Dental Caries, Periodontal Disease and their Associated Factors Among Patients Visiting Dental Teaching Hospital in Multan, Pakistan


Muhammad Amin1          -          BDS
Muhammad Amanullaha2          -          M.Sc, PhD
Anwar Muneer Tarar3          -                BDS,



BACKGROUND: To determine different risk factors of dental caries and periodontal disease among subjects visiting dental hospital, Multan, Pakistan.

METHODOLOGY: A cross-sectional study was conducted at dental hospital, Multan, Pakistan from March, 2014 to August, 2014. A questionnaire was distributed among adult patients visiting the hospital. The chi-square test was used to determine the association of risk factors such as age, gender, smoking, brushing habits etc. with caries and periodontal disease.

RESULTS: Out of 366 patients, there were 186 (50.8 %) females and 180 (49.2%) males. It was observed that gender (p-value 0.14), education (p-value=0.13), income (p-value=0.39), age (p-value=0.17) and tooth paste use (p-value=0.55) have no association with the dental caries and periodontal disease. However, factors such as family history of dental diseases (p-value= 0.02), smoking (p-value <0.01), use of pan (p- value = 0.04), and duration of disease (p-value <0.01) were found to be significantly associated with caries and l disease.

CONCLUSION: Family history, pan using, smoking, and dental duration are found to be significantly associated with caries and periodontal disease among patients visiting dental hospital of Multan, Pakistan.

HOW TO CITE: Amin M, Amanullah M, Tarar AM. Dental Caries, Periodontal Disease and their Associated Factors Among Patients Visiting Dental Teaching Hospital in Multan, Pakistan. J Pak Dent Assoc 2016; 25(3): 98-102.

KEYWORDS: Dental caries, Periodontal disease, prevalence.

Received: 17 August 2016, Accepted: 29 September 2016


Oral diseases such as dental caries and periodontal disease are prevalent all over the world1 . According to W.H.O.3 report, 60 to 90 % school children and 100% adults have been affected by dental caries and 20 % have periodontal disease worldwide. In Pakistan, the people residing in rural areas are at a disadvantage with respect to their oral health mainly because of shortage of oral health care facilities and lack of awareness resulting from poor literacy4 . According to W.H.O.3 , it was  reported that 18% population of Pakistan has some form of periodontal problems and out of these 31% has periodontitis5 . Albandar et al.6 studied some risk factors of periodontal disease and tooth loss in adults. They observed that age, gender, current smoker status and number of years of smoking are the significant risk factors of tooth loss. Treasure et al.7 studied associated factors of tooth loss among in UK adults. They found that age, social status of household head, education, and marital status are the associated factors of tooth loss. Khan et al.4 studied the effect of awareness, attitudes, practices and other factors on dental diseases. They reported that use of sweet and smoking are the significant factors for dental diseases. Eke et al.8 studied the prevalence of periodontitis disease in adult population of United States of America. They reported that 64% adults (age 65 and above) have moderate and severe periodontitis. Brothwell et al.9 studied the factors associated with of visiting a dentist among older population of s in Canadian population. They find that education, relative support, use of health services, residence and income are the significant factors for visiting dental clinics. Khalifa et al.10 studied the tooth loss factors in Sudanese adults. They found that that age, gender, ethnic group, education, tobacco use, periodontal conditions and tooth wear are the significant factors of tooth loss.
From the literature we observed that most studies in Pakistan have considered the dental diseases of children. There was no study on dental diseases among adults ever conducted in Multan, Pakistan., Pakistan. Therefore, our purpose is to determine the prevalence and the risk factors of dental diseases among dental patients at visiting teaching institution of Multan.


