THE INFLUENCE OF MICROCLIMATE AND EXISTING CONTAMINATION

ON THE PERIODONTAL
LUPULESCU TEODORA EVA1, COJOCARU IOANA2, MORARIU STELIAN3
ANGELA CODRUA PODARIU4, URTIL EMIL5 COVRIG VALERIA6
1. University of Medicine and Pharmacy Victor Babes Timisoara, teaching assistant
Dental School, Faculty of Medicine, Arad.
2. University of Medicine and Pharmacy Victor Babes Timisoara, student.
3. University of Medicine Vasile Goldi Arad.
4. Department of Preventive, Community Dentistry and Oral Health, Faculty of
Dentistry,University of Medicine and Pharmacy Victor Babes Timisoara, Romania.
5. Department of Cranio-Maxillo-Facial Surgery, University of Medicine and Pharmacy
Victor Babes Timisoara Romania.
6. Department of Dental Prosthetics, University of Medicine Vasile Goldi Arad
ABSTRACT
The problem of microclimate influence and the contamination on the periodontal
represents a much less studied domain. This domain is at the border between the
pathology of professional and dental diseases. In different branches of industrial activity
an important number of people are exposed to special conditions of caloric radiation,
electromagnetic or substances as: plumb, chromium, cadmium, iron, arsenic, or silica.
The oral manifestations in contaminant poisoning represent a gate of the toxins in the
human body and are the place of early manifestations of general diseases. Symptoms
such as: gingival line, periodontitis or gingival inflammations can be characteristic signs
of alarm and often occur early, a long time before the general symptoms.

Key words: contamination, microclimate, periodontal, stomatitis, plumb

Correspondence to:
Lupulescu Teodora Eva,
Dental School, Faculty of Medicine, Arad
Adress: com.Tudor Vladimirescu, M Eminescu nr.60, ARAD
Phone: 0745063958
E-mail address: teodora_lupulescu@yahoo.com

INTRODUCTION
The dependence of living organisms to the environment is reported from the ancient
times. Physical agents acting on organisms can be divided in two big categories:
Natural physical environments including: heat, cold, humidity, barometric
pressure drop, light, cosmic rays,
Artificial physical environments include: air pollution, toxic fumes, toxic
substances, electromagnetic radiation, noise.
The widespread use of devices equipment in national economy and
development of devices industry led to a situation where large groups of persons are
exposed to radio waves in the microwave band. The annual research in the air-spatial
domain, development of automation and communication, and also the use of speed
devices in various branches of science and engineering have opened up tremendous
opportunities for the use of radio-electronics. The explosive development in radioelectronics and its widespread penetration in different sectors of the economy (radio
communication, television, radar, radio navigation, radio-spectroscopy, radio astronomy
etc.) led to a situation where the number of people who come into contact with
microwave radiation is increasing with each passing year. The study of this radiation led
to the belief that radio waves in the microwave band can have both pathogenic effects
and, in some circumstances, a therapeutic action on the human body. In this regard, there
were issues of paramount industrial hygiene, which involves determining the negative
effects of radio waves made by the human body, setting the maximum permissible
exposure levels, and the development of preventive and protective measures.
The complexity of industrial technologic processes, agricultural, and the
desire for profit made for the human exposure that produces or consumes these products
to be more varied in contamination. The degree of exposure depends on the length and
concentration of pollutants. During a long-term exposure to harmful substances, such as
metals and non-metals, toxic substances penetration into the human body over the
allowed limits, as the presence of favorable conditions can cause functional and
morphological manifestations at different organs and systems, including the oral cavity.
The occurrence of such oral events portends either increased oral intake of toxic, either
decreased overall body strength exhibit.
The salivary flow decreases in volume, and becomes more viscous and more acid and
therefore is no longer easily self-cleaning of food debris, the microbial germs forming the
oral plaque cannot be removed in normal conditions, the processes leading to
development of multiple caries and inflammatory type periodontitis.
MATERIAL AND METHOD
The occupational disease study involving a great difficulty that comes from both
firms operating analyze subjects and are not interested in providing casework illnesses
and diseases in which are involved several organs and affected systems. At the subjects
analyzed are superimposed the direct action of harmful substances simultaneously with
the irritation type of noxious agents or the microclimate.
The study that we conducted in collaboration with the Department of
Occupational Diseases Hospital of Arad Municipality was carried out on 284 subjects
working in conditions of exposure to harmful action of toxic fumes, toxic substances,
electromagnetic radiation, noise, atmospheric pollution among these after the dental exam
a group of 48 subjects of different age, different sex with seniority in work from 5 to 20
2

