As doenças periodontais (DP) são precedidas em importância apenas pela cárie dentária como problema de saúde bucal coletiva no Brasil. Ambas são doenças infecciosas ainda muito prevalentes, entretanto é dada às DP uma importância questionavelmente secundária, pois não são sistematicamente investigadas e prevenidas em saúde pública. Pelo fato de sua prevalência ser atualmente desconhecida no Brasil, a alta freqüência das formas leves e moderadas das doenças periodontais na população como um todo e de suas formas mais graves em grupos ou indivíduos de risco, dentre estes os portadores de cardiopatias isquêmicas, motivou este estudo no Ambulatório de Cardiopatia Isquêmica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, cotejando os resultados com outros obtidos em grupo de pessoas não-cardiopatas atendidas na mesma instituição. Foi investigada a prevalência e gravidade das doenças periodontais, bem como a prevalência de seus fatores de risco, história médica da presença de doenças de interesse à periodontia (diabetes, hipertensão, acidente vascular cerebral) e comportamento relativo à higiene bucal. Dentre as 634 pessoas examinadas na fase de recrutamento dos participantes, 480 foram do grupo de pacientes cardiopatas isquêmicos e 154 de grupo de não-cardiopatas. Foram selecionados respectivamente de cada grupo, 58 e 62 participantes, na faixa etária de 30 a 79 anos, para a investigação periodontal. A média da idade foi de 53 anos em ambos os sexos para os pacientes cardiopatas e de 40 anos nos homens e 37 anos nas mulheres nos pacientes não-cardiopatas. Foram utilizados o Índice Periodontal Comunitário (IPC) e o índice de Perda de Inserção periodontal (PI), ambos recomendados pela OMS (1999). Os resultados mostraram um predomínio de sextantes nos escores indicativos das formas graves da DP entre os pacientes cardiopatas (74,1% contra 20,2%; p < 0,00001). Dentre os pacientes cardiopatas apenas 1,1% dos sextantes exibiram saúde periodontal, contra 32,0% nos pacientes não-cardiopatas (p < 0,00001). No tocante a história pregressa da DP, mensuradas através da perda de inserção, 6,0% dos sextantes não a exibiram entre os pacientes cardiopatas, contra 68,0% dos não-cardiopatas (p < 0,00001). Eram portadores de fatores de retenção de biofilme dental 100,0% dos pacientes cardiopatas e 82,3% dos pacientes não-cardiopatas (p < 0,001). Exigiam tratamento periodontal mais complexo, normalmente praticados por especialistas em periodontia, 94,8% dos pacientes cardiopatas contra 33,9% dos pacientes não-cardiopatas (p < 0,0001). Necessitavam de tratamento de bolsas > 6mm 79,3% dos pacientes cardiopatas contra 9,7% dos pacientes não-cardiopatas (p < 0,0001). Alguns fatores de risco comprovado e/ou provável às DP, foram investigados nos pacientes cardiopatas e pacientes não-cardiopatas: observou-se tabagismo em 10,4% e 33,9% (p < 0,01), respectivamente; alcoolismo em 44,8% e 24,2% (p < 0,02), respectivamente; diabetes em 29,3% e 1,6% (p < 0,0001), respectivamente; hipertensão arterial em 34,5% e 8,1% (p < 0,001), respectivamente. Conclusões: As DP mostraram-se muito prevalentes nos dois grupos estudados, sendo de maior gravidade nos pacientes com cardiopatia isquêmica. A elevada prevalência de fatores de risco às DP aponta para a necessidade de adoção de estratégias de intervenção para minimizá-los. / Periodontal diseases are preceded in importance only by dental caries as oral public health problem in Brazil. Both are infectious diseases and with high prevalences, however, a secondary importance is given to periodontal diseases because they are not routinely investigated and prevented at public health level. Presently its prevalence is not known in the Brazilian population. The high prevalence of mild and moderate forms of periodontal diseases in the general population, and its severe forms in specific groups or in high risk patients, as those with ischaemic coronary diseases, motivated this survey. It was carried out among patients from the Outpatient Clinic of Ischaemic Coronary Disease – Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo – and using for comparisons patients from other clinics of the same hospital. The prevalence and severity of periodontal diseases were investigated, as well as the prevalence of their risk factors, medical history of diseases with periodontic