Oral Health Status of Pregnant and Non Pregnant Women

Oral Health Status of Pregnant and Non Pregnant Women â€Å"ORAL HEALTH STATUS AMONG PREGNANT AND NONPREGNANT WOMEN OF AGRA CITY A HOSPITAL BASED STUDY† ABSTRACT INTRODUCTION Pregnancy is often thought to be a time of happiness for the expectant mothers but it does not only influence her own oral health status but also may increase her risk of other diseases. OBJECTIVE To compare the oral health status among pregnant and nonpregnant women of Agra city. MATRIALS AND METHOD A cross sectional study was carried out among 425 pregnant and 425 nonpregnant women of 18-45 years attending the hospital. A pretested proforma designed in local language for collecting all the relevant information was used which included questions regarding personal information, oral hygiene practices, frequency of dental visits, education, occupation, gravid status along with a self-reported oral health status questions. The investigator was calibrated before the start of the study in order to limit the intra-examiner variability. RESULTS A total of 850 subjects with a mean age of 29.30 ±3.30 years were examined. The mean DMFT was found to be 3.02 ±1.79 and 1.79 ±1.90 in pregnant and nonpregnant respectively. CONCLUSION The results of this study showed that pregnancy had effect on the gingiva and on periodontal attachment levels. Overall oral health was poorer among pregnant women than nonpregnant women. KEY WORDS Gravid status, Oral Health Status, Oral hygiene. INTRODUCTION Pregnancy brings about physical, physiological and psychological changes in women. It affects almost all systems and parts of the body including the oral cavity. Due to changes in the hormones, many opportunistic organisms gain access to various parts of the body in the absence of proper care1. Pregnancy constitutes a special physiological state characterized by a series of temporary adaptive changes in body structure, as a result of an increased production of estrogen, progestron, gonadotropins and relaxin among other hormones. The oral cavity is also affected by such endocrine actions and may present both transient and irreversible changes as well as modifications that are considered pathological2. Pregnancy related oral changes are most marked and frequent in gingival tissue. Gingival inflammation and pregnancy have now been linked for many years; as early as 1978, Vermeeran discussed â€Å"toothpains† in Pregnancy. In 1818, Pitcarin described gingival hyperplasia in pregnancy3. Pinard first described this situation in 1877 characterized with erythema, hyperplasia and increased bleeding4. Women’s pregnancy experience not only influences her own oral health status but also may increase her risk of other diseases. High levels of oral diseases may also have an impact on the Oral Health Related Quality of Life. Although some studies on pregnant women have been reported, they have been limited to exploring the impact of certain factors, such as pain, on the Oral Health Related Quality of Life4. Pregnancy gingivitis marked by the gingival inflammation is the most common condition seen during the pregnancy due to hormonal changes particularly during the second trimester of gestation. The signs and symptoms of pregnancy gingivitis, however do not differ from the gingivitis seen in non pregnant women5. It has been noted that the gingivitis in pregnancy is related to the accumulation of dental plaque and maintenance of proper oral hygiene in pregnant women can play an important role in preventing this condition and maintaining a healthy gingival state6. There is a growing acceptance of the fact that oral disorders too can have a significant impact on physical, social and mental well-being during pregnancy. No study has been conducted on Oral Health Related Status of pregnant and non pregnant women in Agra city. Keeping the above facts in mind, an attempt was made to carry out a comparative hospital based study on Oral Health Status of pregnant and nonpregnant women attending selected hospitals in Agra city. MATERIALS AND METHOD A cross sectional study was carried out among 425 pregnant and 425 nonpregnant women of 18-45 years attending the hospital. A pilot study was conducted on 100 (n=50) pregnant and nonpregnant women each with OHRQoL as a main parameter. The prevalence of Oral Impact on Daily Performance was 76%. The estimated sample size for the study based on prevalence of Oral Impact on Daily Performance was calculated to be 827. Keeping in mind the non-response rate in each hospital, sample size of 850 subjects was