Incidence Of Gingivitis Research Articles

Incidence of Gingivitis with Intensity of Control of Fixed Orthodontic Patients During the Covid-19 Pandemic In Medical Students In Surabaya

Kesehatan periodontal adalah faktor penting yang digunakan untuk mengevaluasi keberhasilan perawatan ortodonti. Komplikasi yang terjadi pada perawatan periodontal dilaporkan sebagai salah satu efek samping paling umum yang terkait dengan ortodonti. Komplikasi periodontal yang terkait dengan ortodonti adalah gingivitis. Rancangan penelitian ini berupa Cross Sectional dan bersifat observasi analitik. Dengan populasi dan sampel penelitian ini mahasiswa Fakultas Kedokteran Universitas Wijaya Kusuma Surabaya yang melakukan perawatan ortodonti cekat pada periode bulan Mei-Juni 2022. Analisis data yang digunakan dalam penelitian ini adalah uji statistik Chi-Square. Didapatkan hasil bahwa terdapat hubungan yang signifikan pada intensitas kontrol terhadap kejadian gingivitis pada pengguna ortodontik cekat di Fakultas Kedokteran Universitas Wijaya Kusuma Surabaya. Pencegahan terjadinya gingivitis pada pengguna ortodontik yaitu dengan cara menjaga higienitas rongga gigi dan mulut. Intensitas kontrol yang rutin dapat menambah informasi mengenai cara menjaga kebersihan rongga mulutnya, serta penggunaan alat bantu oral hygiene yang mungkin dapat membantu mencegah terjadinya stomatitis traumatik.

Correlation Between History of Birth Control Usage and Incidence of Gingivitis among Pregnant Women in Ambulu Public Health Center, Jember District: A Cross-sectional Study

Using birth control (BC) can affect gingiva tissue, increasing the risk of developing gingivitis among women of reproductive age. Based on the Central Bureau of Statistics census, in 2021 61,77% of women in their reproductive age have used contraception and birth control in East Java. This study aims to find the correlation between the history and birth control usage and the incidence of gingivitis among pregnant women in Ambulu Public Health Center. This study uses a cross-sectional method with an analytical observational approach on pregnant women who visited the Dental Outpatient and received dental examinations in April and May of 2022. Thirty respondents were gathered with a history of birth control usage and evaluated using the dentist's Periodontal Index (PI). The results show that nine respondents (30%) had no history of using BC, two respondents (6.6%) used BC pills, ten respondents (33.3%) used 1-month injection BC, five respondents (16.6%) used 3-month injection BC, two respondents (6.6%) used implants BC and two respondents (6.6%) used IUD. From the cross table, one respondent (3.3%) was in the normal category, 1 respondent (3.3%) was in the simple gingivitis category, 15 respondents (50%) were in the early destructive periodontal disease category, and 13 respondents (43.4%) were in the destructive periodontitis. The data are analyzed using Chi-square result, showing that the significant value is p = 0,049 (p<0,05), so it can be concluded there is a significant relation between history of birth control usage and incidence of gingivitis in Ambulu Public Health Center. Dental and oral examinations are highly recommended in routine as early detection of health problems among pregnant women.

THE BEHAVIOR OF MAINTENANCE OF REMOVABLE PARTIAL DENTURES WITH THE INCIDENCE OF GINGIVITIS IN ELDERLY

Background: The incidence of missing teeth at the age of 56-64 years due to extraction in Poso Regency is 35.57%. The high incidence of tooth loss in the elderly will have an impact on decreasing various system functions. Replacement of teeth that have been lost in the elderly can be done using removable dentures. The use of dentures should be accompanied by good maintenance of dentures. The lack of maintenance of dentures will cause various health problems of the oral cavity, which one is gingivitis. Purpose: this study aims to analyze the relationship between the behavior of maintenance of removable partial dentures and the incidence of gingivitis in the elderly. Method: The type of this research was a quantitative study with an analytical observational approached using a cross sectional design. The variable in this research is the behavior of maintenance of removable partial dentures and the incident of gingivitis. The research was conducted at Posyandu Lansia in working area of Puskesmas Kawua on August 2022. The population of this research is 58 respondents. The samples of this research is 50 an calculated by slovin’s formula. Those samples were chosen using purposive sampling technique. The instrument that used in this research were collected from the behavior questionnaires and check sheet which were later analyzed using chi square test. Result: The behavior of maintenance of removable partial dentures in the middle category (54%). Most of elderly had incidence of gingivitis (64%). Based on the chi square test showed that p-value was 0,000. Conclusion: The behavior of maintenance of removable partial dentures corelate with the incidence of gingivitis in elderly.

