ORAL HEALTH RELATED QUALITY OF LIFE

ABSTRACT

The aim of the study was to determine the oral health status and oral health impacts among UPNM first year cadets. The objectives of this study were; (1) to assess the perceived oral health status, satisfaction with oral health and perceived need for treatment among first year cadets in UPNM, (2) to assess their level of caries (DMFS), (3) to assess their level of periodontal disease (CPI) and (4) to assess the oral health impact of oral diseases in the group by using the Oral Health Impact Profile (OHIP). This is a cross-sectional survey of the UPNM first year cadets where data was obtained through oral examination (DMFS and CPI) and self administered questionnaire survey (about demographic, perceived oral health, satisfaction with oral health, perceived treatment need and Oral Health Impact). Three hundred and thirty UPNM first year cadets in Sg Besi campus were involved in this study.
The prevalence of caries free and periodontally healthy subjects were 40.6% and 5.8% respectively. The mean DMFS was 3.07 of which 16.3% is accounted for by decayed surfaces. Females had higher DMFS than males. Nine out of ten cadets had calculus present and 16.7% required complex periodontal treatment. Overall, 36.7% of the subjects had often or very often experienced at least one oral health impact due to teeth, mouth, and denture problem in the last one year. The three OHRQoL domains most commonly affected were functional limitation, physical pain and psychological discomfort. Social disability had the lowest domain impact among the cadets. The impacts which were very often or quite often experienced by the subjects were discomfort due to food getting stuck (24.8%), had ulcer (9.7%) and bad breath (5.8%). Cadets who were free from oral diseases (caries and periodontal diseases) had lesser oral health impact. About three quarters of them perceived they needed dental treatment and it is significantly related with caries status and OHRQoL. It is concluded that there is low level of caries, high level of periodontal diseases and moderate oral health impacts among the cadets. It is recommended that hygienist be stationed in UPNM to assist dentist to manage the high level of periodontal problems encountered.

INTRODUCTION

Good oral health of soldiers would decrease the number of urgent dental interventions and absences from training and the battlefield and would improve the security of the whole formation. Poor dental health may have severe oral health impact and hence can affect the performance of personnel. It may impose on the dental delivery system in providing oral health care by increasing the work burden of the personnel on duty in the Armed Forces dental services and increase the military budget. Gordon et al (1986)1 reported that for the Israeli army 20-40 year aged group, to complete all dental treatment, needs 10.5 hours per soldier and one hour for dental hygiene therapy. Richardson et al (1996)2 in his study on dental status of a cohort of Royal Air Force recruits in 1988 found that the recruits required twice as many restorations in their first year in the service to render them dentally fit as were required in any subsequent year to maintain fitness. This work needed 58 minutes of dental officers’ time in their first year and 43 minutes per year thereafter. Chisick et al (2000)3 found that the estimated treatment costs of USD 1.9 billion for active duty (n=1,699,662) and USD 203 million for recruit (n=202,144) U.S. military personnel. Study by Zainal Abidin (1992)4, among Malaysian military personnel found that 33.5% required emergency treatment, 7% required denture, and 50% required routine treatment (scaling and filling). Only 10.2% did not need any treatment. Jasmin (1995)5 reported a high level of unmet treatment need among Air Force personnel in Kuantan. 95.7% had periodontal diseases of which 89.4% required scaling. Haron (1995)6 found that the DMFX of the ADS group was 6 as compare to 8 for non ADS group. Therefore, it can be concluded that oral health status among Malaysian Armed Forces personnel are generally poor with high levels of dental caries and periodontal diseases.