# Prevalence of _Trichomonas tenax_ in the Population Affected by Periodantal Disease--A Review
## 4 Discussion  
The relevance of the topic is supported by the fact that periodontal disease is a global societal problem, prevalent mainly in developed and developing countries, affecting both children and adults [85]. The literature emphasizes the importance of its etiology. Our \begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**Author(s)** & **Year** & **Country** & \begin{tabular}{c} **Number of Tested** \\ **Samples** \\ \end{tabular} & \begin{tabular}{c} **Number of Samples** \\ **Positive for** \\ _Trichomonas tenax_ \\ \end{tabular} & \
\begin{tabular}{c} **Used Method for** \\ **Detection** \\ \end{tabular} \\ \hline [PERSON] [75] & 1926 & USA & 186 & 49 & Cultivation \\ \hline [PERSON] [76] & 1933 & USA & 350 & 132 & Unknown \\ \hline [PERSON] and & 1970 & USA & 1036 & 301 &
\begin{tabular}{c} Light microscopy, \\ cultivation \\ \end{tabular} \\ \hline [PERSON] et al. [78] & 2008 & Mexico & 150 & 21 & Light microscopy \\ \hline \hline \end{tabular}
\end{table} 
Table 6: _Trichomonas tenax_ prevalence studies carried out in North America. \begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Author(s)** & **Year** & **Country** & \begin{tabular}{c} **Number of Tested** \\ **Samples** \\ \end{tabular} & \begin{tabular}{c} **Number of Samples** \\ **Positive for** \\ _Trichomonas tenax_ \\ \end{tabular} & \begin{tabular}{c} **Used Method for** \\ **Detection** \\ \end{tabular} \\ \hline [PERSON] et al. [79] & 1988 & Kenya & 177 & 5 & Light microscopy \\ \hline [PERSON] et al. [80] & 2004 & Nigeria & 203 & 10 & Light microscopy \\ \hline [PERSON]. & & & & \\ El-Sayed and & 2008 & Egypt & 50 & 15 & \
\begin{tabular}{c} Light microscopy, \\ cultivation, PCR \\ \end{tabular} \\ \hline [PERSON] et al. [82] & 2011 & Nigeria & 60 & 21 & Light microscopy \\ \hline [PERSON] et al. [83] & 2012 & Egypt & 70 & 20 &
\begin{tabular}{c} Light microscopy, \\ cultivation \\ \end{tabular} \\ \hline [PERSON] et al. [84] & 2020 & Nigeria & 180 & 24 & Light microscopy \\ \hline \hline \end{tabular}
\end{table} 
Table 7: _Trichomonas tenax_ prevalence studies carried out in Africa. review aims to enrich the knowledge that exists about the etiology of periodontal disease, since, in addition to bacteria, protozoa such as _Trichomonas tenax_ can also be involved in the inflammatory process. After analyzing the results, we have drawn some important conclusions about the prevalence of _Trichomonas tenax_ and identified the factors associated with its distribution, which will be the focus of the discussion. Regarding the prevalence of _Trichomonas tenax_ in the oral cavity, our analysis revealed that it has been detected in samples of various biological material: most commonly in dental calculus or subgingival dental plaque, and less commonly in saliva, mouthwash or gingival crevicular fluid [71]. In one study, it was found in material from decayed dental cavities, suggesting that it may be associated with caries development [60]. Most articles do not provide information about the distribution of _Trichomonas tenax_ by sex. However, some authors reported a higher incidence of this protist in men than women [27, 29, 77]. In addition, it has been found more in adults. Based on the systematic review of [PERSON] et al., individuals aged 46-55 years showed the highest colonization by oral trichomonads [27]. Several articles highlight the presence of the single-celled microorganism in the pediatric population [29, 30, 78]. According to [PERSON] et al. oral protozoa occur in older children. _Trichomonas tenax_ invasion was found to be higher in children with Down syndrome and periodontitis than in healthy children in a study by [PERSON] et al. [54]. Oral trichomoniasis is more commonly associated with gingivitis and periodontitis. _Trichomonas tenax_ was found more in patients with periodontitis than with plaque-induced gingivitis [74]. It is important to emphasize that most scientists have examined _Trichomonas tenax_ alongside _Entamoeba gingivalis_, another protozoan that is part of the oral microflora.