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ORIGINAL ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 3  |  Page : 200-203

Assessment of periodontal health among jail inmates of Guntur city Andhra Pradesh: A cross-sectional study


Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India

Date of Web Publication10-Oct-2016

Correspondence Address:
Narayana Rao Vinnakota
Department of Public Health Dentistry, H-No. 5-2-1/2, Opp. Arts and Science College, Bapatla, Guntur, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2277-8632.191843

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  Abstract 

Introduction: Oral health is an integral part of general health. Various factors are responsible for maintenance of good oral health. Socioeconomic status, occupation, education are playing major role in the maintenance of good oral health. Prisoners are psychologically, socially, morally and economically affected group, which makes them to neglect their general, as well as oral health.
Materials and Methods: A descriptive cross-sectional epidemiological study was designed and undertaken at district prison in Guntur city to assess the periodontal health status and loss of attachment (LOA) in accordance with their years of imprisonment.
Results: The total prison population of the district prison was 180 (145 males, 35 females) with the age group of 18-65 years. Calculus was observed among 38.8% of total inmates, and it was observed more 25 (35.7%) who were imprisoned for 4-6 years. Pockets measuring 4-5 mm was observed among 15.5% of total inmates and it was observed 10 (35.7%) who were imprisoned for 2-4 years. Pockets measuring >6 mm were observed among 5%of total inmates and it was observed more 4 (40%) who were imprisoned for >6 years. There was highly statistically significant differences in LOA scores between the inmates imprisoned for a different period of imprisonment (P = 0.005).
Conclusion: This study conducted in central jail has clearly indicated that their periodontal health status is poor because of lack of knowledge on oral health care measures and accessibility to aids used in oral hygiene practices. Preventive measures to improve dental care and provision of dental health education are very much necessary to ensure optimum oral health among the inmates.

Keywords: Community periodontal index, jail inmates, loss of attachment


How to cite this article:
Vinnakota NR, Bommireddy VS, Pachava S, Ravoori S, Talluri D, Sanikommu S. Assessment of periodontal health among jail inmates of Guntur city Andhra Pradesh: A cross-sectional study. J NTR Univ Health Sci 2016;5:200-3

How to cite this URL:
Vinnakota NR, Bommireddy VS, Pachava S, Ravoori S, Talluri D, Sanikommu S. Assessment of periodontal health among jail inmates of Guntur city Andhra Pradesh: A cross-sectional study. J NTR Univ Health Sci [serial online] 2016 [cited 2019 Dec 14];5:200-3. Available from: http://www.jdrntruhs.org/text.asp?2016/5/3/200/191843


  Introduction Top


Oral health is an integral part of general health. Various factors are responsible for maintenance of good oral health. Socioeconomic status, occupation, education are playing major role in the maintenance of good oral health.[1] Prisoners are psychologically, socially, morally and economically affected group, which makes them to neglect their general, as well as oral health.[2] The dental health needs of prisoners differ from those of the general population, with a high number of emergency and urgent cases, increased levels of neglect of oral care amongst prisoners, high rates of substance misuse and smoking and underlying poor nutrition. There is a growing recognition that there is a direct link between oral health and other lifestyle-related diseases like heart disease. Several epidemiologic studies have examined the association between dental health status and the risk of cardiovascular disease.[3],[4] This understanding is of importance to health care providers and gives voice to the notion of a holistic integrated health care model.[4]

Few studies carried out in other parts of the world, in a prison setup, have observed that the oral hygiene status of the inmates is poor compared to the general population and there is a higher prevalence of periodontal diseases.[5],[6] This might be due to the lack of availability of oral hygiene devices and knowledge about maintenance of oral hygiene, which may lead to the increase of periodontal diseases among prisoners.

There are no studies done in India with regard to the periodontal health status of these corrective populations and hence the information regarding the periodontal status of prisoners is scant. An attempt has been done in the present study to assess the periodontal health status among the prisoners.


  Materials and Methods Top


Study design

A descriptive cross-sectional epidemiological study was designed and undertaken at district prison in Guntur city to assess the periodontal health status and loss of attachment (LOA) in accordance with their years of imprisonment. The study was done from 1st June to 31st July, 2014. The total prison population of the district prison was 180 (145 males, 35 females) with the age group of 18-65 years. Exclusion criteria included systemically unhealthy and uncooperative patients. However, all 180 prisoners were found eligible to include in the study. Ethical clearance to conduct the study was obtained from Ethical Review Board of Sibar Institute of Dental Sciences, Guntur. Informed consent was obtained from prisoners after the purpose of the study was clearly explained to them. Permission was obtained from the jail authorities.