taken. To obtain the total sample size of 850, 85 pregnant and 85 nonpregnant women from each of the five zone were randomly selected. INCLUSION CRITERA Subjects reporting in the hospitals Subjects willing to participate in the study. Subjects of 18-45 years age group. EXCLUSION CRITERIA Subjects suffering from any systemic disease Subjects in critical condition. Ethical clearance for the study was obtained by the Ethical Committee of K.D. Dental College and Hospital, Mathura. Also informed consent was taken from the women prior to the examination. A pretested Questionnaire and proforma designed in local language for collecting all the required and relevant information was used. The questionnaire included questions regarding name, age, socioeconomic status, oral hygiene practices, frequency of dental visits, education, occupation, gravid status along with a self-reported oral health status questions. Clinical examination included Oral Hygiene Index-Simplified (OHI-S), Gingival Index, Community Periodontal Index and DMFT/DMFS. Oral examination was done using mouth mirror, probe and natural light. Self-reported oral health status was assessed by asking eight questions that collected information about periodontal health and dental health. The eight questions were: Do you have bleeding gums?; burning gums?; swollen gums?; loose teeth?; decayed teeth?; tooth pain?; food lodgment between teeth?; sensitive teeth?. These questions were dichotomized into present and absent. The data obtained was compiled systematically from a pre-coded proforma in computer and a master table was prepared. The statistical analysis was done using SPSS version 16.0 Statistical Analysis Software. Results on continuous measurement were presented in Mean ±SD (Min-Max) and results on categorical measurements were presented in Number (%). Significance was assessed at 5% level of significance. RESULTS A total of 850 study subjects were selected out of which 61(7.17%) were of the age group 20-25 years with mean age observed 29.30 ±3.30. Among pregnant women, 204(48%) had poor OHI-S scores(Table.1), 198(46.58%) had moderate gingivitis(Table.2), 61(14.35%) had CPI score 4 (Table.3) and 37(8.71%) had LOA score 2 (Table.4). The mean number of decayed, missing and filled teeth were 3.42 ±2.66, 2.91 ±2.01 and 3.01 ±1.98 respectively among pregnant group. The mean scores for self reported oral health status, among pregnant group was 64.38 ±5.59 for decayed teeth and among nonpregnant group was 65.81 ±5.36 for burning gums (Table.5). TABLE.1 DISTRIBUTION OF STUDY SUBJECTS ACCORDING TO OHI-S SCORES AMONG PREGNANT AND NONPREGNANT GROUP TABLE.2 DISTRIBUTION OF STUDY SUBJECTS ACCORDING TO GINGIVAL INDEX SCORES AMONG PREGNANT AND NONPREGNANT GROUP TABLE. 3 DISTRIBUTION OF STUDY SUBJECTS ACCORDING TO CPI SCORES AMONG PREGNANT AND NONPREGNANT GROUP TABLE. 4 DISTRIBUTION OF STUDY SUBJECTS ACCORDING TO LOA SCORES AMONG PREGNANT AND NONPREGNANT GROUP TABLE 5: DISTRIBUTION OF STUDY SUBJECTS ACCORDING TO SELF- REPORTED ORAL HEALTH STATUS AMONG PREGNANT AND NONPREGNANT GROUP DISCUSSION In our study, out of the total study population of 850 pregnant and nonpregnant women, 359(42.23%) women were below the age of 30 years, which was in accordance to the studies conducted by Ingrida Vasiliauskiene et al7 and Gaffeid M et al8. On the contrary, in the study conducted by Nuamah and Annan9 20% of pregnant women and 21.4% of nonpregnant group belonged to the age group of 30-35 years. In the present study, among the total study population, 29.30 ±3.30 was the mean age. The results of our study were similar to the study conducted by Machuca et al10, in which the mean age was 30.1 ±1.90. On the contrary, studies conducted by Yalcin et al11 and Tilakarante et al12 showed the mean age pattern of 18.62 ±3.01 and 19 ±2.90 respectively. Among pregnant population 204(48%) had poor oral hygiene. On the contrary, in the study conducted by Santosh Kumar et al13 among total study population only 25% had poor oral hygiene. In our study, among the total study subjects, mean OHI-S score was 2.65 ±0.85. On the contrary, in the study conducted by Ingrida Vasiliauskiene et al7 mean OHI-S score among total study subjects was 1.79 ±1.13. The reason behind this is that during pregnancy, gums are more susceptible to the damaging effects of plaque, gingiva become more edematous and fragile due to which during brushing it bleeds quickly. The problem is compounded if women hav e morning sickness nausea and vomiting which make it hard to brush teeth regularly resulting in more plaque accumulation. Among