Oral hygiene status, interdental cleaning and perception of gingival bleeding among a group of pregnant women in Nigeria

Background: Hormonal and vascular changes in pregnancy can lead to exaggeration of inflammatory response to local irritants like dental plaque causing pregnancy gingivitis which if not treated can result in advanced periodontal diseases and consequent adverse pregnancy outcomes. Objective: Toassess the oral hygiene and gingival bleeding perception of pregnant womenMethods: Self-administered questionnaires were used to collect data. Oral hygiene status and gingival status were assessed with Simplified Oral Hygiene Index (OHI-S) and gingival bleeding index respectively. Data was analysed using IBM SPSS (Statistical Package for the Social Sciences) version 25. Results were presented in frequency and percentages and chi square analysis done for the categorical variables with statistical significance set at P < 0.05. Results: One hundred and fifty-one participants with age range of 20 to 43 years with a mean age of 29.85±4.05years participated in the study. All participants used toothbrush to clean their teeth and 44.4% used medium bristled toothbrush. Two-third used herbal toothpaste. More than two-thirds (84.1%) of the participants used both horizontal and vertical tooth brushing technique. Only 33.8% brushed twice daily. Though 92.1% claimed to clean interdentally, only 19.4% used dental floss. Prevalence of gingival bleeding was 31.8%. Two persons (1.3%) thought it normal to bleed from the gum while brushing and 86.8% did not know one can bleed from the gum during pregnancy Forty-four (29.1%) and 18(11.9%) of participants had fair and poor oral hygiene status respectively. 55.6% bled on probing and had gingival bleeding index of 1 and 2. Four (2.6%) of participants had gingival recession measuring 3mm to 4mm and 8.6% had halitosis. Statistical analysis of the association between participants' perception of gum bleeding and oral hygiene status showed statistical significance. Conclusion: The knowledge of pregnancy gingivitis is poor among the participants. There is the need to educate them about this and incorporate periodontal care into antenatal care so as to increase their quality of life during pregnancy.

Púrpura trombocitopénica idiopática (pti): su diagnóstico a través de lesiones en cavidad oral / Purple Idiopathic Thrombocytopenic (Itp): diagnosis through lesions in the oral cavity

La PTI es una alteración hemorrágica de instalación súbdita, adquirida, que se manifiesta inicialmente con petequias, equimosis o hematomas en piel y mucosas, sangrado nasal y gingival, sin causa aparente. La mucosa bucal puede ser el sitio donde las lesiones se observen con frecuencia y por primera vez. Se reporta el caso de un paciente masculino de 28 años de edad, con manifestaciones clínicas de un cuadro purpúrico, se describen signos, síntomas, terapéutica y manejo estomatológico (AU)

PTI is a hemorrhagic alteration of sudden installation, acquired, which manifests initially with petechiae, esquimosis or bruises on skin and mucosae, nasal and gingival bleeding without apparent cause. Bucal mucosae can be the site where lesions are observed with frequency, and for the first time. The case of a male patient with 28 years of age with clinical manifestationsofpurpuric syndrome is reported, signs, symptoms, therapeutic and stomatological handling are described (AU)

Gingival Health Related to Intake of Different Types of Foods and Body Mass Index in 12-year-old Schoolchildren / Salud gingival y su relación con la ingesta de diferentes tipos de alimentos y el índice de masa corporal en escolares de 12 años

Abstract: Research on gingival health of 12-year-old schoolchildren in Costa Rica is scarce. Since nutrition is an integral component of oral health, this study aimed to determine gingival status of 12-year-olds at Carmen Lyra Public School, San José, Costa Rica, and correlate these variables with the frequency of intake of different types of food and body mass index (BMI (kg/m2)). Sixty-two 12-year-old schoolchildren were recruited. A periodontist assessed Plaque Index (Silness and Löe,1964), presence of calculus, and Gingival Index (Löe and Silness, 1967). Gingivitis was defined as the presence of bleeding on probing (BOP) on at least one site, and the extent was classified according to the percentage of teeth whose gingiva presented BOP limited: 25-49% of teeth tested; extensive >50% of teeth tested. A semi-quantified food consumption frequency questionnaire was administered. BMI was calculated for each participant. Overall Plaque Index was 1.18. Calculus was present on 40.40% of the sample, 19.4% had supragingival calculus and 21% had either supragingival/subgingival calculus or both. Presence of calculus was related with number of bleeding surfaces (p=0.030). Number of teeth with calculus was related to bleeding(p=0.029), and number of bleeding surfaces (p=0.009). Gingival Index was 0.97, mild gingivitis. Gingivitis was present on 96.8% of children examined. Limited gingivitis was present in 11.5% of children and extensive gingivitis in 88.5%. None of the variables measured differed by gender. No relationships were found between the consumption of starchy foods, animal and vegetable protein sources, fruit, vegetables, fast foods, sugar sweetened beverages and desserts with Plaque Index, calculus, Gingival Index, and BOP. Teeth calculus was related with being overweight (chi- square=0.038). BMI for males was 20.21 and females 20.11. BMI was not related to BOP or calculus. Within the limitations of this pilot study, we concluded the prevalence of gingivitis and calculus is high in the sample examined. A greater sample is needed to determine correlations between the frequency of foods evaluated and gingival health.