The inmates were asked to sit comfortably on a chair in a well-ventilated room and clinical examination was carried out under natural light with a mouth mirror and a Community Periodontal Index and Treatment Needs-E probe. The examination was carried out by a single examiner and intra-examiner reliability was checked using test and retest method, which yielded good intra-examiner agreement (kappa value 0.8). The community periodontal index (CPI) and LOA from World Health Organization oral health assessment form (1997)[7] were recorded as per the requirement of the study.

Statistical analysis

Results were analyzed using SPSS software version 20 and Chi-square test was applied to test for significant differences between categorical variables. A statistical significant was inferred at P < 0.05.


  Results Top


[Table 1] shows the distribution of subjects according to their age and sex, 80.5% were males and 19.5% were females and majority of subjects 115 (68.3%) belong to 39-58 years age group.
Table 1: Distribution of study subjects according to age and sex

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[Table 2] shows the distribution of study subjects according to duration of imprisonment, majority of them were in the range of 2-4 years of imprisonment among them 77.7% were males and 22.3% were females and few belong to >6 years of imprisonment.
Table 2: Distribution of study subjects according to duration of imprisonment

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[Table 3] shows CPI of the study population according to duration of imprisonment. It was found that only 6.6% of the study subjects had healthy periodontium, and it was observed more 6 (50%) who were imprisoned for 2-4 years, bleeding was observed among 30.55% of total inmates and it was observed more 15 (27.2%) who were imprisoned for 1-2 years. Calculus was observed among 38.8% of total inmates, and it was observed more 25 (35.7%) who were imprisoned for 4-6 years. Pockets measuring 4-5 mm was observed among 15.5% of total inmates and it was observed 10 (35.7%) who were imprisoned for 2-4 years. Pockets measuring >6 mm were observed among 5% of total inmates, and it was observed more 4 (40%) who were imprisoned for >6 years. Among the total population, 2.7% were excluded. A significant difference in CPI scores (P < 0.05) were observed among the inmates with respect to the period of imprisonment (P = 0.002).
Table 3: Distribution of study subjects according to cpi scores and years of imprisonment

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[Table 4] shows distribution of LOA scores according to duration of imprisonment for period for 1-2 years showed 46.1% had no LOA and 28.5%, 25% had showed LOA of 6-8 mm and 4-5 mm respectively. Who were imprisoned for 2-4 years showed 19.2% had no LOA and 51.4%, 50% and 20% had showed LOA of 6-8 mm, 4-5 mm and >12 mm respectively. Who were imprisoned for 4-6 years showed 23% had no LOA and 33.3%, 26% had showed LOA of 9-12 mm, and >12 mm respectively. Who were imprisoned for >6 years showed 15.3% had no LOA and 53.3% and 40% had showed LOA of >12 mm and 9-12 mm, respectively There was highly statistically significant differences in LOA scores between the inmates imprisoned for different period of imprisonment (P = 0.005).
Table 4: Distribution of study subjects according to loss of attachment scores and years of imprisonment

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  Discussion Top


A cross-sectional descriptive epidemiological survey was conducted to assess the periodontal health status of inmates of District Jail, Guntur city, India. A total of 180 inmates were examined. In the present study, it was observed that the prevalence of periodontal diseases was 93.3%, but the studies conducted by by McGrath [8] and Clare [9] Anup et al.[1] Dayakar et al.[14] had shown higher prevalence rates than present study.

It was observed that among 38.8% of total inmates had calculus and similar results were obtained in the study conducted by Dayakar et al.[10] and dissimilar result was observed in the study conducted by Anup et al.[1] Reddy et al.[11] Kumar et al.[12] The probable reason for calculus formation might be that the jail authorities do not provide oral cleaning materials to the inmates. Therefore the inmates used finger and tooth paste/powder for cleaning their teeth.