The Relationship Of The Anterior Dental Malocclusion With The Incidence Of Gingivitis In Students Of Medical Faculty in Surabaya

Introduction: Gingivitis is an inflammation of the gums, which is the initial stage of gum and periodontal tissue disease, characterized by red gingival tissue, bleeding easily, bad breath (halitosis), and the presence of debris on the teeth and cervical area. Misaligned tooth is said to be one of the predisposing factors for gingivitis. Purpose: To determine the relationship between the arrangement of the anterior mandibular teeth with the incidence of gingivitis in students of the Faculty of Medicine, Wijaya Kusuma University, Surabaya. Methods: This study used a purposive sampling method with a total population of 125 subjects. From this population, 56 people were taken who experienced anterior crowding with gingivitis. The degree of malocclusion, i.e. anterior crowding, was examined clinically and was associated with gingivitis. The data obtained were analyzed by Chi-square test. Results: There is a significant relationship between the anterior mandibular malocclusion and the incidence of gingivitis (p< 0,05). Conclusion: Anterior tooth arrangement affects the incidence of gingivitis among medical faculty students in Surabaya.

Сучасні аспекти захворюваності гінгівітом та пародонтитом дітей та підлітків України, ефективність лікування та профілактики

The purpose of the work was to study modern aspects of the incidence of gingivitis and periodontitis in children and adolescents in Ukraine and to create an algorithm for treatment and prevention tactics in this pathology. It has been established that the high prevalence of gingivitis and periodontitis among children and adolescents makes this problem one of the most important problems of modern dentistry. The problem of periodontal pathology in children and adolescents is due to both the prevalence of diseases and the fact that poor-quality treatment of diseases in childhood and adolescence will lead to severe irreversible damage to periodontal tissues in adults. Modern prevention of inflammatory periodontal diseases in children and adolescents should be carried out on the basis of an algorithm of therapeutic and preventive measures: elimination of local traumatic factors, restoration of the anatomical shape of the teeth, high-quality treatment of the root system, replacement of defective restorations, professional oral hygiene, selection and correction of means and methods of individual hygiene. Results and discussion. The results of the study of oral hygiene and periodontal condition in patients with chronic limited catarrhal gingivitis and chronic localized periodontitis showed that the average value of most of the studied parameters in patients had significant differences when compared with healthy individuals in the control group, as well as between groups of patients. Index evaluation of the functional state of the peripheral circulation in the periodontal tissues of young patients revealed a significant decrease in capillary resistance. Based on literature data and the results of our own research and an objective method for predicting the localization of inflammatory diseases of periodontitis, a therapeutic and prophylactic tactic was developed in young patients with indications of diseases and risk factors for their development. Evaluation of the effectiveness of the developed method of treatment and prevention of localized periodontal tissue damage in patients of the main group was carried out on the basis of the results of clinical, physicochemical and functional research methods in comparison with groups of patients who underwent therapeutic and preventive measures in the traditional way. The results of treatment of localized inflammatory periodontal diseases were analyzed in 34 patients of the main group with chronic limited catarrhal gingivitis, 26 patients with chronic localized periodontitis of degree I and in a similar number of patients in the comparison group with an identical diagnosis. Conclusion. The results of treatment of 60 patients of the main group showed the high efficiency of the developed method. At the same time, a significant improvement in the subjective and objective symptoms of diseases was found. Complete clinical recovery with the elimination of the inflammatory process in the gums was found in 94.1% of patients with chronic limited catarrhal gingivitis of degree I. The obtained positive results of treatment of the main group of young patients with localized inflammatory lesions of periodontal tissues in terms of hygienic and periodontal indices and the state of peripheral circulation confirm the high efficiency of the developed algorithm for the treatment and prevention of these diseases

Effects of Low-Level Diode Laser on the Level of Interleukin 1-Beta in the Gingival Crevicular Fluid and the Incidence of Gingivitis Caused by the Use of Orthodontic Separators: A Randomized Clinical Trial