Resumen: La investigación sobre la salud gingival en escolares de 12 años en Costa Rica es escasa. Dado que la nutrición es un componente integral de la salud oral, este estudio tuvo como objetivo determinar el estado de salud gingival de los niños de 12 años de la escuela Carmen Lyra, San José, Costa Rica, y correlacionar estas variables con la frecuencia de ingesta de diferentes tipos de alimentos y el índice de masa corporal (IMC (kg/m2)). Sesenta y dos escolares de 12 años fueron reclutados. Una periodoncista calibrada, evaluó el índice de placa (Silness y Löe, 1964), la presencia de cálculo y el índice gingival (Löe y Silness, 1967). La gingivitis se definió como la presencia de sangrado al sondaje en al menos un sitio. La extensión se clasificó de acuerdo con el porcentaje de dientes que presentaba sangrado al sondaje. Entre un 25-49% de los dientes con sangrado al sondaje, gingivitis limitada y extensiva, si presentaba más del 50% de dientes con sangrado al sondaje. Se administró un cuestionario de frecuencia de consumo de alimentos. El IMC se calculó para cada participante. El índice de placa fue de 1,18. El cálculo estuvo presente en el 40.40% de la muestra, el 19.4% tenía cálculo supragingival y el 21% tenía cálculo supragingival / subgingival o ambos. La presencia de cálculo se relacionó con el número de superficies sangrantes (p=0.030). El número de dientes con cálculo, se relacionó con el sangrado (p=0.029) y el número de superficies sangrantes (p=0.009). El índice gingival fue de 0.97, gingivitis leve. La gingivitis estuvo presente en el 96,8% de los niños examinados. La gingivitis limitada estuvo presente en el 11.5% de los niños y la gingivitis extensa en el 88.5%. Ninguna de las variables evaluadas difirió por género. No se encontraron relaciones entre el consumo de harinas, fuentes de proteínas animales y vegetales, frutas, verduras, comidas rápidas, bebidas azucaradas y postres con el índice de placa, cálculo, índice gingival y sangrado al sondaje. El cálculo se relacionó con el sobrepeso (chi-cuadrado=0.038). El IMC para los hombres fue 20.21 y las mujeres 20.11. El IMC no estaba relacionado con el sangrado al sondaje o cálculo. Dentro de las limitaciones de este estudio piloto, concluimos que la prevalencia de gingivitis y cálculo es alta en la muestra examinada. Se necesita una muestra mayor para determinar las correlaciones entre la ingesta de los diferentes tipos de alimentos evaluados y la salud gingival.

Efficacy of periodontal endoscope-assisted non-surgical treatment for severe and generalized periodontitis / 华西口腔医学杂志

OBJECTIVE@#To evaluate the effectiveness of periodontal endoscope as an adjuvant therapy for the non-surgical periodontal treatment of patients with severe and generalized periodontitis.@*METHODS@#Patients (n=13) were divided into three groups: patients treated with conventional subgingival scaling and root planing (SRP) (n=7, 408 sites) (group A), SRP using periodontal endoscope (n=4, 188 sites) (group B) or SRP with periodontal endoscope 3 months after initial SRP (n=2, 142 sites) (group C). Two subgroups were divided into 2 subgroups according to PD at the baseline: 46 mm as subgroup 2. Probing depth (PD), attachment loss (AL), gingival recession (GR) and bleeding on probing (BOP) were recorded.@*RESULTS@#The results of 3 months after treatment showed all PD, AL, and GR values in group A1 were less than those in group B1 (P6 mm, the application of periodontal endoscopy can increase the effect, reducing PD and GR, which may be an effective supplement to the current non-surgical periodontal treatment.

