Epidemiology of gingivitis.

In recent years, tremendous strides have been made in understanding the etiology of gingivitis. This increase in knowledge has come, for the most part, from basic research in oral microbiology, immunology, histology and pathology. Over the past decade, less progress has been made in further refining the epidemiological relationships between gingivitis and various host and environmental factors. The major restraint has been the great difficulty in reliably measuring gingival inflammation. This problem has resulted in great inter- and intra-study variation in diagnosing the prevalence and severity of gingivitis in human populations. Consequently, it is almost impossible to estimate longitudinal trends in gingivitis and it is nearly as difficult to make comparisons among different population groups studied by different examiners. Nevertheless, by focusing on the most apparent and robust epidemiological relationships, an instructive overview of the epidemiology of gingivitis can be gained. A number of host and environmental factors have been studied in relation to gingivitis and some of these will be reviewed. With respect to age, there is general concensus that marginal gingivitis begins in early childhood, increases in prevalence and severity to the early teenage years, thereafter subsiding slightly and leveling off for the remainder of the second decade of life. Gingivitis during the adult period is much more difficult to characterize due to paucity of data. Estimates of the general prevalence of adult gingivitis vary from approximately 50 to 100% for dentate subjects. In terms of gingivitis prevalence, the dentate elderly do not deviate appreciably from the general adult pattern. When adjusted for cohort effects, gingival disease appears to be on the decline.(ABSTRACT TRUNCATED AT 400 WORDS)