Oral Health Status of Institutionalized Leprosy Patients in Kerala

This study has been undertaken to evaluate the oral health status of treated institutionalised leprosy patients in Kerala. A cross sectional descriptive study was conducted in 750 institutionalized treated leprosy patients residing in 6 different leprosy care centres (three government sanatoria and three non governmental leprosy institutions) in Kerala. Treated leprosy afflicted persons (LAPs) who provided consent to participate in the study were included. The oral health status was assessed by clinical examination and findings were recorded using WHO Oral Health Assessment Form (1997). Among 750 leprosy patients examined, 393 were males and 357 were females. The prevalence of oral mucosal lesions was 57 (7.6%). Oral Candidiasis 18 (2.4%) was the most prevalent oral mucosal lesion followed by palatal ulceration 12(1.6%). The proportion of persons having extra oral lesions was 531(70.8%). Temporo-mandibular-joint (TMJ) disorders were present in 352 (47%) subjects. Periodontal status of the subjects were poor, 570 (76.8%) subjects were having calculus or pockets. Majority of the subjects 411(54.8%) had periodontal pocket of 4mm or more. 581 (76.8%) subjects had attachment loss. These subjects had a prevalence of 459 (61.2%) for dental caries. The treatment needs of the population were high, i.e. 73.6% needed filling, 70.4% required extraction, 92.6% required prostheses and 0.8% required crown. Dental caries, periodontal disease, oral mucosal lesions, and TMJ problems were prevalent in these institutionalized leprosy patients. After the comparison with National Oral Health data, it was observed that only the missing teeth and DMFT were higher in this institutionalized population of leprosy afflicted persons (LAPs), otherwise oral health conditions as such are not good in this age groups in general population as well as LAPs. The prosthetic needs of this community appear to be largely unmet, which requires timely intervention. Oral health problems of such leprosy afflicted persons, already treated for leprosy but living in institutions due to social reasons, can be minimised by appropriate interventions such as oral health education and oral health care programmes organized on a regular basis.