A survey on the risk factors of caries and periodontal disease was carried out at Dental Hospital, Multan, Pakistan. Different questions were asked to the patients at the face to face interview during diagnosis at outpatient’s patients department from March, 2014 to August, 2014.A total 499 patients were examined in the Dental Hospital, in this period. In present study, the variables of interest are bleeding gums, dental caries and periodontal disease. Following risk factors were explored: gender, age, diseases duration, education level, income level, profession, smoking, family history, use of pan, and tooth paste habit. For the data analysis, Statgraphics, Centurion XVI (USA) software was used. Frequency and percentages of dental diseases were computed. The Chi-square test was used to determine the association of the mentioned risk factors with the dental diseases.


The distribution of dental diseases and their risk factors are shown in Table 1. Factors such such as duration of dental disease, family history of dental disease, smoking and use of pan turned out to be significantly associated with the presence of caries, bleeding gums and dental disease among adults visiting dental hospital, Multan, Pakistan.


The association between the different types of dental diseases with family history indicated that there are 8.47%, 11.20% and 24.59% patients in bleeding gums, caries and periodontal diseases category whose family members have or have had dental diseases. The results show that family history has a significant effect on dental diseases (p-value = 0.02).

The association between the dental diseases and disease duration showed that there are 12.88%, 14.24%and 48.49% patients in the bleeding gums, caries and periodontal disease category. This means that there are 75.62% patients having diseases duration fewer than 500 days. In the light of these results, it is obvious that there are just 0.20% patients with duration of diseases over 3000 days. The disease duration has significant effect on presence of dental diseases (p-value <0.01).

On studying the association between dental disease and education, we observed that bleeding gums, caries and periodontal diseases are 6.01%, 4.37% and 15.30% respectively among illiterate subjects… There are 37.30% patients who have college education who presented with bleeding gums, caries and periodontal dental disease. However, the results showed that education has no significant association with dental diseases (p-value = 0.13).

Similarly, we noticed that that income level has no statistically significant effect on the development of dental diseases (p-value = 0.39).

There were 3.28%, 3.01% and 4.37% dental patients who did not use pan but presented with bleeding gums, caries and periodontal disease respectively. Whereas, there are 18.03%, 16.12% and55.19% subjects in bleeding gums, caries and periodontal disease category who were regular pan chewers.. Use of pan had a marginally significant association with dental disease (p-value = 0.04).

Another factor which may cause the dental diseases is the smoking. There were 47(12.84%), 59(16.12%) and 187 (51.09%) smokers subjects who reported bleeding gums, caries and periodontal problems respectively. It is evident that there are more smoking is associated with dental disease (p-value <0.001).

Table 1. Dental diseases with the associated risk factors.

The relationship between the age of the patient (p-value = 0.55) and use of tooth paste (p-value = 0.17) did not turned out to be related with development of dental disease.

Parveen et al.11 studied the status of oral health and oral hygiene practices at Nishtar Institute of Dentistry, Multan. They reported that the oral health status of the majority of the patients was very poor. Similar studies were done by Nasir et al. in Islamabad12, Ali et al. 13 at Lahore, Umer et al.14 at Sargodha, Anwar et al. 15 at Peshawar and Shaikh et al.16 at Larkana. Mutamuliza et al.17 studied the risk factors of periodontal disease of adults in Rwanda. They have found that age, education level, occupation, tooth brushing, dental office attendance, diabetes, smoking status are the significant factors of periodontal disease. Baranwal et al.18 studied the patterns of dental caries of adults in Uttar Pradesh, India. They reported that mostly dental caries problems occurred in patients with age less than 30 years.


Limitations of this research include:

  • Results are only generalizable to the subjects visiting in the Nishter Dental Hospital. Only limited risk factors were taken into account for analysis. Other factors such as eating habits, carbohydrate intake, physical disability, life styles etc. may also be associated with dental diseases.


Awareness about the dental diseases is necessary for better oral health. Better education and taking precautions may help to reduce the dental diseases prevalence.


It was observed that family history of dental diseases, disease duration, smoking and use of pan using are the significant factors for .caries and periodontal disease among adults visiting dental hospital, Multan, Pakistan.