Gingivitis influences oral health-related quality of life in adolescents: findings from a cohort study / A gengivite influencia a qualidade de vida relacionada à saúde bucal de adolescentes: achados de um estudo de coorte

ABSTRACT: Introduction: Oral health-related quality of life (OHRQoL) is affected by different clinical conditions. The aim of this study was to evaluate the impact of gingivitis on OHRQoL in adolescents. Methodology: This cohort study consisted of a random sample of 1,134 schoolchildren enrolled during 2012, in Santa Maria, Brazil. After two years, 743 adolescents were follow-up (response rate: 65.5%). Clinical, socioeconomic and OHRQoL data were collected. OHRQoL was assessed by the short Brazilian version of the Child Perceptions Questionnaire 11-14 (CPQ11-14), and gingival bleeding through Community Periodontal Index. Gingivitis was considered with the presence of 15% or more bleeding sites. Poisson regression models were used to evaluate the association between gingivitis and overall and domain-specific CPQ11-14 scores. Prevalence of gingivitis at baseline was considered the main predictor for the OHRQoL at follow-up. Results: Gingivitis at baseline was associated with higher overall CPQ 11-14 score (RR = 1.07; 95%CI 1.01 - 1.14), and emotional well-being (RR = 1.17; 95%CI 1.04 - 1.31), independently of other oral conditions and socioeconomic variables. Conclusions: The findings indicate that gingivitis negatively impacts the adolescents' OHRQoL. Moreover, gender, maternal schooling and household income were also associated with OHRQoL.

RESUMO: Introdução: Qualidade de vida relacionada à saúde bucal (QVRSB) é afetada por diferentes condições clínicas. O objetivo deste estudo foi avaliar o impacto da gengivite na QVRSB de adolescentes. Metodologia: Este estudo de coorte consistiu em uma amostra aleatória de 1.134 escolares iniciado em 2012, na cidade de Santa Maria, Brasil. Após dois anos, 743 adolescentes foram acompanhados (taxa de resposta: 65,5%). Dados clínicos, socioeconômicos e de QVRSB foram coletados. A QVRSB foi avaliada pela versão brasileira curta do Child Perceptions Questionnaire 11-14 (CPQ11-14) e o sangramento gengival foi coletado através do Índice Periodontal Comunitário. Gengivite foi considerada com o indivíduo apresentando 15% ou mais locais de sangramento. Os modelos de regressão de Poisson foram utilizados para avaliar a associação entre gengivite e os escores total e específico do domínio do CPQ11-14. A prevalência de gengivite na primeira avaliação foi considerada o preditor principal para a QVRSB no acompanhamento. Resultados: A gengivite no baseline foi associada à maior pontuação geral do CPQ 11-14 (RR = 1,07; IC95% 1,01 - 1,14) e ao domínio de bem-estar emocional (RR = 1,17; IC95% 1,04 - 1,31), independentemente das outras condições orais e variáveis socioeconômicas. Conclusão: Os achados indicam que a gengivite impacta negativamente a QVRSB de adolescentes. Além disso, sexo, escolaridade materna e renda familiar mensal também foram associados à QVRSB.

Acesso à saúde bucal na primeira infância no município de Porto Alegre, Brasil / Access to oral health in early childhood in the city of Porto Alegre, Brazil

Resumo O objetivo foi avaliar o acesso e fatores associados à consulta odontológica em crianças de até 5 anos no município de Porto Alegre, Brasil. Estudo transversal realizado em 10 Unidades Básicas de Saúde, através de questionário e exame clínico em 560 crianças. Foram avaliadas variáveis clínicas (placa visível, sangramento gengival e ceo-s), sociodemográficas, e de acesso à consulta. Regressão de Poisson foi utilizada para cálculo de Razões de Prevalência (RP), com intervalo de confiança de 95%. Os resultados mostraram que 68,2% das crianças nunca haviam ido ao dentista. O principal motivo relatado para a não realização de consulta odontológica foi não ter sentido necessidade (48,7%) e dificuldade de acesso ao posto de saúde (15,8%). A procura pelo dentista teve como propósito a prevenção/revisão (55,8%) e os locais mais procurados para consultas foi o consultório particular (43,9%) e o posto de saúde (39,5%). O modelo multivariado final mostrou que a idade da criança (IC95%, RP = 1,03 (1,02-1,05)), a renda familiar (RP = 1,05; (1,01-1,08)) e a mãe ter concluído o ensino médio (RP = 1,69 (1,15-2,56)) estiveram associados com a procura por consulta odontológica. Assim, torna-se fundamental reconhecer a importância do contexto familiar durante os primeiros anos de vida.

Abstract The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.

