2% of patient participants had healthy gums, while 56% had evidence of periodontitis.In comparison, UK government studies showed that 53% and 76% of participants experienced bleeding during probing10 and midwood et al.828% respectively, periodontal pocket >48 and 45% of adults.11 The higher levels of gingivitis and periodontitis observed in this study may reflect the relatively larger number of older participants, as periodontal disease increases with age,12 This is despite similar age demographics in the UK government study.10

In this study, nearly one in five participants reported a family history of periodontal disease, and those with periodontitis were twice as likely to report this condition. Although genetic risk factors for periodontitis are known,13 The prevalence may be high in some families,14 There is limited literature on the prevalence of periodontitis in the general population with a family history. In periodontal clinics, 37% of patients have a family history of periodontitis;15 This is higher than the figure obtained in the present study (23%), but may reflect the fact that participants in the current study were seen in all-adult clinics.

In this study, nearly 50% of participants used electric brushes, which are more common among patients with periodontitis. Likewise, a large proportion of participants (>40%) used IDB daily, with twice as many patients with periodontitis as those with gingivitis, probably because IDB is recommended when patients with periodontitis present with gingival inflammation.6 Both electric brush and IDB usage rates are much higher than the 26% and 6% reported in the 2009 Adult Dental Health Survey (ADHS),16 However, ADHS participants used more dental floss and wooden sticks, and the lack of use of electric brushes and IDBs may be due to their availability at the time. In the current study, periodontitis patients used electric brushes and IDBs more often than gingivitis patients, possibly because they received more OHA for gum health due to periodontal disease, which is the correct treatment in a teaching hospital method.

In this study, more than 50% of dentists stated that patients with gingivitis should use IDB and/or power brushes. A systematic review has confirmed that using an electric toothbrush is more beneficial than using a manual toothbrush for people with gingivitis,number 17 However, it is not suitable for patients receiving supportive periodontal care.18 IDBs have been shown to be the preferred choice for patients with periodontitis, and there is weak evidence that they improve periodontal health in patients with gingivitis as long as the patient uses the appropriate size.18,19,20 Therefore, most patient participants in this study used appropriate oral hygiene aids and most dental participants strongly recommended them.

Interestingly, while dentists in this study believed that their patients were less aware of gingivitis than of dental caries, nearly three-quarters of patient participants rated healthy gums as equally important as healthy teeth, indicating that they Have a good understanding of the importance of gum health. However, the number of patients who report daily symptoms of gingivitis is much lower than the number of patients with periodontal disease, suggesting that patients are unaware of their symptoms. A recent UK study also showed that regular dental visits with good overall oral health reported oral health conditions less frequently than would be clinically detectable.6

In general, neither patient nor dental participants in this study were overly concerned about gingivitis. Dentists say they are not worried because gingivitis is reversible with the right treatment.twenty one And if patients only occasionally realize they have symptoms, or don't realize them at all, they won't worry. Patients who did exhibit some level of anxiety were those who frequently reported being aware of one or more symptoms of gingivitis, and this group of patients was also more aware of the risks associated with these symptoms. Dentists who expressed more concern about gingivitis primarily cited the risk of developing more severe disease as a reason for their responses. Although not everyone with gingivitis will develop periodontitis,4 It's a continuum of the same inflammatory disease,number 22 Treatment of gingivitis is key to a periodontitis prevention strategy.6 In fact, patient home care is critical to preventing gingivitis and periodontitis. Economic analysis shows that using home care prevention techniques (e.g. brushing, IDB) to eliminate gingivitis and increase periodontitis diagnosis rates to 90% and manage all patients diagnosed would have a positive return on investment in the UK .twenty three

Dentists in this study reported providing OHA to gingivitis patients but were not asked to specify what it was. The majority of patient participants reported receiving advice regarding toothbrushing and IDB techniques, which was consistent with advice expressed by dentists and supported by a systematic review.6,18 However, 40% of patients reported difficulty following recommendations over an extended period of time, consistent with dentists' belief that patients are fine at first but most are unable to make lasting changes. The majority of patient participants felt that being informed about the risks of not following recommendations, being shown correct oral hygiene techniques, or being advised to use mouthwash would improve their compliance, which is consistent with dentists' views on the most important things to support patients in improving their gum health consistent. In addition, more than half of dentists also reported using behavior change methods, purchasing an electric toothbrush, or regular reminders about oral hygiene as good support tools. However, in a recent study, using cards that indicated patient risks through images of their plaque and providing verbal advice produced only small improvements in patient-reported brushing behavior, with no differences between groups.twenty four

It is recognized that changing behaviors to maintain improved oral hygiene long-term is difficult, which is why many people who visit the dentist regularly continue to suffer from gingivitis or periodontitis despite receiving OHA.8,10 Behavior change techniques have been shown to be successful in quitting smoking25 The literature shows that interventions including goal setting, self-monitoring, and planning are effective in improving oral hygiene behaviors.26 In a recent study, an intervention that included goal setting and planning improved gum health in patients who received the intervention compared with patients who received standard OHA.27 Most dental participants in this study indicated that behavior change was an area in which they would like more training, but they also indicated that they would like to receive training in other areas of OHA.

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