Elias-Boneta Augusto R, Ramirez Karol, Rivas-Tumanyan Sona, Murillo Margarita, Toro Milagros J
School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico.
Faculty of Dentistry, University of Costa Rica, San Pedro Montes de Oca, San José, Costa Rica.
BMC Oral Health. 2018 Jan 19;18(1):13. doi: 10.1186/s12903-017-0471-5.
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.
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.
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).
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.
牙龈炎是一种常见的口腔健康问题。未经治疗的牙龈炎可能会发展为牙周炎，而牙周炎是导致牙齿脱落的常见原因。波多黎各儿童中牙龈炎和牙结石的患病率尚不清楚。了解这一患病率有助于制定早期公共卫生预防策略。本研究旨在按健康区域估算12岁波多黎各人中牙龈炎和牙结石的患病率，并探讨按学校类型（社会经济地位的替代指标）和性别划分的分布差异。
根据入学人数比例，选取113所学校作为基于概率的样本，并按健康区域、学校类型和性别进行分层。两名经过培训的检查人员评估牙龈炎以及龈上和龈下牙结石的存在情况。牙龈炎定义为至少一个部位在轻柔探诊时出现牙龈出血（BOP），并根据牙龈出现BOP的牙齿百分比对问题的严重程度进行分类（有限：测试牙齿的25%-49%；广泛：>测试牙齿的50%）。使用针对健康区域进行调整的逻辑回归和线性回归模型，比较不同性别和学校类型之间牙龈炎和牙结石的患病率及严重程度。
在接受评估的1586名儿童中，80.41%发现患有牙龈炎。城市公立学校儿童的患病率（83.24%）略高于私立学校儿童（79.15%，p = 0.16）；农村公立学校儿童（77.59%）和私立学校儿童的患病率相似（p = 0.15）。所有儿童中60.81%存在广泛的牙龈炎。出现BOP的部位平均百分比（BOP%）为17.79%。与私立学校儿童相比，农村和城市公立学校儿童的BOP%显著更高（分别为p = 0.0005，p = 0.002）。样本中61.59%检测到牙结石，男孩的牙结石总量和龈上牙结石显著更高（p = 0.005）。与私立学校儿童相比，农村公立学校儿童龈下牙结石的患病率显著更高（p = 0.02）。
与美国青少年报告的数据相比，12岁波多黎各人中牙龈炎的患病率更高。与私立学校儿童相比，公立学校儿童的BOP%部位显著更高。男孩的牙结石总量和龈上牙结石患病率显著高于女孩。本研究确定了与性别和学校类型相关的口腔健康差异。建议开展研究探索这些差异的原因。
