Gingival bleeding and calculus among 12-year-old Chinese adolescents: a multilevel analysis.

BACKGROUND: Gingivitis is a common oral health problem, and untreated gingivitis can progress to periodontitis. The objectives of this study were to (1) explore associated factors of gingival bleeding and calculus among 12-year-old adolescents; (2) find predictive models for gingivitis management. METHODS: Four thousand five hundred twenty-five subjects aged 12 in Sichuan Province were investigated. The questionnaire and clinical examination were applied in schools, and two-level logistic regression models were constructed to interpret the effect of individual and contextual factors on Chinese adolescents' gingival bleeding and calculus. RESULTS: 46.63% (95%CI: 40.71, 51.60) and 66.94% (95%CI: 56.85, 67.45) of the subjects presented gingival bleeding and calculus, respectively. For the gingival bleeding cases, the model showed the significant associated indicators were hukou (OR = 0.61, 95% CI: 0.52-0.72), family size (OR = 1.41, 95% CI: 1.19-1.68), parental educational level (father: OR = 0.53, 95% CI: 0.45-0.63; mother: OR = 0.71, 95% CI: 0.59-0.86), tooth-brushing frequency (OR = 0.35, 95% CI: 0.26-0.48), dental floss use (OR = 0.58, 95% CI: 0.41-0.83), sugar-containing drink consumption (OR = 2.11, 95% CI: 1.80-2.49), and dental visit (OR = 1.44, 95% CI: 1.19-1.74). It also confirmed that gender (OR = 1.32, 95% CI: 1.13-1.54), hukou (OR = 0.69, 95% CI: 0.59-0.82), family size (OR = 1.34, 95% CI: 1.12-1.59), parental educational level (father: OR = 0.46, 95% CI: 0.39-0.54; mother: OR = 0.65, 95% CI: 0.59-0.82), tooth-brushing frequency (OR = 0.57, 95% CI: 0.42-0.78), dental floss use (OR = 0.66, 95% CI: 0.48-0.90) and sugar-containing drink consumption (OR = 1.30, 95% CI: 1.11-1.53) were associated factors for dental calculus. CONCLUSIONS: Gingival bleeding and calculus were common in western Chinese adolescents. Socio-demographic factors including gender, hukou and family factors are strong determinants of gingival health in Chinese adolescents. In addition, health-related lifestyle behaviors such as healthy diet, good hygiene care and more dental visits are good predictors of better gingival status.

Tooth grooves, occlusal striations, dental calculus, and evidence for fiber processing in an Italian eneolithic/bronze age cemetery.

OBJECTIVES: We conducted a systematic macroscopic and microscopic examination of occlusal and para-occlusal wear in a large dental sample (n = 3,014) from 217 individuals dated to the Early Bronze age site of Gricignano d'Aversa, Italy. We used macroscopic and microscopic techniques to document nondietary occlusal and para-occlusal wear and to analyze calculus inclusions in some of the teeth. In combining an analysis of the wear with the calculus inclusions we linked the specific wear to the likely fiber that was involved in producing it. MATERIALS AND METHODS: Teeth and their high resolution epoxy casts were analyzed through SEM and reflected light microscopes. Nineteen individuals (fifteen with activity induced dental modifications and four as a control sample) were examined for the presence of calculus inclusions. RESULTS: Activity induced dental modifications (AIDMs), notches, grooves and micro-striations, were found in the 62.2% of the adult females, in 21.2% of the adults of unknown sex and in a single male. We found the full spectrum of dental manipulations from very minor nonocclusal wear in some young individuals to severe attrition at the other extreme. The width of the striations and grooves, mostly on the upper incisors, suggests a craft activity involving fibers and thread production and manipulation. From the dental calculus of two females with grooves and striations, we extracted three fragments of fibers, identified as hemp (Cannabis, sp.). Previously from Gricignano woven hemp fibers were found on both surfaces of a metal blade associated with a male burial. DISCUSSION: This study found the co-occurrence of tooth AIDMs and the actual fibers preserved in the dental calculus. As more work is done analyzing dental calculus in a variety of humans, it is apparent that this biological material holds rich resources documenting non-dietary habits.

Periodontal diseases in Asians.

