The Journal
91.2 % of the subjects having periodontal disease had dental caries while 100 % subjects had dental caries in the absence of periodontal disease . 90 % of the subjects with mild PD , 89 % with moderate and 94 % with severe PD had dental caries ( Table 1 , Graph 1 ). Accordingly , persons having severe periodontal disease had more dental caries compared with mild periodontal disease . Though dental caries was seen in all the age groups , percentage of subjects with dental caries were maximum in the highest age group . With age above 65 years , dental caries were prevalent in 20 %, 10 % and 70 % of mild , moderate and severe periodontitis subjects ( Table 1 ).
Discussion
In the present study , 400 subjects were included ( 64 % males and 36 % females ) with a mean age of 37 years . It was found that 85.6 % of the subjects amongst total study population were suffering from periodontal disease . The prevalence distribution observed for mild , moderate and severe periodontitis was 32.8 %, 19.8 % and 33 % respectively and male subjects had greater prevalence than females in all categories ( 37.9 % females and 62.1 % males had mild , 30.4 % females and 70 % males had moderate and 35.1 % females and 64.9 % males had severe periodontal disease respectively ). The prevalence of periodontal disease in the many earlier investigations in different background settings ranged from 27-99 %.[ 12- 20 ] The findings about the prevalence of periodontal disease in present study population are in line with the earlier studies conducted . Accumulation of dental plaque on teeth is the primary factor in initiating inflammation in adjacent gingival .[ 21 ] Increased flow and altered composition of gingival crevicular fluid in long standing cases of gingival disease , provides a competitive advantage to the periopathogenic bacteria , including P . gingivalis , over other commensal bacteria and leads to progression of periodontal disease .[ 22 ] Evidence suggests that the presence of
periodontal pathogens , though necessary to cause disease , may not be always sufficient to cause the disease , a susceptible host is necessary . Several factors have been shown to modulate the clinical expression of gingival inflammation in response to plaque accumulation . Apart from genetic factors , several acquired or environmental factors , have been strongly implicated . Smoking and diabetes are recognized as the two major players in this regard .[ 23 , 24 ] The overall prevalence of dental caries in the present study was 92.5 % and its intergroup distribution was 90.2 % in mild periodontitis , 88.6 % in moderate periodontitis , 93.9 % in severe periodontitis group respectively . The maximum number of caries were prevalent in younger age group ( 25- 34 yrs ). These findings were much higher in males ( 134 females had caries and 236 males had caries ). The prevalence of dental caries in the present investigation is in line with previous studies which reported ranging from 31 % - 94 %.[ 20 , 25-31 ] Multifactorial etiology of dental caries , including environmental and host factors along with the prime factors microbes , could be responsible for the variable results by different studies as different set of factors may have contributed to the clinical manifestations ( carious lesion ) in different study populations . Dental caries is a chronic bacterial disease , that causes demineralization and destruction of the hard tissues , usually by production of acid by bacterial fermentation of the food debris accumulated on the tooth surface .[ 32 ] Streptococcus mutans is the prime species responsible for caries initiation and bacteria of the genus M21 M24 M22 . Lactobacillus are important in further caries development , especially in the dentin .[ 32 ] The development of the caries lesion is conditioned by the carbohydrates supply frequency , mainly sucrose and glucose from food , sometimes impact of cariogenic factors , as well as the tooth surface susceptibility , quantity and quality of the saliva , and the time for which fermentable dietary carbohydrates are available for bacterial fermentation .[ 33 ]
17 Vol . 12 No . 23 May-August Sept-Dec 2016