PERIODONTAL DISEASE : A RISE IN PREVALENCE IN MILITARY TROOPS PENYAKIT PERIODONTAL

Amaliya Amaliya*    -  Universitas Padjadjaran, Indonesia
Snataka Pribadi  -  Indonesian Naval Dental Institute RE Martadinata - Jakarta, Indonesia
Yun Mukmin Akbar  -  Indonesian Naval Dental Institute RE Martadinata - Jakarta, Indonesia
Suhardjo Sitam  -  Universitas Padjadjaran, Indonesia

(*) Corresponding Author

Background: Oral condition is one of substantial factors in general health. Good oral health will determine dental fitness or readiness in military troops. Oral diseases affecting soldiers may have negative impacts in readiness on deployment or fight and contributes to lowering morale among personnel. At the recruitment stage, the prevalence of periodontal disease is low and controlled before the commencement of the training. As a matter of fact, periodontal health was not considered to be maintained and found to be worsening through the course of time. In the end, many of soldiers were found to suffer from periodontal diseases.
Method : This review article aims to discuss several factors in military way of life related to oral condition.
Result : Lack of oral hygiene practices, stress, deficiency of nutritious food, and smoking among military personnel may contribute to the prevalence of periodontal disease. Several attempts should be incorporated in military life to reduce the negative impacts of these factors on oral health.
Conclusion: Periodontal therapy should be provided early in the military careers and repeated at intervals specific to the needs of each personnel. Several risk factors contributing to the development and severity of periodontal disease should be assessed and overcome to arrest the progression of the disease.

Keywords: dental fitness; military troops; periodontal condition

  1. Chaffin J, King JE, Fretwell LD. US Army dental emergency rates in Bosnia. Military Medicine. 2001; 1;166(12):1074-8.
  2. Bishop BG, Donnelly JC. Proposed criteria for classifying potential dental emergencies in Department of Defense military personnel. Military Medicine. 1997; 1;162(2):130-5.
  3. Škec V, Macan JŠ, Sušac M, Jokić D, Brajdić D, Macan D. Influence of oral hygiene on oral health of recruits and professionals in the Croatian Army. Military Medicine. 2006; 1;171(10):1006-9.
  4. Hopcraft M, Morgan M. Dental caries experience in a young adult military population. Australian Dental Journal. 2003; 1;48(2):125-9.
  5. Hyman JJ, Reid BC, Mongeau SW, York AK. The military oral health care system as a model for eliminating disparities in oral health. The Journal of the American Dental Association. 2006; 1;137(3):372-8.
  6. Katz J, Peretz B, Sganâ€Cohen HD, Horev T, Eldad A. Periodontal status by CPITN, and associated variables in an Israeli permanent force military population. Journal of Clinical Periodontology. 2000; 1;27(5):319-24.
  7. Grewal Y & Evans W. Dental fitness of Indian army soldiers. Journal of Pharmaceutical and Biomedical Sciences. 2014; 04(05):375-381.
  8. Yousaf A, Manzoor MA, Rafi S, Yousaf N, Shabbir SM. Frequency of gingival and periodontal diseases among troops deployed in operational area. Pakistan Armed Forces Medical Journal. 2014; 1(1):92.
  9. KovaÄević V, Milosavljević M, RanÄić N, Daković D. Assessment of the periodontal health and community periodontal index in the Army of Serbia. Vojnosanitetski Pregled. 2015;72(11):953-60.
  10. Sutthavong S, Cae-ngow S, Rangsin R. Oral health survey of military personnel in the Phramongkutklao Hospital, Thailand. Journal of the Medical Association of Thailand. 2011; 11;92(2):84.
  11. Chrysanthakopoulos NA. Periodontal reasons for tooth extraction in a group of greek army personnel. Journal of Dental Research, Dental Clinics, Dental Prospects. 2011;5(2):55.
  12. Pindborg JJ. Influence of service in armed forces on incidence of gingivitis. The Journal of the American Dental Association. 1951;1;42(5):517-22.
  13. Dufty JR. Report for the pathological committee of the war office of an inquiry into gingivitis and Vincent's disease occurring in the Army. Journal of the Royal Army Medical Corps. 2014;160:i7.
  14. Loesche WJ, Syed SA, Laughon BE, Stoll J. The bacteriology of acute necrotizing ulcerative gingivitis. Journal of Periodontology. 1982; 1;53(4):223-30.
  15. Page RC. Gingivitis. Journal of Clinical Periodontology. 1986; 1;13(5):345-55.
  16. Löe H, Anerud A, Boysen H, Morrison E. Natural history of periodontal disease in man. Journal of Clinical Periodontology. 1986;13(5):431-40.
