Periodontitis on the Red Sea: Prevalence, Risk Factors, and the Cleaning Paradox in Coastal Sudan

Background: Periodontal disease represents a significant public health challenge in Sub-Saharan Africa, yet baseline prevalence data for coastal regions of Sudan remain scarce, particularly amidst ongoing humanitarian crises. Objective: The study aims to determine the prevalence and patterns of periodontitis and identify associated risk factors among adults attending Port Sudan Dental Hospital. Methods: A cross-sectional study was conducted in July 2024 at Port Sudan Dental Hospital. A total of 189 participants were enrolled using convenience sampling. Data were collected through clinical periodontal examinations and structured questionnaires covering demographics, oral hygiene practices, social habits, medical history, and water consumption patterns. Statistical analysis employed SPSS version 27, with chi-square tests for associations (significance set at P<0.05). Results: Periodontitis prevalence was 57.7%, with dental calculus present in 68.3% of participants. While 96.8% reported tooth brushing, only 37.2% brushed twice daily. Significant associations with periodontitis were observed for age (P=0.023), cleaning frequency (P=0.031), tobacco use (P=0.045), and diabetes (P=0.042). Current smokers (71.0%) and diabetic patients (83.3%) showed markedly higher disease rates. Mean pocket depth increased significantly with age (P=0.008), tobacco use (P=0.021), and presence of medical conditions (P=0.035). Desalinated water was the primary source for 50.3% of participants. Conclusion: This study reveals a high burden of periodontitis in coastal Port Sudan, significantly associated with modifiable risk factors including infrequent cleaning, tobacco use, and diabetes. Findings underscore the urgent need for integrated oral health strategies within Sudan's conflict-affected healthcare context.