Gingival diseases in childhood - a review

Clinical effectiveness of picture exchange communication system (PECS) on 5- to 7-year-old children's oral health

PURPOSE

To assess the impact of the picture exchange communication system (PECS) on oral hygiene motivation and practices in healthy children aged five to seven years.

METHODS

A total of 160 healthy children aged five to seven years were included in this study. At the first visit, the participants' guardians were asked to answer a questionnaire focussing on the sociodemographic, and the oral hygiene habits of the participants. All participants received a clinical examination to assess their dental caries experience using the ICDAS score, gingival condition using the gingival index (GI), and the amount of accumulated dental plaque using the Turesky Modification of the Quigley-Hein Plaque Index (TQHI), followed by comprehensive explanation of the proper oral hygiene protocol. The participants were randomly divided into two equal groups; the PECS group and the control group. The participants were re-assessed after 6 months. The collected data were statistically analysed using the Statistical Package for Social Sciences (SPSS) software version 23 at a p-value ≤ 0.05.

RESULTS

By the end of the follow-up period, the PECS group reported significantly greater adherence to regular tooth brushing (p = 0.006) with a frequency higher than twice per day (p < 0.000) and no need for parental motivation (p < 0.001), and had significantly lower mean GI and TQHI scores (p < 0.000). Most of the participants' guardians reported that the PECS cards were useful for use and that they would continue to use them 66/76 (86%).

CONCLUSION

The PECS was found to be effective in motivating children to adhere to proper tooth-brushing practices, as reflected by improvements in their oral health status and gingival condition.

The Efficacy of Populus euphratica and Myrtus communis Herbal Mouthwash on Gingivitis in Pediatric Patients Diagnosed Clinically and with Photometric CIELab Analysis: An In Vivo Randomized Double-blind Clinical Study

Background

Children are more prone to develop gingivitis as a result of deficient oral hygiene, morphological variance, and a diet that encourages the growth of pathogenic oral bacteria.

Aim

The purpose of this randomized, double-blind clinical study is to compare the therapeutic effect of an herbal mouthwash made of decoction and ethanolic extract of Populus euphratica and Myrtus communis to that of chlorhexidine (CHX) mouthrinse.

Materials and methods

In this study, 60 patients aged between 8 and 10 years were divided into four groups, each with 15 patients. The first group was treated with a mouthwash made of ethanolic herbal extract, the second group was treated with a mouthwash made of herbal decoction, the third group was treated with CHX mouthwash (0.12%) (positive control), and the fourth group was treated with a placebo made with colored distilled water (negative control). Clinical parameters gingival index (GI) and plaque index (PI) were evaluated at the start, 1, and 2 weeks from ensuing the treatment. Preoperative and postoperative photographs of the maxillary anterior sextant were recorded to evaluate CIELab coordinates to monitor color changes.

Statistical analysis

One-way analysis of variance (ANOVA) with Tukey's honest significant difference (HSD) post hoc tests were used for data assessment.

Results

Significant reductions in GI and PI were found among the tested groups (p < 0.05). A significant reduction in a* value was observed, while L* value showed a significant increase between baseline and posttreatment (p < 0.05).

Conclusion

Herbal-based mouthwash of Populus euphratica and Myrtus communis, whether prepared by boiling or ethanolic extraction, reduced gingival inflammation significantly and has a lot of potential for treating and preventing periodontal disease in young children. Digital photography is a reliable supplementary approach for diagnosing and monitoring gingival inflammation in pediatric patients.

How to cite this article

Mohamed-Ali SF, Jasim AA, Mahmood MAK, et al. The Efficacy of Populus euphratica and Myrtus communis Herbal Mouthwash on Gingivitis in Pediatric Patients Diagnosed Clinically and with Photometric CIELab Analysis: An In Vivo Randomized Double-blind Clinical Study. Int J Clin Pediatr Dent 2024;17(8):918-924.