Impact of smoking on gingival inflammation in representative samples of three South American cities

Abstract The aim of this study was to investigate the impact of smoking on gingival inflammation in a representative sample of 1,650 adults from Santiago (Chile), Porto Alegre (Brazil), and Tucumán (Argentina). A questionnaire was administered to participants to gather demographic and behavioral characteristics, including smoking habits. The participants were clinically examined to obtain gingival index (GI), gingival bleeding index (GBI), visible plaque index (VPI), and calculus presence values. Gingival inflammation was defined as a mean GI > 0.5. Heavy smokers presented significantly lower levels of gingival inflammation, as reflected by both GI and GBI, than both light and moderate smokers, despite their having increased amounts of plaque and calculus. Being 50 years old or older [odds ratio (OR), 1.93], a VPI ≥ 30% (OR, 28.1), and self-reported diabetes (OR, 2.79) were positively associated with detection of gingival inflammation. In conclusion, the occurrence of clinically detectable gingival inflammation was lower in heavy smokers than light and moderate smokers. Older age, diabetes, and visible plaque emerged as risk indicators of gingivitis. Plaque and gingival indices are significantly associated regardless of the smoking status.

Occurrence and predictors of gingivitis and supragingival calculus in a population of Brazilian adults

Abstract: The aim of this study was to determine the occurrence of gingivitis and calculus and their predictors in a population of adults in Brazil. A representative sample of 758 adults from 35 to 59 years of age from Porto Alegre city was examined. A structured questionnaire was applied. The Gingival Bleeding Index and the presence of calculus were measured at 4 sites/tooth. Multivariable logistic models were fitted to determine the predictors for gingival bleeding at >20% of sites. Overall, 96.5% (95% confidence interval [CI]=95.1-98.0) of individuals had ≥ 1 bleeding site. The mean percentages of sites with gingivitis and calculus were 26.1% and 44.6%, respectively. The odds of gingivitis decreased by ∼45% for individuals ≥40 years old compared to younger adults. Individuals that never performed interproximal cleaning and non-whites had an approximately two times higher chance of gingivitis. Smokers had lower chances of gingivitis than never-smokers (odds ratio=0.40; 95% CI=0.24-0.68). Higher numbers of missing teeth were associated with higher chances of gingivitis. The percentage of calculus was significantly associated with skin color, education, proximal cleaning, smoking exposure, dental visits, and tooth loss. It can be concluded that the occurrence of gingivitis and calculus was high in this Brazilian population, and it was associated with age, skin color, education, self-reported proximal cleaning, smoking, dental care, and tooth loss.

Literature Review: Dental Aspects in Gaucher Disease / Revisión de la Literatura: Aspectos Dentales en la Enfermedad de Gaucher

SUMMARY: Knowledge about Gaucher disease, characteristics, clinical and radiographic alterations, demonstrate the importance of using anamnesis, laboratory tests and radiological images, among these dental analysis and images, making possible the early detection in the oral manifestations and the success in the control and treatment of the disease.

RESUMEN: El conocimiento sobre la enfermedad de Gaucher, características, alteraciones clínicas y radiográficas, demuestra la importancia de utilizar la anamnesis, los exámenes de laboratorio e imágenes radiológicas, entre ellas las odontológicas, posibilitando la detección precoz de las manifestaciones orales, y el éxito en el control y tratamiento de la enfermedad.

Edema and gingival bleeding in anterior region have a negative influence on quality of life of adolescents

Abstract The aim of the present study was to verify if clinical signs of gingivitis such as color changes, edema, and bleeding in the anterior region influence the OHRQoL of adolescents. We followed a cross-sectional convenience sample of 67 adolescents aged 11 to 16 years receiving dental treatment at the Federal University of Santa Maria (UFSM), in southern Brazil. The participants were evaluated for the following clinical variables: edema, gingival color alteration, and marginal bleeding of the gingival tissues, collected at 6 sites per tooth in the anterior region of the mouth. Socioeconomic variables were collected through questionnaires and OHRQoL was evaluated through the Brazilian version of the Children Perception Questionnaire (CPQ 11-14) short form. A Poisson regression model was used to verify associations between clinical variables and general CPQ11-14 scores. In the unadjusted analysis, edema, color alterations, and marginal bleeding in the anterior region were associated with worse scores of OHRQoL. Edema and marginal bleeding remained associated after adjusting for clinical and sociodemographic variables. Adolescents with higher levels of marginal bleeding and edema in the anterior region had higher mean CPQ11-14 scores. Therefore, the presence of bleeding and gingival edema in the anterior region can be considered clinical signs of gingivitis that are associated with a worse OHRQoL in adolescents.