interest (diabetes, hypertension, stroke), and behaviour related to oral hygiene. During the recruitment phase, among 634 patients examined, 480 were from the group with cardiopathy and 154 from the group without cardiopathy. From each group were selected, respectively, 58 and 62 participants, aged 30 to 79 years for the periodontal investigation. Mean age was 53 years for both sexes in the group with cardiopathy and 40 years for men and 37 years for women in the group without cardiopathy. The Community Periodontal Index and the Attachment Periodontal Index, both recommended by the World Health Organization (1999), were used. Results showed a predominance of sextants in the scores indicating severe forms of periodontal diseases among patients with cardiopathy (74.1 vs. 20.2%; p< 0.00001). Among patients with cardiopathy, only 1.1% of the sextants showed periodontal health against 32.0% in the other group (p< 0.00001). Previous history of periodontal diseases, measured through lost of insertion, was present in 6.0% of the sextants in patients with cardiopathy and 68.0% in those without cardiopathy (p< 0.0001). All patients with cardiopathy and 82.3% of those without cardiopathy were carriers of retention factors of dental biofilm (p< 0.001). It was found that 94.8% of the patients with cardiopathy against 33.9% of the other group (p< 0.0001) required more complex periodontal treatment, usually performed by periodontal specialists. Treatment of sites &#8805; 6mmm was required by 79.3% of the patients with cardiopathy and by 9.7% from the other group (p< 0.0001). The frequency of confirmed or possible risk factors for periodontal diseases in the groups with and without cardiopathy were, respectively: smoking – 10.4 and 33.9% (p< 0.001); alcoholism – 44.8 and 24.2% (p< 0.02); diabetes – 29.3 and 1.6% (p< 0.0001); hypertension – 34.5 and 8.1% (p< 0.001). Conclusions: Periodontal diseases were highly prevalent in the two groups studied, but with higher severity among patients with cardiopathy. The high frequency of risk factors for periodontal diseases in both groups appointed to the need of intervention strategies towards these risk factors.

As doenças periodontais (DP) são precedidas em importância apenas pela cárie dentária como problema de saúde bucal coletiva no Brasil. Ambas são doenças infecciosas ainda muito prevalentes, entretanto é dada às DP uma importância questionavelmente secundária, pois não são sistematicamente investigadas e prevenidas em saúde pública. Pelo fato de sua prevalência ser atualmente desconhecida no Brasil, a alta freqüência das formas leves e moderadas das doenças periodontais na população como um todo e de suas formas mais graves em grupos ou indivíduos de risco, dentre estes os portadores de cardiopatias isquêmicas, motivou este estudo no Ambulatório de Cardiopatia Isquêmica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, cotejando os resultados com outros obtidos em grupo de pessoas não-cardiopatas atendidas na mesma instituição. Foi investigada a prevalência e gravidade das doenças periodontais, bem como a prevalência de seus fatores de risco, história médica da presença de doenças de interesse à periodontia (diabetes, hipertensão, acidente vascular cerebral) e comportamento relativo à higiene bucal. Dentre as 634 pessoas examinadas na fase de recrutamento dos participantes, 480 foram do grupo de pacientes cardiopatas isquêmicos e 154 de grupo de não-cardiopatas. Foram selecionados respectivamente de cada grupo, 58 e 62 participantes, na faixa etária de 30 a 79 anos, para a investigação periodontal. A média da idade foi de 53 anos em ambos os sexos para os pacientes cardiopatas e de 40 anos nos homens e 37 anos nas mulheres nos pacientes não-cardiopatas. Foram utilizados o Índice Periodontal Comunitário (IPC) e o índice de Perda de Inserção periodontal (PI), ambos recomendados pela OMS (1999). Os resultados mostraram um predomínio de sextantes nos escores indicativos das formas graves da DP entre os pacientes cardiopatas (74,1% contra 20,2%; p < 0,00001). Dentre os pacientes cardiopatas apenas 1,1% dos sextantes exibiram saúde periodontal, contra 32,0% nos pacientes não-cardiopatas (p < 0,00001). No tocante a história pregressa da DP, mensuradas através da perda de inserção, 6,0% dos sextantes não a exibiram entre os pacientes