J. Maxillofac. Oral Surg.

(July–Sept 2014) 13(3):267–270

DOI 10.1007/s12663-013-0533-4

RESEARCH PAPER

Demographic Study of Prevalence of Systemic Diseases in Oral

Maxillofacial Surgery Patients of Central India
Vrinda Sunil Kolte • Rameshwar Sakharam Dolas •

Ramakrishna Shenoi

Received: 2 October 2012 / Accepted: 15 May 2013 / Published online: 20 June 2013
Ó Association of Oral and Maxillofacial Surgeons of India 2013

Abstract which is 4.055 % with highest population showing

Summary An evaluation and consideration of health status involvement of cardiovascular disease and minimum pop-
of patient prior to any surgical treatment forms an essential ulation undergoing oral surgical procedures are compro-
part of comprehensive health care. Apparently well but in mised by various infectious diseases.
fact medically compromised patients usually present with
unacceptable possibility of complications; whereas adequate Keywords Prevalence
Systemic diseases
Oral surgery
pretreatment utilization of many techniques available to
diagnose and treat underlying systemic disease significantly
decreases morbidity and mortality associated with it. Introduction
Aims and Objectives Purpose of this study was to eval-
uate, prospectively, prevalence of various systemic dis- In times when reliability motives of professionals are under
eases in oral surgery patients. constant scrutiny, oral maxillofacial surgeons have
Materials and Methods For analyzing prevalence of immeasurably added to it by extending their horizons to
systemic diseases in oral surgery patients, the patients include broad health picture of an individual. An evaluation
reporting to oral surgery department for various treatments and consideration of health status of patients prior to any
were prospectively evaluated for a period of 6 months and surgical treatment in general and oral surgical procedures in
were grouped according to a system involved and findings particular forms an essential part of comprehensive health
analyzed to get prevalence in central India. care system. Apparently well but in fact medically com-
Result Of the 12,487 patients who reported to the promised patients (here medically compromised term
department 506 (4.055 %) were medically compromised indicates patient whose general condition is deranged
with a highest prevalence of cardiovascular diseases because of underlying systemic disease) when presented
(35.57 %), and least prevalence of infectious diseases with oral surgical problems, majority of them are unaware
(3.55 %). These results are statistically significant (by Chi- of their systemic status i.e. whether they are healthy or have
square test) at p \ 0.01 (v2 = 342.752). any systemic disease which increases unacceptable possi-
Conclusion The aim of study was to evaluate prevalence bility of complications if disease remains untreated [1].
of systemic disease in oral surgery patients of central India Systemic diseases are responsible for erosion of an
organ system’s reserve or ability to respond to internal or
external stress body type [2]. This diminished adaptive
V. S. Kolte (&)
R. Shenoi
capability results in increased potential for system failure
Department of Oral and Maxillofacial Surgery, VSPM Dental
College, Digdoh Hills, Nagpur, India due to maxillofacial pathologies and their surgical proce-
e-mail: [email protected] dures. Whereas adequate pretreatment knowledge of
involvement of systemic disease may significantly decrease
R. S. Dolas
complications associated with surgical procedure, which
Department of Oral and Maxillofacial Surgery,
DY Patil Dental College, Pune, India can be effectively done by utilization of many techniques
e-mail: [email protected] available to diagnose and treat the underlying systemic

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disease which results in decreased morbidity and mortality 1. Tuberculosis