A multicenter study of oral health behavior among adult subjects from three South American cities

Abstract The aims of this study were to describe the self-reported oral hygiene habits, dental visit frequency, and gingival bleeding perception in adult populations from three South American cities, and also to assess the association of these variables with sociodemographic data and with the clinical presence of plaque and gingival inflammation. Five-hundred and fifty adult subjects from each city (Porto Alegre, Brazil; Tucumán, Argentina; Santiago, Chile) received full mouth examinations to determine visible plaque and gingival index. A structured questionnaire on demographics, habits, attitudes and knowledge of oral health was also administered. The data were analyzed according to dental visit frequency, toothbrushing frequency, interproximal tooth cleaning frequency, subjects' perception of gum bleeding, and proportion of subject sites with VP and bleeding sites. Analysis of the association among the variables was performed using either a chi-square test or Fischer's exact test. Toothbrushing twice a day or more was reported by 84.2% of the subjects, but only 17.7% reported daily interdental cleaning, and 60.2% reported visiting a dental clinic only in an emergency. Only 2.97% had no bleeding sites, whereas 33.7% had 50% or more bleeding sites. Regular interdental self-cleaning and a dental visit every 3-6 months was associated with less plaque and less gingival bleeding. More than 12 years of education was associated with healthier habits, less bleeding and plaque scores. In conclusion, the oral health behavior of South American adult subjects from these cities is below the international recommendations, especially in relation to interdental cleaning and regular dental visits.

Risk factors for periodontal diseases among Yemeni type II diabetic patients: a case-control study

BACKGROUND: chronic periodontal diseases are one of diabetes mellitus complications. The present study aims to compare the periodontal status of type II diabetic patients to a control group and assess the role of risk factors in both groups. MATERIALS AND METHODS: A case-control study was conducted of 270 individuals (132 type II diabetics and 138 non-diabetics). Full mouth periodontal examination including plaque index, gingival bleeding, gingival recession, clinical attachment loss (CAL), tooth mobility, furcation involvement and the number of missing teeth. The case group was subdivided according to glycosylated hemoglobin (HbA1c) status (poorly controlled HbA1c >8 and well controlled HbA1c≤8) Likewise, the duration of diabetes mellitus as short or long duration (DM≤10 or >10). The diabetic group was also subdivided according to smoking and Khat chewing habits. RESULT: The severity of periodontal disease among type II diabetic patients were significantly higher compared to the control group regarding the plaque index 2.6 (1.6-4.3), bleeding on probing 3.5 (2.3-13.0), gingival recession 2.0 (1.2-3.4), furcation involvement 4.0 (2.3-6.7), clinical attachment loss 5.7 (3.1-10.5), tooth mobility 2.0 (1.2-3.4), and number of missing teeth 4.4 (2.3-8.5). In addition, poorly controlled type II DM and long duration had higher CAL and number of missing teeth than well-controlled DM and short duration. No significant differences were found between smokers/nonsmokers and Khat chewers/non-chewers among the diabetic group. CONCLUSION: Type II diabetic patients have severe periodontal destruction and tooth loss compared to non-diabetic people and there were no differences within the diabetic group in regards to smoking and Khat chewing habits.(

Clinical and Individual Variables in Children's Dental Fear: A School-Based Investigation

Abstract This cross-sectional study evaluated the prevalence of dental fear and associated factors in schoolchildren aged 8 to 12 years old, in Pelotas, southern Brazil. Schoolchildren enrolled in 20 public and private schools were selected using a multi-stage sample design. Sociodemographic characteristics, children's dental visit and oral hygiene habits were assessed by questionnaires. The Dental Anxiety Question was used to measure dental fear prevalence. Children's clinical examination evaluated presence of dental caries (DMFT/dmft index) and gingival bleeding. Data were analyzed using Poisson regression with robust variance (prevalence ratio; 95% confidence interval). One thousand two hundred and two children were included. Dental fear prevalence was 24.6%. After the adjustment, girls [PR=1.71 (CI 95%: 1.31-2.22)], children from poorer families [PR=1.96 (CI 95%: 1.36-2.83)], those who had decayed teeth (D/d index>0)[PR=1.32 (CI 95%: 1.01-1.72), and who had never been at the dentist [PR=1.85 (CI 95%: 1.42-2.41) remained significantly associated with dental fear. The prevalence of dental fear indicates that it is a common problem among schoolchildren. Early dental care and dental caries prevention are important factors to prevent dental fear.