Analysis of Adverse Events Following Phenobarbital Administration for Pediatric Patients Categorized by One-Year Age Increments Using the U.S. Food and Drug Administration Adverse Event Reporting System

Background Organ and body development greatly varies in pediatric patients from year to year. Therefore, the incidence of each adverse event following phenobarbital (PB) administration would vary with age. However, in clinical trials, increasing the sample size of pediatric patients in each age group has been challenging. Therefore, previous studies were conducted by dividing pediatric patients into three or four age groups based on the development stage. Although these results were useful in clinical settings, information on adverse events that occurred at one-year age increments in pediatric patients could further enhance treatment and care. Objectives This study investigated in one-year age increments the occurrence tendency of each adverse event following PB administration in pediatric patients. Methods This study used data obtained from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS). Two inclusion criteria were set: (1) treatment with PB between January 2004 and June 2023 and (2) age 0-15 years. Using the cutoff value obtained using the Wilcoxon-Mann-Whitney test by the minimum p-value approach, this study explored changes in the occurrence tendency of each adverse event in one-year age increments. At the minimum p-value of <0.05, the age corresponding to this p-value was determined as the cutoff value. Conversely, at the minimum p-value of ≥0.05, the cutoff value was considered nonexistent. Results This study investigated all types of adverse events and explored the cutoff value for each adverse event. We identified 34, 16, 15, nine, five, five, eight, three, and eight types of adverse events for the cutoff values of ≤3/>3, ≤4/>4, ≤5/>5, ≤6/>6, ≤7/>7, ≤8/>8, ≤9/>9, ≤10/>10, and ≤11/>11 years, respectively. Conclusions This study demonstrated that adverse events requiring attention in pediatric patients varied with age. The findings help in the improvement of treatment and care in the pediatric clinical settings.

Current status and factors of periodontal disease among Japanese high school students: a cross-sectional study

INTRODUCTION

This study aimed to investigate the prevalence of periodontal disease and the factors of the disease among high school students.

METHOD

The participants were all students aged 15-18 years (n = 1202) at a high school in Japan. The data on oral health perceptions and behaviours were collected by a questionnaire survey. The prevalence of periodontal disease among them was investigated with the partial community periodontal index (PCPI). A logistic regression analysis was used to identify the factors associated with the PCPI.

RESULTS

A total of 1069 students (88.9%) participated in this study. The prevalence of gingival bleeding, calculus, pocket depth of 4-5 mm, and pocket depth of 6 mm or more were 44.2%, 42.2%, 11.4%, and 1.6%, respectively. Approximately one-third of the students had a fear of dental treatment, and only 28.4% used dental floss. The results of logistic regression analysis, adjusted for sex and school year, showed that not visiting dentists regularly, not using dental floss, brushing teeth for less than 5 min, fear of dental treatment, and drinking sports drinks frequently were positively associated with periodontal conditions.

CONCLUSION

This study identified a high prevalence of periodontal disease among Japanese high school students aged 15-18 years and its risk factors, such as poor oral health behaviours and fear of dental treatment.

Effectiveness of Smart Applications of Oral Hygiene Instructions on Periodontal Health Compared to Oral Information: A Prospective Study

Nowadays, smartphone applications are widely used in different areas of life, including medical science. The present study aimed to assess the effectiveness of a smartphone application of oral hygiene instructions (OHI) on periodontal health compared to the traditional chairside OHI. All the participants (n = 39) were divided into two groups: control group and test group. Participants of the control group were given verbal OHI and participants of the test group were asked to use a smartphone application to upkeep their oral habits. The gingival index (GI) and Quigley-Hein Turesky modification index (QHTMI) were used for scoring the plaque accumulation at baseline and after one month of the periodontal treatment. A paired t-test and an independent t-test were performed to compare the mean of GI and QHTMI between intra-group and inter-group, respectively. The paired t-test showed significant differences in GI and QHTMI improvement after one month in both groups. Moreover, the independent t-test showed no significant differences between the two groups. However, the test group showed a lower mean score in GI and QHTMI assessments compared to the control group. Smartphone applications in oral health applications did not exhibit any superiority in periodontal health over the traditional OHI method in the current study.

Risk indicators for dental caries, and gingivitis among 6-11-year-old children in Nigeria: a household-based survey

Background

There is little is known about the factors associated with caries experience and gingivitis among 6–11-year-old children in Nigeria. The aim of the study was to determine the prevalence and preventive oral health behaviors associated with caries and gingivitis among 6–11-year-old children in Nigeria.