years coming from businesses which are exposed to various toxins, presented dental
disorders associated with professional illnesses.
Before starting this study the subjects were informed about its purpose and their
consent were obtained, in write and signed. It was necessary obtaining the permission of
the company manger to develop the research, and also the support of the mangers. Were
not included in the study the subjects who have not given their consent or they did not
received it from the manger.
The subjects were evaluated in natural light. The natural light or artificial was
used according to the examination conditions. The clinical exam was performed by a
single dentist with dental instruments (probe, forceps, disposable dental mirror) with
detailed examination of dental and periodontal affected areas. Were visually inspected,
and the suspects were explored with the probe to determine the contours and the surface
defects. Diagnosis was made by comparison with standard images after from medical
point of view was familiar with the injuries as defined by the authors.
Table and graphic no.1
Distribution of sujects by gender
SUBJECTS WOMEN
284
88

MEN
196

SUBJECTS REVIEW

women
21%

men
79%

Statistically the number of men enrolled in this study is higher because they were
subject to study in the small and medium companies (wood processing industry,
construction industry of machinery parts, road construction industry, clothing industry,
trade and services)

Table and graphic no. 2

Seniority of subjects
1year-5years
76

5years-10years
49

10years-15years
148

15years-20years
11

total
284

LENGTH OF WORK
148

160
140
120
100

76

80

49

60
40

11

20
0

1year-5years

5years-10years 10years-15years 15years-20years

Regarding the working years, the ones with age from 1 years and 5 years is very
high 52% because exists a high migration of labor. It is noted due to economic difficulties
of the free market that the number of companies resists in time without changing the
profile is less and therefore the number of those that have seniority in the area is reduced
with 4% (the ones with seniority 15 years 20 years).
Table no. 3
The predictor level of the microclimate and occupational contamination
VARIABLE
GENDERS
MEN
WOMEN
SENIORITY
1-5 years
5-10 years
10-15 years
15-20 years
LABOR CONDITIONS
Pb
Cu
Hg
Se
Phosphates
Acrylic
Stress
Physical exhaustion
Radiations

No of SUBJECTS

PERCENTAGE %

284
196
88

69%
31%

148
76
49
11

52%
27%
17%
4%

108
75
9
17
38
29
241
209
56

38%
29%
3%
6%
13%
10%
85%
74%
20%

Vicious positions
LIVING CONDITIONS
>1000 lei
<1000lei
EDUCATIONAL LEVEL
>10 classes
<10 classes

197

7%

125
159

44%
56%

72
212

25%
75%

Table no. 4
Oral manifestations and their degree of addressability at the specialized treatment
VARIABLE

No SUBJECTS

Congestive buccal mucosa with

glossy
aspect
Edematous
gingival mucosa
Ulcerated gingival mucosa
True periodontal pockets
False periodontal pockets
Periodontal abscess
Spontaneous gingival
Caused gingival
Gingival retractions
Gingival hypertrophy
Teeth with tartaric deposits
Gingival lizereu
Hyper chrome dental deposits
Simple caries
Complicated dental caries
Extractions

2
4
3
19
4
11
16
37
24
12
46
5
8
362
171
694

0,5%
8,3%
6,3%
39,6%
8,3%
22,9%
33,3%
77,1%
50%
25%
95,8%
1,1%
16,7%
43%
20,3%
45,2%