Pockets measuring 4-5 mm was observed among 15.5% of total inmates and pockets measuring >6 mm were observed among 5% of total inmates, which was less when compared to study conducted by McGrath,[8] Anup et al.[1]

Periodontal assessment using CPI in prison inmates revealed nearly one sextant per individual demonstrated deep pocket, the findings of which are consistent with the national and regional averages reported among general population; National Oral Health Survey and Fluoride Mapping 2002-2003; Dental Council of India; India.[13]

In the present study, 46.1% had no LOA (0-3 mm) which was not in accordance to study conducted by McGrath,[8] Anup et al.,[1] Dayakar et al.[10] It was observed in the present study that as the duration of stay in jail increased LOA scores also increased. The probable reason for poor periodontal health might be associated with poor oral hygiene practices and lack of awareness among the prisoners.


  Conclusion Top


This survey conducted in central jail has clearly indicated that their periodontal health status is poor because of lack of knowledge on oral health care measures and accessibility to aids used in oral hygiene practices. Providing access to appropriate dental care for the underserved segments of the population is a challenge. Preventive measures to improve dental care and provision of dental health education are very much necessary to ensure optimum oral health among the inmates.

 
  References Top

1.
Anup N, Gautam B, Preeti V, Swasti T, Siddharth A, Himanshu K. Oral health status and treatment needs of inmates in district Jail of Jaipur City — A cross sectional study. Int Organ Sci Res J Nurs Health Sci 2014;3:22-31.  Back to cited text no. 1
    
2.
Prison Heath. Available from: http://www.prisons.tn.nic.in/history.htm. [Last accessed on 2014 Jan 20].  Back to cited text no. 2
    
3.
Mattila KJ, Nieminen MS, Valtonen VV, Rasi VP, Kesäniemi YA, Syrjälä SL, et al. Association between dental health and acute myocardial infarction. BMJ 1989;298:779-81.  Back to cited text no. 3
    
4.
Morrison HI, Ellison LF, Taylor GW. Periodontal disease and risk of fatal coronary heart and cerebrovascular diseases. J Cardiovasc Risk 1999;6:7-11.  Back to cited text no. 4
[PUBMED]    
5.
Osborn M, Butler T, Barnard PD. Oral health status of prison inmates — New South Wales, Australia. Aust Dent J 2003;48:34-8.  Back to cited text no. 5
[PUBMED]    
6.
Clare JH. Survey, comparison, and analysis of caries, periodontal pocket depth, and urgent treatment needs in a sample of adult felon admissions 1996. J Correct Health Care 1998;5:89-101.  Back to cited text no. 6
    
7.
WHO. Oral Health Surveys, Basicmethods. 4th ed. Geneva: WHO; 1997.  Back to cited text no. 7
    
8.
McGrath C. Oral health behind bars: A study of oral disease and its impact on the life quality of an older prison population. Gerodontology 2002;19:109-14.  Back to cited text no. 8
[PUBMED]    
9.
Clare JH. Dental Health status, unmet needs, and utilization of services in a cohort of adult felons at admission and after three years' incarceration. J Correct Health Care 2002;9:65-76.  Back to cited text no. 9
    
10.
Dayakar MM, Shivprasad D, Pai PG. Assessment of periodontal health status among prison inmates: A cross-sectional survey. J Indian Soc Periodontol 2014;18:74-7.  Back to cited text no. 10
[PUBMED]  Medknow Journal  
11.
Reddy V, Kondareddy CV, Siddanna S, Manjunath M. A survey on oral health status and treatment needs of life-imprisoned inmates in central jails of Karnataka, India. Int Dent J 2012;62:27-32.  Back to cited text no. 11
[PUBMED]    
12.
Kumar SM, Fareed N, Shanthi M, Sudhir KM. Oral health status and treatment needs amongst prison inmates of Nellore District in Andhra Pradesh. J Indian Assoc Public Health Dent 2011;18:1-4.  Back to cited text no. 12
    
13.
Bali RK, Mathur VB, Talwar PP, Chanana HB. National Oral Health Survey and Fluoride Mapping 2002-03, India.  Back to cited text no. 13
    
14.
Dayakar MM, Shivprasad D, Pai PG. Assessment of periodontal health status among prison inmates: A cross-sectional survey. J Indian Soc Periodontol 2014;18:74-7.  Back to cited text no. 14
[PUBMED]  Medknow Journal  



 
 
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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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