Prevalence and severity of plaque-induced gingivitis in a Saudi adult population

Objectives:

To evaluate the prevalence and severity of plaque-induced gingivitis among a Saudi adult population in Riyadh region.

Methods:

Three hundred and eighty-five eligible participants in this cross-sectional study were recruited from routine dental patients attending the oral diagnosis clinic at Al-Farabi College in Riyadh, Saudi Arabia from June 2013 to December 2013. A clinical examination was performed by 2 dentists to measure the gingival and plaque indices of Löe and Silness for each participant.

Results:

The prevalence of gingivitis was 100% among adult subjects aged between 18-40 years old. Moreover, the mean gingival index was 1.68±0.31, which indicates a moderate gingival inflammation. In fact, males showed more severe signs of gingival inflammation compared with females (p=0.001). In addition, the mean plaque index was 0.875±0.49, which indicates a good plaque status of the participants. Interestingly, the age was not related either to the gingival inflammation (p=0.13), or to the amount of plaque accumulation (p=0.17). However, males were more affected than females (p=0.005).

Conclusion:

The results of this study show that plaque accumulation is strongly associated with high prevalence of moderate to severe gingivitis among Saudi subjects.Plaque-induced gingivitis is the most common form of periodontal disease,1 which is considered to be the second most common oral disease after dental caries, affecting more than 75% of the population worldwide.2,3 In 2000, the United States Surgeon General released a report calling interest to the ‘‘silent epidemic’’ of dental and oral diseases, mainly dental caries and periodontal diseases suffered by millions of people throughout the US.4 The prevalence of periodontal diseases varies in different studies and different countries as a result of variations in study populations, age of participants, and the procedure of defining and diagnosing this type of disease. In general, gingivitis begins in early childhood, and becomes more prevalent and severe with age.5,6 Epidemiological studies revealed that plaque-induced gingivitis is prevalent among all ages of dentate individuals.7-9 Plaque-induced gingivitis is characterized by the presence of inflammation confined to gingiva without extension into other tooth-supporting structures.10-12 Persistence of this type of inflammation is correlated with the presence of microbial dental plaque. As long as this microbial biofilm is present adjacent to the gingival tissues, the inflammation will not resolve.13 However, it has been shown to be reversible after removing these causative factors.14 The clinical features that can be used as characteristic of gingivitis could be one of the following signs: erythematic and sponginess; changes in contour; bleeding upon stimulation; and presence of calculus, or plaque without clinical attachment loss, or radiographic evidence of crestal bone loss.15 Clinically, the severity and signs of gingival inflammation can be expressed by means of gingival index (GI) of Löe and Silness.16 According to this index, gingival inflammation can be classified as mild, moderate, or severe. However, the presence of these signs of inflammation is considered the initial stage for the more severe and irreversible form of periodontal diseases.17-19 A patient''s susceptibility to develop this type of disease also is highly variable and depends on the host response towards periodontal pathogens,17-19 which may be influenced by both acquired and genetic factors that can modify this susceptibility to infection.12,20 Prevention of dental plaque accumulation and early treatment of gingivitis reduces the risks associated with the development of a more severe, and destructive form of periodontal diseases.11,21 It is well known and documented that gingivitis develops after 10-21 days of accumulation of dental plaque,22 necessitating a daily effort to prevent plaque accumulation. Several studies revealed a significant correlation between reducing the incidence of gingivitis and regular plaque control measures.23-25 The aim of this study was to evaluate the prevalence and severity of plaque-induced gingivitis among a Saudi adult population in Riyadh region.