Methods

A cross-sectional questionnaire-based survey was conducted in Ile-Ife, Nigeria. The dependent variables were caries and gingivitis. The dmft/DMFT index was used to assess dental caries experience (present or absent) and caries severity. The gingival index was used to assess the prevalence (present or absent) and severity of gingivitis (healthy gingiva/mild gingivitis versus moderate/severe gingivitis). The independent variables were preventive oral health behaviors (frequency of daily tooth brushing, frequency of consumption of refined carbohydrates in-between-meals, use of fluoridated toothpaste, and use of dental floss, history of dental service utilization). A series of logistic regression analysis models were constructed to determine the associations between the dependent and independent variables after adjusting for confounders (age, sex, and socioeconomic status).

Results

There were 69 (5.2%) children with caries. The mean (standard deviation) dmft was 0.08 (0.457) and the mean DMFT was 0.02 (0.159). There were 839 (63.3%) children with gingivitis with a mean (SD) gingival index score of 0.503 (0.453). Children who seldom or never used fluoride toothpaste had significantly higher odds of developing moderate to severe gingivitis (AOR; 1.671; 95% CI: 1.003–2.786; p = 0.049). Children with middle socio-economic status had significantly lower odds of developing moderate to severe gingivitis (AOR: 0.573; 95%CI: 0.330–0.994; p = 0.048). There were no risk indicators identified for caries.

Conclusion

The prevalence of dental caries was low while the prevalence of gingivitis was high in the study population. The daily used of fluoridated toothpaste seem to reduce the risk for moderate/severe gingivitis. Further studies are needed to understand these findings.

Application of the extended theory of planned behavior to understand Chinese students' intention to improve their oral health behaviors: a cross-sectional study

BACKGROUND

The present study aimed to develop and test an extended theory of planned behavior (TPB), which includes attitudes, subjective norms and perceived behavioral control, oral health knowledge, and past oral health behavior on the intention to improve oral health behaviors among primary school students in Shanghai, China.

METHODS

A school-based cross-sectional study was conducted with 414 students in the third-grade from 10 classes of Mingqiang Primary School located in Shanghai, China. Participants were recruited in October 2019. Data were collected through self-reported questionnaires, consisting of demographic characteristics, TPB variables, oral health knowledge and past oral health behaviors. Exploratory factor analysis was used to analyze TPB items. Pearson's correlation and hierarchical regression analyses were conducted to identify the associated factors of intention to improve oral health behaviors.

RESULTS

The study showed that among students in the third grade, attitudes, subjective norms, perceived behavioral control, and past oral health behaviors were associated with the intention to improve oral health behaviors. In the hierarchical regression analysis, age and sex were entered in Model 1 which significantly explained 3.00% of the variance (F = 6.26, p < 0.01). The addition of Model 2 variables of attitudes, perceived behavioral control, subjective norms, and oral health knowledge revealed that TPB variables explained 26.70% (F = 29.59, p < 0.01). For Model 3, the addition of past oral health behaviors accounted for a further 1% of variance, and the full model has accounted for 28.30% of the variance with the intention to improve oral health behaviors (F = 22.8, p < 0.01). Regression analyses supported that among the significant variables, perceived behavioral control had the largest beta weight, followed by subjective norms and past oral health behaviors.

CONCLUSION

The extended TPB model constructed in this study could be used to explain children's intentions to improve oral health behaviors. Children's oral health-related perceived behavioral control, subjective norms, and past oral health behaviors may serve as priority intervention targets in oral health promotion practices aimed at children.

Polysaccharide-Based Micro- and Nanosized Drug Delivery Systems for Potential Application in the Pediatric Dentistry

The intensive development of micro- and nanotechnologies in recent years has offered a wide horizon of new possibilities for drug delivery in dentistry. The use of polymeric drug carriers turned out to be a very successful technique for formulating micro- and nanoparticles with controlled or targeted drug release in the oral cavity. Such innovative strategies have the potential to provide an improved therapeutic approach to prevention and treatment of various oral diseases not only for adults, but also in the pediatric dental practice. Due to their biocompatibility, biotolerance and biodegradability, naturally occurring polysaccharides like chitosan, alginate, pectin, dextran, starch, etc., are among the most preferred materials for preparation of micro- and nano-devices for drug delivery, offering simple particle-forming characteristics and easily tunable properties of the formulated structures. Their low immunogenicity and low toxicity provide an advantage over most synthetic polymers for the development of pediatric formulations. This review is focused on micro- and nanoscale polysaccharide biomaterials as dental drug carriers, with an emphasis on their potential application in pediatric dentistry.