cardiopatas, contra 68,0% dos não-cardiopatas (p < 0,00001). Eram portadores de fatores de retenção de biofilme dental 100,0% dos pacientes cardiopatas e 82,3% dos pacientes não-cardiopatas (p < 0,001). Exigiam tratamento periodontal mais complexo, normalmente praticados por especialistas em periodontia, 94,8% dos pacientes cardiopatas contra 33,9% dos pacientes não-cardiopatas (p < 0,0001). Necessitavam de tratamento de bolsas > 6mm 79,3% dos pacientes cardiopatas contra 9,7% dos pacientes não-cardiopatas (p < 0,0001). Alguns fatores de risco comprovado e/ou provável às DP, foram investigados nos pacientes cardiopatas e pacientes não-cardiopatas: observou-se tabagismo em 10,4% e 33,9% (p < 0,01), respectivamente; alcoolismo em 44,8% e 24,2% (p < 0,02), respectivamente; diabetes em 29,3% e 1,6% (p < 0,0001), respectivamente; hipertensão arterial em 34,5% e 8,1% (p < 0,001), respectivamente. Conclusões: As DP mostraram-se muito prevalentes nos dois grupos estudados, sendo de maior gravidade nos pacientes com cardiopatia isquêmica. A elevada prevalência de fatores de risco às DP aponta para a necessidade de adoção de estratégias de intervenção para minimizá-los. / Periodontal diseases are preceded in importance only by dental caries as oral public health problem in Brazil. Both are infectious diseases and with high prevalences, however, a secondary importance is given to periodontal diseases because they are not routinely investigated and prevented at public health level. Presently its prevalence is not known in the Brazilian population. The high prevalence of mild and moderate forms of periodontal diseases in the general population, and its severe forms in specific groups or in high risk patients, as those with ischaemic coronary diseases, motivated this survey. It was carried out among patients from the Outpatient Clinic of Ischaemic Coronary Disease – Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo – and using for comparisons patients from other clinics of the same hospital. The prevalence and severity of periodontal diseases were investigated, as well as the prevalence of their risk factors, medical history of diseases with periodontic interest (diabetes, hypertension, stroke), and behaviour related to oral hygiene. During the recruitment phase, among 634 patients examined, 480 were from the group with cardiopathy and 154 from the group without cardiopathy. From each group were selected, respectively, 58 and 62 participants, aged 30 to 79 years for the periodontal investigation. Mean age was 53 years for both sexes in the group with cardiopathy and 40 years for men and 37 years for women in the group without cardiopathy. The Community Periodontal Index and the Attachment Periodontal Index, both recommended by the World Health Organization (1999), were used. Results showed a predominance of sextants in the scores indicating severe forms of periodontal diseases among patients with cardiopathy (74.1 vs. 20.2%; p< 0.00001). Among patients with cardiopathy, only 1.1% of the sextants showed periodontal health against 32.0% in the other group (p< 0.00001). Previous history of periodontal diseases, measured through lost of insertion, was present in 6.0% of the sextants in patients with cardiopathy and 68.0% in those without cardiopathy (p< 0.0001). All patients with cardiopathy and 82.3% of those without cardiopathy were carriers of retention factors of dental biofilm (p< 0.001). It was found that 94.8% of the patients with cardiopathy against 33.9% of the other group (p< 0.0001) required more complex periodontal treatment, usually performed by periodontal specialists. Treatment of sites &#8805; 6mmm was required by 79.3% of the patients with cardiopathy and by 9.7% from the other group (p< 0.0001). The frequency of confirmed or possible risk factors for periodontal diseases in the groups with and without cardiopathy were, respectively: smoking – 10.4 and 33.9% (p< 0.001); alcoholism – 44.8 and 24.2% (p< 0.02); diabetes – 29.3 and 1.6% (p< 0.0001); hypertension – 34.5 and 8.1% (p< 0.001). Conclusions: Periodontal diseases were highly prevalent in the two groups studied, but with higher severity among patients with cardiopathy. The high frequency of risk factors for periodontal diseases in both groups appointed to the need of intervention strategies towards these risk factors.