pregnant group, about half of the total study subjects i.e 46.58% had moderate gingivitis. Results of our study were similar to the studies conducted by Yalcin et al11 and Tilakarante et al12. In our study, among the total study subjects, it was found that 98(11.52%) had healthy periodontium On the contrary, studies conducted by Santosh Kumar et al13 and Ingrida Vasiliauskiene et al7 found that approximately half of the total study population i.e 49.8% had healthy periodontium whereas, among pregnant group 36.6% and among nonpregnant group 61% had healthy periodontium. While the study conducted by Miyazaki et al14 stated that 82% of the pregnant study population had 4 or 5mm pocket which is much higher in comparison to our study. In our study, the mean scores among pregnant group and non pregnant group was 64.38 ±5.59 for decayed teeth and 65.81 ±5.36 for burning gums respectively. No earlier studies have been carried out that show distribution of study subjects according to self- reported oral health status among pregnant and non pregnant groups. In conclusion, results of the study showed that oral health status among pregnant and nonpregnant group of Agra city was not good. The study also drew attention towards the need for highlighting the importance of maintaining oral health during pregnancy. Regular dental care is a key component to good oral and general health. It can be stated that there is a need for the health care professionals to acknowledge the importance of good oral health in ensuring a safe and successful pregnancy and overcome misconceptions regarding rendering of essential dental care during this vital period in a woman’s life. REFERENCES Shashidhar Acharya and Parvati V. Bhat. Oral health related quality of life during pregnancy. American Association of Public Health Dentistry 2009;69:7477. Tracy M. Dellinger and H. Mark Livingston. Pregnancy:physiologic changes and considerations for dental patients. British Journal of Obstetric and Gynaecology 2006;5:677-697. Ojanotko-Harri AO, Harri M.P, Hurltia H.M and Sewon L.A. Altered tissue metabolism of progesterone in pregnancy gingivitis and granuloma. Journal of Clinical Periodontalogy 1991;18:262-266. Steinberg B.J. Woman’s oral health issues. Journal of Dental Education 1999;63:271-275. Miyagi M., Aoyama H., Moroshita M and Iwamoto Y. Effects of sex hormones on chemotaxis of human peripheral polymorphonuclear leukocytes and monocytes. Journal of Clinical Periodontology 1992;63:2832. Laine M.A. Effect of pregnancy on periodontal and dental health. Acta Odontologica Scandinavica Journal 2002;60:257-264. Ingrida Vasiliauskiene. Oral health status of pregnant women. Stomatologia, Baltic Dental and Maxillofacial Journal 2003;5:57-61. Gaffield M., Brenda J.,Gilbert C., Malvitz D.M. and Romaguera R. Oral Health during Pregnancy. Journal of American Dental Association 200;132:189-194. Nuamah I and Annan B.D. Periodontal status and oral hygiene practices of pregnant and non-pregnant women. East African Medical Journal 1998;75:712–714. Machuca G., Khoshfeiz O., Lacalle R.J., Machuca C. and Bullon P. The influence of general health and socio – cultural variables on the periodontal condition of pregnant women. Journal of Clinical Periodontology 1999;70:779–785. Yalcin F., Eskinazi E., Soydinc M., Basegmez C., Issever H. and Isik G. The effect of socio cultural effects on periodontal condition in pregnancy. Journal of Clinical Periodontology 2002;74:178-182. Tilakaratne A., Soory M., Ranasinghe AW., Corea SMX., Ekanayake S L. and Desilva M. Periodontal disease status during pregnancy and 3 months post partum, in a rural population of Sri-Lankan women. Journal of Clinical Periodontalogy 2000;27:787-792. Santosh Kumar Tadakamadla, Prachi Agarwal and Preksha Jain. Dental status and its socio-demographic influences among pregnant women attending a maternity hospital in India. Journal of Clinical Express in Dentistry 2007;3:183-192. Miyazaki H, Yamashita Y and Shirahama R. Periodontal conditions of pregnant women assessed by CPITN. Journal of Clinical Periodontology 1991:18:751-4. Manau C, Echeverria A, Agueda A, Guerrero A and Echeverria JJ. Periodontal disease definition may determine the association between periodontitis and pregnancy outcomes. Journal of Clinical Periodontology 2008; 35: 385-397. Navin Anand Ingle, Akila Ganesh, Preetha Elizabeth Chaley and V. Chandrasekhara Reddy. A survey on dental knowledge and gingival health of pregnant women attending government maternity hospital, Chennai. Journal of Oral Health and Community Dentistry 2011;5:24-30.