Resumo Este estudo transversal avaliou a prevalência do medo odontológico e fatores associados em escolares de 8 a 12 anos de idade, na cidade de Pelotas, RS, Brasil. Alunos matriculados em 20 escolas públicas e privadas foram selecionados através de um delineamento de conglomerado em duplo estágio. As características sociodemográficas, a experiência odontológica da criança e os hábitos de higiene bucal foram avaliados por meio de questionários. O medo odontológico da criança foi avaliado através da Dental Anxiety Question. Examinadores calibrados avaliaram a presença de cárie dentária (CPOD) e o índice de sangramento gengival. Os dados foram analisados por meio de regressão de Poisson com variância robusta (razão de prevalência; 95% intervalo de confiança). No total, 1202 crianças foram incluídas. A prevalência medo odontológico foi de 24,6%. Após o ajuste, as meninas [RP=1,71 (IC 95%: 1,31-2,22)], as crianças de famílias mais pobres [RP=1,96 (IC 95%: 1,36-2,83)], com lesões de cárie (D/d index>0) [RP=1,32 (IC 95%: 1,01-1,72) e as que nunca tinham ido ao dentista [RP=1,85 (IC 95%: 1,42-2,41) permaneceram significativamente associadas ao medo dental. A prevalência de medo odontológico encontrada indica que este é um problema comum em escolares. O atendimento odontológico precoce e a prevenção de cárie são fatores importantes para evitar o medo.

Dental flossing as a diagnostic method for proximal gingivitis: a validation study

ABSTRACT This study evaluated the clinical diagnosis of proximal gingivitis by comparing two methods: dental flossing and the gingival bleeding index (GBI). One hundred subjects (aged at least 18 years, with 15% of positive proximal sites for GBI, without proximal attachment loss) were randomized into five evaluation protocols. Each protocol consisted of two assessments with a 10-minute interval between them: first GBI/second floss, first floss/second GBI, first GBI/second GBI, first tooth floss/second floss, and first gum floss-second floss. The dental floss was slid against the tooth surface (TF) and the gingival tissue (GF). The evaluated proximal sites should present teeth with established point of contact and probing depth ≤ 3mm. One trained and calibrated examiner performed all the assessments. The mean percentages of agreement and disagreement were calculated for the sites with gingival bleeding in both evaluation methods (GBI and flossing). The primary outcome was the percentage of disagreement between the assessments in the different protocols. The data were analyzed by one-way ANOVA, McNemar, chi-square and Tukey's post hoc tests, with a 5% significance level. When gingivitis was absent in the first assessment (negative GBI), bleeding was detected in the second assessment by TF and GF in 41.7% (p < 0.001) and 50.7% (p < 0.001) of the sites, respectively. In the absence of gingivitis in the second assessment (negative GBI), TF and GF detected bleeding in the first assessment in 38.9% (p = 0.004) and 58.3% (p < 0.001) of the sites, respectively. TF and GF appears to be a better diagnostic indicator of proximal gingivitis than GBI.

The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1

ABSTRACT Objective To evaluate the influence of disease control, expressed by the mean values of glycated hemoglobin (HbA1c), in the oral health of children and adolescents with diabetes mellitus type 1 (T1DM). Subjects and methods A cross sectional study involving 87 children and adolescents (59 girls), 10 ± 2.6 years old. The participants were divided into three groups: HbA1c ≤ 8%, 8% < HbA1c ≤ 10% and HbA1c > 10%. The duration of the disease, age and average HbA1c were obtained from their medical records. Oral health was evaluated according to the following indexes: Simplified Oral Hygiene Index (OHI-S); Community Periodontal Index (CPI); Decayed, Missing or Filled Teeth Index (DMFT/dmft) for permanent and deciduous teeth; and the stimulated salivary flow rate (SSFR). Results The median SSFR was 1.1 mL/min in the group with HbA1c ≤ 8%, 0.7 mL/min in the intermediary group and 0.6 mL/min in the HbA1c > 10% group. A significant decrease in salivary flow was observed with an increase in HbA1c (p = 0.007). The DMFT/dmft and CPI indexes were higher in individuals with higher HbA1c values. More caries-free individuals were found in the group with HbA1c ≤ 8% compared to those with HbA1c > 10%. The group with HbA1c > 10% exhibited more caries and bleeding gums than the other groups. HbA1c values in girls were higher than in boys. Conclusion Children and adolescents with unsatisfactory glycemic control, represented by higher HbA1c concentrations, exhibited a higher frequency of caries and gingivitis, and a reduction in salivary flow. Arch Endocrinol Metab. 2015;59(6):535-40.

