Gingival health and oral hygiene practices among high school children in Saudi Arabia

BACKGROUND: Gingivitis is a site-specific inflammatory condition initiated by dental biofilm accumulation. The accumulation of dental plaque on the gingival margin triggers inflammatory effects that can become chronic. In addition to its local effect, gingival inflammation has recently been suggested to have an impact on general health. OBJECTIVE: Determine the prevalence of gingivitis and its relationship to oral hygiene practices in high school children in Saudi Arabia. DESIGN: Cross-sectional. SETTING: High schools from different regions in Saudi Arabia. PATIENTS AND METHODS: Periodontal examinations were conducted on a randomly selected sample of high school children between the ages of 15 and 19 years. Gingival and plaque indices, probing depth, clinical attachment level, oral hygiene practices and sociodemographic characteristics were recorded. Data were analyzed using descriptive statistics, chi-square and the independent t test. MAIN OUTCOME MEASURE: Prevalence of gingivitis as defined by mean gingival index. SAMPLE SIZE: 2435 high school students. RESULTS: Twenty-one percent of the sample had slight gingivitis, 42.3% had moderate, and 1.8% had severe. Gender, toothbrushing, tongue brushing, plaque index, and the percentage of pocket depth (PD) >= 4 mm showed a significant relationship with the severity of gingivitis. Almost 39.3% of females had a healthy periodontal status when compared to males (30.7%). Thirty-five percent (35.5%) of students who brushed their teeth had a healthy periodontium compared to 26.9% who did not brush. The mean plaque index was significantly higher in students with severe gingivitis when compared to students with healthy periodontium (2.4 vs. 0.79, respectively). CONCLUSION: Gingivitis prevalence was high compared with Western countries in a nationally representative sample of high school students in Saudi Arabia and was influenced by oral hygiene practices. LIMITATIONS: The half-mouth study design may underestimate disease prevalence. Data on oral hygiene practices was self-reported and may thus have been affected by social desirability bias.