Background: In recent years, there has been an increased tendency for using dental lasers for the treatment of soft tissue problems. The aim of this study was to evaluate the effect of low-level diode laser (980 nm) on the level of interleukin 1 beta (IL-1β) in the gingival crevicular fluid (GCF) and the incidence of initial gingivitis caused by the use of orthodontic separators. Methods: In this randomized clinical trial, 30 patients, who were beginning a fixed orthodontic treatment without gingivitis, were randomly assigned to control and diode laser radiation (980 nm wavelength, 3 J of energy, a density of 3 J/cm2 , a power of 0.2 W, and at a distance of 1 cm away from the tissue for 15 seconds on the buccal and palatal sides of the tooth) groups. The gingival index (GI) and bleeding on probing (BOP) were measured at the beginning of the study and one week after the treatment. The level of IL-1β was evaluated using an enzyme-linked immunosorbent assay at the beginning of the study and one week after the placement of the separator. Finally, the inter-group and intra-group statistical analyses were performed using independent and paired t tests, and P<0.05 was considered as the significance level. Results: The evaluation of clinical variables in the entire mouth showed a slight clinical improvement in the experimental group although there was no significant difference between the two groups. No significant difference was observed between intra-group and inter-group evaluations of clinical indices in the studied specific teeth. Eventually, no difference was found between the two groups in terms of IL-1β changes. Conclusions: In general, the single-diode laser radiation session is not effective in the treatment of gingivitis in patients undergoing orthodontic treatment. Thus, it is recommended to perform frequent laser radiation sessions in further studies.

The periodontal status of mandibular incisors in patients with angle’s class II malocclusion treated with orthodontic therapy or orthognathic surgery with orthodontic therapy: A single centered retrospective study

Malocclusion is any deviation from physiologically acceptable contact between opposing dental arches. Occlusal trauma is a term used to describe injury resulting in tissue change within the attachment apparatus which may occur in a healthy or reduced periodontium. Clinically one of the tests to assess trauma from occlusion is the fremitus test with confirmatory test for trauma from occlusions such as histological evaluation of a block section biopsy or modern aids like T-scan. Considering these findings Angles Class II molar relation with or without skeletal Class II relation has great influence in underlying peridium. The present study was aimed at correlating the relation between angles class II malocclusion treated with orthodontic therapy alone or combined with orthognathic surgery and the periodontal status of mandibular incisors. The study was a single centered retrospective university design, using patient records for the comparison of the entire patient outflow of a dental college in Chennai from 1st June 2019 till 1st March 2020. The included patients were individuals with angles class II malocclusion treated by orthodontic therapy alone or combined with orthognathic surgery. In this study, we observed that the periodontal status of mandibular incisors was mostly healthy with the incidence of gingivitis associated at a higher tendency in patients treated by fixed orthodontic appliance therapy along with orthognathic surgery. There was also a negative correlation of non-extraction cases and periodontal status suggesting orthodontic extraction cases have a relatively healthy periodontium which was both clinically and statistically significant.

PERIODONTAL DISEASE STATUS, KNOWLEDGE, ATTITUDE, PRACTICE AND TREATMENT NEEDS OF PREGNANT WOMEN

Background: Periodontal disease is a prominent and important issue of public health, especially in pregnant women. The objective of this study is to describe the clinical characteristics; learn knowledge, attitudes, practice oral hygiene and assess the need for treatment of periodontal disease in pregnant women. Subjects and Methods: A cross-sectional study of 210 pregnant women who visited the Department of Obstetrics and Gynecology at the Hue University of Medicine and Pharmacy Hospital. Clinical examination and interview questions on knowledge, attitudes and practice of oral care for all subjects. Results: The incidence of gingivitis was 100%, with mild gingivitis of 4,3% and moderate gingivitis of 95.7%. There was a difference in incidence rates of gingivitis in the gestational period (p<0.001). The incidence of periodontitis is 17.6% and there is no difference in gestational age (p>0.05). The mean values of GI and BOP indices differed by gestation period (p<0.05) and PD, OHI-S, PlI have statistically significant relationship with gestation period (p>0.05). The incidence of periodontal disease is 80.5%; The percentage of pregnant women who abstain from brushing their teeth after birth is 61.4%. Prevalence of brushing once a day: 7.1%; Twice a day: 70.5% and 3 times daily: 22.4%; The mean values of GI, PD, BOP, OHI-S and PlI were inversely proportional to the number of brushing (p<0.001). The rate of dental hygiene is just 3.3%; The rate of oral hygiene, dental plaque and plaque removal was 94,3%; The proportion of subjects required for intensive treatment is 2.4%. Conclusion: Periodontal disease, especially for pregnant women, is high. It is necessary to educate the knowledge, attitudes and practice of proper oral hygiene and to better meet the demand for periodontal disease treatment for pregnant women. Key words: Periodontal disease, pregnant women, knowledge, attitude, practice for oral hygiene, treatment needs

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.

