Assessment of Risk Factors and Periodontitis in Ukraine: Unraveling the Impact of Smoking, Stress, and More

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Abstract

This article focused on the “Assessment of the impact of various risk factors (e.g., smoking, stress) on the prevalence and severity of periodontitis in the Ukrainian population”. The study's primary goals were to assess the prevalence of periodontitis, various risk factors, and their influence on periodontitis within the Ukrainian population. A descriptive cross-sectional study design was employed. Secondary data collected. Descriptive statistics were obtained and utilized.

The prevalence of oral health issues especially periodontitis varies across age groups, with a significant proportion affected, including 46.5% of children (1-9 years) having untreated deciduous tooth caries, persisting into adulthood (32.4% with permanent tooth caries, ages 5+). Severe periodontal disease affects 18.9% (ages 15+), and 14.0% (ages 20+) experience edentulism. Results further show that sugar availability at 91.3g/day; tobacco use at 11.6% (males) and 40.7% (females); and average alcohol intake of 8.3 units, notably higher for females and periodontitis. These findings suggest females' increased tobacco and alcohol consumption and stress may contribute to a higher oral disease risk, necessitating deeper analysis. Results further highlight the periodontitis determinants encompass structural (macroeconomic policies, globalization), intermediate (socio-economic factors), and proximal (diet, hygiene, inflammation) influences, collectively impacting oral health burdens, especially periodontitis. Current evidence indicates high periodontal disease prevalence in Ukraine, with stress and smoking highly prevalent and possibly contributing. More research is needed to understand their exact connection for better treatment approaches.

Keywords: Impact assessment, Periodontitis prevalence, Severity, Smoking, Stress, Ukrainian population

Determinates of Oral Health Problems (Periodontitis)

Table 2 presents the determinants of oral diseases, specifically focusing on periodontitis. These determinants are categorized into three levels: structural, intermediate, and proximal. At the structural level, issues such as macroeconomic laws, welfare policies, trade restrictions, international development plans, globalization, and urbanization all play a part in the process of determining the prevalence of oral illnesses as well as the influence that they have. The intermediate determinants include a wide range of socioeconomic characteristics, some of which include social class, income, education, gender, ethnicity, material circumstances, social interactions, psychological issues, and access to health care and environmental conditions. In conclusion, the proximal determinants have a direct impact on the development of periodontitis. These proximal determinants include factors such as nutrition, alcohol intake, cigarette use, physical activity, hygiene habits, inflammation, infection, and immunological response. The eventual consequences of these factors may be seen in the prevalence of dental disorders and non-communicable diseases, most notably periodontitis. Understanding these factors and taking a comprehensive approach to treating them can assist in the development of successful methods for the prevention and management of periodontitis as well as the reduction of the disease's negative effects on overall health.

Table 2. Determinates of Oral Health Problems (Periodontitis)

Source: Authors’ development based on (Global Oral Health Status Report WHO, n.d.).

According to the findings of the investigation, the incidence of periodontal disease is rather high in Ukraine. In a similar vein, research that was carried out in the year 2020 discovered that 81.58 percent of patients in Chernivtsi who had metabolic syndrome also had periodontal disease (Hlushchenko et al., 2020). Another study conducted in Ukraine found that tooth decay was the main oral pathology, affecting 60.3% of the population (Ziuzin et al., 2021b). According to the findings of a study conducted on gingival recession in individuals suffering from periodontitis in the Ukrainian population, the prevalence of gingival recession was one hundred percent (Humagain & Kafle, 2013). The World Health Organization estimates that severe periodontal diseases impact around 19% of the world's adult population, which equates to more than 1 billion people affected globally (World Health Organization, 2023). Based on the findings of a recent study, the average age-standardized prevalence rate of severe periodontitis increased by 8.44% worldwide between the years 1990 and 2019 (Chen et al., 2021). In individuals suffering from periodontitis in the Ukrainian population, gingival recession was determined to have a prevalence of one hundred percent, according to a study on gingival recession (Mazur et al., 2020).

Regarding the evaluation of the influence of various risk factors on the prevalence and severity of periodontitis in the Ukrainian population, there is vast research that focuses on issues associated with this topic. This finding is consistent with earlier research that has revealed a greater frequency of smoking among girls in Ukraine and a high incidence of periodontitis or oral health concerns. The prevalence of tobacco usage is much higher among females than it is among males. Additionally, there is a larger intake of alcohol per capita among females, which is consistent with the findings of earlier research that indicated higher rates of alcohol consumption among females and a high incidence of periodontitis or other oral health problems in Ukraine (Ludvigsson & Loboda, 2022; Center of Excellence in Newcomer Health, n.d.).

