Journal of Indian Society of Periodontology
Journal of Indian Society of Periodontology
Home | About JISP | Search | Accepted articles | Online Early | Current Issue | Archives | Instructions | SubmissionSubscribeLogin 
Users Online: 1002  Home Print this page Email this page Small font size Default font size Increase font sizeWide layoutNarrow layoutFull screen layout

   Table of Contents    
Year : 2020  |  Volume : 24  |  Issue : 3  |  Page : 271-275  

A survey on the awareness of interrelationship of periodontal disease and systemic health among Mahe population

Department of Periodontology, Mahe Institute of Dental Sciences and Hospital, Mahe, Puducherry, India

Date of Submission16-May-2019
Date of Decision28-Nov-2019
Date of Acceptance29-Nov-2019
Date of Web Publication04-May-2020

Correspondence Address:
Ashitha Mohandas
Department of Periodontology, Mahe Institute of Dental Sciences and Hospital, Chalakkara, Mahe - 653 310, Puducherry
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jisp.jisp_286_19

Rights and Permissions

Background: Systemic health is the fundamental right of any individual, and it cannot be attained or maintained without oral health. Oral cavity is the gateway and the mirror of health. This link is often ignored. This lack of understanding of the correlation between oral and systemic health often leads to the poor systemic health because of the poor oral status. Aim: The aim of the study was to assess the awareness among the general public about periodontal diseases and its impact on systemic health. Materials and Methods: A questionnaire with 15 questions including general awareness about periodontitis and its impact on systemic health were given to patients and were asked to select their preferred option of yes, no, and don't know. The awareness of the individuals was categorized based on their educational qualification, age, and gender as well. Results: The results obtained showed increased awareness among females, postgraduates, and 35–50 years group of individuals according to their category of gender, education, and age group, respectively. Conclusion: There is always a strong influence of oral health on systemic well-being. This link among the two is often ignored and overlooked. Oral health upholds the overall well-being of the patient. Further studies need to be conducted on large scale population and camps need to be conducted to increase the awareness among the general public of periodontal diseases and their systemic impact.

Keywords: Awareness, general public, interrelationship, oral health, periodontitis, systemic health

How to cite this article:
Hemalatha DM, Melath A, Feroz M, Subair K, Mohandas A, Chandran N. A survey on the awareness of interrelationship of periodontal disease and systemic health among Mahe population. J Indian Soc Periodontol 2020;24:271-5

How to cite this URL:
Hemalatha DM, Melath A, Feroz M, Subair K, Mohandas A, Chandran N. A survey on the awareness of interrelationship of periodontal disease and systemic health among Mahe population. J Indian Soc Periodontol [serial online] 2020 [cited 2022 Jul 5];24:271-5. Available from:

   Introduction Top

Oral health is an inevitable and essential requisite for the systemic well-being of an individual. The systemic health of an individual depends on the degree of oral hygiene maintenance.[1] A wide variety of microbes are found in the oral cavity.

It is well known that a periodontal disease if left untreated leads to recession, loss of attachment, and mobility eventually leading to loss of tooth.[2] It also has systemic influence which is not as well-known as its local effects, and it should be educated to common people [Table 1].[3]
Table 1: Mechanism of infection from oral cavity to systemic diseases

Click here to view

Literary search on diverse epidemiological studies has revealed the worldwide occurrence and prevalence of periodontitis.[4] It is alarming to see the significant rise in the incidence of periodontal diseases in recent times. Severe form of periodontitis is the sixth most prevalent disease with higher prevalence worldwide.[5] Prevention is always better than cure. To prevent any disease, awareness about the concerned disease is mandatory. This awareness needs to be enhanced by patient education. The knowledge about periodontitis and its systemic impact needs to be made aware to the general public to aid them in maintaining their oral as well as systemic health.[6] There are various steps that can be taken to aid in this. For example, periodic visits to dental surgeon for oral prophylaxis, oral health maintenance, and lifestyle modification like abstaining from smoking.

