Assessment of Gingival Health Status among 5- and 12-Year-Old Children in Yemen: A Cross-Sectional Study

Abstract

Purpose. There are limited data about the gingival health status in Yemeni children. The aim, therefore, was to assess oral hygiene status and prevalence and severity of gingivitis among Yemeni preschool and school children. Materials and Methods. A total of 5396 children were included from 5 representative Yemeni governorates: Sana'a, Hajjah, Hodeida, Hadramaut, and Taiz. Five-year olds (1292) were recruited from private kindergartens while 12-year olds (4104) were selected from public primary schools. Gingival health status was assessed using the plaque index (PI), calculus index (CAI), and gingival index (GI) on the 6 Ramfjord teeth. The latter index was used to categorize gingivitis severity at the subject level. Data were analyzed using simple hypothesis testing, as well as ordinal regression. Results. The 12-year old children had significantly much higher mean PI, CAI, and GI (P < 0.001) with 78.6% presenting with gingivitis and 47.8% with moderate gingivitis. In contrast, the figures were 27.2% and 3.1% in the younger group (P < 0.001). There were significant variations according to gender, area of residence, and governorate. Regression analysis revealed that mean PI (OR = 35), mean CAI (OR = 7.7), male gender (OR = 1.6), living in rural areas (OR = 1.4), and being from Hajjah or Sana'a were independent risk factors of gingivitis severity in the older group. For the 5-year olds, the determinants were mean PI (OR = 122), male gender (OR = 1.4), and living in Sana'a or Taiz. Conclusions. Bad oral hygiene and moderate gingivitis are highly prevalent among Yemeni preschool and school children. Geographical location appeared as important independent risk factors of gingival inflammation.

Evaluation of Gingival Health Status among 6- and 12-years-old Children in Dhamar City, Yemen: A Cross-sectional Study

“…However, some previous reports showed opposite results. 12,18,24 The current study found that 12-year-old children had more calculus accumulation than 6-year-old children. It appears that children 12 years of age are 1.65 times more likely to have calculus deposits than 6-year-old children.…”

“…Another possible factors might be the culture, food habits, and geographical location that act as independent determinant. 12 There was no significant difference between the 6-year-old group and the older age group in relation to the mean of PI and GI. This result differs from previous reports.…”

“…The results of the PI and GI among the participants of this study were higher than the results observed in previous studies conducted on 6-to 14-year-old and 5-to 12-year-old age groups in other Yemeni governments. 11,12 Different findings have been reported from other parts of the world. [17][18][19][20] These variations may be attributed to differences in methodology and/or age of study samples and may also be related to the socioeconomic condition which reflects genuine differences in oral hygiene practices.…”

“…This result is in agreement with other studies. 11,27,28 Al-Haddad et al 12 conducted a study on 5-and 12-year-old children in five Yemeni governorates and indicated that about 90% of the 12-year-old children in Sana'a city had gingivitis. The high occurrence of gingivitis among the current study subject can be attributed to the poor oral hygiene and the weak or absent of oral preventive programs that should be followed in public primary schools.…”

“…9,10 The previous epidemiological studies for the periodontal health status among Yemeni children are still less than the minimum. 11,12 Therefore, the aim of this study was to evaluate the gingival health status among 6-and 12-year-old children from Dhamar city, Yemen.…”