Muhammad Amin conceived the study, did planning, questionnaire development, data analysis, and interpreted the results. Muhammad Amanullah supervised the research and did proof reading of manuscript. Anwar Muneer Tarar collected the data and wrote the manuscript under the guidance of Muhammad Amanullah.


We have no conflict of interest.


  1. Nazir R, Hussain A, Kaleem M. Oral health status and malocclusion in flood affected and internally displaced children in Pakistan. Pak Oral Dent J. 2012; 32: 110-4.
  2. Iqbal F. Prevalence of oral and dental diseases among domestic employees working in sector f-7 Islamabad. Pak Oral Dent J. 2011;31(1): 137-40.
  4. Khan F, Ayub A, Kibria, Z. Knowledge, attitude and practice about the oral health among the general population of Peshawar. J Dow Uni Health Sci 2013; 7: 117-21.
  5. Bokhari SA, Suhail AM, Malik AR, Imran MF. Periodontal disease status and associated risk factors in patients attending a Dental Teaching Hospital in Rawalpindi, Pakistan. J Indian Soc Periodontol 2015; 19: 678-82.
  6. Albandar JM, Streckfus CF, Adesanya MR, Winn DN. Cigar, pipe and cigarette smoking as risk factors for periodontal disease and tooth loss. J Periodontol. 2000; 71: 1874-81.
  7. Treasure E, Kelly M, Nuttall N, Nunn J, Bradnock G, White D. Factors associated with oral health: a multivariate analysis of results from the 1998 adult dental health survey. Br Dent J. 2001; 190: 60-8.
  8. Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012; 91: 914-20.
  9. Brothwell DJ, Jay M, Schonwetter DJ. Dental service utilization by independently dwelling older adults in Manitoba, Canada. J Can Dent Assoc. 2008; 74: 161- 161f.
  10. Khalifa N, Allen PF, Abu-bakr NH, Abdel-Rahman ME, Abdelghafar KO. A Survey of oral health in a Sudanese population. BMC Oral Health 2012; 12: 5.
  11. Parveen N, Ahmad B, Bari A, Butt A. Oral dental health: Awareness and practices. J Uni Med Dent Coll 2011; 2: 5-10.
  12. Nasir N, Ali S, Hayat Y, Bashir U. Oral health status of patients visiting Islamic International Dental Hospital. Ann. Pak. Inst. Med. Sci. 2012; 8: 27-30.
  13.  Ali S, Bhatti M, Syed A, Chaudhry A, Iqbal Z. Prevalence of dental caries among 5 – 14 years old locality school children of Lahore. Pak Oral Dent J 2012; 32: 279-83.
  14. Umer MF, Farooq U, Shabbir A, Zofeen S, Mujtaba H, Tahir M. Prevalence and associated factors of dental caries, gingivitis, and calculus deposits in school children of Sargodha district, Pakistan. J Ayub Med Coll Abbottabad 2016; 28: 152-6.
  15. Anwar S, Rehman K, Khan M, Afridi, R. Body mass index and dental caries. J Khyber Coll Dent 2013; 3: 30- 3.
  16. Shaikh MA, Rajput F, Khatoon S, Shaikh MA. . Prevalence of dental caries in BiBi Aseefa dental College, Larkana Areas. Pak Oral Dent J 2014; 34: 131- 4.
  17. Mutamuliza J, Rwema F, Rulisa S, Ntaganira J. Prevalence and associated risk factors of periodontal disease among adults attending dental department in Rwanda Military Hospital (Rwanda): a cross sectional study. Dent Open J. 2015; 2: 105-11.
  18. Baranwal HC, Pandiar D, Singh TB. Pattern of dental carries among adults purvanchal region of Utter Pradesh, India. Int J Sci Res 2015; 4: 323-6.

1. Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
2. Professor, Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
3. Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
Corresponding author: “Muhammad Amin” < >