Association between Age, Gender and Severity of Gingivitis among Children between 6-10 Years- A Retrospective Study
Kadambari Sriram1, Ganesh Jeevanandan2*, M.P. Santhosh Kumar3
1 Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
2 Reader, Department of Pedodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
3 Reader, Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
*Corresponding Author
Ganesh Jeevanandan,
Reader, Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 162, PH Road, Chennai
600077, Tamil Nadu, India.
Tel: 9884293869
E-mail: ganesh.sdc@saveetha.com
Received: July 30, 2021; Accepted: August 11, 2021; Published: August 18, 2021
Citation:Kadambari Sriram, Ganesh Jeevanandan, M.P. Santhosh Kumar. Association between Age, Gender and Severity of Gingivitis among Children between 6-10 Years- A
Retrospective Study. Int J Dentistry Oral Sci. 2021;8(8):4105-4108. doi: dx.doi.org/10.19070/2377-8075-21000838
Copyright: Ganesh Jeevanandan©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Children and adolescents are often affected by a variety of periodontal diseases and conditions. Gingivitis, if it occurs at an early age, tends to increase in its severity and finally peaks at the onset of puberty. However untreated gingival diseases in childhood, may progress to severe forms of periodontal diseases in adulthood. There have been many studies over the years which have analysed the character and factors affecting the distribution of carious lesions no similar measures have been implemented for gingivitis and periodontitis in pediatric dentistry. The aim of the present study was to evaluate the association between gender, age and gingivitis among children between 6-10 years of age visiting Saveetha Dental College. A retrospective study was carried out using digital records of patients who reported to the Department of Paediatric and Preventive Dentistry from June 2019 to March 2020. A total of 103 patients between ages of 6-10 years were finally included for the study evaluation. The age, gender and gingival status were observed from the digital records and tabulated on a spreadsheet. The collected data was analysed by computer software SPSS version 20 using Chi square test with the level of significance set at 5%. It was observed that around 46% of the participants had gingivitis. There was no significant association between gender and age and gingival status (p>0.05). Within limits of the study it can be concluded that there is high prevalence of gingivitis among pediatric patients, but there is no significant variation in gingival status by age and gender.
2.Introduction
3.Conclusion
4.References
Keywords
Brushing Frequency; Gingivitis; Oral Hygiene; Periodontal Health.
Introduction
Gingivitis is defined as a reversible inflammation of the gingiva
[34]. Children and adolescents are often affected by a variety of
periodontal diseases and conditions. Gingivitis especially is common
around the time of puberty. Gingivitis, if it occurs at an early
age, tends to increase in its severity and finally peaks at the onset
of puberty. Thereafter the severity of gingivitis gradually decreases.
If it persists, chronic periodontitis which is measured loss of
attachment or recession becomes dominant and may continue to
increase in severity [31, 32]. There have been many studies over
the years which have analysed the character and factors affecting
the distribution of carious [49] lesions for preventive dental care
[13], no similar measures have been implemented for gingivitis
and periodontitis in pediatric dentistry. Previously several clinical
trials on treatment as well as preventive dental care for carious
lesions as well as dental trauma [45] have been conducted by
our team (Govindaraju, Jeevanandan and E. M. G. Subramanian,
2017a [14]; Govindaraju, Jeevanandan and E. Subramanian, 2017
[13]; Jeevanandan, 2017 [20]; Jeevanandan and Govindaraju, 2018
[21]; Nair et al., 2018 [33]; Panchal, Jeevanandan and Subramanian,
2019 [38]). Previous literature has revealed that while there
was high prevalence of periodontal disease in children, the correlation
of gingivitis incidence as well as severity with age was low.
The relation between plaque accumulation and gingival inflammation
in children was also found to be lower than that of adults
[50]. However untreated gingival diseases in childhood, may progress
to severe forms of periodontal diseases in adulthood [30]
which emphasizes the diagnosis and treatment of gingivitis in early
ages. Previously our team has a rich experience in working on various research projects across multiple disciplines. [1, 19, 16, 24,
25, 36, 37, 40, 43, 48, 54, 57]. Now the growing trend in this area
motivated us to pursue this project. The purpose of the present
study was to determine the prevalence and severity of children
and evaluate if age and gender are factors which cause variation
in gingivitis in children.
Materials and Methods
Study Design:
In this retrospective study, data from 86000 patients within
Saveetha Dental College were collected from dental records. At
data extraction, all information was anonymized and tabulated
onto a spreadsheet. The study was commenced after approval
from the Institutional Review Board. To fulfil the inclusion criteria,
patients between the age group of 6-10 years should have
been included in the study. Patients who were outside this age
group or those with other systemic complications were excluded
from the study.