  17. Slots J, Ting M. Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in human periodontal disease: occurrence and treatment. Periodontology 2000. 1999; 1;20(1):82-121.
  18. Socransky SS, Haffajee AD. Dental biofilms: difficult therapeutic targets. Periodontology 2000. 2002; 1;28(1):12-55.
  19. Van Winkelhoff AJ, Loos BG, Van Der Reijden WA, Van Der Velden U. Porphyromonas gingivalis, Bacteroides forsythus and other putative periodontal pathogens in subjects with and without periodontal destruction. Journal of Clinical Periodontology. 2002; 1;29(11):1023-8.
  20. Slots J. Human viruses in periodontitis. Periodontology 2000. 2010; 1;53(1):89-110.
  21. Axelsson P, Lindhe J. Effect of controlled oral hygiene procedures on caries and periodontal disease in adults. Journal of Clinical Periodontology. 1981; 1;8(3):239-48.
  22. Axelsson P, Lindhe J, Nyström B. On the prevention of caries and periodontal disease. Journal of Clinical Periodontology. 1991; 1;18(3):182-9.
  23. Diefenderfer KE, Ahlf RL, Simecek JW, Levine ME. Periodontal health status in a cohort of young US Navy personnel. Journal of Public Health Dentistry. 2007; 1;67(1):49-54.
  24. Uzel NG, Teles FR, Teles RP, Song XQ, Torresyap G, Socransky SS, Haffajee AD. Microbial shifts during dental biofilm reâ€development in the absence of oral hygiene in periodontal health and disease. Journal of Clinical Periodontology. 2011; 1;38(7):612-20.
  25. Supreetha S, Prathima K, Sam G, Penumatsa NV, Khanapure S, Jagadeesh KN. Utilization of dental services and oral health status among police personnel in Virajpet, South India. International Journal of Oral Care and Research 2016; 4(2) : 87-90.
  26. Wojcik BE, Szeszel-Fedorowicz W, Humphrey RJ, Colthirst P, Guerrero AC, Simecek JW, Fedorowicz A, Eikenberg S, Rogers GG, DeNicolo P. Risk of dental disease non-battle injuries and severity of dental disease in deployed US Army personnel. Military Medicine. 2015; 1;180(5):570-7.
  27. Suman M, Spalj S, Plancak D, Dukic W, Juric H. The influence of war on the oral health of professional soldiers. International Dental Journal. 2008; 1;58(2):71-4.
  28. Genco RJ, Ho AW, Kopman J, Grossi SG, Dunford RG, Tedesco LA. Models to evaluate the role of stress in periodontal disease. Annals of Periodontology. 1998;3(1):288-302.
  29. Hilgert JB, Hugo FN, Bandeira DR, Bozzetti MC. Stress, cortisol, and periodontitis in a population aged 50 years and over. Journal of dental research. 2006;85(4):324-8.
  30. Rosania AE, Low KG, McCormick CM, Rosania DA. Stress, depression, cortisol, and periodontal disease. Journal of Periodontology. 2009;80(2):260-6.
  31. Reners M, Brecx M. Stress and periodontal disease. International Journal of Dental Hygiene. 2007; 1;5(4):199-204.
  32. Shannon IL, Kilgore WG, O'Leary TJ. Stress as a predisposing factor in necrotizing ulcerative gingivitis. Journal of Periodontology. 1969;40(4):240-2.
  33. Cogen RB, Stevens Jr AW, Cohen-Cole S, Kirk K, Freeman A. Leukocyte function in the etiology of acute necrotizing ulcerative gingivitis. Journal of Periodontology. 1983;54(7):402-7.
  34. Van der Velden U, Kuzmanova D, Chapple IL. Micronutritional approaches to periodontal therapy. Journal of Clinical Periodontology. 2011; 1;38(s11):142-58.
  35. Moynihan P, Petersen PE. Diet, nutrition and the prevention of dental diseases. Public Health Nutrition. 2004;7(1a):201-26.
  36. Bhaskaram P. Micronutrient malnutrition, infection, and immunity: an overview. Nutrition reviews. 2002; 1;60(s5).
  37. Enwonwu CO. Cellular and molecular effects of malnutrition and their relevance to periodontal diseases. Journal of Clinical Periodontology. 1994;1;21(10):643-57.
  38. Tabak, L. A. & Bowen, W. H. Roles of saliva (pellicle), diet, and nutrition on plaque formation. Journal of Dental Research. 1989; 68 : 1560-1566.
  39. Chandra RK. McCollum Award lecture. Nutrition and immunity: lessons from the past and new insights into the future. American Journal of Clinical Nutrition (USA). 1991.