Oxygen :: essays research papers

Oxygen content of air Objective: To measure the percent of oxygen in air and the percent of oxygen in an exhale of a breath Hypothesis: Air has more oxygen content in it rather than the exhale of a human breath. Procedure: Wash hands to remove oils Obtain 2 samples of steel wool (.7g each) Expose one sample of the wool to 35mL of vinegar solution for 1 minute Remove the wool from the solution and shake it to remove the vinegar Place the steel wool in a syringe. Put the plunger in the syringe at the 28mL mark Place the syringe a 250mL beaker that is slightly filled with water Pull the plunger until the water reaches the 0mL mark Record observations every three minutes of the water level Fill a balloon with the exhale from breath Put 100mL of water in the balloon and shake for 5 minutes Place the other sample of steel wool in another 35mL vinegar solution for one minute and clean it Put the steel wool in another syringe and then release the air from the balloon into the syringe Repeat steps 6 - 9 with this syringe. Data and observations: (THE GRAPH WILL GO HERE!!!!!) Conclusion: The oxygen combined with the steel wool in both syringes. This is apparent because rust was formed on both samples. The water came up to the 5.5mL mark on the syringe with the air in it, while the syringe with the breath only reached 4.5mL. Therefore, concluding that the oxygen content of air is higher than the oxygen content in a human breath. Albertson’s Brand Condensed Chicken Noodle Soup has many different ingredients within the steel container. These ingredients are as follows: Water, enriched egg noodles (enriched wheat flour [niacin, ferrous sulfate, thiamine mononitrate, riboflavin, folic acid] , eggs) chicken, salt, modified corn starch, chicken fat, dextrose, soybean oil, monosodium glutamate, soy protein isolate, natural flavoring, garlic powder, beta carbonate, sodium phosphate, paprika, and onion concentrate.   Ã‚  Ã‚  Ã‚  Ã‚  Thiamine mononitrate, also known as Vitamin B, is a white crystalline powder. It has a positive reaction. The Chemical formula is C12H17N5O4S. â€Å"Thiamine Mononitrate is stable for at least 36 months when stored in the unopened container. It is stable in acid solutions at a pH less than 4.0 but deteriorates rapidly in neutral or alkaline solutions, especially when exposed to air. Moisture and contact with metal accelerates oxidation and reduction.