The role of a periodontist is crucial in creating awareness to the patients regarding this systemic interrelationship. As a first step toward educating the patient, we have conducted a questionnaire based study among the general public population attending the outpatient department (OPD) of Department of Periodontics, to assess their awareness on the periodontal-systemic interrelationship.

   Materials and Methods Top

Inclusion criteria

A total of 317 outpatients with minimal education qualification of high school education, above the age of 20, attending the OPD of department of periodontology were included in the study. In case of postgraduate individuals, individuals with postgraduation in any subjects other than medical, dental, and paramedical courses were included in the study.

Exclusion criteria

(a) Patients without schooling and (b) medical, dental, and paramedical individuals.

A questionnaire containing 15 questions pertaining to the link between periodontal health and general health, along with demographic details was given to the patients. The questions were grouped based on general awareness toward periodontitis, interrelation between periodontitis, and various factors such as smoking, nutrition, diabetes, cardiovascular disease, and pregnancy. The individuals were allowed to select from three options: YES, NO, and DON'T KNOW. The questionnaires were then evaluated for their responses.

The questions were categorized into six groups: A, B, C, D, E, and F.

  • Group A – Questions were based on the general awareness on periodontitis
  • Group B – Interrelationship between smoking and periodontitis
  • Group C – Effects of nutrition on periodontium
  • Group D – Influence of diabetes on periodontium
  • Group E – Cardiovascular system effects on periodontium
  • Group F – Effects of pregnancy on periodontium.

The individuals were assessed based on their age, gender, and qualification.

Statistical analysis

Chi-square test was used to find the association between the variables, to determine the significant differences between the frequencies in one or more categories. SPSS version 22.0 SPSS version 22.0, (IBM Corp, Armonk, NewYork) was used.

   Results Top

The study comprised of 317 general population attending the OPD of the department of periodontology.

Out of 317 individuals, according to gender specification, 156 were females and 161 were males.

According to age group, 147 individuals were <35 years, 109 individuals were 35–50 years, and 61 individuals were >50 years.

Based on educational qualification, 127 who completed high school education, 172 graduates, and 18 postgraduates were enrolled for our study.

The responses of the 317 individuals were evaluated. [Figure 1] shows the overall awareness level among the 317 individuals.
Figure 1: Overall awareness of survey population. Greater proportion of individuals were aware on periodontal and systemic interrelationship

Click here to view

The individuals were most aware about the detrimental effects of smoking on the periodontium and least aware about the effects of periodontal disease on the cardiovascular system as well as pregnancy [Figure 2] and [Figure 3].
Figure 2: Awareness based on categories of questions. Distribution of awareness among the question categories

Click here to view
Figure 3: Graph comparing awareness level based on category. Awareness level low for pregnancy and chorionic villus sampling effects on periodontium

Click here to view

Females were found to have higher level of awareness than males [Figure 4]. Based on level of education, postgraduates were found to be most aware of this interrelationship [Figure 5].
Figure 4: Awareness based on gender. Females have higher awareness than males in all question categories

Click here to view
Figure 5: Awareness based on educational qualification. Increased awareness level with increase in education qualification

Click here to view

Based on the age group on an average, the group of individuals 35–50 years were found to have higher awareness level than the other two groups [Figure 6].
Figure 6: Awareness based on age group. 35–53 year age group have higher awareness level in all question categories

Click here to view

   Discussion Top

Accumulation of plaque and calculus causes sequelae of reactions leading to gingivitis and if not treated, periodontitis.[7],[8] Poor oral health not only causes gingivitis and periodontitis but also impacts the systemic health. Periodontitis is known to have various systemic relationships with endocrine system, cardiovascular system, etc.[9] This systemic interrelationship if understood correctly will enhance both oral and systemic health.[10],[11] Individuals with higher awareness were found to have good glycemic control than the unaware population.