Exploring Self-Care Needs of Pregnant Women with Gingivitis: A Qualitative Study in Iran.

Background:Oral self-care behaviors are not satisfactory among pregnant women; incidence of gingivitis is high in them and training programs have slightly improved their gingivitis. This study was aimed to explore self-care needs of pregnant women suffering from gingival inflammation.Materials and Methods:This study was carried out in Sanandaj, west of Iran, in 2017. Twenty pregnant women with gingivitis were included in the study. Data were collected via semi-structured individual and group interviews and note-taking, and were analyzed by conventional content analysis. To confirm the accuracy and strength of the data, credibility, confirmability, and transferability components were taken into account.Results:The results of data analysis yielded six major categories, including “organizational support,” “dentist's professional competence,” “increasing perceived threat,” “increasing self-efficacy,” “increasing perceived benefits,” and “culture-making.” Increased self-efficacy was the most important concern of pregnant women.Conclusions:The findings showed that self-care behaviors to prevent gingivitis in pregnant women are influenced by various factors. It is essential to consider the cooperation of the media and organizations, support of society, and attention of families and authorities to oral health education and disease prevention among women.

Relationship between Gingivitis and Autism in Children: A Matched Case-control Study

Autism is a neurodevelopmental disorder diagnosed in early childhood. Studies have shown that autistic children have poorer gingival health and hence chances of higher incidence of gingivitis may occur in autistic than non-autistic children. Gingivitis is characterized by gingival inflammation without loss of attachment due to continuous exposure to dental plaque. Studies on the gingival health of autistic children in Malaysia are lacking. Hence, this study aims to evaluate and compare the gingival health status of autistic and non-autistic children. Materials and Methods: A total of 86 children were recruited and an oral assessment was performed on each child to assess the degree of calculus, plaque accumulation and gingival Original Research Article Sikarwar et al.; BMRJ, 7(4): 174-179, 2015; Article no.BMRJ.2015.109 175 inflammation using the calculus, plaque and gingival indices respectively. Pooled dental plaque (supragingival margins and gingival crevices of the buccal surface of the anterior maxillary molar and lingual of mandibular molar teeth) samples were collected and transferred to Stuart transport media. Samples were diluted and 100 μl aliquots were cultured on Columbia agar with 5% sheep blood. Plates were incubated in an anaerobic environment at 37oC for 7 days. Colonies were Gram stained and examined for cellular morphology followed by indole and catalase test. Bacterial identification was done using the Rapid ID 32 A kit. Kolmogorov-Smirnov, Chi-square, MannWhitney U, Odds ratio and Spearman’s correlation analyses were used to analyze the data. Results: The prevalence of dental calculus was significantly elevated in the autistic group with 43 sample size in each group (p = 0.001). However, the prevalence of gingivitis and plaque were not significantly different between the two groups. The presence of plaque (p = 0.001) and calculus (p = 0.004) were significantly associated with the development of gingivitis. Conclusion: While the autistic children had significantly more calculus, the occurrence of gingivitis and plaque were similar between autistic and control groups. Measures to control dental plaque and calculus among the autistic children should be improved to prevent gingivitis.

PENGARUH ORAL HYGIENE PADA WANITA PASKAMENOPAUSE DENGAN KEJADIAN GINGIVITIS PADA KELOMPOK WANITA TANI (KWT) DI KECAMATAN LUBUK ALUNG KABUPATEN PADANG PARIAMAN

Menopause is the end of menstruation cycle and reproduction period for women. A woman is entering postmenopausal if she doesn’t get menstruation for 12 months or more. As menopause, estrogen and progesteron hormone decreased. Decrease of progesteron and estrogen level followed by clinical change in oral cavity which gets risk gingivitis and influence oral hygiene. This study aims to know the relation between oral hygiene of postmenopausal women and the incidence of gingivitis in Kelompok Wanita Tani (KWT) in Kecamatan Lubuk Alung Kabupaten Padang Pariaman. The design of this study is the Cross Sectional Study. This study was conducted to 53 postmenopausal women in Kelompok Wanita Tani in Kecamatan Lubuk Alung Kabupaten Padang Pariaman in Desember 2012. The data was collected through questionnaires and examinations of OHIS index and gingival index by chi-square analysis. The results showed that the majority (43,4%) postmenopausal women in Kelompok Wanita Tani had a moderate oral hygiene and also (45,3%) had a moderate of gingivitis. The gum looks pale or red about (75,5%) and easy to bleed about (56,6%). All of postmenopausal women in Kelompok Wanita Tani in Kecamatan Lubuk Alung Kabupaten Padang Pariaman got gingivitis althought they had good oral hygiene