Asia encompasses three of the four most populous nations in the world (China, India and Indonesia), accounting for nearly two-fifths of the worlds' total population. Over half of the world's population now inhabits Asia, which by definition includes countries of the Middle East and some former Socialist Soviet Republics. There has been a generally held view that Asians are particularly susceptible to periodontitis. The aim of this review is to consider the reasons for this view having become entrenched and to examine the evidence on which it could have been established and sustained. This view of a particularly high prevalence of periodontal diseases in Asians appears in retrospect to have originated from early epidemiological studies using an index system which gives weight to gingivitis and moderate periodontitis resulting from poor oral hygiene and calculus deposition, very commonly encountered in Asian populations. Studies that have been conducted comparing Asians immigrants with native Caucasians in industrialized northern hemisphere nations broadly concluded that Asians displayed worse periodontal conditions than Caucasians. Similarly, a classic study comparing Norwegian males with Sri Lankan Tamil males demonstrated worse periodontal conditions in the Asian males. A recent review (Albander and Rams, 2002) has stated that those of African origin display the highest prevalence of periodontitis followed by Hispanics and Asians. Studies of the natural history of periodontal disease in Asians, of perio-dontopathogens in Asians, of risk for periodontal destruction, and of reasons for extraction do not appear to explain increased susceptibility of Asians to periodontal destruction. Poor oral hygiene and calculus deposits are widespread, however. Traditional assessments of periodontitis focus on destruction of the periodontal attachment in terms of attachment loss and probing pocket depths, with no consideration being given to the morphological features of the dentition from which the periodontal attachment is being lost, features that may predispose to or complicate the management of periodontal destruction. The Mongoloid dentition shows a high prevalence of such features, which adds a further dimension to the consideration of periodontal diseases among many Asian peoples. Appropriate strategies for the prevention and management of periodontal disease should focus upon improvements in the oral hygiene situation in the diverse continent of Asia.

Periodontal disease in adolescents: some clinical and microbiologic correlates of attachment loss.

The influence of several clinical and microbiological variables on the site-specific risk of attachment loss was studied in Navajo Indian adolescents aged 14-19. Diagnoses were made at mesio-buccal sites of the four first permanent molars. Case-control analytical methods were used, with A. actinomycetemcomitans, B. gingivalis, and B. intermedius considered the "risk" variables, and with calculus, gingival bleeding, age, and gender treated as possible confounders. The presence of B. intermedius significantly increased the likelihood that attachment loss would be diagnosed at a site (odds ratio = 2.86). However, this association was confounded by calculus and gingival bleeding; when either or both were present, the effect of B. intermedius was markedly weaker. Step-wise multiple logistic regression analyses showed that, of the variables considered, the combination of calculus, gingival bleeding, and B. intermedius gave the most parsimonious explanation of the presence of attachment loss. The chance that attachment loss would be diagnosed was increased five times when calculus was present, 16.5 times in the presence of both calculus and gingival bleeding, and 37 times when these variables plus B. intermedius were observed at a particular site.

The relationship between first presentation and subsequent observations in heavy calculus formers.

There are few studies that provide information on the natural history of calculus formation. The purpose of this study is to evaluate the relationship between pre-scaling baseline calculus scores, the time since the last prophylaxis before baseline, and scores 8 weeks after scaling in a group of presumed heavy calculus formers. Scaling and polishing were completed on 203 subjects with Volpe-Manhold Index (VMI) calculus scores of 7 or higher, and the date of the last prophylaxis was noted. All were re-examined after 3 weeks. The group included 45.8% males and 54.2% females; the mean age was 41.74 (range = 24 to 72). Racial mix was 57.6% African-American, 39.9% white, and 2.5% other. The mean baseline VMI score was 24.07 (SD = 15.38, range = 7-97). The VMI scores were directly related (P = < .001) to the date of the last scaling and were highest in subjects whose last scaling was more than 2 years earlier (33.67) and least in subjects whose last scaling was less than 6 months previous (15.12). At 8 weeks the mean VMI score was 9.96 (SD = 7.30; range = 0-41). The VMI scores at this time were inversely related (P = < .05) to the date of the last scaling before baseline and were lowest in subjects whose last scaling was more than 2 years earlier (9.07) and highest in subjects with the last scaling less than 6 months previous to baseline (13.07).(ABSTRACT TRUNCATED AT 250 WORDS)

Morphology and elemental composition of subgingival calculus in two ethnic groups.