Role of Innate Inflammation in the Regulation of Tissue Remodeling during Tooth Eruption

Tooth eruption is characterized by a coordinated complex cascade of cellular and molecular events that promote tooth movement through the eruptive pathway. During tooth eruption, the stratum intermedium structurally changes to the papillary layer with tooth organ development. We previously reported intercellular adhesion molecule-1 (ICAM-1) expression on the papillary layer, which is the origin of the ICAM-1-positive junctional epithelium. ICAM-1 expression is induced by proinflammatory cytokines, including interleukin-1 and tumor necrosis factor. Inflammatory reactions induce tissue degradation. Therefore, this study aimed to examine whether inflammatory reactions are involved in tooth eruption. Reverse transcription-polymerase chain reaction (RT-PCR) analysis revealed sequential expression of hypoxia-induced factor-1α, interleukin-1β, and chemotactic factors, including keratinocyte-derived chemokine (KC) and macrophage inflammatory protein-2 (MIP-2), during tooth eruption. Consistent with the RT-PCR results, immunohistochemical analysis revealed KC and MIP-2 expression in the papillary layer cells of the enamel organ from the ameloblast maturation stage. Moreover, there was massive macrophage and neutrophil infiltration in the connective tissue between the tooth organ and oral epithelium during tooth eruption. These findings suggest that inflammatory reactions might be involved in the degradation of tissue overlying the tooth organ. Further, these reactions might be induced by hypoxia in the tissue overlying the tooth organ, which results from decreased capillaries in the tissue. Our findings indicate that bacterial infections are not associated with the eruption process. Therefore, tooth eruption might be regulated by innate inflammatory mechanisms.

Factors Associated with Dental Plaque, Gingivitis, and Caries in a Pediatric Population: A Records-Based Cross-Sectional Study

This retrospective, cross-sectional study evaluated dental records of 1000 healthy children to determine factors associated with plaque, gingivitis, and caries. A logistic model for plaque and gingivitis (mild versus moderate/severe) and caries (yes/no) was carried out separately for each variable using the following potential factors: Age, Gender, Brush Type, Starting Age of Brushing, Brushing Frequency, and Bite Type. Data from 998 children (median age: 4 years, 10 months (range: 2.5-7 years)) were analyzed. Sixty-four percent were manual toothbrush users; 36% were oscillating-rotating electric toothbrush users. For plaque and gingivitis, but not caries, Brush Type was more impactful than Brushing Frequency. Age influenced the severity of plaque and gingivitis, with increases in the odds of having moderate/severe plaque or gingivitis associated with increasing age. The probability of caries increased until approximately age 5 and then decreased until age 7. Oscillating-rotating brush users were more likely to present with less plaque, gingivitis, and caries, with 6.0, 5.1, and 1.4 times greater odds of having mild (versus moderate/severe) plaque, less severe gingivitis, and being caries-free, respectively, than manual brush users. Similarly, brushing twice daily and starting brushing at an earlier age were associated with better oral health outcomes. Children with anterior bite abnormalities had increased odds of developing moderate/severe plaque and gingivitis than children with normal anterior bites. Gender was not a statistically significant factor associated with plaque, gingivitis, or caries. Children's oral health is influenced by toothbrush type, starting age of brushing, compliance with twice-daily brushing, and bite abnormalities.

Comparative Evaluation of Efficacy of 4% Tulsi Extract (Ocimum sanctum), Fluoridated and Placebo Dentifrices against Gingivitis and Plaque among 14-15 years School Children in Davangere City, India - A Triple Blinded Randomized Clinical Trial

Context:

Gingivitis is the most prevalent periodontal disease among adolescents. The most important factor associated with gingivitis is plaque accumulation. Mechanical plaque control through tooth brushing and mouth rinsing are the most commonly used preventive methods.

