Prevalence of gingivitis and calculus in 12-year-old Puerto Ricans: a cross-sectional study

Abstract

BackgroundGingivitis is a common oral health problem. Untreated gingivitis may progress to periodontitis, a common cause of tooth loss. The prevalence of gingivitis and calculus among Puerto Rican children is unknown. Understanding this prevalence can support early public health preventative strategies. This study aims to estimate the prevalence of gingivitis and calculus among 12-year-old Puerto Ricans by health region and to explore differences in distribution by school type (proxy for socio-economic status) and gender.MethodsA probability-based sample of 113 schools was selected proportional to enrollment size and stratified by health region, school type, and gender. Two trained examiners evaluated the presence of gingivitis and both supragingival and subgingival dental calculus. Gingivitis was defined as the presence of gingival bleeding upon gentle probing (BOP) in at least one site, and the extent of the problem was classified according to the percentage of teeth whose gingiva presented BOP (limited: 25–49% of the teeth tested; extensive: >50% of teeth tested). Logistic and linear regression models, adjusted for health regions, were used to compare gingivitis and calculus prevalence and extent between genders and school types.ResultsGingivitis was found in 80.41% of the 1586 children evaluated. Urban-public schoolchildren had a slightly higher prevalence (83.24%) compared to private (79.15%, p = 0.16); those in rural-public (77.59%) and private schools had similar prevalence (p = 0.15). Extensive gingivitis was present in 60.81% of all children. The mean percentage of sites presenting BOP (BOP%) was 17.79%. Rural and urban public schoolchildren presented significantly higher BOP% compared to children from private schools (p = 0.0005, p = 0.002, respectively). Dental calculus was detected in 61.59% of the sample, boys presenting significantly higher (p = 0.005) total and supragingival calculus. Rural-public schoolchildren had a significantly higher prevalence of subgingival calculus compared to private schoolchildren (p = 0.02).ConclusionsGingivitis prevalence is higher among 12-year-old Puerto Ricans compared to data reported for U.S. adolescents. Public schoolchildren presented significantly higher BOP% sites compared to private schoolchildren. Boys presented a significantly higher total and supragingival calculus prevalence than girls. Oral health disparities related to gender and school type were identified by this study. Studies exploring the reasons for these disparities are recommended.Electronic supplementary materialThe online version of this article (10.1186/s12903-017-0471-5) contains supplementary material, which is available to authorized users.

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“…18 A higher level of gingival bleeding may be related to the hormonal changes that occur at this stage of puberty. 27 It may also be related to other risk factors, such as inefficient oral hygiene, high sugar consumption and insufficient knowledge about oral health. 28 The majority of these risk factors should also be recognized as being associated with a lower socioeconomic level, which may interfere with the higher rates of dental caries prevalence.…”

Gingival Health Related to Intake of Different Types of Foods and Body Mass Index in 12-year-old Schoolchildren

“…Supragingival calculus does not always trigger the progression of periodontal disease (4), however, subgingival calculus in a host with a susceptible immune system, is a determining factor in the progression of periodontitis (5). Plaque-induced gingivitis promotes the formation of the periodontal pocket and increases the flow of minerals present in the crevicular fluid, that favors the formation of subgingival calculus (3,6). Several longitudinal clinical studies of both, initiation and progression of periodontitis in adolescents and young adults, have shown that calculus is a risk factor for initiation of periodontal disease (7) and is associated with the prevalence of this disease (8).…”

Estudo epidemiológico de saúde bucal em crianças de 12 anos de idade, Quito, Equador: relação entre gengivite e fatores associados

“…Entretanto, em alguns casos a gengivite pode evoluir para periodontite, com perda de suporte ósseo e posteriormente dos dentes. Assim a epidemiologia analítica -que busca identificar os fatores de risco para a doença periodontal, verificando se as associações são causais e, em caso positivo, quantificando-asreveste-se de grande importância (Lopez et al, 2001;Susin et al, 2004;Costa et al, 2012;Elias-Boneta et al, 2018).…”

“…A comparação entre investigações epidemiológicas voltadas à doença periodontal desenvolvidas na América Latina é dificultada em virtude das diferenças metodológicas utilizadas, como definição dos casos, nível de precisão dos exames, protocolos adotados, restrições de tempo e custos e aspectos operacionais. (Collins et al, 2005;Chiapinotto et al, 2013;Morales et al, 2015;Machado et al, 2017;Elias-Boneta et al, 2018). Ainda assim, e embora os estudos de prevalência de gengivite em crianças registrem diferentes resultados, a maioria deles aponta patamar superior a 80% (Chiapinotto et al, 2013).…”

“…Além disso, os levantamentos epidemiológicos permitem a realização de avaliações de associações entre variáveis explanatórias e a ocorrência de doenças, de forma mais fácil e mais barata do que os estudos longitudinais Schulz, 2002b;Elias-Boneta et al, 2018). E, ainda que não possibilitem o estabelecimento da relação de causa e efeito entre o fator investigado e a doença, propiciam avaliações importantes, preliminarmente ao planejamento de estudos de coorte ou de caso-controle (Burt, 1997;Schulz, 2002b).…”