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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 5  |  Page : 237-240  

Assessment of periodontal status and treatment needs among beedi factory workers


1 Department of Dentistry, Darbhanga Medical College and Hospital, Darbhanga, Bihar, India
2 Community Health Centre, Amnour, Saran, Bihar, India
3 Department of Orthodontics and Dentofacial Orthopedics, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
4 Primary Health Centre, Health Department, Government of Bihar, Rajpur, Rohtas, Bihar, India
5 Primary Health Centre, Baniapur, Saran, Bihar, India
6 Department of Oral and Maxillofacial Surgery, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India

Date of Submission22-Oct-2020
Date of Acceptance30-Oct-2020
Date of Web Publication05-Jun-2021

Correspondence Address:
Raman Kant Sinha
Medical Officer, (Dentist), Community Health Centre, Amnour, Saran, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.JPBS_699_20

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   Abstract 


Introduction: Periodontal disease is considered to be one of the most common oral conditions in human population sharing an equal prevalence rate in both developed and developing countries. It is observed that in India, more than 800 million beedis are sold every year; hence, beedi making is a big industry involving approximately 4.4 million workers, and 76% of these workers are women. Objectives: The objectives of this study were to assess the frequency of gingival and periodontal disease and to evaluate the treatment needs in labors working in a beedi factory. Materials and Methods: A cross-sectional study was conducted on 1000 daily wage labors working in a beedi factory resided at Patna, Bihar. Subjects aged between 19 and 60 years were randomly selected for the study. The community periodontal index of treatment needs (CPITN) index with CPTIN probe along with the demographic data was recorded in daylight. Results: None of the study subjects was found to fall in category community periodontal index-1 (CPI-1), 67.2% of the study population was found to be in CPI-2, 12.3% were found to be in CPI-3, and 9.7% of the study subjects scored CPI-4. For the treatment needs, majority of the subjects were in TN2 category; however, with advancing age, there was increase in the percentage of population requiring TN3 treatment needs. Conclusion: CPITN index along with the demographic data was recorded in daylight. The high prevalence rate of periodontal disease in these beedi factory workers was found, which increased with advancing age. The treatment need index also showed rise in the requirement of complex procedures with advancing age, suggesting the role of dental education and regular checkups in these population groups.

Keywords: Beedi factory workers, community periodontal index of treatment needs index, periodontal disease, smoking, tobacco


How to cite this article:
Singh A, Sinha RK, Richa S, Kumar R, Kishor A, Kumar A. Assessment of periodontal status and treatment needs among beedi factory workers. J Pharm Bioall Sci 2021;13, Suppl S1:237-40

How to cite this URL:
Singh A, Sinha RK, Richa S, Kumar R, Kishor A, Kumar A. Assessment of periodontal status and treatment needs among beedi factory workers. J Pharm Bioall Sci [serial online] 2021 [cited 2021 Jun 22];13, Suppl S1:237-40. Available from: https://www.jpbsonline.org/text.asp?2021/13/5/237/317633




   Introduction Top


Periodontal disease is the most frequent oral condition in human population,[1] which shares an equal prevalence rate in both developed and developing countries. It is observed that about 20%–50% of global population is affected by one or other periodontal disease. More than 50% of extractions for patients aged between 41 and 70 years are due to periodontal disease.[2],[3],[4]

Smoking affects vascular and immunologic reactions, by undermining the supportive functions of the periodontal tissues, thus altering with the host response. This leads to periodontal destruction with tooth loss.[5]

It is estimated that in India, more than 800 million beedis are sold every year against 100 million cigarettes. Beedi making involves about approximately 4.4 million workers, and 76% of these workers are women. The workers working in these factories are of low socioeconomic status, have very poor oral hygiene, and hence are more prone to periodontitis; hence, we randomly selected our subjects for the factory located in Patna, Bihar. The objectives of this study were to assess the frequency of gingival and periodontal disease and to evaluate the treatment needs in labors working in a beedi factory.


   Materials and Methods Top


An epidemiological, cross-sectional study was carried out on 1000 beedi factory workers. The survey was conducted in between January 2010 and June 2020; on average, 25–30 workers were interviewed and examined per day. Subjects aged between 19 and 60 years were randomly selected. Along with the demographic data, the community periodontal index of treatment needs (CPITN) index[6] was also recorded with the help of CPITN probe in daylight. Randomization was done by selecting every third worker for the study.