Aims:

This study aims to assess and compare the antiplaque and antigingivitis effect of 4% Tulsi leaf extract dentifrice, fluoridated and placebo dentifrice (PD) among 14–15-year-old school children in Davangere city.

Materials and Methods:

A triple blinded concurrent parallel trial. A sample of 84 participants with a baseline mean gingival index score of at least 1.0 and mean plaque index score of at least 1.5 were randomly selected. Participants were divided into three groups by block randomization and concealed random allocation method was used to distribute dentifrices. Postassessment of plaque and gingivitis was done on the 21^st day.

Statistical Analysis Used:

Wilcoxon signed rank test for within group comparison and Kruskal–Wallis ANOVA for intergroup comparison was used.

Results:

Significant reduction in the plaque and gingival scores between the groups was observed on the 21^st day (P = 0.001). Maximum reduction in gingivitis (P = 0.001) and dental plaque (P = 0.01) was seen in 4% tulsi dentifrice group compared to PD.

Conclusion:

Antiplaque and antigingivitis efficacy of 4% tulsi and commercially available fluoridated dentifrice remained the same after 21 days.

Effectiveness of the GumChucks flossing system compared to string floss for interdental plaque removal in children: a randomized clinical trial

Flossing, an important oral hygiene skill, is technique-sensitive and challenging for children with developing manual dexterity. GumChucks is a novel flossing device designed to assist children with proper flossing technique. The aim of this study was to assess the efficacy of the GumChucks flossing device compared to string floss (SF). We conducted a randomized trial with 40 children aged 4–15 years at the UCLA Children’s Dental Center from January- April 2017. Participants were randomly assigned to either GumChucks or SF. Interdental plaque score (IPS) and gingival index (GI) were recorded at baseline and 4-week post-usage. Flossing speed and interdental plaque reduction were also determined immediately after first use. In addition, questionnaires were completed by children, parents and dentists. Overall, children flossed significantly faster (p < 0.001) and achieved greater IPS reduction after first use (47.0% vs. 26.8%) with GumChucks compared to SF. After 4-week post-usage, children ages 10–15 in the GumChucks group demonstrated significantly greater improvement in GI and IPS from baseline (p < 0.01) and greater efficacy in interdental plaque removal compared to the SF group (p < 0.01). Children ages 4–9 flossed more effectively (p < 0.01) with GumChucks after first use, but no significant IPS and GI improvement after 4-week post-usage. Children preferred GumChucks (92.5%) over SF, with a similar positive attitude reported by parents and dentists. GumChucks is an effective alternative interdental plaque removal aid that allows children to floss with greater speed and efficacy, with recommended parental supervision for children under age 10.

Prevalence and Associated-Factors for Entamoeba gingivalis in Adolescents in Southeastern Iran by Culture and PCR, 2017

BACKGROUND

This study aimed to identify the prevalence and potential factors associated with Entamoeba gingivalis in adolescents in the city of Kerman, southeastern Iran, 2017.

METHODS

In this descriptive cross-sectional study, 315 adolescents (mean age; 15 yr) consisting of 189 males and 126 females were randomly selected. For each adolescent, two specimens were collected for culturing and examination by polymerase chain reaction (PCR). Univariate and multivariate logistic regression models were performed to explore any association with demographic and clinical variables.

RESULTS

The prevalence of E. gingivalis was 11.7%. Totally, 30 (15.9%) males and 7 (5.6%) females were infected with E. gingivalis. The rate of infection in males was 2.8 times higher than that in females (P<0.001). Statistical analysis identified 4 major factors including sex (OR=4.12, P<0.001), gingival index with severe inflammation (OR = 50, P<0.001), Candida spp. infection (OR=4.41, P<0.001) and decay-missing-filled teeth [DMFT (OR=3.27, P<0.001)]. In contrast to the aforementioned factors, adolescents with history of antibiotic consumption were significantly protected from E. gingivalis infection (OR= 3.24, P<0.001). Culture media detected 9.2% (n= 29), whilst PCR identified 11.4% (n= 36) of infection.

CONCLUSION

The present findings clearly demonstrate a positive association between E. gingivalis and distinct demographic and clinical risk determinants. Therefore, dental practitioners and health surveillance personnel should be aware of these confounding factors to rigorously detect and critically manage oral health issues in school-age children in order to prevent or at least minimize the eventual periodontal complications in later life.