Frequency of Gingivitis in Pregnancy : A Comparative Study between First and Third Trimesters of Pregnancy

Objective: The aims of this study were to determine the incidence of gestational gingivitis and assess oral health status in two groups of women at different stages of pregnancy. Methods: A comparative descriptive study was conducted on pregnant women attending the outpatient antenatal care clinic at Princess Haya Hospital in Aqaba from January 2010 to August 2010. Data were collected from 580 women. Two groups were created. The first group (n=260) included women at their first trimester and the second group (n=320) included women in their third trimester of pregnancy at the time of their dental examination. Data were collected from the women by face-to-face interview and intra-oral examination. The two groups were compared. Results: Gingivitis was detected in 26.8% in women examined during their first trimester of pregnancy as compared to 32.1% in women examined during their third trimester. There was no statistical significant difference in the incidence of gingivitis between trimesters. However, there was significant difference between the first and third trimester of pregnancy regarding associated calculus (p<0.0001) and the presence of malodor (p=0.006) with both being more common in later pregnancy. Oral hygiene habits and regular dental care were much better during first months of pregnancy compared to the last three months (p<0.0001). Conclusion: Our study confirms that the frequency of gingivitis during the third trimester of pregnancy is higher than during the first trimester. Further studies are needed to determine the relation of gingivitis to oral hygiene and dental care habits. Key wards: Gingivitis, Pregnancy, Trimester

Spontaneous Gingivitis Related to Hair Penetration in Rats

Maxillary gingivae from male and female Crl:CD(SD) rats at 12, 16, 21, and 34 weeks of age were examined histologically. The incidence of gingivitis was approximately 40%, with no age or sex predilection, and was most frequent between the first and second molar. Lesions were characterized by acute focal neutrophilic infiltration into the gingival mucosa, occasionally with inflammatory exudate. In severe cases, inflammation extended to the periodontal ligament with abscess formation, and adjacent alveolar bone destruction/resorption. The most characteristic finding was the presence of hair shafts associated with the lesion, which was observed in approximately 80% of the rats with gingivitis. These findings suggest that molar gingivitis occurs in rats from an early age and persists thereafter, and that the main cause of gingivitis in rats is hair penetration into the gingiva. It would be prudent to keep these background lesions in mind as potential modifiers in toxicity studies.

A clinical evaluation of the effect of 0.2% chlorhexidine gluconate as a mouthrinse on gingival inflammation in pregnant and non-pregnant women with and without undergoing scaling and root planing procedures

There is a high incidence of gingivitis in pregnant women due to combined effect of local and systemic factors. Chlorhexidine is an effective chemical plaque control agent by virtue of its property substantivity. Aim and Objective: In the present work we propose to study the effect of 0.2% chlorhexidine gluconate solution as a mouth rinse on gingival inflammation in pregnant women in comparison with non-pregnant women, before and after scaling and polishing procedures. Materials and Methods: A total number of seventy six healthy pregnant and non pregnant females in the age group of 20 to 30 years were included for the study. All the subjects used 0.2% chlorhexidine gluconate mouthrinse twice a day for 3 weeks. Weekly observations were made in both subgroups. Results: There was no significant reduction in plaque index, papilla,marginal gingiva and attached gingiva index and gingival bleeding index when 0.2% chlorhexidine gluconate mouth rinse was used alone without scaling and polishing procedures. When 0.2% chlorhexidine gluconate mouthrinse was used after scaling and polishing procedures at the end of 3 weeks, there was highly significant reduction in PMA index and gingival bleeding index in nonpregnant women group, whereas in pregnant women group there was only a significant reduction in the gingival bleeding index. Conclusion: 0.2% chlorhexidine gluconate used as mouth rinse twice a day for three weeks reduces gingival inflammation and gingival bleeding in both pregnant and non pregnant women, but significantly more in non pregnant women.