The exercises for calibration for the index were carried out by the principal investigator. Initially, the examination was done on the first ten patients, and then, diagnostic criteria were applied on a group of 20 patients with a time interval of 30 min between the examinations. These interpretations of codes, clinical findings and application of criteria for periodontal diseases were recorded. The intraexaminer reliability was assessed to ensure consistency (Kappa value, x = 0.87).

Method of collection of data

Demographic data such as name, age, and sex were recorded. CPTIN index was also recorded. The CPITN probe was first described by the WHO (TRS 621–1978), which is used for recording findings. For recording the index, the mouth was divided into six sextants defined by tooth numbers, namely 17–14, 13–23, 24–27, 47–44, 43–33, and 34–37.

For recording the index for epidemiological purpose, only ten teeth in adults are recorded, namely 17/16, 11, 26/27, 47/46, 31, and 36/37. Two molars in each posterior segment were paired for recording, and if one is missing, there is no replacement. If no index teeth or tooth was present in a segment qualifying for the examination, all the remaining teeth in that segment were examined and the highest score was recorded.

The examination was conducted on the workers in the collection point of beedi factories on the ordinary chair in natural daylight using mouth mirrors and CPITN probes.

Following parameters were recorded:

  • TN0: No need for treatment
  • TN1: Need for improving personal oral hygiene
  • TN2: Need for professional cleaning of the teeth and removal of plaque retentive factors with oral hygiene instructions to the patient
  • TN3: Need for complex treatment involving deep scaling, root planning, and more complex surgical procedures.


One-way ANOVA was used to find the significance of study parameters.


   Results Top


The study included 258 males and 742 females. The majority of the workers were in the age group of 21–30 years [Table 1].
Table 1: Age distribution according to gender

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[Table 2] shows the CPI index. 64% of the study subjects fall under CPI-2 category followed by 24.3% in the CPI-3 category and 9.7% in CPI-4 category. None of the study subjects could be ascertained CPI-0 – healthy category.
Table 2: Distribution of community periodontal index

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[Table 3] summarizes the treatment needs according to age. 97.47% of the patients of 0-20 year age group were found to be in TN2 grade. Where professional cleaning of the teeth and removal of plaque retentive factors with oral hygiene instructions were given to the patients.
Table 3: Distribution of treatment needs according to age

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   Discussion Top


This is an epidemiological, cross-sectional study carried out on 1000 beedi factory workers. Our study subjects were within 19–60 age groups and were randomly selected for the study. CPITN index along with the demographic data was recorded in daylight. The high prevalence rate of periodontal disease in these beedi factory workers was found, which increased with advancing age. The treatment need index also showed rise in the requirement of complex procedures with the advancing age, suggesting the role of dental education and regular checkups in these population groups.

The beedi factory workers are exposed to the tobacco environment and dust. Tobacco is the main raw material used for beedi rolling, which is provided in the powder form, to which the workers are constantly exposed. We found a direct correlation of periodontal disease increased with the advancing age. Our results were found to be consistent with the studies conducted by Miyazaki et al.,[7] Van Palenstien Helderman et al.,[8] Krustrup and Erik Petersen,[9] and Vanishree.[10]

67.2% of the study population was found to be in CPI-2 category having visible black calculus, and 12.3% were found to be in CPI-3 category having shallow pockets. Studies conducted by Roman A and Pop A2 (38%), van Palenstein Helderman et al.[8] (38%), and Vanishree et al.[10] (34%) showed lower scores as compared to our study; this could be due to different geographical conditions and education status of the study population.

9.7% of the study subjects scored CPI-4 (pocket 6 mm or more) in our study. Our results were similar to the study conducted by Holmgren et al.[11] (16%).

Treatments needs index showed that not a single worker (0%) presented with TN0 (there is no need of treatment), only 0.3% of the population requires TN1, that is, they fall in TN2 spectrum of the index. 9.9% of the total population was in the TN3 category (needs complex treatment involving deep scaling, root planning, and more complex surgical procedures), but only 1.5% population was willing to undergo the required treatment, suggesting the need for through counseling.

In a similar study conducted by Songpaisan and Davies,[12] they found that 93.2% required TN2, 3.2% needed TN3, and 3.6% needed TN0.