The results of our study showed that the general awareness level of patients on periodontitis was good with a percentage of 78%. This result was found to be contradictory to the result seen in a study conducted by Bhatia et al.[12] which showed a poor awareness among the study conducted among North Indian population. This higher level of awareness might be due to the higher literacy level of the survey population at Mahe region.

Awareness level of females was found to be higher than males in our study. These results signify the increased level of awareness of females on periodontitis and its systemic interrelationship than males. These results were in accordance with the results of Gupta et al.[13] where females were aware than males.

Postgraduates had higher awareness than the other two study groups. This increased awareness could be attributed to their higher education level. This result was in contrary to the results of other study, where the individuals with least educational qualification had higher knowledge on awareness.[14]

In our study, the awareness of 35–50 years age group was higher than other ages. This result was found to be in contrast to the study done among Andhra Pradesh population where the age group of 18–24 years had higher awareness.[14]

However, this study reveals a low awareness about the detrimental effects of periodontal disease on pregnancy and chorionic villus sampling. Increased levels of Prostaglandin E2 is significant of Chronic inflammation like Periodontitis. Periodontopathic bacteria and high levels of Prostaglandin E2 have been identified in the amniotic fluid of women who had preterm birth.[15],[16] This can lead to several pregnancy-related complications such as low birth weight, preterm delivery, and preeclampsia.[17] Interdisciplinary approach with regard to oral health care during pregnancy can enhance the quality of maternal and fetal health. Pregnant women must be enrolled under a strict oral hygiene maintenance program from their first trimester.

Number of patients consuming antihypertensive drugs for hypertension is alarming, and there are remote chances for patients to be aware that some of the antihypertensive drugs have the potential to cause gingival hyperplasia. Awareness must be created among cardiac patients for the potential risk for cardiac accidents due to periodontitis.

From the results obtained in our study, it was evident that the public had a general awareness about the link between periodontal disease and systemic health. Hence, with due motivation of the patients, periodontal maintenance and attaining healthy oral hygiene would be easily achievable. Patients with systemic diseases must be distinguished from other patients and advocated to have a strict recall visit in dental OPD.

The general public must be made aware that self medication might mask a serious underlying perIodontal and systemic problem. Timely professional advice should be pursued to ensure oral and systemic well-being.

  1. Enhance public awareness
  2. Improve access to periodontal care
  3. Upgrade awareness on standard of professional care for periodontitis
  4. Enhance public awareness of the potential of undergoing timely periodontal treatment in saving medical care.

   Conclusion Top

General public needs to be educated on the benefits of maintaining good oral hygiene. Treating periodontitis is known to decrease the risk of cardiovascular accidents like atherosclerosis in cardiac patients and also found to influence the premature childbirth and decreased birth weight of the babies.[18],[19] The impact of nutritious food on gingival health also needs to be emphasized to the patient.[20] Periodontal health care should also be incorporated into primary and community health services. Dental awareness must be intensified by awareness programs, camps, and through social media. Further studies need to be conducted on larger sample size and with individualized questionnaire for specific systemic complications to evaluate the results of our study. Patients with systemic complications which have impact on oral care must be penned down to a recall visit protocol for their overall well-being.

Limitations of the study

Spacing of population based on education qualification should have been equal.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