TREATMENT
EMERGENCY
CONSERVATIVE
2
2
1
2
6
5
2
1
8
1
10
2
7
11
5
16
7
5
5
21
2
1
3
2
145
110
46
29

Figure 1. periodontal abscess, tartaric deposits teeth, hyper chrome dental deposits

Table no. 6
5

Dental maxillary apparatus diseases at the analyzed subjects

VARIABLE
Necrotizing ulcerative stomatitis
Medium intensity stomatitis
Easy stomatitis
Congestive form
Catarrhal form
Ulcerative form
Marginal chronic profound periodontitis with
atrophic appearance
Superficial
marginal chronic periodontitis
Periodontal abscess
Glossitis

No SUBJECTS
1
9

%
2,08%
18,75%

6
2
1
4
13
11
1

12,6%
4,16%
2,08%
8,33%
27,08%
22,92%
2,08%

Figure 2: marginal atrophic periodontitis, periodontal abscess, medium intensity

stomatitis
RESULTS
Generally the symptoms and manifestations at the dental-maxillary apparatus that
we have found during the course development and we have shown in the tables from
above falls among those described in the specialized literature. The most common oral
lesions at the bucal mucosa were detected in the form of spontaneous gingival bleeding
(33.3%) and especially challenging (77.1%) (chewing, tooth brushing), in case of a
stomatitis with medium intensity and much rare as necrotizing ulcerative stomatitis.
These manifestations were found at the subjects that work in medium with environmental
exposure at Hg, Cu, Pb.
The features is that due to the chronic exposure to work experience of over 10
years, frequently occurs gingival stomatitis, as necrotic ulcerative stomatitis.
Regarding the periodontal marginal lesions, commonly encountered are
superficial marginal gingivitis and periodontitis (27.08%) and much smaller percentage
marginal periodontitis with atrophic aspect (8,33%). As a clinical manifestations I
frequently met gingival swelling, gingival papillae congestion as purple-red color, with
fake periodontal pockets and sometimes periodontal abscess (22.9%). Subjectively, the
patients accuses sensation of gum itching. Gingival bleeding caused at chewing or
brushing make them to stop the oral hygiene, thus worsening the situation.
Gingival lisereum present only in 5 cases was determined by the presence of
tartaric blocks favorable in the retention areas (dental or prosthetic ingrowth iatrogenic),
having different colors depending on the type of contamination, grey, scarlet with Pb,
black with Hg or green with Cu.

From clinical observations that we conducted in this study, deep chronic marginal
periodontitis either it is shallow or profound it takes clinical forms by early involution of
periodontal towards the age of the subject.
Regarding the dental lesions at the subjects exposed to a toxic environment,
statistically I ascertain that the number of simple caries (43%) or complicated (20,3%) is
no higher at this ones than at the subjects non-exposed. Exposure to pollutants has does
not have a cariogenic effect.
DISSCUSIONS
Oral manifestations at contaminant exposure and micro-climate variations we have found
that although are not in a first place of a general symptomatology, except for acute
intoxication, they can be a warning signal, that indicates a decrease in overall body
strength. We ascertain that toxic work environment for the subjects group 1 year 5
years is not a decisive factor in the onset of disease, but irritant action of superimposed
pollution (stress, longer working hours, radiation, heat variations and light intensity),
those who often neglect or ignore wearing protective equipment.
CONCLUSIONS
We can say with certainty that the mechanism of periodontitis occurrence in
exposures to pollutions and microclimate influences is extremely complex and depends
heavily to the prior exposure dental status, age, working years in the environment, the
consciousness of properly wearing the protection equipment, dental hygiene,
establishment of preventive measures.
It is clear that despite numerous technical progress there are still many risks of
occupational illnesses. The occupational risks are unavoidable in many professions.
Employers should be guided by the dictum to be occupational productive, should be
healthy. Must be remembered that each technology can exert a direct negative impact on
the recipient and his family. Must always be a balance between maximum and minimum
benefits without affecting in any way the health.
REFERENCE
1. Slagter AP, Bosman F, Van der Bilt A (1993) Comminution of two artificial test foods
by dentate and edentulous subjects. J Oral Rehabil 29,
2.Morita M, Nishi K, Kimura T, Fukushima M, Watanabe T, Yamashita F, Zhou R, Yang
J, Xu X (2003) Correlation between periodontal status and biting ability in Chinese adult
population. J Oral Rehabil 30, 97-186.
3. Daniel, M., and F. Dusbabek. 1994. Micrometeorological and microhabitat factors
affecting maintenance and dissemination of tick-borne diseases in the environment, pp.
91138. In D. E. Sonenshine and T. N. Mather [eds.], Ecological dynamics of tick-borne
zoonoses. Oxford University Press, New York.
4.Semtner, P. J., D. E. Howell, and J. A. Hair. 1971. The ecology and behavior of the
lone star tick (Acari: Ixodidae). I. The relationship between vegetative habitat type and
tick abundance and distribution in Cherokee Co., Oklahoma. J. Med. Entomol. 8:
329335.
5.Kanerva L, Estalender T, Jolanki R, Alanko K. False-negative patch test reactions due
to a lower concentration of a patch test substances then declared. Contact Dermatitis
2000; 42: 219-99.
7