Oral health and plaque microbial profile in juvenile idiopathic arthritis

BACKGROUND

The oral microbiota has been implicated in the pathogenesis of rheumatoid arthritis through activation of mucosal immunity. This study tested for associations between oral health, microbial communities and juvenile idiopathic arthritis (JIA).

METHODS

A cross-sectional exploratory study of subjects aged 10-18 years with oligoarticular, extended oligoarticular and polyarticular JIA was conducted. Control groups included pediatric dental clinic patients and healthy volunteers. The primary aim was to test for an association between dental health indices and JIA; the secondary aim was to characterize the microbial profile of supragingival plaque using 16S rRNA gene sequencing.

RESULTS

The study included 85 patients with JIA, 62 dental patients and 11 healthy child controls. JIA patients overall had significantly more gingival inflammation compared to dental patients, as evidenced by bleeding on probing of the gingiva, the most specific sign of active inflammation (p = 0.02). Overall, however, there was a trend towards better dental hygiene in the JIA patients compared to dental patients, based on indices for plaque, decay, and periodontitis. In the JIA patients, plaque microbiota analysis revealed bacteria belonging to genera Haemophilus or Kingella elevated, and Corynebacterium underrepresented. In poly JIA, bacteria belonging to the genus Porphyromonas was overrepresented and Prevotella was underrepresented.

CONCLUSION

Increased gingival inflammation in JIA was independent of general oral health, and thus cannot be attributed to poor dental hygiene secondary to disability. The variation of microbial profile in JIA patients could indicate a possible link between gingivitis and synovial inflammation.

Oral health and obesity in the SAYCARE study: reliability and internal validity of diagnostic methods

OBJECTIVE

The aim of this pilot study was to address the reliability, internal validity and viability of oral health methods used in the South American Youth/Child cARdiovascular and Environmental study.

METHODS

South American Youth/Child cARdiovascular and Environmental study was a multicentre feasibility observational study and conducted in seven South American cities. The training sessions were performed in two steps before data collection: the first verified the inter-rater reproducibility between the examiners of the six centres in relation to the gold standard, and the second one verified the inter-rater reproducibility between the examiners at each centre in relation to the main rater. The diagnostic methods used were International Caries Detection and Assessment System II and Pulpal Involvement, Ulceration, Fistula and Abscess for dental caries and Periodontal Screening and Recording and Index Plaque for periodontal disease. Anthropometric variables were measured and used to calculate the body mass index and were classified according to the cut-off points defined by the International Obesity Task Force. Cohen's kappa coefficient and proportions of agreement were calculated to report inter-rater and intra-rater reliability in the calibration process and pilot study.

RESULTS

The inter-rater weight kappa ranged from 0.78 to 0.88 and proportion of agreement from 96.07% to 98.10% for the International Caries Detection and Assessment System II and for the Periodontal Screening and Recording, 0.68 to 0.95 and 94.40% to 98.33%, respectively, in the calibration process. At the pilot study, a total of 490 children (40.8% overweight and 12.9% obese) and 364 adolescents (23.4% overweight and 4.3% obese) were examined. The prevalence of dental caries was 66% in children and 78% in adolescents, and gingival bleeding was 49% and 58.20%, respectively.

CONCLUSION

The results demonstrated good reliability and internal validity after the examiners were trained, as well as the feasibility of using the methods chosen for this multicentre study.

Prevalence of Plaque-Induced Gingivitis in a Sample of the Adult Egyptian Population

AIM

The aim of this cross-sectional study is recording the prevalence and evaluation of the severity of plaque-induced gingival inflammation among a sample of the adult Egyptian population.

PATIENTS AND METHODS

Four hundred and twenty-five subjects in this contemplate were seen from patients visiting the diagnostic clinic at the Faculty of Dentistry, Cairo University. The gingival and plaque indices for each patient diagnosed as having plaque-induced gingivitis were recorded. The pocket depth was also measured.

