Periodontal conditions and oral hygiene in rural population of post-war Vukovar region, Croatia in correlation to stress.

OBJECTIVE The greatest burden of oral diseases is on the socially marginalized population, such as those living in small villages and war areas. The aim of this study was to assess the periodontal conditions of people in post-war area villages in relation to oral hygiene, habits and war stress. METHODS The study was conducted on a sample of 282 subjects (mean age 41.5 +/- 17.8) in seven Vukovar villages using the questionnaire and clinical periodontal examination. RESULTS Five years after the war in Croatia the population was still very poor, low educated, and had a low level of periodontal health and oral hygiene habits. The level of periodontal disease and attachment loss tended to increase with age and physical activity and decrease with education level, higher frequency of tooth brushing and toothbrush replacement, dental visits and utilisation of auxiliary devices. Subjects exposed to any kind of war stress had a significantly worse periodontal status and more excluded sextants than those who were not exposed to such stress experience (p<0.05). Better periodontal conditions were found in individuals that were refugees, than those who were in war, wounded or lost a dear person (p<0.05). Individuals who were in war rarely brushed their teeth, visited dentist and changed toothbrushes, but more frequently drank alcohol and smoked, in comparison to other groups, especially those who have not been exposed to war stress. CONCLUSIONS Specific socio-economic and psychological conditions in post-war areas could be significant risk factors for poor periodontal conditions.