BACKGROUND: The aim of the present study was to compare the morphology and elemental composition of subgingival calculus between Indo-Pakistani and Caucasian patient groups. METHODS: Extracted teeth from 14 Indo-Pakistani and 19 Caucasian subjects were collected. Of these, 12 Indo-Pakistani and 10 Caucasian teeth had sufficient subgingival calculus for analysis. Subgingival calculus present on the 22 teeth was classified into six morphological types: 1) crusty/spiny/nodular; 2) ledge/ ring; 3) thin, smooth veneers; 4) finger/fern-like; 5) individual islands/spots; or 6) supramarginal on submarginal. Subgingival calculus was zoned: coronal, mid, and apical. A sample obtained from each zone was subdivided to allow 3 separate analyses: transmission electron microscopic (TEM) x-ray microanalysis for elemental composition, fluoride analysis, and carbonate analysis. RESULTS: Crusty/spiny/nodular, ledge/ring, and thin, smooth veneers were more commonly found in the Indo-Pakistani group; individual islands were more prevalent in the Caucasian subjects. Supramarginal on submarginal calculus was found only in the Indo-Pakistani group. No finger/fern-like deposits were found. No differences within or between the two ethnic groups were found with regard to calcium:phosphate ratios, fluoride, or carbonate content. However, the Indo-Pakistani group showed significantly lower levels of sodium in apical samples than in coronal samples (ANOVA, F1,16 = 5.98, P= 0.03), and significantly lower levels of sodium (ANOVA, F1,12 = 4.75, P= 0.05) and magnesium (ANOVA, F1,12 = 5.16, P= 0.04) in apical samples than in those from Caucasians. After adjusting for smoking, the magnesium results remained significant (ANOVA, F2,11 = 4.64, P= 0.05). CONCLUSIONS: Subgingival calculus demonstrated differences in morphology between these two ethnic groups and differences in elemental composition, which may influence its overall solubility and contribute to its greater accretion in the Indo-Pakistani subjects.

Early onset periodontitis in the United States of America.

A National Survey of the Oral Health of U.S. children aged 5 to 17 was conducted by the National Institute of Dental Research during the 1986-87 school year. Eleven thousand and seven adolescents aged 14 to 17 years received a periodontal assessment. Their patterns of loss of periodontal attachment as assessed by probing at mesial sites were used to classify adolescents as cases of early onset periodontitis. Approximately 0.53% of adolescents nation-wide were estimated to have localized juvenile periodontitis (LJP), 0.13% to have generalized juvenile periodontitis (GJP), and 1.61% to have incidental loss of attachment (LA) (greater than or equal to 3 mm on 1 or more teeth). The total number of adolescents affected were not trivial. Close to 70,000 adolescents in the U.S. were estimated to have LJP in 1986-87. More destructive GJP affected an estimated 17,000 adolescents. Another 212,000 adolescents were estimated to have incidental LA. Blacks were at much greater risk for all forms of early onset periodontitis than whites. Males were clearly more likely (4.3 to 1) to have GJP than females when other variables were statistically controlled. Gender associations were more complicated for LJP because gender interacted with race. Black males were 2.9 times as likely to have LJP as black females. In contrast, white females were more likely than white males to have the disease by about the same odds. When interactions among demographic variables exist, caution must be taken in comparing results from different studies.

Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994.

