Extent Of Gingival Bleeding Research Articles

Low association between bleeding on probing propensity and the salivary aMMP-8 levels in adolescents with gingivitis and stage I periodontitis.

Bleeding on probing (BOP) is a widely accepted measure used in periodontal diagnostics. Previous studies suggest that several factors can affect BOP propensity. The aim of this study was to investigate the relative impact of different local and modifying factors on BOP levels. The oral health of five hundred and forty-four adolescents (two birth cohorts) aged 15-17years living in Kotka, Finland, was examined including periodontal probing depth, visible plaque index, root calculus, and BOP. Whole saliva samples were collected and measured for active matrix metalloproteinase-8 (aMMP-8) by time-resolved immunofluorometric assay (IFMA). Bacterial plaque/calculus accumulation (oral hygiene) had a major influence on BOP levels. The relative impact was several times greater compared with the extent of periodontal pocketing, aMMP-8 levels, smoking, toothbrushing, or gender. Furthermore, BOP levels were significantly elevated among adolescents with poor oral hygiene than good oral hygiene even if adjusted for the extent of periodontal pocketing (P<.001). BOP levels could be low even if several≥4mm deep periodontal pockets existed. The difference in the extent of periodontal pocketing was not significant between the two birth cohorts of adolescents (P=.731). BOP levels can be regarded as an important indicator of the extent of bacterial challenge and its adverse effects on the gingival inflammation. However, the level of oral hygiene may mask the association between the extent of gingival bleeding and the severity of the periodontal inflammatory condition. Thus, relying on BOP levels (below 10% or 20%) may provide insufficient information about the periodontal treatment need of an adolescent depending on his/her level of oral hygiene. Yet, more research is needed to confirm the results, also in adult populations.

The Effect of Parenting Practices on the Severity of Gingival Bleeding in Children.

Studies have consistently reported that parenting practices have an impact on eating styles which determine obesity levels in children. However, to the best knowledge of the authors, there is no study that evaluates the association of parenting practices on gingivitis in children using path analysis to evaluate if oral health-related behavior mediates this association. This study aims to test a model of parenting and family demographic factors that could account for gingivitis in children, with a focus on the mediational roles of oral health-related behaviors and oral hygiene status. Clinical examination of oral hygiene status and gingivitis was conducted using simplified oral hygiene and modified Community Periodontal Indices, respectively, on sixth-grade school children (n = 1,539) of Medak District in Telangana State, India. Children also answered a questionnaire consisting of five closed-ended questions on oral health-related behavior. Parents responded to queries related to socioeconomic status (SES), family structure, number of children, oral health-related behavior, and parenting practices. Prevalence of gingival bleeding was 92.4%. Power assertion parenting (representing coercive or controlling parenting practices) had a negative effect on oral hygiene status (β = 0.044; P = 0.07), and also had an indirect effect on gingival bleeding (β = 0.011; P = 0.05). Oral hygiene status was positively associated with the extent of gingival bleeding (β = 0.24; P = 0.01). Children living in families with lower SES had worse oral hygiene (β = -0.101; P = 0.01) and gingival bleeding status (β = -0.024; P = 0.01). Power assertion parenting had a deleterious effect on the extent of gingival bleeding via a worse oral hygiene status of children, but SES was also important for predicting oral hygiene and gingival bleeding.

Partial-mouth periodontal examination protocols for the determination of the prevalence and extent of gingival bleeding in adolescents.

To compare the performance of partial-mouth periodontal examination (PMPE) protocols with different cut-off points to the full-mouth examination (FME) in the assessment of the prevalence and extent of gingival bleeding in adolescents. A cross-sectional study was conducted involving 12-year-old adolescents. Following a systematic two-stage cluster sampling process, 1134 individuals were evaluated. Different PMPE protocols were compared to the FME with six sites per tooth. Sensitivity, specificity, area under the ROC curve (AUC), intraclass correlation coefficient (ICC), relative and absolute biases and the inflation factor were assessed for each PMPE protocol with different cut-off points for the severity of gingival bleeding. The highest AUC values were found for the six-site two-diagonal quadrant (2-4) (0.97), six-site random half-mouth (0.95) and Community Periodontal Index (0.95) protocols. The assessment of three sites [mesiobuccal (MB), buccal (B) and distolingual (DL)] in two diagonal quadrants and the random half-mouth protocol had higher sensitivity and lower specificity than the same protocols with distobuccal (DB) sites. However, the use of DB sites led to better specificity and improved the balance between sensitivity and specificity, except for the two-diagonal quadrant (1-3) protocol. The ≥1 cut-off point led to the most discrepant results from the FME. Six-site two-diagonal quadrant (2-4) and random half-mouth assessments perform better in the evaluation of gingival bleeding in adolescents. However, when a faster protocol is needed, a two-diagonal quadrant assessment using only MB, B and DL sites can be used with no important loss of information.