Made available in DSpace on 2014-12-17T15:30:55Z (GMT). No. of bitstreams: 1 Eudivar Correia de Farias Neto_DISSERT.pdf: 1661843 bytes, checksum: 00073311cd74dc1565ed066097489ecc (MD5) Previous issue date: 2010-07-27 / This study clinically evaluated the relationship of gingival recessions with the periodontal index of gingival and plaque, dental alignment, keratinized mocous, type of periodontal, and occlusal disorders. Study participants were individuals aged between 19 and 33 years. The evaluations were performed by using questionnaires and clinical examinations. In subjects examined, the teeth were assessed and divided into groups (Molars, premolars, canines and incisors). The gingival recession were measured in the central region of the teeth and individuals were subject to disclosure to the plate and observing the poll of plaque and gingival index, respectively. 558 teeth were examined, with 24.1%, 135 had gingival recession greater than or equal to 1mm. Through the combination of tests used to evaluate the average of the recession and its relationship with the variables studied, we observed that the degree of recession of the elements assessed dental showed, almost for the most part, when higher values associated with the index plaque (p = 0.101), Gingival Index (p = 0.053), dental alignment (p = 0.962), width of keratinized mocous (p = 0.004) and type of periodontium (p = 0.033), however statistically significant difference could only be considered when related the recessions in the keratinized mocous and the type of the periodontium. Although we identify, when we evaluate the whole set of teeth that occlusal disturbances (p = 0.002) were more strongly associated with cases of gum recession that the gingival index (p = 0.006), however, these two conditions were correlated with the cases of recession, contributing to its occurrence / Este trabalho avaliou clinicamente a rela??o das recess?es gengivais com o ?ndice de placa, ?ndice gengival, alinhamento dental, mucosa ceratinizada, tipo de periodonto, e dist?rbios oclusais. Participaram do estudo indiv?duos com idades variando entre 19 e 33 anos. As avalia??es foram realizadas utilizando-se question?rios e exames cl?nicos. Nos indiv?duos examinados, os dentes foram avaliados e divididos por grupos (Molares, pr?molares, caninos e incisivos). As recess?es gengivais foram mensuradas na regi?o central dos dentes e os indiv?duos foram submetidos ? evidencia??o de placa e sondagem para observa??o dos ?ndices de placa e gengival, respectivamente. Foram examinados 558 dentes, sendo que 24,1%, isto ?, 135 apresentavam recess?o gengival maior ou igual a 1mm. Por meio dos testes de associa??o utilizados para avalia??o da m?dia das recess?es e sua rela??o com as vari?veis pesquisadas, observou-se que o grau de recess?o dos elementos dent?rios avaliados apresentaram, quase que em sua maioria, valores m?dios maiores quando associados ao ?ndice de Placa (p=0,101), ?ndice de Gengival (p=0,053), alinhamento dent?rio (p=0,962), largura da mucosa ceratinizada (p=0,004) e tipo de periodonto (p=0,033), no entanto diferen?a estatisticamente significante s? p?de ser considerada quando relacionamos as recess?es com a mucosa ceratinizada e com o tipo do periodonto. Ainda foi poss?vel identificar, quando avaliamos todo o conjunto dos dentes que os dist?rbios oclusais (p=0,002) estiveram mais fortemente associados aos casos de recess?o gengival que o ?ndice gengival (p=0,006), no entanto, essas duas condi??es se mostraram correlacionadas com os casos de recess?o, contribuindo na sua ocorr?ncia