6.Bellissimo-Rodrigues WT, Bellissimo-Rodrigues F, Machado AA. Occupational

exposure to biological fluids among a cohort of Brazilian dentists. Int Dent J 2006; 56:
308-7.
7.Kai M, Luebeck EG, Moolgavkar SH. Analysis of the incidence of solid cancer among
atomic bomb survivors using a two-stage model of carcinogenesis. Radiat Res 1997; 102:
219-58.
8.Winship, K. A. Toxicity of inorganic arsenic salts. Adv. Drug. React. Acute poisoning
Rev. 3, pp 141-17, 1984.
9.Zachariac, H., Sogard, H., and Nyfors, A. Liver biopsy in psoriatics previously treated
with potassium arsenate. Acto Derm Venereol (Stock). 54, pp 115-229, 1974.
10.NAS. Medical and biological effects of environmental pollutants: Arsenic
Washington, D. C.National Academic of Science. 1977.
11.Nordenson, I., Sweins, A., and Beckman, L. Chromosome abberations in cultured
human lymphocytes exposed to trivalent and pentavalent arsenic. Scand. J. work Environ.
Health. 7, pp 153-206, 1981.
12.Moore, J. E. In modern treatment of syphilis. Charles C Thomas. (ed.) Springfield III,
1933.
13.. Morton, W. E., and Caron, G. A. Encephalopathy: An uncommon manifestation of
workplace arsenic poisoning. Am. J. Ind. Med. 15, pp 3-9, 1989.
14. Podariu Angela, Jumanc Daniela, Glucan Atena, Vcaru Roxana, Muntean
Ramona Tratat de prevenie oro-dentar - Editura Waldpress Timioara, 2003
15. Emil Urtil, Marius Pricop. Infeciile Buco-Maxilo-Faciale Editura Helicon
Timioara 1993 p 11- 49
16. Swimmer L. Occupational disease and disorders as related to dentistry, J. Dent. Res,
1953 p14-18,
17.Pambuccian Gr. Infrastructura celulei i a esuturilor normale i parodontale i
patologice. Actualiti medicale1971 p 9-54.
18.Gadariu Ghe, Barhad B, Gavrilescu N Igiena muncii, Editura Medical Buc1967 p 5291.
19. Practica Medicinii Muncii- subredacia Toma Ion, Editia revizuit i adugit, Ed.
Sitech Craiova 2011 p 67-112
20.Medicina Ocupaional, vol. I si vol. II- subredacia Aristotel Cocrl, Ed. Medical
Universitar Iuliu Haegan, Cluj Napoca 2009 p 35-62