  40. Folayan MO. The epidemiology, etiology, and pathophysiology of acute necrotizing ulcerative gingivitis associated with malnutrition. Journal of Contemporary Dental Practice. 2004;15;5(3):28-41.
  41. Taylor CA, Hampl JS, Johnston CS. Low intakes of vegetables and fruits, especially citrus fruits, lead to inadequate vitamin C intakes among adults. European Journal of Clinical Nutrition. 2000; 54(7):573.
  42. Wrieden WL, Hannah MK, Bolton-Smith C, Tavendale R, Morrison C, Tunstall-Pedoe H. Plasma vitamin C and food choice in the third Glasgow MONICA population survey. Journal of Epidemiology & Community Health. 2000; 1;54(5):355-60.
  43. Amarasena N, Ogawa H, Yoshihara A, Hanada N, Miyazaki H. Serum vitamin C–periodontal relationship in communityâ€dwelling elderly Japanese. Journal of Clinical Periodontology. 2005; 1;32(1):93-7.
  44. Amaliya, Timmerman MF, Abbas F, Loos BG, Van der Weijden GA, Van Winkelhoff AJ, Winkel EG, Van der Velden U. Java project on periodontal diseases: the relationship between vitamin C and the severity of periodontitis. Journal of Clinical Periodontology. 2007;34(4):299-304.
  45. Chapple IL, Milward MR, Dietrich T. The prevalence of inflammatory periodontitis is negatively associated with serum antioxidant concentrations. The Journal of Nutrition. 2007; 1;137(3):657-64.
  46. Bergström J. Tobacco smoking and chronic destructive periodontal disease. Odontology. 2004; 1;92(1):1-8.
  47. Dietrich T, Bernimoulin JP, Glynn RJ. The effect of cigareté smoking on gingival bleeding. Journal of periodontology. 2004; 1;75(1):16-22.
  48. Bergström J, Eliasson S, Dock J. A 10-year prospective study of tobacco smoking and periodontal health. Journal of Periodontology. 2000; 1;71(8):1338-47.
  49. Albandar JM, Streckfus CF, Adesanya MR, Winn DM. Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss. Journal of Periodontology. 2000; 1;71(12):1874-81.
  50. Sreedevi M, Ramesh A, Dwarakanath C. Periodontal status in smokers and nonsmokers: a clinical, microbiological, and histopathological study. International Journal of Dentistry. 2012.
  51. Persson L, Bergström J, Ito H, Gustafsson A. Tobacco smoking and neutrophil activity in patients with periodontal disease. Journal of Periodontology. 2001; 1;72(1):90-5.
  52. Gonçalves RB, Coletta RD, Silvério KG, Benevides L, Casati MZ, Da Silva JS, Nociti FH. Impact of smoking on inflammation: overview of molecular mechanisms. Inflammation Research. 2011;1;60(5):409-24.
  53. Levin L, Baev V, Lev R, Stabholz A, Ashkenazi M. Aggressive periodontitis among young Israeli army personnel. Journal of Periodontology. 2006; 77(8):1392-6.
  54. Ahuja A, Singh BN. Assessment of disease burden among army personnel and dependents in Lucknow city. Journal of Indian Association of Public Health Dentistry. 2015; 1;13(1):14.
  55. Bray RM, Hourani LL. Substance use trends among active duty military personnel: findings from the United States Department of Defense Health Related Behavior Surveys, 1980–2005. Addiction. 2007; 1;102(7):1092-101.
  56. Cronan TA, Conway TL. Is the Navy attracting or creating smokers?. Military Medicine. 1988; 1;153(4):175-8.
  57. Conway TL. Tobacco use and the United States military: a longstanding problem. Tobacco Control. 1998; 7 : 219-221.
  58. Cronan TA, Conway TL, Kaszas SL. Starting to smoke in the Navy: when, where and why. Social Science & Medicine. 1991; 1;33(12):1349-53.
  59. Shahar Y, Carel RS. Changes in smoking patterns in young military recruits in relationship to psychosocial characteristics. Military Medicine. 1991;1;156(9):455-61.
  60. Forgas LB, Meyer DM, Cohen ME. Tobacco use habits of naval personnel during Desert Storm. Military Medicine. 1996; 1;161(3):165-8.
  61. Talcott GW, Cigrang J, Sherrill-Mittleman D, Snyder DK, Baker M, Tatum J, Cassidy D, Sonnek S, Balderrama-Durbin C, Klesges RC, Ebbert JO. Tobacco use during military deployment. nicotine & tobacco research. 2013; 8;15(8):1348-54.