THE PATTERN AND DISTRIBUTION OF GINGIVITIS IN SCHOOL CHILDREN OF BOSHEHR-IRAN

Background: Gingivitis is the most common oral disease that involves various areas of the mouth with different degree and intensity. The beginning of gingivitis is seen in age 5, and its prevalence is increased with age. There are different opinions about the involved areas that are most commonly or most severely affected in epidemiological researches. This study was designed to determine the pattern and distribution of gingivitis and to compare the prevalence and severity of gingivitis in involved areas. Materials and methods: In this investigation, 659 randomly selected cases of school children were evaluated with periodontal Russel Index. The results of this study were compared to those of others. Results: The findings showed that %43.5 of the students had gingivitis and its prevalence was more in boys than girls and more in the lower Jaw than the upper one. The prevalence and severity of the disease was more in the molar area than the incisor area and the most affected teeth were the first molars. The prevalence of gingivitis was almost similar in the right and left sides but its intensity was a little more in the right side. The most affected age was 15 years old. Conclusion : High incidence of gingivitis indicates that oral hygiene measures are poor among Booshehri school children and need much more attention and consideration. Key words: Gingivitis, Distribution, Gingiva

Immunostimulatory potential of smokeless tobacco extract in in vitro cultures of murine lymphoid tissues.

Despite numerous studies on the general toxicologic effects of smokeless tobacco (ST) little immunotoxicologic information is available. As a first step in assessing the potential activity of ST on the immune system, the effects of an aqueous extract of ST was studied in in vitro cultures of mouse lymphoid cells. There was a significant increase in the proliferation of spleen cells cultured with different concentrations of ST extract. The polyclonal IgM antibody responses as determined by protein A plaque assay were also elevated in ST stimulated spleen cell cultures. Similar immunostimulatory results were seen in the mesenteric lymph node cell cultures also. ST extract was able to stimulate the spleen cells of the immune defective CBA/N mice. The mitogenic ability of ST extract may not be due to lipopolysaccharide (LPS) contamination as determined by its response in the LPS resistant C3H/HeJ mice spleen cells. ST extract was mitogenic not only to B cells but also to T cells. However the magnitude of response was less in T cells than in B cells. The proliferation of T cells was not accompanied by secretion of IL-2 or expression of IL-2 receptors on T cells. However there was an increase of IL-1 activity in spleen cells cultured with ST extract. Finally, activation of B or T lymphocytes by ST did not result in the elevation of intracellular calcium levels. Since ST is consumed orally, the chronic immunostimulation by ST in oral mucosal lymphoid tissues may be associated with the increased incidence of gingivitis, leukoplakia and oral cancer seen in human ST users.

Periodontal Diseases and Diabetes

Inflammatory periodontal diseases are common in the United States. The incidence of gingivitis and periodontitis appears to be the same for persons with controlled diabetes as for those in the nondiabetic population. For patients with uncontrolled diabetes, however, periodontal diseases progress more rapidly than in their controlled counterparts. In addition, once a person with diabetes has periodontitis, the disease is usually more aggressive than in nondiabetic controls. These differences may be due to microangiopathy, altered polymorphonuclear leukocyte chemotaxis, increased dental plaque formation, or other causes. Patients with diabetes should be counseled to have a periodontal screening, which must include the use of a probe to measure the depth of the periodontal pockets. When problems are found, they should be treated and the patient should be placed in maintenance therapy.

The association between tooth irregularity and plaque accumulation, gingivitis, and caries in 11-12-year-old children.

The association between tooth irregularity and plaque accumulation, gingivitis and caries is somewhat controversial, primarily because of interplay of a number of factors which makes the determination of the role of irregularity difficult. This baseline study of 1015, 11–12-year-old children has attempted to unravel the effect of various interrelated factors using 4- way hierarchical analysis of variance. Preliminary analysis demonstrated that there was a modest but significant positive correlation (r=0.24p<0.001) between the subjects' mean plaque and mean irregularity indices. The main analysis, based on data from pairs of contralateral teeth, one of which was irregular and the other not, took into account differences between subjects, the position of the tooth in the mouth and whether the irregular tooth was on the toothbrushing hand side or not. Irregular teeth retained more plaque than straight teeth by a modest though statistically significant (p<0.05) extent, but no significant differences in the incidence of gingivitis or dental caries were found.

A trial of ascorbic acid and of multivitamin supplementation on the oral health of West African children

204 children between the ages of 1·5 and 6·5 years living in a West African village where the incidence of gingivitis and bleeding gums is about 40% of the population at the end of the rainy season, were given vitamin C or a placebo for 69 days, followed by a multivitamin supplement or placebo for 47 days. The condition of their gums was continuously monitored by trained field workers and by a paediatrician during the supplementation period, and was also assessed in greater detail by the paediatrician at the beginning and end of each treatment period. No benefit of either type of supplement could be detected, either on incidence of bleeding, or on over-all severity of gingivitis, although there was a clear-cut seasonal trend towards lower incidence of bleeding in both groups as the study progressed.