Objective: This study sought to determine the association between periodontal disease in pregnancy and the delivery of low birth weight newborns in a rural population of South African women. Methods: This case-control study involved 348 new mothers. All subjects were recruited post-delivery from three public hospitals in the rural Eastern Cape of South Africa. The cases (n=119) were mothers who delivered through normal delivery and whose babies at the time of delivery weighed <2.5 kg. Age-matched controls (n=229) were mothers who delivered ≥2.5 kg babies. Potential risk factors for periodontal disease and low birth weight were collected by means of a structured questionnaire and maternity record review. Using the WHO's community periodontal index, a trained dental clinician blinded to participants' birth-outcomes recorded the periodontal health status of each participant (intraexaminer reliability; kappa = 0.95). Mothers who presented with a probing depth ≥4 mm on more than four index teeth without the presence of gingival overgrowth were deemed to present with periodontal disease. Data analysis included conditional logistic regression analysis. Results: Periodontal disease was diagnosed in 37.9%> (n=45) of the case group and 9.2°/o (n=21) of the control group. Low birth weight was also significantly more common among those who were unemployed, those who reported fewer than three antenatal visits and drinking on five or more days per week during pregnancy. After controlling for potential confounders, mothers presenting with a probing depth ≥ 4 mm on four teeth (OR = 4.12; 95°/o Cl = 1. 78 - 9.50) or more than four teeth (OR = 4.95; 95%> Cl: 1.52 - 15.81) were found to be significantly more likely to have low birth weight babies. Conclusions: The study findings suggest that there is a significant dose-dependent positive association between periodontal disease and low birth weight, independent of other risk factors measured in this study. / Dissertation (MSc)--University of Pretoria, 2013. / Community Dentistry / unrestricted

A osteonecrose dos maxilares associada aos bisfosfonatos (OMAB) é reconhecidamente uma complicação tardia dos bisfosfonatos, que são empregados para tratar desordens esqueléticas marcadas pela perda de massa óssea. Hoje, o reconhecimento da variante clínica sem exposição óssea e de outras classes de drogas associadas à osteonecrose dos maxilares (inibidores de RANK-L, VEGF, m- TOR e TNF-a) integram um novo aspecto do conceito dessa entidade patológica. Vários fatores de risco para o desenvolvimento de OMAB foram identificados, incluindo procedimentos odontológicos invasivos, má higiene oral, o uso de bisfosfonatos (particularmente, os bisfosfonatos nitrogenados como o pamidronato e o zoledronato), infusões frequentes e tempo prolongado de exposição aos bisfosfonatos. A saúde bucal é um fator significativo que afeta o risco de OMAB e, juntamente com a predisposição genética, pode explicar algumas das diferenças de incidência encontrada na literatura. Fatores genéticos parecem influenciar o risco de desenvolvimento da OMAB. Os polimorfismos de nucleotídeo único dos genes CYP2C8 e RBMS3 foram significativamente associados com um risco mais elevado. Enquanto o gene CYP2C8 está envolvido na inibição dos osteoclastos, diferenciação dos osteoblastos e regulação do tônus vascular, RBMS3 é um gene envolvido no metabolismo ósseo e foi associado à massa óssea reduzida e a fraturas osteoporóticas. Contudo, houve limitações metodológicas nesses estudos, dos quais apenas um abordou a diferença da frequência de polimorfismos associados à OMAB em grupos étnicos distintos. Até o momento faltam estudos genéticos sobre polimorfismos associados com OMAB que tenham sido replicados e validados com evidências convincentes, particularmente, envolvendo populações não caucasianas. Ainda hoje permanece um grande desafio: estratificar o risco para desenvolvimento da OMAB no contexto clínico. Assim, o objetivo do presente estudo é investigar a associação de fatores clínicos (saúde bucal) e genéticos com a ocorrência da OMAB. Realizou-se um estudo transversal com pacientes oncológicos expostos ao zoledronato e/ou pamidronato por pelo menos 7 meses, com ou sem OMAB. Submeteram-se os participantes à avaliação odontológica. Avaliou-se a condição de cárie dentária e doença periodontal através do índice de dentes cariados perdidos e obturados (CPOD) e índice periodontal comunitário. O índice gengival e o índice de higiene oral simplificado (IHOS) também constaram nessa avaliação. Para a discriminação dos genótipos dos genes CYP2C8 e RBMS3, 2 ml de saliva foram coletados e processados para a técnica de PCR