Investigation And Analysis Between Oral Hygiene Behaviors And Periodontal Diseases And Dental Caries Among The Troops Located At Different Altitudes

Objective:Periodontal diseases and dental caries are two common diseases to affect people's oral health for the high incidence and serious damages. Periodontal disease can cause gingivitis, periodontal tissue damage and alveolar bone absorption, even leading to teeth loss. Dental caries destroy odontal tissue, gradually induce dental cavity, residual crown and root base, even causes missing teeth. It is reported that more than 80% of tooth loss is caused by periodontal disease and dental caries, which can affect people at every age range and harm the health of whole body. So how to prevent and cure periodontal disease and dental caries has become a research focus of stomatology. China has the largest area of plateau and the largest population of plateau residents in the world. Plateau, mainly located in border of the country, takes 1/6 of land and is very important in strategic development of China. The garrison troops spread all over different altitudes. According to the records, for all military troops in tibet, 40.96% of teeth extraction is due to periodontal disease, 38.53% due to dental caries. Therefore, periodontal disease and dental caries are the major reasons of tooth depression and extraction for military personnel. Furthermore, the pathogenic bacteria can be transferred to other organs of human body with blood flow, resulting in systemic diseases such as angiocardiopathy, diabetes mellitus and pneumonia. In plateau, oxygen defficiency, cold and low pressure may cause chronic and acute damage to many organs. Does this damage increase the risk of periodontal disease and dental caries or harsh environment and lack of hardship medical care induce the diseases or both contribute. There is no a clear definition yet according to current researches. We made a survey on the oral health behaviors and incidences of oral diseases among the sodiers positioned at different altitudes of plateau in order to investigate the overal condition of oral hygiene of troops and propose the effective measures for preventing and curing periodontal disease and dental caries. We surveyed the sodiers at the altitudes of 2900 m, 3700 m and 4500 m and recorded their index of gingival bleeding, calculus dentalis, the pocket depth, attachment loss and decay missing filling, and analysed the influence of altitudes, service time on the occurrence of these two diseases, so as to give references for the further systematic plan on prevention and treatment of periodontal disease and dental caries in the plateau。Methods:1. Based on The Third National Oral Health Investigation Criteria and oral questionnaire of the Fourth Military Medical University, we designed the questionaire of this study. Then all the examiners received a professional training course and a standard consistency checking. According to the distribution of troops at different altitudes, with methods of stratified and simple random sampling, 1300 male sodiers were invloved, including 100 people in plain,400 at the each altitude of 2900±100 m, 3700±100 m and 4600±100 m, respectively.2. From June 2006 to November 2006, in coordination with the General Hospital of Tibet Military Command and the 18th Hospital of PLA, we investigate the sodiers positioned in YeCheng of XinJiang, Linzhi, Naqu and Rikaze in Tibet on their oral care behaviors and indexes of gingival bleeding, calculus dentalis, pocket depth, attachment loss and decay missing filling.3. After the survey of cross-sectional study, we established a recording template with software Epi-Info 2002, then input the data and analysed them with SPSS 13.0.Results:1. The results shows that the soldiers in plateau knew little about the harm of smoking, the right way to clean teeth, the use of fluoride toothpaste, correlation of brushing teeth and gingival bleeding, how to handle with toothache, the assessment of oral health, dental diseases and oral health care. It is necessary to promote the campaign of oral health and raise the soldiers'awareness of teeth protection.2. The data on pocket depth and attachment loss of troops at different altitude were analysed. There is no statistical difference (P<0.05) between plain group and 1-year groups (including 2900 m Group, 4500 m Group, 3700 m Group and 4500 m Group). Significant difference was observed between plain group and groups at 2-4 years, 5-9 years, and over 10 years. All data indicated that pocket depth and attachment loss were increased with the increase of altitude and service time of troops.3. Among the 1300 male sodiers who finished the survey, the morbilities of dental caries were 44.00% in plain, 42.25% at 2900m, 44.25% at 3700m and 48.75% at 4500m, respectively. The average caries were 1.48, 1.46, 1.54 and 1.58, respectively. Statistic analysis demonstrated that significant difference was observed on DMFT between 2900 m Group and 4500 m Group, 3700 m Group and 4500 m Group and on teeth loss between plain group and 3700 m Group, between 3700 m Group and 4500 m Group.Conclusion;1. The soldiers in plateau do not have enough awareness on teeth protection and lack of knowledge on health care. We should promote the oral health campaign for maintaining the oral health of soldiers and preventing oral diseases.2. The occurrence of periodontal disease for soldier in plateau remains high. We should improve the education on health care among all sodiers and train military dental practitioners.3. There is a high prevalence of tooth missing because of dental caries among the soldiers at high altitudes. It is suggested that the oral health education on dental caries and early prevention be pupolarized among soldiers in plateau.