  62. Boos CJ, Croft AM. Smoking rates in the staff of a military field hospital before and after wartime deployment. Journal of the Royal Society of Medicine. 2004;97(1):20-2.
  63. Di Nicola M, Occhiolini L, Di Mascio R, Vellante P, Colagrande V, Ballone E. Smoking habits in a sample of young Italian soldiers. Military Medicine. 2006;1;171(1):69-73.
  64. Barton CA, McGuire A, Waller M, Treloar SA, McClintock C, McFarlane AC, D’Este C. Smoking prevalence, its determinants and short-term health implications in the Australian Defence Force. Military Medicine. 2010; 1;175(4):267-72.
  65. Pflanz SE, Ogle AD. Job stress, depression, work performance, and perceptions of supervisors in military personnel. Military Medicine. 2006;1;171(9):861-5.
  66. Groves, RR. Dental fitness classification in the Canadian forces. Military Medicine 2008; 173, suppl_1: 18-22.
  67. Eliasson, A., Kashani, M., Dela Cruz, G., & Vernalis, M. Readiness and associated health behaviors and symptoms in recently deployed Army National Guard solders. Military Medicine. 2012; 177(11) :1254-1260.
  68. Schlagenhauf, U., Rehder, J., Gelbrich, G., & Jockelâ€Schneider, Y. Consumption of Lactobacillus reuteriâ€containing lozenges improves periodontal health in navy sailors at sea: A randomized controlled trial. Journal of Periodontology. 2020; 91(10), 1328-1338..
  69. Deinzer, R., Granrath, N., Spahl, M., Linz, S., Waschul, B., & Herforth, A. Stress, oral health behaviour and clinical outcome. British Journal of Health Psychology. 2005; 10(2) : 269-283.
  70. Breland, J. Y., Donalson, R., Nevedal, A., Dinh, J. V., & Maguen, S. Military experience can influence Women's eating habits. Appetite. 2017; 118 : 161-167.
  71. Radler, D. R., & Lister, T. Nutrient deficiencies associated with nutritionâ€focused physical findings of the oral cavity. Nutrition in Clinical Practice. 2013; 28(6): 710-721.
  72. Sheetal, A., Hiremath, V. K., Patil, A. G., Sajjansetty, S., & Kumar, S. R. Malnutrition and its oral outcome–a review. Journal of Clinical and Diagnostic Research: JCDR. 2013; 7(1): 178.
  73. Bulthuis, M. S., Jager, D. H. J., & Brand, H. S. Relationship among perceived stress, xerostomia, and salivary flow rate in patients visiting a saliva clinic. Clinical Oral Investigations. 2018; 22(9): 3121-3127.
  74. Smyth, N., Rossi, E., & Wood, C. Effectiveness of stress-relieving strategies in regulating patterns of cortisol secretion and promoting brain health. Stress and Brain Health: Across the Life Course. 2020; 219.
  75. Clow, A., Edwards, S., Owen, G., Evans, G., Evans, P., Hucklebridge, F., & Casey, A. Post-awakening cortisol secretion during basic military training. International Journal of Psychophysiology. 2006; 60(1): 88-94.
  76. Cavanagh, K., Strauss, C., Forder, L., & Jones, F. Can mindfulness and acceptance be learnt by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clinical Psychology Review. 2014; 34(2):118-129.
  77. Gerber, M., Brand, S., Elliot, C., Holsboer-Trachsler, E., & Pühse, U. Aerobic exercise, ball sports, dancing, and weight lifting as moderators of the relationship between stress and depressive symptoms: An exploratory Cross-sectional study with Swiss university students. Perceptual and Motor Skills. 2014; 119(3): 679-697.
  78. Reibel, J. Tobacco and oral diseases. Medical principles and practice. 2003; 12(Suppl. 1): 22-32.
  79. Polosa, R., Caponnetto, P., Morjaria, J. B., Papale, G., Campagna, D., & Russo, C. Effect of an electronic nicotine delivery device (e-Cigarette) on smoking reduction and cessation: a prospective 6-month pilot study. BMC public health 2011; 11(1), 786.
  80. Meadows, S. O., Engel, C. C., Collins, R. L., Beckman, R. L., Cefalu, M., Hawes-Dawson, J., ... & Williams, K. M. 2015 Department of Defense Health Related Behaviors Survey (HRBS). Rand Health Quarterly. 2018; 8(2).

Lisensi Creative Commons
This work is licensed under a Lisensi Creative Commons Atribusi-BerbagiSerupa 4.0 Internasional.
Contact us: Odonto Dental Journal: Jl. Raya Kaligawe Km.4, PO BOX 1054/SM Semarang, Central Java, Indonesia, 50112. Email: odontodentaljournal@unissula.ac.id
apps