quantitativa. A amostra consistiu de 80 pacientes (69 mulheres e 11 homens). O índice geral de OMAB foi 11,2% (câncer de mama: 11,3%; câncer de próstata: 22,2%). Houve forte correlação positiva entre o estadiamento clínico da OMAB e CPOD (rho=0.9189, p=0.001). Inflamação gengival moderada e cálculo dentário alcançaram, respectivamente, 72% e 50% dos indivíduos com OMAB. Bolsa periodontal de 4 mm ou mais envolveu 37,5% desse grupo. IHOS revelou aproximadamente 25% dos indivíduos desse grupo com higiene oral regular. O polimorfismo do gene CYP2C8 estava presente em 50% dos pacientes com OMAB, enquanto 12% apresentou mutação para o gene RBMS3. Em conclusão, a saúde bucal da população oncológica foi bastante precária e o polimorfismo do gene CYP2C8 pareceu se associar à OMAB em população oncológica. / Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is recognized as a late complication of bisphosphonates, which are used to treat skeletal disorders characterized by loss of bone mass. The recognition of clinical variation without bone exposure and other classes of drugs associated with osteonecrosis of the jaws (RANK-L, VEGF, m-TOR and TNF-inhibitors) are part of a new aspect of the pathological concept. Several risk factors for the development of BRONJ have been identified, including invasive dental procedures, poor oral hygiene, use of bisphosphonate (particularly, nitrogen-containing bisphosphonate such as pamidronate and zoledronate), frequent infusions and prolonged exposure to bisphosphonate. Oral health is a significant factor that affects the risk of BRONJ and, along with a genetic predisposition, it might explain epidemiological differences found in literature. Genetic factors seem to impact the risk of developing BRONJ. Single nucleotide polymorphisms of the CYP2C8 and RBMS3 genes were significantly associated with a higher risk. While the CYP2C8 gene is involved in osteoclast inhibition, osteoblast differentiation and regulation of vascular tone, RBMS3 is a gene involved in bone metabolism and has been associated with reduced bone mass and osteoporotic fractures. However, methodological limitations are present in these studies, of which only one addressed the difference in the frequency of polymorphisms associated with BRONJ in different ethnic groups. So far genetic studies have been lacking on polymorphisms associated with BRONJ that have been replicated and validated with convincing evidence, particularly involving non- Caucasian populations. In clinical context, a great challenge remains: classify patients in high risk for the development of BRONJ. Thus, the present study aims to investigate an association of clinical (oral health) and genetic factors with the occurrence of BRONJ. A cross-sectional study was performed with oncologic patients exposed to zoledronate and/or pamidronate for at least 7 months, with or without BRONJ. Participants were submitted to dental evaluation. Dental caries and periodontal disease were evaluated through the index of missing and filled teeth (DMFT) and community periodontal index. The gingival index and the simplified oral hygiene index (SOHI) were also included in this evaluation. For the discrimination of genotypes of the CYP2C8 and RBMS3 genes, 2 ml of saliva were collected and processed for the quantitative PCR technique. The sample consisted of 80 patients (69 women and 11 men). The overall BRONJ index was 11.2% (breast cancer: 11.3%, prostate cancer 22.2%). There was a strong positive correlation between the clinical staging of BRONJ and DMFT (rho=0.9189, p=0.001). Moderate gingival inflammation and dental calculus comprised, respectively, 72% and 50% of individuals with OMAB. Periodontal pocket of 4 mm or more involved 37.5% of this group. SOHI revealed approximately 25% of individuals in this group with regular oral hygiene. The polymorphism of the CYP2C8 gene was present in 50% of patients with BRONJ, while 12% had a mutation for the RBMS3 gene. In conclusion, the oral health of the cancer population was very precarious and CYP2C8 gene polymorphism is apparently associated with BRONJ in cancer population.