Association of gingivitis with child oral health-related quality of life.

Child oral health-related quality of life (COHRQoL) has been increasingly assessed. However, the full relationship between gingivitis and COHRQoL has been assessed by only a small number of studies. This study aims to assess the association between gingival bleeding and how a child perceives its OHRQoL. This cross-sectional study used multistage random sampling to enroll 1,134 12-year-old schoolchildren from Santa Maria, a southern city in Brazil. Participants were examined for gingival bleeding according to the community periodontal index criteria, a full-mouth clinical examination of six sites per tooth. COHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11- to 14-Year-Old Children (CPQ11-14), and data on socioeconomic status were collected. Multilevel Poisson regression models fitted the association of gingivitis with overall and domain-specific CPQ11-14 scores. In general, children with bleeding in ≥15% of sites had higher total CPQ11-14 scores and domain-specific scores than their counterparts. This association persisted after adjustment for other potential confounders. The presence and extent of gingival bleeding was associated mainly with emotional limitation domains of the CPQ11-14; those with extended levels of gingivitis had a 1.20 times higher mean score than those with low-level/no gingival bleeding (rate ratio = 1.20; 95% confidence interval = 1.10 to 1.31). The present results indicate that the presence of extensive levels of gingivitis might be negatively associated with how children perceive their oral health and their daily life.

Metabolic syndrome and gingival inflammation in Caucasian children with a family history of obesity

To investigate whether metabolic syndrome (MetS) and its components are associated with gingival inflammation in children. This is a cross-sectional analysis from the baseline visit of the QUebec Adipose and Lifestyle InvesTigation in Youth cohort, an ongoing longitudinal study investigating the natural history of obesity in children of Quebec, Canada. The analytic sample includes 448 children aged 8-10 years, 39% of whom were overweight or obese. MetS was defined according to the International Diabetes Federation recommendations. Gingival inflammation was defined by the level of gingival crevicular fluid (GCF) tumour necrosis factor alpha (TNF-α) and the extent of gingival bleeding. Sex-specific linear regression analyses estimated the associations between MetS and gingival inflammation, adjusting for potential confounders. Twenty-five children had MetS. Boys with MetS compared to those without, had a 49.5% (p-value = 0.001) higher GCF TNF-α level and 13.7% (p-value = 0.033) more sites with gingival bleeding. Moreover, for three of the five components of MetS - waist circumference, fasting plasma triglycerides, systolic blood pressure - an increase was associated with increased GCF TNF-α level in boys. No such findings were seen in girls. An association between MetS and gingival inflammation was observed as early as in childhood, and may differ by sex.

Promotion of periodontal health through professional toothbrushing and education on the use of the interdental brush in the elderly