The Economizing Problem

These Short Essays are partial fulfillment of Paper IE1001 of Part 1 of Certified Islamic Finance Professional (CIFP) [DRAFT V0. 4] INCEIFStudent Name: Mustafa AydemirStudent ID: 1200279 IE1001Assignment in Islamic Economics – Short Essay No 1 by Mustafa Aydemir – Version 0. 4. doc -1- Bismillahirrahmanirrahim The economizing problem – And its direct effect on the economy at large. A short essay from Islamic perspective by Mustafa Aydemir Human beings are greedy by nature and their needs are universally recognized as infinite.A simple prove for this statement is the wish of every person to live forever. The unlimited wants are the main reason that resources are considered insufficient or scarce. This is probably the strongest argument and a good justification to define an entire field of study to explain and solve the resulting economizing problem between unlimited needs versus limited resources. â€Å"Economics is the social science that studies the allocation of scarce resources to satisfy unlimited wants† (INCEIF Lecture Notes1), It is divided into Macro- and Microeconomics.The former is the field of economics that studies the behavior of the economy as a whole, and not just on a singular company, but entire industry sector and markets. Whereas, the latter focuses on supply and demand as well as other forces that determine the price levels seen in the economy. The previous section described the economizing problem, that is the relation between the scarcities or resources relative to ‘needs and wants’. People are self-interested economic agents that maximize their own utility by using goods and services (Williamson, 1985)2.In the capitalistic worldview, people are rational in their choices and would for example prefer a job paying 3000 USD salary over a job with a 1500 USD pay. The individual is looking after his own well-being, which is likely to increase by taking the higher income employment. 1 Title: Overview On Ec onomics; Class: Islamic Economics [IE1001]; Prof: Dr. Magda Ismail Abdel Mohsin; Institution: INCEIF; Date: 8/16/2006 # Of Pages: 28 2 The Economic Institutions Of Capitalism; Firms, Markets, Relational Contracting; Oliver E.Williamson; Yale University IE1001 Assignment in Islamic Economics – Short Essay No 1 by Mustafa Aydemir – Version 0. 4. doc -2- However, the well-being of all people needs to be guaranteed, which is well noted by theological, human and western researchers and recognized by all civilizations in the present and the past (Chapra, 1995)3. With the assumption that resources are limited, the well-being of the entire human race may remain just a dream if the scarce resources are not utilized efficiently and rightfully. In order to achieve this vision, societies develop effective strategies that can be considered as worldviews.For the sake of simplicity the (1) secular and the (2) religious worldviews are the only two that are subject to this essay. The s ecular worldview emphasis the importance of material aspects of well-being and disregards the religious aspect completely. The secularist argue that ‘maximum material’ well-being can be best realized if economic agents are given freedom to actualize their self-interest whatever it may be with regards to taste and preference and the guidance of God in any form is replaced by the help of human reasoning.Moreover, in this liberal view of secularism neither values nor government intervention can play a major role in the fair distribution of resources to achieve the well-being of all people. The liberal view has not succeeded and was overthrown nearly everywhere (Mirakhor, 2012)4. The need of people for social well-being is vital to the happiness of a human being. However, the secular worldview refers to market forces that would ensure social interests because competition will keep self-interest (that may lead to exaggerated greed) under control. 3 4 Chapra, M. Umer. (1995). Islam and the economic challenge.Leicester, U. K. : Islamic Foundation Abbas Mirakhor (2012).Lecture: Macroeconomic Policies & Islamic Finance. Kuala Lumpur, Malaysia: INCEIF IE1001 Assignment in Islamic Economics – Short Essay No 1 by Mustafa Aydemir – Version 0. 4. doc -3- In contrary to the secular or capitalist worldview stands the religious or spiritual worldview. It gives tribute and attention to both the spiritual as well as the material aspects of human wellbeing. In fact, the spiritual worldview does not necessarily reject logical reasoning in human improvement, individual freedom or self-interest (Chapra, 1995).This worldview, however, highlights that moral values and good governance are required as restraining factors for freedom and self-interest in the journey of a reaching a civilization where well-being in ensured to all people and to achieve social harmony and family integrity. The direct effects of the economizing problem to a nations wealth are manif old. Well after capitalism had been established in medieval Europe and the west, its consequences in terms of unemployment and mal-distribution of income