Background: Since self-reported periodontal or ‘gum’ health may be explained by the same factors that are associated with clinical periodontal health status, it has been suggested as a useful measure for service planning and for monitoring periodontal health in developing and resource-limited countries, where logistics and the costs of clinical oral surveys may be major barriers to risk factor surveillance. Objectives: To determine the systemic health and lifestyle factors associated with self-reported poor periodontal health status in South Africa. Data source: The second South African Demographic and Health Survey (SADHS) done in 2003. Methods: This secondary data analysis focused on data on dentate adults aged ≥15 years who participated in the 2003 SADHS (n=6,319). Information obtained included socio-demographic data, health risk behaviours (tobacco and alcohol use) and chronic diseases. Nutrient intake was computed based on food frequency items contained in a Nutrient Index (N-Index) developed for use in South Africa. Taking into account the complex sample design used in the SADHS, data analysis included the use of t-test, Chi-square and multiple logistic regression analysis. The level of significance was set at p<0.05. Results: Of the respondents, 4.6% (95% CI = 3.9 - 5.5) self-reported having had a ‘gum problem’ or poor periodontal health in the 6 months prior to the survey date. In the general dentate population, those who reported poor periodontal health were older than those who did not report poor periodontal health at a significant level (36.2% vs. 38.8%; p = 0.02); and they were more likely to be problem drinkers (2.53; 95% CI = 1.68 – 3.82), as compared to non-drinkers. Having suffered a stroke (4.13; 95% CI = 1.53 – 11.11) or suffering from arthritis (1.70; 95% CI = 1.00 = 2.90) were significant associated with higher odds of reporting poor periodontal health. Black South Africans have higher odds of reporting poor periodontal health (3.91; 95% CI = 1.38 – 11.05) than white South Africans. On further stratifying the study participants into younger (≤45 years) and older (>45 years) adults, factors associated with poor periodontal health were found to be different. In particular, reporting making yearly preventive dental care visits was significantly associated with reporting poor periodontal health only among younger adults (OR = 0.40; 95%CI = 0.18 – 0.90), while the racial gradient in reporting poor periodontal health remained significant only for older adults. Conclusion: The study’s findings highlight the need to integrate oral health promotion with general health promotion programmes, especially those targeted at chronic disease prevention and rehabilitation. / Dissertation (MSc)--University of Pretoria, 2010. / Community Dentistry / unrestricted

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This study aimed to investigate associations between psychosocial factors, obesity, and oral health in a study population of 10- to 18-year-old adolescents who participated in the LIFE Child study. Psychosocial information (socioeconomic status (SES) based on parents’ education, occupation and household income, Strengths and Difficulties Questionnaire (SDQ), health-related quality of life) and physical activity behavior were obtained. Nutritional status was classified based on age- and sex-adjusted body mass index into underweight, overweight, normal weight and obese. Clinical dental examinations were performed and scored with respect to caries experience (CE), oral hygiene (OH), and periodontal status (periodontal health score: PERIO-S). Age-adjusted regression analysis under the assumption of a double Poisson distribution was performed with and without adjusting for SES (α = 5%). A total of 1158 study participants (590 girls, 568 boys; mean age 13.2 ± 2.3 years) were included (17.2% were classified as obese). CE was 20% higher for moderate and 60% higher for low SES compared to high SES (p < 0.05). PERIO-S was 10% higher for moderate and 30% higher for low compared to high SES (p < 0.05). Poor OH was associated with higher CE (Ratio R = 2.3, p < 0.0001) and PERIO-S (R = 3.1, p < 0.0001). Physical activity in a sports club was associated with lower CE-S and PERIO-S (R = 0.85, p < 0.001). Obesity was associated with increased CE (R = 1.3, p < 0.001) compared to normal weight. For low but not high SES, more reported difficulties were associated with higher CE. In conclusion, low SES, poor OH, and obesity are associated with unfavorable oral health conditions, whereas physical activity and high SES are potentially protective.

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