associated with systemic diseases which is precipitated by 2. Leprosy
dental treatment. 3. HIV
To keep a high status of awareness it is necessary to
GROUP V: Respiratory disorders
periodically review the type of patient population currently
being treated so that necessary amendments can be made in 1. Bronchial asthma
the health care protocol. To compile such information it
GROUP VI: Neurological disorders
was decided to conduct this prospective demographic study
to determine prevalence rate of systemic diseases in oral 1. Epilepsy
surgery patients. 2. Cerebrovascular Episodes
3. Psychiatric problems
GROUP VII: Multisystem diseases
Aims and Objectives
Patients having more than one systemic disease.
GROUP VIII: Others
1. To find out overall prevalence of various systemic dis-
This included patients with systemic disease which
eases in patients reporting to oral maxillofacial surgery
cannot be considered under the above stated headings.
department for various oral surgical procedures.
2. To find out prevalence of individual systemic diseases
in patients reporting to oral maxillofacial surgery
Review of Literature
department for various oral surgical procedures.
Systemic diseases may be thought of as an erosion of an
organ system’s reserve or ability to respond to internal or
Materials and Methods external stress. This diminished adaptive capability results
in increased potential for system failure due to maxillofa-
For conducting this prospective demographic study of cial pathologies and their surgical procedures. From this,
prevalence, after approval from local ethical committee, all perspective it is important to know about patients, systemic
patients reporting to OPD of Oral Maxillofacial Surgery disease so as to reduce the amount of tissue damage and
Department were recorded for a period of 6 months and improve strategic reserve.
patients having systemic diseases were grouped according Rothwell and Wagg [1], conducted a survey by preparing a
to the system involved under the following headings; all questionnaire to assess the awareness of patients attending a
the data so compiled was subjected to statical analysis by dental center about their medical status and compared the
Chi-square test. results with usual method of verbal history taking. In this
GROUP 1: Hematological disorders survey they could find that 167 patients had systematic diseases
but were not aware of the condition and its relation to dental
1. Anemia
treatment. Only 4 out of 500 patients were aware about having
2. Leukemia
a systemic disease and its relevance to dental treatment.
3. Hemophilia
Cottone and Katyraya [2], carried out a survey to pro-
4. Other bleeding disorders
cure information of systemic diseases of dental patients and
GROUP II: Cardiovascular disorders frequency of drug used by patients for managing them.
Two-third of the total patients studied were having positive
1. Hypertension
medical history for at least one problem and more than
2. Congenital heart disease (CHD)
50 % of the patients reported multiple medical problems.
3. Rheumatic heart disease (RHD)
Goss [3], studied systemic diseases in terms of adverse
4. Ischemic heart disease (IHD)
reaction between systemic diseases and dental treatment and
5. Patients undergone angioplasty and prosthetic valve
need of emergency management. Dental treatment of these
replacement
patient may interact essentially with stability of systemic
GROUP III: Metabolic disorders diseases like co-operation in epileptic or mentally retarded
patients, bleeding in patients on anticoagulant therapy, altered
1. Diabetes mellitus(DM)
healing in diabetes mellitus and long term steroid therapy.
2. Renal diseases
In 1986, Parnell Anthony [4] proposed a screening
3. Thyroid problems
method for medically compromised patients, especially for
GROUP IV: Infectious diseases patients with diabetes mellitus and hypertension.

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J. Maxillofac. Oral Surg. (July–Sept 2014) 13(3):267–270 269

Jean and Nam [5] conducted a survey for oral surgery Discussion
patients and found an incidence of 4.3 % for systemic
diseases in oral surgery patients. A similar study was done For analyzing prevalence of systemic diseases in oral surgery
by Hari et al. [6] who collected clinical data regarding patients, the patients reporting to oral surgery department for
medical condition and medications used by the patients. various treatments were evaluated for a period of 6 months.
Out of 900 patients studied, 131 (3.3 %) had systemic During this period of the 12,487 patients who reported 506
diseases. (4.055 %) were medically compromised. Highest preva-
Trend Inga Berge [7] tried to evaluate medically com- lence was seen for cardiovascular diseases (35.57 %), fol-
promised patients in terms of their extent, scope, referrals lowed by metabolic diseases (20.35 %), hematological
and emergencies related to them. In average 6.6 % patients diseases (12.84 %), multisystem diseases (13.24 %), other
seen as medically compromised in Norwegian dental diseases (5.92 %). Neurological diseases (4.34 %), respira-
practice with domination of cardiovascular disorder. tory diseases (4.15 %) were also detected. Least prevalence
was seen of infectious diseases (3.55 %). This prevalence of
systemic diseases is statistically significant (by Chi-square
Observations and Results test) at p \ 0.01 (v2 = 342.752) (Table 1).
Finding of this study are in accordance with study by
See Table 1. Jean and Nam [5] in which they could get incidence of
systemic diseases upto 4.3 %.

