National survey of periodontal diseases in adolescents and young adults in Morocco

Discriminant validity of the current gingivitis classification in adolescents: a cohort study

OBJECTIVES

To compare the prevalence of gingivitis estimated by the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classification with the other case definitions and assess the ability of this classification system in discriminating sociodemographic and clinical factors associated with the presence of gingivitis in a cohort study.

MATERIALS AND METHODS

A multistage random sample of 1134 12-year-old adolescents was submitted to a full-mouth examination according to the Community Periodontal Index. Socioeconomic and clinical variables were collected at baseline. Gingivitis was considered according to the following criteria: (a) ≥ 10% of bleeding sites (the 2018 EFP/AAP criteria); (b) ≥ 15% of bleeding sites; and (c) the mean full-mouth bleeding sites. Adjusted multilevel Poisson regression assessed the association between independent variables at baseline and each definition of gingivitis at 2-year follow-up.

RESULTS

Seven hundred forty-two 14-year-old adolescents were re-revaluated at follow-up. The prevalence of gingivitis was 28.7% according to 10% of bleeding threshold. The 2018 EFP/AAP criteria and other definitions showed higher prevalence and mean of gingivitis for low-household income adolescents and for those with higher levels of dental plaque and untreated dental caries. Nonetheless, the highest strengths of association were observed for the threshold of ≥ 15% of bleeding sites.

CONCLUSION

The 2018 EFP/AAP case definition of gingivitis showed a similar discriminant validity compared to the 15% threshold and the mean full-mouth bleeding sites.

CLINICAL RELEVANCE

The 2018 EFP/AAP classification allows the discrimination of important risk factors and should be used for the establishment of priorities for large-scale therapeutic programs.

Prevalence of periodontal disease in young moroccans. A national survey

BACKGROUND

There are few large surveys of periodontal disease in young age cohorts, and national surveys in Africa do not existent. This study assessed the prevalence and severity of periodontal disease in a national survey of adolescents and young adults in Morocco.

METHODS

A multi-stage probability sampling design was used to draw a sample of 14,667 students 12-25 years old attending 87 schools. The sample was representative of approximately 3 million Moroccan students in this age group.

RESULTS

27.9%, 11.9%, and 7.7% of the subjects had ≥1 teeth with ≥4 mm, ≥5 mm, and ≥6 mm probing depth, and the population estimates were approximately 822, 350, and 226 thousand affected subjects, respectively. For attachment loss the prevalences were: 11.6%, 9.5%, and 6.9% (or ≈ 342, 281, and 204 thousand affected subjects) for ≥4 mm, ≥5 mm, and ≥6 mm, respectively. The rates of probing depth and attachment loss increased significantly with the increase in age (p<0.01, p<0.001). Gender and urban status did not show significant effects on the prevalence of periodontal disease (p>0.05). Similarly, the relationship between the occupation status and periodontal status was modest and not statistically significant (p>0.05).

CONCLUSIONS

Children and young adults attending public schools in Morocco have a high prevalence and severity of periodontal disease compared to other populations of similar age. The rate of periodontal disease reported here may be used as baseline population estimates in the surveillance of disease status in this population. This article is protected by copyright. All rights reserved.