   References Top

Scannapieco FA. Position paper of The American Academy of Periodontology: Periodontal disease as a potential risk factor for systemic diseases. J Periodontol 1998;69:841-50.  Back to cited text no. 1
Novak MJ, Novak KF. Chronic periodontitis. In: Newman MG, Takei H, Klokkevold P, Carranza FA, editors. Carranza's Clinical Periodontology. 10th ed. St. Louis, MO: Saunders Elsevier; 2006. p. 494-9.  Back to cited text no. 2
Nanaiah KP, Nagarathna DV, Manjunath N. Prevalence of periodontitis among the adolescents aged 15-18 years in Mangalore City: An epidemiological and microbiological study. J Indian Soc Periodontol 2013;17:784-9.  Back to cited text no. 3
[PUBMED]  [Full text]  
Scannapieco FA. Systemic effects of periodontal diseases. Dent Clin North Am 2005;49:533-50, vi.  Back to cited text no. 4
Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. J Clin Periodontol 2017;44:456-62.  Back to cited text no. 5
Nagarakanti S, Epari V, Athuluru D. Knowledge, attitude, and practice of medical doctors towards periodontal disease. J Indian Soc Periodontology 2013;17:137-9.  Back to cited text no. 6
Williams RC. Understanding and managing periodontal diseases: A notable past, a promising future. J Periodontol 2008;79:1552-9.  Back to cited text no. 7
Kapoor D, Gill S, Singh A, Kaur I, Kapoor P. Oral hygiene awareness and practice amongst patients visiting the Department of Periodontology at a Dental College and Hospital in North India. Indian J Dent 2014;5:64-8.  Back to cited text no. 8
  [Full text]  
Li X, Kolltveit KM, Tronstad L, Olsen I. Systemic diseases caused by oral infection. Clin Microbiol Rev 2000;13:547-58.  Back to cited text no. 9
Singla N, Acharya S, Prabhakar RV, Chakravarthy K, Singhal D, Singla R. The impact of lifestyles on the periodontal health of adults in Udupi district: A cross sectional study. J Indian Soc Periodontol 2016;20:330-5.  Back to cited text no. 10
[PUBMED]  [Full text]  
Kim J, Amar S. Periodontal disease and systemic conditions: A bidirectional relationship. Odontology 2006;94:10-21.  Back to cited text no. 11
Bhatia A, Bains SK, Singh MP. To assess knowledge and awareness of North Indian Population towards periodontal therapy and oral-systemic disease link: A cross-sectional study. J Interdiscip Dent 2013;3:79-85.  Back to cited text no. 12
Gupta V, Singh AK, Gupta B. Assessment of oral hygiene practices and awareness of periodontal-systemic health interrelationship amongst the local population of Kanpur region – A cross sectional study. J Oral Health Community Dent 2016;10:1-8.  Back to cited text no. 13
Penmetsa GS, Gadde P, Begum Z, Mandalapu N, Ramaraju AV. Assessment of periodontal knowledge among residents of West Godavari district of Andra Pradesh, India: A descriptive epidemiological survey. J NTR Univ Health Sci 2018;7:39-43.  Back to cited text no. 14
  [Full text]  
Skuldbøl T, Johansen KH, Dahlén G, Stoltze K, Holmstrup P. Is pre-term labour associated with periodontitis in a Danish maternity ward? J Clin Periodontol 2006;33:177-83.  Back to cited text no. 15
Mannem S, Chava VK. The relationship between maternal periodontitis and preterm low birth weight: A case-control study. Contemp Clin Dent 2011;2:88-93.  Back to cited text no. 16
[PUBMED]  [Full text]  
López NJ, Da Silva I, Ipinza J, Gutiérrez J. Periodontal therapy reduces the rate of preterm low birth weight in women with pregnancy-associated gingivitis. J Periodontol 2005;76:2144-53.  Back to cited text no. 17
Fowler EB, Breault LG, Cuenin MF. Periodontal disease and its association with systemic disease. Mil Med 2001;166:85-9.  Back to cited text no. 18
Paquette DW. The periodontal infection-systemic disease link: A review of the truth or myth. J Int Acad Periodontol 2002;4:101-9.  Back to cited text no. 19
Dayakar MM, Kumar J, Pai GP, Shivananda H, Rekha R. A survey about awareness of periodontal health among the students of professional colleges in Dakshina Kannada district. J Indian Soc Periodontol 2016;20:67-71.  Back to cited text no. 20
[PUBMED]  [Full text]  


  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]

  [Table 1]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
    Materials and Me...
    Article Figures
    Article Tables

 Article Access Statistics
    PDF Downloaded296    
    Comments [Add]    

Recommend this journal