Periodontal disease burden and associated factors among tea plantation workers in Tamil Nadu, India: a cross-sectional study

To estimate the prevalence and severity of periodontitis and identify factors associated with severe periodontitis among tea plantation workers attending community dental screening camps in Kothagiri Tea Plantation region of Tamil Nadu, India. A camp-based cross-sectional study was conducted among 540 tea plantation workers recruited from community dental screening camps across four tea estates in Kothagiri, Tamil Nadu, India. Sociodemographic characteristics, oral hygiene practices, and dental attendance were recorded using a modified WHO Oral Health Assessment proforma. Periodontal examination included bleeding on probing (BOP), calculus, probing pocket depth (PPD), and clinical attachment loss (CAL) assessed by a calibrated examiner (κ = 0.85). Periodontal severity was categorized using a field-adapted clinical approach based on available CAL, PPD, and clinically observed tooth-loss patterns. Severe periodontal destruction was reported as consistent with field-adapted Stage III/IV severity because radiographic and comprehensive complexity assessments were unavailable. Severe periodontitis was operationally defined as field-adapted Stage III/IV severity for epidemiological analysis. Chi-square, Mann–Whitney U, and multivariable logistic regression analyses were performed. Among the participants, 62.6% (338/540; 95% CI: 58.4%-66.6%) presented with disease states consistent with field-adapted Stage III/IV severity. Severe CAL (≥ 6 mm) was more frequent among males, whereas BOP was more common among females. The use of charcoal for tooth cleaning was widely reported. In multivariable analysis, male sex (adjusted OR = 1.9, 95% CI: 1.2–3.0), low educational attainment (adjusted OR = 2.3, 95% CI: 1.4–3.9), and irregular dental attendance (adjusted OR = 1.7, 95% CI: 1.1–2.8) were significantly associated with severe periodontitis. Age was not significantly associated with severe periodontitis in the adjusted model. This cross-sectional study suggests a high prevalence of periodontitis among tea plantation workers in Southern India. Severe periodontitis was associated with male sex, lower educational attainment, and irregular dental attendance. Because recruitment was voluntary and field-adapted periodontal staging relied on field clinical assessment without radiographic evaluation, the findings should be interpreted with caution.