Table 1 Prevalence of systemic diseases in oral surgery patients

Systemic problem Jun Jul Aug Sept Oct Nov Total Incidence rate (%)

Anemia 9 13 9 9 8 13 61
Leukemia – – 1 1 – 1 3
Thalassemia – – – – – 1 1
Group I: Hematological disorders 9 13 10 10 9 14 65 12.84
Hypertension 29 27 30 28 15 29 158
Rhumatic heart disease 3 1 2 2 1 2 11
Ischemic heart disease 6 1 – 2 2 – 11
Group II: Cardiac disorders 38 29 32 32 18 31 180 35.57
Diabetes mellitus 14 15 14 18 9 16 86
Renal 2 – 1 – – 1 4
Thyroid 5 2 3 1 1 1 13
Group III: Metabolic disorders 21 17 18 19 10 18 103 20.35
Psycological problems – – – – 1 1 2
Epilepsy 5 3 2 3 3 4 20
Group IV: Neurological problems 5 3 2 3 4 5 22 4.34
Bronchial asthma 4 3 4 4 3 3 21
Group V: Respiratory diseases 4 3 4 4 3 3 21 4.15
HIV – – – 1 – 1 2
Leprosy – 1 – – – – 1
Tuberculosis 2 3 3 3 3 1 15
Group VI: Infectious diseases 2 4 3 4 3 2 18 3.55
Group VII: Multisystem involvement 11 13 12 8 11 12 67 13.24
Group VIII: Other 6 5 2 7 4 6 30 5.92
Total number of patients with systemic problems 96 87 83 87 62 91 506 4.06
Total number of OPD patients 1,979 2,744 2,040 2,190 1,760 2,344 12,487
2
Chi-square test v = 342.752, p \ 0.01

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Hari et al. [6] in a study conducted at Calicut, in the past was seen to be 4.055 % with highest prevalence of car-
saw a prevalence rate of systemic disease in dental patients diovascular disease (35.57 %) followed by metabolic dis-
up to 14.5 % whereas in the present study the prevalence is orders (20.35 %), hematological disorders (12.84 %) and
much less. This might be attributed to the fact that the minimum incidence (3.55 %) of infectious diseases.
present study considered systemic status of patients
undergoing surgical procedures whereas the study by Hari
et al. [6] considered patients seeking any of the dental
treatments although highest prevalence of cardiovascular References
diseases and diabetes is observed in both studies.
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alence rate of medically compromised patients in dental 2. Cottone HA, Katyraya H (1979) Medications and health histories:
practice as 35.3 % with highest prevalence for cardiovas- survey of 4365 dental patients. J Am Dent Assoc 98:713–718
cular diseases followed by metabolic diseases. 3. Alastir Goss N (1984) The dental management of medically
compromised patients. Int Dent J 34:227–231
Trend Inge Berg [7], stated that the incidence rate of 4. Parnell Anthony G (1986) The medically compromised patient. Int
medically compromised patients in Norwegian dental Dent J 36:73–82
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disease similar to the present study. and their treatment, teaching chukka Usa Hypha Chi, 27(1):83–90
6. Hari S, Oomen Aju Jacob, Mangalam MK (1992) Systemic health
The above studies prevalence of systemic diseases status of adult dental patients and its dental care, study of 900 out
among general population reporting for any dental treat- patients. JIDA 63:301–303
ment whereas in our study we have considered patients 7. Trend Inge Berg (1992) Oral surgery in Norwegian general dental
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Medically compromised patients. Acta Odontol Scand 50:7–16

Conclusion

In this demographic study of population of central India,

the prevalence of systemic diseases in oral surgery patients

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