RESULTS

The incidence of gingivitis was 100% amid adult subjects with an age range between 18-45 years. The average plaque index (PI) was 1.05 ± 0.43, which reflects relatively superior plaque control of the participants. The mean gingival index (GI) was 1.66 ± 0.40, which reflects the presence of moderate gingival inflammation. PD mean values confirmed limitation of inflammation to the gingiva. The sex was correlated to the condition of the inflamed gingiva (p = 0.014) and the quantity of biofilm build-up (p = 0.003). Females were less affected than males (p = 0.005).

CONCLUSION

The outcomes of this contemplate demonstrated that biofilm build-up is stoutly accompanied with elevated incidence of modest to rigorous gingivitis amid adult Egyptian individuals.

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

Background

Gingivitis 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.

Methods

A 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.

Results

Gingivitis 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).

Conclusions

Gingivitis 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 material

The online version of this article (10.1186/s12903-017-0471-5) contains supplementary material, which is available to authorized users.

Prevalence of Helicobacter pylori vacA Genotypes and cagA Gene in Dental Plaque of Asymptomatic Mexican Children

The variability in Helicobacter pylori vacA and cagA genes has been related to the progression of the gastrointestinal disease; also the presence of H. pylori in the oral cavity has been associated with periodontal disease in adults, but, in children without dyspeptic symptoms, little is known about this. We evaluated the prevalence of H. pylori and the presence of vacA/cagA genotypes in the oral cavity of Mexican children without dyspeptic symptoms. The gingival status was measured, and dental plaque samples (n = 100) were taken. 38% of children were positive for H. pylori 16S rRNA gene by qPCR. A significant association between H. pylori oral infection and gingival status was observed (P < 0.001). In 34.6% (9/26) of mild gingivitis cases, s1m2 genotype was found, while s1m1 was typed in 50% (3/6) of moderate gingivitis. The cagA prevalence among H. pylori-positive children was 80.8% (21/26), 83.3% (5/6), and 16.7% (1/6) of cases of mild gingivitis, moderate gingivitis, and nongingivitis, respectively (P < 0.001). The s1m1/cagA+ combinational genotype was the most detected in children with gingivitis. Our results suggest that the prevalence of H. pylori and detection of vacA/cagA genotypes-associated gastrointestinal disease in the oral cavity could be related to the progression of gingivitis in asymptomatic children.

The Burden of Oral Disease among Perinatally HIV-Infected and HIV-Exposed Uninfected Youth

Objective

To compare oral health parameters in perinatally HIV-infected (PHIV) and perinatally HIV-exposed but uninfected youth (PHEU).

Methods

In a cross-sectional substudy within the Pediatric HIV/AIDS Cohort Study, participants were examined for number of decayed teeth (DT), Decayed, Missing, and Filled Teeth (DMFT), oral mucosal disease, and periodontal disease (PD). Covariates for oral health parameters were examined using zero-inflated negative binomial regression and ordinal logistic regression models.

Results

Eleven sites enrolled 209 PHIV and 126 PHEU. Higher DT scores were observed in participants who were PHIV [Adjusted Mean Ratio (aMR) = 1.7 (95% CI 1.2–2.5)], female [aMR = 1.4 (1.0–1.9)], had no source of regular dental care [aMR = 2.3 (1.5–3.4)], and had a high frequency of meals/snacks [≥5 /day vs 0–3, aMR = 1.9 (1.1–3.1)] and juice/soda [≥5 /day vs 0–3, aMR = 1.6 (1.1–2.4)]. Higher DMFT scores were observed in participants who were older [≥19, aMR = 1.9 (1.2–2.9)], had biological parent as caregiver [aMR = 1.2 (1.0–1.3)], had a high frequency of juice/soda [≥5 /day vs 0–3, aMR = 1.4 (1.1–1.7)] and a low saliva flow rate [mL/min, aMR = 0.8 per unit higher (0.6–1.0)]. Eighty percent had PD; no differences were seen by HIV status using the patient-based classifications of health, gingivitis or mild, moderate, or severe periodontitis. No associations were observed of CD4 count and viral load with oral health outcomes after adjustment.

Conclusions

Oral health was poor in PHIV and PHEU youth. This was dismaying since most HIV infected children in the U.S. are carefully followed at medical health care clinics. This data underscore the need for regular dental care. As PHIV youth were at higher risk for cavities, it will be important to better understand this relationship in order to develop targeted interventions.