and wealth became painfully evident (Haferkamp and Smelser, 1992).Market cycles are considered part of an economy and crisis are accepted as unavoidable. The market itself is the overarching governance frame that determines prices through supply and demand and overrules the social interest of human beings. It is like an autocratic dictator without mercy that supports the rich and the powerful and penalizes the poor and the needy people. Consequently, societies began overtime to assign an increasingly expansive role to the government to correct the shortcomings of capitalism (market capitalism) with billion or even trillion dollar bailout packages for so called ‘to-big-to-fail’ institutions.All paid with tax money. Simultaneously however a contrary view developed objecting to the governments’ involvement in the e conomy on efficiency ground. Anyhow, even after the massive global financial crisis in 2007/2008 the high net-worth individuals are better off (see 5 Haferkamp, H. , & Smelser, N. J. (Eds. ). (1992). Social change and modernity. Berkeley: University of California Press. IE1001 Assignment in Islamic Economics – Short Essay No 1 by Mustafa Aydemir – Version 0. 4. doc -4-Forbes Magazine6) and have more wealth than the middle class and low-income classes, likely due to cost cutting and austerity measures for companies and governments alike. The Islamic economic system is unique and provides a divine solution to the economizing problem this essay has elaborated thus far. It starts with the scarcity of resources that illustrates the issue quite clear. If we assume that resources are available in abundance (INCEIF Lecture Notes7) rather than limited, the paradigm shifts dramatically from strategies to accumulate wealth to strategies of wealth distribution.Wealth in Islam can be distributed by Zakah and Sadaqah but also by introducing a risk-sharing model into the financial system to replace it with interest (Askari, Iqbal, Krichene and Mirakhor, 2011)8. Islam recognizes differences in human potentials because each person is gifted with different skillsets and depth of abilities. Human beings are not identical is proof that no two individuals have identical capabilities. This differences will bring income and wealth inequalities in societies (Chapra, 1992)9. Furthermore, the self-interest and rational human aspects are fully endorsed but to a different end.Choices however are enhanced by ethical values and rules. Consider for example Islamic teachings where there is a sense of duty and obligation to follow rules of behavior and be in full compliance with them, often there are also some ends in view like Jannah (Paradise), the total well-being of society or approval and satisfaction of Allah. Even Allah’s love and mercy or fear of hell are motivato rs of a self-interested spiritual person. To the extent that ends is gaining strength over 6 7 The Worlds Billionaires List http://www. forbes. com/billionaires/ Retrieved on November 12, 2012Title: Overview On Economics; Class: Islamic Economics [IE1001]; Prof: Dr. Magda Ismail Abdel Mohsin; Institution: INCEIF; Date: 8/16/2006 # Of Pages: 28 8 Hossein Askari, Zamir Iqbal, Noureddine Krichene and Mirakhor (2011) Risk-sharing in Finance: The Islamic Finance Alternative; Singapore: John Wiley & Sons 9 Chapra M (1992). â€Å"Islam and the Economic Challenge†, The Islamic Foundation and International Institute of Islamic Thought, London and Herndon. IE1001 Assignment in Islamic Economics – Short Essay No 1 by Mustafa Aydemir – Version 0. 4. doc -5- the obligation and duty.Muslims may think of consequences in the hereafter more than over what was to be material well-being in this world. The position of Quran is in the first instance decoupling of actions from conseq uences, actions are done as a sense of duty to do what Allah teala and his beloved Messenger have ordered. At the same time, however, the Quran itself repeatedly emphasizes the desirable and undesirable consequences of actions (Lecture Notes Prof Mirakhor, 2012)10. In conclusion, Ibadah is the justification for rules. If one adores almighty Allah swt, one does what the creator orders.Hence, peoples unlimited wants are recognized and mentioned in the Quranic verse And ye love wealth with inordinate love: (al-Fajr 89:20)    and following hadith: Narrated Ibn ‘Abbas and Anas bin Malik: Allah’s Messenger said, â€Å"If a son of man had a valley full of gold, he would desire to have two. Nothing can fill his mouth except the earth (of the grave). Allah turns with mercy to him who turns to Him in repentance. †(Al-Bukhari and Muslim) That is why it may seem that Islamic economic system is probably the strongest alternative to greed and unfair markets that have led the world from crisis to crises. At least it is worth a try in the advanced economies. 10 Abbas Mirakhor (2012).Lecture: Macroeconomic Policies & Islamic Finance. Kuala Lumpur, Malaysia: INCEIF IE1001 Assignment in Islamic Economics – Short Essay No 1 by Mustafa Aydemir – Version 0. 4. doc -6

5 Worksheets for Calculating Mean Averages