Relação entre condição gengival e fatores sociodemográficos de adolescentes residentes em uma região brasileira / The relationship between gingival condition and socio-demographic factors of adolescents living in a Brazilian region

O objetivo deste artigo é relacionar as condições gengival e socioeconômica e distribuição demográfica de adolescentes residentes em uma região desfavorecida brasileira. O estudo transversal foi realizado com amostra probabilística de 450 adolescentes (15-19 anos) em 13 municípios sorteados no Vale do Jequitinhonha (MG). A condição gengival foi avaliada por um examinador calibrado (Kappa ≥ 0,85) e baseado Índice Periodontal Comunitário (CPI). Foram calculadas as frequências para indivíduos e sextantes com posterior Análise de Correspondência Múltipla (Anacor) que explorou relações entre o CPI e as características sociodemográficas. Como resultados: 16 (3,6%) apresentaram-se sem alterações gengivais, 235 (52,2%) com sangramento, 36 (8,0%) com cálculo dental e 163 (36,2%) com sangramento e cálculo. A Anacor identificou dois grupos que guardavam semelhanças entre si em relação à doença periodontal. O grupo 1 reuniu os adolescentes com CPI sadio, 19 anos de idade, que trabalham e têm maior renda familiar. No grupo de CPI com sangramento, tem-se os adolescentes com 15 e 16 anos de idade, de ambos os sexos, cursando o ensino fundamental, menor renda familiar e que se autodeclararam pardos ou negros. A gengivite foi relacionada às condições socioeconômicas e demográficas de adolescentes da região.

The scope of this study is to correlate the gingival condition and sociodemographic status of adolescents living in an economically disadvantaged Brazilian region. The survey was conducted with a random sample of 450 adolescents in 13 cities selected in the Jequitinhonha Valley (State of Minas Gerais). The gingival condition was evaluated using a calibrated examiner (Kappa ≥ 0.85). The oral exam was based on the Community Periodontal Index (CPI). The frequencies of individuals were calculated and sextants subsequently assessed using Multiple Correspondence Analysis (ANACOR) to reveal the relationship between CPI and sociodemographic characteristics. The results showed that: 16 (3.6%) were healthy; 235 (52.2%) had gingival bleeding; 36 (8%) had dental calculus and 163 (36.2%) had both bleeding and calculus. ANACOR identified two groups with similarities in relation to periodontal disease. Group one featured 19-year-olds with healthy CPI who work and have higher family income. Group two included 15- and 16-year-olds of both sexes with CPI and gingival bleeding in elementary school with lower family income, who declared themselves to be of mixed or Afro-descendant race. The presence of gingivitis was related to the socioeconomic and demographic characteristics of adolescents in the region.

Knowledge of medical doctors in Turkey about the relationship between periodontal disease and systemic health

Understanding the relationship between periodontal disease (PD) and systemic health (SH) is necessary for the accurate diagnosis and treatment of both. The aim of this study was to evaluate the knowledge of medical doctors in Turkey with regard to the association between PD and SH. This study was carried out using self-reported questionnaires that were sent to medical doctors who work at various universities and public and private hospitals in different cities in Turkey. The questionnaires consisted of questions about the demographic information of the medical doctors, as well as the knowledge of those doctors about the relationship between PD and SH. In total, 1,766 responses were received and 90.8% of the participants agreed that there was a relationship between PD and SH. Diabetes mellitus was the most frequent systemic disease (66.8%) known to be related to PD. Of the participants, 56.5% of the medical doctors referred their patients to periodontists for different reasons. Gingival bleeding was the most frequent reason for patient referrals, with 44% of doctors giving such referrals. Doctors who worked in basic medical sciences were significantly less aware of the relationship between PD and SH than the doctors in other specialties. Although the vast majority of the medical doctors reported that they knew the relationship between PD and SH, the findings of this study showed that this awareness was not supported by precise knowledge, and often failed to translate into appropriate clinical practice.

Efficacy of dentifrices containing policresulen in controlling dental plaque and gingivitis formation / 대한구강보건학회지