Treatment needs according to the age showed that as the age increases the patient's needing, TN3 increases. We found that till the age group of 40 years, only 3.03% of the study population needed TN3; however, as the age increases beyond 40, the study subjects showed steep rise for the TN3 level of treatment needs (15.7% and 56.77%).

There was also an increase in the TN2 level with age rather than TN3 level. We found support for our findings in the study conducted by Gamonal et al.[13]

Tobacco is a well-established risk factor for periodontal diseases and oral cancer. Beedi factory workers are exposed to tobacco dust as they are involved in rolling of beedis. Hence, it is an occupational hazard. The aim of our study was to assess the periodontal status and treatment needs in these beedi factory workers.


   Conclusion Top


In our study, we found high prevalence rate of periodontal disease in the beedi factory workers, which increased with advancing age. The CPTIN index indicated that none of the workers was found to be completely healthy, with only 0.3% in CPI-1, and majority were in CPI-2. With advancing age, the need for complex treatment also showed steep rise. TN3 was required by only 1.32% till 30 years of age; however, as soon as this age bracket increased to 40 years, more than 3% came to fell in this category; however, the most steep rise was seen when the age group increased above 40. More than 15.7% of population in the age group of 41–50 years required TN3 level of treatment needs.

Low socioeconomic background, poor understanding of oral hygiene measures, and low literacy rate were the main reasons; we could attribute to our findings. Hence, to improve the oral hygiene measures in this population, regular dental checkup camps should be organized while putting emphasis on improving oral hygiene.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Raitapuro-Murray T, Molleson TI, Hughes FJ. The prevalence of periodontal disease in a Romano-British population c. 200-400 AD. Br Dent J 2014;217:459-66.  Back to cited text no. 1
    
2.
Srikandi TW, Clarke NG. Periodontal status in a South Australian industrial population. Community Dent Oral Epidemiol 1982;10:272-5.  Back to cited text no. 2
    
3.
Bergström J. Cigarette smoking as risk factor in chronic periodontal disease. Community Dent Oral Epidemiol 1989;17:245-7.  Back to cited text no. 3
    
4.
Bergström J. Tobacco smoking and supragingival dental calculus. J Clin Periodontol 1999;26:541-7.  Back to cited text no. 4
    
5.
Dharmashree S, Chandu GN, Pushpanjali K, Jayashree SH, Shafiulal MD. Periodontal status of industrial workers in Davangere city, Karnataka – A descriptive cross sectional study. J Indian Assoc Public Health Dent 2006;7:20-4.  Back to cited text no. 5
    
6.
Cutress TW, Ainamo J, Sardo-Infirri J. The community periodontal index of treatment needs (CPITN) procedure for population groups and individuals. Int Dent J 1987;37:222-33.  Back to cited text no. 6
    
7.
Miyazaki H, Shiraham R, Itoh-Andoh M, Yasmashita Y, Saito T, Sogame A, et al. Prevalence and treatment needs of periodontal disease in employees of supermarkets in Japan. Singapore Dent J 1988;13:10-3.  Back to cited text no. 7
    
8.
van Palenstein Helderman WH, Joarder MA, Begum A. Prevalence and severity of periodontal diseases and dental caries in Bangladesh. Int Dent J 1996;46:76-81.  Back to cited text no. 8
    
9.
Krustrup U, Erik Petersen P. Periodontal conditions in 35-44 and 65-74-year-old adults in Denmark. Acta Odontol Scand 2006;64:65-73.  Back to cited text no. 9
    
10.
Vanishree N, Sequeira PS, Ashwini R, Gupta N, Chandrashekhar BS, Mohan AN. Oral health status and treatment needs of female beedi workers in Mangalore city India. Al Amen J Med Sci 2014;1:26-33.  Back to cited text no. 10
    
11.
Holmgren CJ, Corbet EF, Lim LP. Periodontal conditions among the middle-aged and the elderly in Hong Kong. Community Dent Oral Epidemiol 1994;22:396-402.  Back to cited text no. 11
    
12.
Songpaisan Y, Davies GN. Periodontal status and treatment needs in the Chiangmai/Lamphun provinces of Thailand. Community Dent Oral Epidemiol 1989;17:196-9.  Back to cited text no. 12
    
13.
Gamonal JA, Lopez NJ, Aranda W. Periodontal conditions and treatment needs, by CPITN, in the 35-44 and 65-74 year-old population in Santiago, Chile. Int Dent J 1998;48:96-103.  Back to cited text no. 13
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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