Plaque on teeth is the single most important risk factor for periodontitis, which is a chronic inflammatory disease that is caused by a complicated interaction of several risk factors (GOV.UK, 2021). According to the Global Oral Health Status Report published by the World Health Organization (WHO), the two most significant risk factors for periodontal disease are improper oral hygiene and cigarette use (World Health Organization, 2023). Tobacco use, improper dental hygiene, diabetes, certain medications, advanced age, genetic predisposition, stress, nutrition, intake of alcoholic beverages, regular physical activity, inadequate hygiene practices, periodontitis, infection, and immunological response are some of the additional risk factors for periodontitis. There is some evidence to suggest that a lower amount of sleep is connected with an increased prevalence of periodontitis (Alhassani & Al-Zahrani, 2020).

The effect of various stressors on the prevalence of periodontitis in Ukraine and worldwide is a complex topic that requires comprehensive research. Association between chronic stress and periodontitis was studied in a study conducted in the South Indian population found a positive association between chronic stress and chronic periodontitis. However, it is essential to point out that this study had certain shortcomings, including a limited sample size and a lack of temporality in the events that were examined. To determine whether or if there is a genuine connection between stress and periodontitis, further prospective research with bigger sample numbers is required (Varma et al., 2023).

It's important to note that periodontal disease is influenced by various factors, including poor oral hygiene, tobacco use, diabetes, and health inequalities. Stress may be one of the contributing factors, but its exact role and impact on the prevalence of periodontitis require further investigation (World Health Organization, 2023). In another study that sought to determine how stress affects periodontal health, individuals who suffered from periodontal disease were shown to have a much higher incidence of anxiety, depression, distress, and moderate to high levels of stress. This shows that stress may affect periodontal health; however, further study is required to understand the particular processes and causation involved in this relationship (Corridore et al., 2023).

Conclusion

In conclusion, the prevalence of periodontal disease in Ukraine appears to be a big problem, since studies indicate high rates of both periodontitis and other oral health concerns such as tooth decay and gingival recession. In addition, the prevalence of periodontal disease in Ukraine looks to be a serious concern. Despite severe periodontal diseases afflicting a sizeable proportion of the adult population across the world, the prevalence of these conditions in Ukraine appears to be significantly greater than the norm for the rest of the world. The progression and severity of periodontitis are both influenced by several risk factors, some of which are a lack of proper dental hygiene, the use of tobacco products, the intake of alcohol, diabetes, and maybe even stress. Although stress has been hypothesized to have a role in the development of periodontal disease, the nature of this function and the effects it has on the body are still not fully understood and require more research. There is a need for further strong research to demonstrate a conclusive relationship between chronic stress and periodontitis. Although some studies point to a connection between chronic stress and periodontitis, there are limitations in the study design and the sample size. Comprehensive and prospective research is required because of the interaction of stress with other risk factors that are present in the Ukrainian community as well as the particular impact that stress has on periodontal health. Furthermore, addressing periodontal health requires a holistic approach that encompasses various factors, including oral hygiene practices, tobacco and alcohol use, diabetes management, and potentially stress reduction. Improving public awareness, promoting healthier lifestyles, and enhancing access to oral healthcare services are crucial steps in mitigating the burden of periodontal disease in Ukraine and globally.

In summary, the information that is currently available reveals that there is a considerable incidence of periodontal disease in Ukraine and draws attention to the probable role that stress and smoking play as contributing factors. Despite this, further study is required to determine the precise link that exists between stress, smoking, and periodontitis. Because of this, it will be possible to establish solutions that are more focused and more successful in promoting periodontal health as well as general well-being.

Acknowledgments: We would like to take this opportunity to extend our heartfelt appreciation to each individual who took part in and contributed to this study analyzing the influence of a variety of risk variables on the periodontitis prevalence and severity in the Ukrainian population. Throughout the whole process of data gathering, we would also want to offer our gratitude to the healthcare professionals and institutions that provided assistance and worked in conjunction with us. The quality of our research was significantly improved because of your ideas and skills.

Conflict of interest: None

Financial support: None

Ethics statement: None