OBJECTIVES: This clinical study aimed to investigate if dentifrices containing policresulen would help to control dental plaque and gingivitis. METHODS: Seventy-eight eligible adults participated in this double-blind and randomized clinical study after an initial oral examination, calculus removal, and tooth prophylaxis. Two weeks after the procedure, the participants were assigned to three groups using the following dentifrices: (1) a dentifrice containing 0.22% NaF (control group); (2) a dentifrice containing 0.22% NaF and 100 ppm policresulen (policresulen group); and (3) a dentifrice containing 0.22% NaF, 100 ppm policresulen, and 1.00% bamboo salt (policresulen/bamboo group). The participants used only the provided dentifrice (for 1 min, twice a day, over 8 weeks) when brushing their teeth and followed their normal brushing habits. Dental plaque accumulation and gingivitis measurements were conducted using the Turesky modification of the Quigley-Hein plaque index (PI), the Loe and Silness gingival index (GI), and the percent bleeding on probing (%BOP) to obtain baseline data and 4- and 8-week data after grouping. RESULTS: A total of 73 participants aged 35.92+/-11.46 years (mean+/-SD) completed the study. The results after 8 weeks demonstrated statistically significant group-by-time interactions for PI, GI, and %BOP (P<0.001). The PI observed in the control groups increased over time up to 6%, while that observed in the dentifrice groups containing policresulen decreased by 5% (P<0.001). For GI and %BOP, the control group exhibited significantly higher values after 8 weeks, while the policresulen and the policresulen/bamboo groups revealed similar index values as the baseline after 4 and 8 weeks. The changes in all indices were significantly different between the control and the two experimental groups. There were no significant differences in the results obtained from the policresulen/bamboo group and the results obtained from the policresulen group. CONCLUSIONS: Use of dentifrices containing policresulen over 8 weeks demonstrated anti-plaque and anti-gingivitis efficacy compared to a control dentifrice.

Discomfort associated with fixed orthodontic appliances: determinant factors and influence on quality of life

OBJECTIVE: To investigate the determinant factors of discomfort attributed to the use of fixed orthodontic appliance and the effect on the quality of life of adolescents. MATERIAL AND METHODS : Two hundred and seventy-two individuals aged between 9 and 18 years old, enrolled in public and private schools and undergoing orthodontic treatment with fixed appliance participated in this cross-sectional study. The participants were randomly selected from a sample comprising 62,496 individuals of the same age group. Data was collected by means of questionnaires and an interview. Discomfort intensity and bio-psychosocial variables were assessed using the Oral Impact on Daily Performance questionnaire. Self-esteem was determined using the Global Negative Self-Evaluation questionnaire. Statistical analysis involved the chi-square test and both simple and multiple Poisson regression analyses. RESULTS: Although most individuals did not present discomfort, there was a prevalence of 15.9% of impact on individuals' daily life exclusively due to the use of fixed orthodontic appliance . Age [PR: 3.2 (95% CI: 1.2-8.5)], speech impairment [PR: 2.2 (95% CI: 1.1-4.6)], poor oral hygiene [PR: 2.4 (95% CI: 1.2-4.8)] and tooth mobility [PR: 3.9 (95% CI: 1.8-8.1)] remained independently associated with a greater prevalence of discomfort (P ≤ 0.05). CONCLUSIONS: Discomfort associated with the use of fixed orthodontic appliances exerted a negative influence on the quality of life of the adolescents comprising the present study. The determinants of this association were age, poor oral hygiene, speech impairment and tooth mobility. .

OBJETIVO: investigar os fatores determinantes do desconforto atribuído ao uso do aparelho ortodôntico fixo e sua influência na qualidade de vida de adolescentes. MÉTODOS: participaram desse estudo transversal 272 indivíduos, com idades entre 9 e 18 anos, estudantes de escolas públicas e privadas, que usavam aparelhos ortodônticos fixos (braquetes). Os participantes foram selecionados aleatoriamente, entre 62.496 indivíduos da mesma faixa etária. A coleta de dados foi feita em forma de entrevista e questionário. A intensidade do desconforto e variáveis biopsicossociais foram avaliadas por meio do Oral Impact on Daily Performance (OIDP). A autoestima foi determinada pela Global Negative Self-Evaluation (GSE). A análise estatística envolveu o teste qui-quadrado e a análise de regressão de Poisson, simples e múltipla. RESULTADOS: embora a maioria dos indivíduos não apresentasse desconforto, observou-se uma prevalência de impacto na vida diária devido, exclusivamente, ao uso do aparelho ortodôntico fixo, de 15,9%. Variáveis idade de 15 a 18 anos [RP = 3,2 (IC 95% = 1,2-8,5)], dificuldade de falar [RP = 2,2 (IC 95% = 1,1-4,6)], dificuldade de limpar a boca [RP = 2,4 (IC95% = 1,2-4,8)] e mobilidade dos dentes [RP = 3,9 (IC 95% = 1,8-8,1)] permaneceram associadas, de forma independente, à maior prevalência de desconforto (p ≤ 05). CONCLUSÕES: desconforto associado ao uso de aparelhos ortodônticos fixos influenciou negativamente a qualidade de vida de adolescentes. Os fatores determinantes foram idade, dificuldade de limpar a boca, de falar e mobilidade dentária. .