Copyright © 2013 by Journal of Korean Academy of Oral Health This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives: This study is intended to evaluate the effects of promotion of periodontal health in the elderly, through professional toothbrushing and education on the use of the interdental brush, using the Gingival Bleeding Index and the Patient Hygiene Performance Index (PHP index). Methods: The study was conducted on 87 participants, who had given the informed consent to participate in the study at a general hospital ‘B’ in Busan from June to August, 2011. After assessing the general health condition and the medical history of the participants, the Watanabe toothbrushing method was used for professional toothbrushing on four different visits, along with imparting of education on the use of the interdental brush for self-management. The periodontal health of the participants was assessed based on the extent of gingival bleeding, by using the Gingival Bleeding Index, and the degree of plaque accumulation, by using the Patient Hygiene Performance Index. The data thus obtained was analyzed using Statistical Analysis Systems (SAS) (ver 9.13), followed by frequency analysis, analysis of variance (ANOVA), and the mixed effect model. Results: The average gingival bleeding index was 1.65 at the commencement of the study and 1.25, 0.88, and 0.65, after the first, second and third trial, respectively. The PHP index of dental plaque was 2.90 prior to commencement of the study, 2.79, 2.77, and 2.76 after the first, second, and third trials, respectively, thus significantly improving with every successive visit. Gingival bleeding index and PHP index significantly reduced with every visit, regardless of age, smoking habits, or systemic chronic diseases such as diabetes, hypertension, central nervous system or cardiovascular diseases. Conclusions: Education on the use of the interdental brush and professional tooth brushing promotes periodontal health, regardless of the chronic diseases seen in the elderly. Education on self-management of oral health, along with professional care at regular intervals should be recommended to effectively maintain periodontal health in the elderly.

Relação Entre Doenças Periodontais e Cardiovasculares em Cardiopatas Assistidos na Univali – Itajaí/SC

Cardiovascular diseases are among the main causes of death in our contemporary society. The development of these diseases is the result of a complex etiology and risk factors such as hypertension, smoking, diabetes and genetic predisposition, among others. The periodontal disease, which is an inflammatory state of the tissues supporting the teeth, also shares the same risk factors, and this pathology affects the health of the endothelium, the metabolism of plasma proteins, coagulation, and the function of the blood platelets. For this reason, the objective of this work was to determine the relationship between periodontal and cardiovascular diseases in cardiopathy patients attended at UNIVALI. An anamnesis was carried out, to determine which pathology each patient presented, harmful habits, associated the pathologies, age, and sex. The periodontal examination was carried out on the patients who met the criteria for inclusion in this work and who agreed to take part in the study. Next, they were classified in terms of the severity of the periodontal disease, and the extent of gingival bleeding. The author concludes that the condition of the mouth, and in particular, the presence of periodontal disease, appears to be a significant risk factor for cardiovascular disease and that systemic factors may be simultaneously involved in the origin of both diseases.

Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994.

The aim of this study was to assess the prevalence and extent of gingival recession, gingival bleeding, and dental calculus in United States adults, using data collected in the third National Health and Nutrition Examination Survey (NHANES III). The study group consisted of 9,689 persons 30 to 90 years of age obtained by a stratified, multi-stage probability sampling method in 1988 to 1994. The weighted sample is representative of U.S. adults 30 years or older and represents approximately 105.8 million civilian, non-institutionalized Americans. Gingival recession, gingival bleeding, and dental calculus were assessed at the mesio-buccal and mid-buccal surfaces in 2 randomly selected quadrants, one maxillary and one mandibular. Data analysis accounted for the complex sampling design used. We estimate that 23.8 million persons have one or more tooth surfaces with > or = 3 mm gingival recession; 53.2 million have gingival bleeding; 97.1 million have calculus; and 58.3 million have subgingival calculus; and the corresponding percentages are 22.5%, 50.3%, 91.8%, and 55.1% of persons, respectively. The prevalence, extent, and severity of gingival recession increased with age, as did the prevalence of subgingival calculus and the extent of teeth with calculus and gingival bleeding. Males had significantly more gingival recession, gingival bleeding, subgingival calculus, and more teeth with total calculus than females. Of the 3 race/ethnic groups studied, non-Hispanic blacks had the highest prevalence and extent of gingival recession and dental calculus, whereas Mexican Americans had the highest prevalence and extent of gingival bleeding. Mexican Americans had similar prevalence and extent of gingival recession compared with non-Hispanic whites. Gingival recession was much more prevalent and also more severe at the buccal than the mesial surfaces of teeth. Gingival bleeding also was more prevalent at the buccal than mesial surfaces, whereas calculus was most often present at the mesial than buccal surfaces. Dental calculus, gingival bleeding, and gingival recession are common in the U.S. adult population. In addition to their unfavorable effect on esthetics and self-esteem, these conditions also are associated with destructive periodontal diseases and root caries. Appropriate measures to prevent or control these conditions are desirable, and this may also be effective in improving the oral health of the U.S. adult population.