The effects of scaling and oral hygiene education on the periodontal status of factory workers in Kenya

Abstract

This study was designed to determine the effects of scaling and of oral hygiene educ et i on COHE) on the periodontal status of a group of 101 factory workers. 101 male factory workers aged between 30-50 years were selected from 2 mill ing f ect ori es in the Neirobi ' s industria I area. These workerswere first subjected to a baseline examination after which they were randomly assigned to 4 intervention groups. The treatments were carried out three months after the baseline examination. Group 1, received scaling alone, group 2, scaling combined with UHE, group 3 OHE alone and group 4 received no treatment at all. A final examination was carried out 6 months following treatment. There were no differences among the groups at baseline. For the final examination, there were statistically significant differences among the groups in: plaque score 2CF=4.24; P=O.OOB), gingivitis score 0(F=3.31; P=O.0246), supragingival calculus (F=3.6B; P=O.015B), subgingival calculus (F=41.4B; P=O.OOOl) and pocket depth (F=2.B7; P=0.042). An analysis of the changes that occurred within each group between the baseline and final examination indicated that there was a significant increase in the number of plaque free sites in all the treatment groups, p<O.OOl, p<0.01, p<0.01, and p<O.05 for

groups 1,2,3, and 4 respectively. The number of ce lcu lu s free ites increased significantly, p<O.OOl in both groups 1 and 2. This was mainly due to a decrease in the number of sites with ubgingival calculus. These decreased significantly (p<O,OOl) in these groups, while in the groups that did not receive scaling i.e groups 3 and 4 the number of sites with subgingival calculus increased significantly (p<O.Ol and 0.05 respectively), The number ot sites with supragingival calculus decreased significantly (p<n.Ol) only in group 1. A significant increase in the number of gingivitis free sites was observed in group 1 (p<O.OOI) and group 2 (p<O.OI). Groups I and 2 demonstrated a significant increase in the number of shallow pockets (p<O.OI, p<O.OI respectively) and a decrease in the number of deep pockets (p<O.OI, p<O.OS respectively). In all the groups, the number of sites with attachment loss 0 mm increased significantly (p<O.OOI in all the groups) while the number of sites with attachment loss 1-3 mm decreased significantly (p<O.OOl for all the groups). However. the number of sites with attachment loss 14 mm showed a significant decrease (p<O.OS) in group 2 only. The effect of scaling was determined by comparing the "scaled" group (group 1+2) with the "non scaled" group (group 3+4). For plaque, scaling was found to have a significant effect (p<O.OS) on plaque score 2 only. It had no effect on the number of plaque free sites (score 0). Scaling was found to significantly

(p<O.OOOI) increase the number of calculus free sites. This was round mainly attributed to a decrease in the number of sites wi th subgingival calculus (p<O.OOOl). Scaling did not have a significant effect on the supragingival calculus. Scaling was associated with a significant increase (p<O.003) in the number ot gingivitis free sites. Scaling also caused a significant reduction (p=O.05) in the number of deep pockets. Following scaling, the number of sites with attachment loss 0 mm increased significantly (p=O.Ol) while the number of sites with attachment loss 1-3 mm and 14 mm decreased significantly (p=O.035 and p=O.021 respectively), In this study, scaling was found to improve all the periodontal parameters except for plaque. Scaling resulted in a limited improvement on the pocket depth and attachment level. The greatest effect of scaling was limited to the subgingival calculus. Scaling produced a significant reduction in the number of bleeding sites. OHE was not effective in this study. A combination of scaling and OHE did not offer any significant advantage over scaling alone. Although scaling was associated with a statistically significant improvement in periodontal status over a six month period study, some deterioration was observed to have occurred after treatment on the supragingival calculus. Due to the poor plaque controlled in the scaled group, it is possible that a deterioration may have

occurred in the other periodontal parameters. This would not have been detectable in this study since it had only one posttreatment examination. Before scaling can be recommended as a method of treating periodontal disease in the community, better methods of controlling plaque should be sought. AIso a longer study with more post-treatment examinations should be carried out to determine the effects of scaling on the progression of the disease.