Magister Chirurgiae Dentium - MChD / Purpose: To assess the oral health status of 4-15-year-old schoolchildren in the Western Region of the Eastern Cape Province, by determining the prevalence of dental caries, periodontal disease, dental fluorosis, malocclusion and oral mucosal lesions and to create baseline data for planning oral health services in this region. Materials and Methods: The prevalent analytic survey was undertaken on 822 schoolchildren between the ages of 4-15 years in 27 different schools. The sample size selected for this region by the Department of Statistics, University of Pretoria, for the National Oral Health Survey of 1999/2000 was used. The data on 209, 210, 209 and 194 scholars in the 4-5, 6, 12 and 15-year-old age groups respectively were collected. The World Health Organization's (1997) criteria were used to determine the prevalence of caries, periodontal treatment needs, the dental fluorosis, malocclusion and prevalence of oral mucosal lesions. Six calibrated and trained examiners recorded the data on a survey form. The WHO survey forms were used for data collection. The data were analysed and processed by the author on Microsoft Excel 2000. Results: The sample size consisted of 1.35 % Asian, 51.89 % Black, 26.07 % Coloured and 20.06 % White scholars. Nearly equal amounts of males (48.3 %) and females (51.7%) were examined. The dental caries prevalence in the primary dentition of 4-5-year-olds with an average age of 4.43 years was 40.67%, with a mean dmft of 3,56. The dental caries prevalence in the permanent dentition of6-, 12- and 15-year-oldage groups was 67.62%, 46.05% and 67.92% respectively. The mean DMFT for 6-, 12- and 15 year olds were 0.05, 1.19 and 2.02 respectively. Gender differences and differences in prevalence of dental caries between the populations groups were recorded. The Coloured children experienced the highest dental caries prevalence. In the 4-5- and 15-year-old groups the males were affected more than the females by dental caries. Prevalent differences were recorded between rural and urban areas in the same population group. The prevalence of periodontal disease in 373, 12-15-year-olds was 79.09%. Only 4.02 % were in need of dental hygiene instructions and polishing. Dental education, dental hygiene instructions, dental scaling and polishing were needed by 75.07% of the children. Dental fluorosis prevalence in 450, 6-15-year-olds was 13.03%. Dental fluorosis did not affect 86.97% of the scholars; 10.63% had mild fluorosis and 2.05% was severely affected. The mean fluoride concentration in the drinking water in this region were 1.07 mgIL, ranging between 0.3-3 mgIL. Definite malocclusion was recorded in only 0.48% of the 12-year-old group, whom needed elective treatment. In the 12-year-olds, 99.52% needed no or slight treatment for no or minor malocclusions. The majority of children had no oral mucosal lesions (91.55%). The prevalence of oral mucosal lesions was 8.5% in this survey. The most frequent conditions were traumatic lesions (1.96%), dento-alveolar abscess (1.22%) and herpes labialis (1.22%). The intra-examiner reliability for caries, dental fluorosis, periodontal treatment needs and prevalence of malocclusions was 97.66%, 100%, 88.89% and 86.67% respectively. The inter-examiner reliability was 98.75%, 98.34%, 100%, 100% and 100% respectively for the five examiners. Conclusion: This survey indicated a higher prevalence of dental caries in the primary dentition (63.48%), than the permanent dentition (41.3%). The mean dmft was 3.65 and the DMFT 1.2, which indicated a low mean caries experience for these children. The WHO goal for the year 2000 for the 6-year-olds of 50% being caries free has not reached for only 32.56% were caries free. The mean DMFT of 1.2 for 12-year-olds in this survey is below the WHO goal of a mean DMFT of 1.5 or less. The lack of available preventative service provision, were ) indicated by the low percentage of fissure sealants (2.8%). The need for dental treatment was highlighted by the need mostly for one-surface restorations. Preventative treatment, two-surface fillings and extractions were also needed. Periodontal disease was a major public oral health concern for this region for a prevalence of 79.09% was recorded for the 12-15-year-olds. The majority of the children affected by periodontal disease (75.07%) were in need of professional cleaning and calculus removal. The prevalence of dental fluorosis was 8.2%, 19.87% and 13.05% for 6-, 12- and IS-year age groups respectively. The prevalence of malocclusion was 0.48% for the 12-year-old group. The prevalence of oral mucosa lesions was 8.5% for 4-15-year-old schoolchildren. Therefore, the conclusion can be made that dental fluorosis; malocclusions and oral mucosal lesions were no public concern in this region. The major public oral health concerns were dental caries in the primary dentition and periodontal disease in all age groups. Recommendations: Dental services in this region should be directed towards prevention of dental caries in the primary dentition and periodontal disease in all age groups. The focus of dental services should be primarily on preventative programs and treatments. The public dental treatments needs indicated in this survey, namely scaling and polishing, restorations and extractions, consists of the primary health care package delivery. Currently, no evaluation tool exists to monitor the efficiency of oral health programs, no baseline data for the Province exists. Therefore, the urgent need for dental research and oral health service planning and delivery are recommended.