Subjects and Procedures:
Data were collected from June 2019 to March 2020 for 103 patients.
The following data were retrieved from the dental records:
patient age, gender, Gingival index score, Plaque index score and
periodontal status. The records were examined for errors by photographic
evaluation.
Statistical Analysis
The statistical analysis was done using SPSS software version 20.0
(SPSS Inc., Chicago, IL, USA). Chi-square test was used to compare
the gender wise and age wise gingival status of the patients.
The significance level was set at 5% for the present study.
Results
The present study included a total of 103 patients within 6-10
years of age with a mean age of 8 years. Chi-square test between
the three groups with respect to gingival status showed an unequal
distribution of participants. 40.8% of the participants presented
with generalised chronic gingivitis, 5.8% presented with localized
chronic gingivitis and 53% had clinically healthy gingiva [Figure 1].
On analysis, there was no statistically significant association noted
between gender and gingivitis in pediatric patients>0.05 by Chi
square test [Figure 2]. However higher prevalence of Generalised
chronic gingivitis was seen in males [Figure 2]. Higher prevalence
of Generalised chronic gingivitis was observed among 10 year
olds, followed by 8 year olds[Figure 3] however the association
between age and gingivitis in pediatric patients was not found to
be statistically significant by Chi square test, p=0.20 [Figure 3].
It has been established in previous studies that there are changes
in healthy gingiva towards gingivitis in early childhood itself [18].
The severity of gingivitis has also been reported to increase with
increase in age. This cannot be verified in the current study as
only the prevalence and distribution was recorded. The greater
prevalence of gingivitis among 10 year old children is consistent
with findings of a study by Hugoson et al. This variation in incidence
of gingivitis can be attributed to the changing dentition at
this age [4, 26, 53]. Hormonal changes according to Ketabi et al,
during the onset and period of puberty are also known to aggravate
gingival response to local factors [23]. Presence of loose, partially
exfoliated deciduous teeth could also cause some degree of
gingivitis. No significant association however was found between
age and incidence of gingivitis was found in our study.
Mild chronic gingivitis is the most common form of periodontal
disease [5] observed in children [28]. Aside from dental plaque,
systemic conditions, pathologies [35] and economic conditions
may also influence gingival response [6]. The prevalence of gingivitis
was found to be 73% among children between 6-11 year olds in the study by Ketabi et al, while it was only 46% in the present
study. This result may be due to the smaller sample size of the
present study.
The prevalence of gingivitis was higher in males than in females
in the present study; however this result was not statistically significant.
This is in consensus with the results of a study by Kelly
and Sanchez [22]. Whereas in a study by Gopinath et al, females
had significantly greater incidence of gingivitis than in males [11].
A study by Marshal and Magnusson showed that this variation
between gender could be more due to social differences [12, 17];
‘Fluoride, Fluoridated Toothpaste Efficacy And Its Safety In Children
- Review’, 2018), as opposed to any genetic predilection [27,
52]. The limitations of this study were that it was limited to the
population of pediatric patients visiting Saveetha Dental College
and was limited only to patients aged within 6-10 years. Certain
factors which affect the results Hormonal changes, mixed dentition,
partially exfoliated, loose deciduous teeth which could cause
some degree of gingivitis. This study can be further taken forward
with a larger study population in the future. The age group of
children under the study can also be expanded for more conclusive
results. Our institution is passionate about high quality evidence
based research and has excelled in various fields [3, 8, 41-
48, 51-57]. We hope this study adds to this rich legacy.
Figure 1. Pie chart depicting Percentage distribution of gingivitis. Generalised chronic gingivitis (40.7%) (Blue) was more in children followed by localised chronic gingivitis ( 5.8%) (Green). 53.4 % of children had healthy gingiva (Red).
Figure 2. Bar graph depicting the association between the gender and gingival status. X axis denotes genders (Female, Male, Transgender) and Y axis denotes the number of patients by gingival status. Males have a higher prevalence of generalised chronic gingivitis (Blue) compared to other genders. Females have a higher prevalence of Localized chronic gingivitis (Green) compared to other genders. However, there was no statistically significant difference among the different genders (Chi-square P value = 0.793) (p>0.05).
Figure 3. Bar graph shows the association between gender and systemic disease. Bar graph X-Axis represents the various systemic diseases and the Y-Axis shows the number of patients who are involved in the study. Both the males and females had similar distribution of systemic illness with no statistically significant differences. (Pearson Chi square test;P=0.363,P>0.05). It is shown that both the male and female patients are not affected with any systemic disease.
Conclusion
Within the limits of this Study it can be concluded that, there is
high prevalence of gingivitis among pediatric patients, however,
there is no significant association between age, gender and severity
of gingivitis.
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