Prevalence, Severity, and Risk Factors of Gingival Inflammation in Caribbean Adults: A Multi-City, Cross-Sectional Study

Augusto R. Elías-Boneta, Milagros J. Toro, Sona Rivas-Tumanyan, Arvind Babu Rajendra-Santosh, Michael Brache, James R. Collins C


Objective: To estimate the prevalence, severity, and associated risk factors of gingival inflammation in a group of adults from Kingston, Jamaica; Santo Domingo, Dominican Republic; and San Juan, Puerto Rico. Methods: In this representative cross-sectional study, participants completed medical and oral health questionnaires and received an oral clinical examination by trained and calibrated examiners. Clinical assessments included: gingival health (modified Löe–Silness index), visible plaque and presence of calculus. Findings were summarized as mean overall and interproximal gingival indices (GI; IGI), gingival bleeding index (GBI), gingival inflammation prevalence (GI>0.5) and severity (mild, moderate, severe), mean and interproximal visible plaque indices (VPI; IVPI), and calculus index. Multivariate logistic regression was used to evaluate the associations between risk factors and gingival bleeding on probing (BOP) at >40% sites;. odds ratios were estimated. Results: All 1,847 participants presented gingival inflammation; most (81.9%) had moderate inflammation. Mean GI, VPI, IVPI, and calculus indices were 1.49, 0.94, 0.96, and 0.66, respectively; most participants presented a VPI >30%. BOP >40% of sites was significantly associated with education (ORmiddle/technical vs. university education=1.61; p=0.001 and ORnone/basic vs. university= 2.86; p<0.001), calculus index (OR: 10.35), VPI > 30% (OR: 7.85; p<0.001 for both), and being a resident of Kingston or Santo Domingo (vs. San Juan, OR: 4. 74 and OR: 7.09, respectively), after adjusting for age, gender, smoking, dental visit frequency, diabetes, and hypertension. Conclusion: Gingival inflammation was highly prevalent. Most participants presented moderate gingival inflammation. Educational attainment, dental calculus, and VPI > 30% were strongly associated with gingival inflammation.


prevalence; gingival inflammation; bleeding on probing; dental plaque; dental calculus

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