Gingivitis and gingival recession in adults from high-fluoride and low-fluoride areas

Abstract

The prevalence of gingivitis and gingival recession in 1884 dentate adults, aged 15–65 yr, continuously resident in the natural fluoride area of Hartlepool (1.5–2.0 ppm F.) was compared with that in 2015 dentate adults from the low-fluoride town of York (0.15–0.28 ppm F.). The measurement of gingivitis was restricted to the anterior labial gingival sites, after the method described by Jackson (1965). The prevalence of gingivitis did not vary with increasing age. Therefore, data for all age groups were combined. Eighty nine per cent in Hartlepool and 87 per cent in York had one or more gingival sites inflamed. In both communities, the slightly higher prevalence of gingivitis in males than in females disappeared when only those with good oral cleanliness were considered. In Hartlepool, the site prevalence of gingivitis was 37.2 per cent and in York 35.4 per cent. In those with good oral cleanliness, the site prevalence of gingivitis was 21.8 per cent in Hartlepool and 19.8 per cent in York. The maximum divergence between the two communities was 0.4 gingival units. No sex difference in the prevalence of gingival recession was observed in either community. Therefore, data for males and females were combined. In Hartlepool at 15–19 yr of age, 3.0 per cent were affected by gingival recession; at 60–65 yr, virtually 100 per cent were affected. The trend with age in York followed exactly the same pattern as that observed in Hartlepool. The percentage of teeth with gingival recession also increased steadily with age. In Hartlepool at 15–19 yr of age, 0.2 per cent of teeth had gingival recession. At 60–65 yr, 66.7 per cent of teeth were affected. The corresponding values in York were 0.2 per cent and 63.8 per cent. No significant differences were observed between Hartlepool and York data. It was concluded that fluoride in drinking water, at least up to the level of 2 ppm, has no effect of clinical significance on the prevalence of gingivitis or gingival recession in adults.