BACKGROUND: The aim of this study was to assess the prevalence and extent of gingival recession, gingival bleeding, and dental calculus in United States adults, using data collected in the third National Health and Nutrition Examination Survey (NHANES III). METHODS: The study group consisted of 9,689 persons 30 to 90 years of age obtained by a stratified, multi-stage probability sampling method in 1988 to 1994. The weighted sample is representative of U.S. adults 30 years or older and represents approximately 105.8 million civilian, non-institutionalized Americans. Gingival recession, gingival bleeding, and dental calculus were assessed at the mesio-buccal and mid-buccal surfaces in 2 randomly selected quadrants, one maxillary and one mandibular. Data analysis accounted for the complex sampling design used. RESULTS: We estimate that 23.8 million persons have one or more tooth surfaces with > or = 3 mm gingival recession; 53.2 million have gingival bleeding; 97.1 million have calculus; and 58.3 million have subgingival calculus; and the corresponding percentages are 22.5%, 50.3%, 91.8%, and 55.1% of persons, respectively. The prevalence, extent, and severity of gingival recession increased with age, as did the prevalence of subgingival calculus and the extent of teeth with calculus and gingival bleeding. Males had significantly more gingival recession, gingival bleeding, subgingival calculus, and more teeth with total calculus than females. Of the 3 race/ethnic groups studied, non-Hispanic blacks had the highest prevalence and extent of gingival recession and dental calculus, whereas Mexican Americans had the highest prevalence and extent of gingival bleeding. Mexican Americans had similar prevalence and extent of gingival recession compared with non-Hispanic whites. Gingival recession was much more prevalent and also more severe at the buccal than the mesial surfaces of teeth. Gingival bleeding also was more prevalent at the buccal than mesial surfaces, whereas calculus was most often present at the mesial than buccal surfaces. CONCLUSIONS: Dental calculus, gingival bleeding, and gingival recession are common in the U.S. adult population. In addition to their unfavorable effect on esthetics and self-esteem, these conditions also are associated with destructive periodontal diseases and root caries. Appropriate measures to prevent or control these conditions are desirable, and this may also be effective in improving the oral health of the U.S. adult population.

Gingival state and dental calculus in early-onset periodontitis.

This study was undertaken to 1) compare the prevalence of gingival inflammation and dental calculus in adolescents with early-onset periodontitis and their matched controls and 2) assess and compare the relationship between the presence of dental calculus and the extent of gingival bleeding and attachment loss in these subjects. The study group consisted of 1,285 13 to 20 year-old individuals, 651 males and 634 females, selected from a national survey of the oral health of U.S. adolescents in 1986/1987. It included 709 (55.2%) Blacks, 224 (17.4%) Hispanics, and 352 (27.4%) Whites. Eighty-nine subjects had localized or generalized juvenile periodontitis (JP), 218 had incidental attachment loss (IAL), and 978 were without clinical attachment loss (controls). The controls were matched to cases on gender, race, age, and geographic location. The subjects were examined clinically to assess the percentage of sites with gingival bleeding and supragingival calculus only and subgingival calculus with or without supragingival calculus. The IAL and JP groups had significantly more gingival bleeding and subgingival calculus than the controls. Also, the JP group had significantly higher prevalence of both conditions than the IAL group. The percentage of sites with supragingival calculus was not different between the groups, but varied by ethnicity. Hispanics with JP had the highest percentage of sites with gingival bleeding and subgingival calculus, and the lowest percentage of sites with only supragingival calculus. The results demonstrate that gingival inflammation and subgingival calculus are associated with early periodontal breakdown, and contradict earlier reports of early-onset periodontitis not being associated with these factors.

Fluoride and magnesium concentrations in human dental calculus obtained from Japanese and Chinese patients.

Calculus deposited on a total of 68 permanent teeth from patients 30-60 years old from Nagoya in Japan and Beijing in China was investigated. An abrasive microsampling method was used to examine the fluoride (F) and magnesium (Mg) distribution, using a fluoride ion-specific electrode and atomic absorption spectrophotometry, respectively. F concentrations decreased from the surface towards the interior of the calculus. Mg concentrations, however, gradually rose towards the innermost surface adjacent to the tooth. In all parts of the depth profiles, the average concentrations of both magnesium and fluoride were higher in the Japanese than in the Chinese calculus. Towards the inner surface of the calculus, F and Mg concentrations were also much higher in the Japanese than in the Chinese group. A greater intake of sea foods and greater use of fluoride dentifrices are possible reasons for the higher F and Mg concentrations in the Japanese individuals.

Subgingival calculus: where are we now? A comparative review.

OBJECTIVE: To critically analyse the formation, composition, ethnic variations and pathogenic potential of subgingival calculus in comparison with supragingival calculus. DATA SOURCES: Using CD-ROM and index medicus, scientific papers relating to subgingival calculus or subgingival and supragingival calculus written in the English language since 1960 were considered, with the emphasis on more recent articles. STUDY SELECTION: Studies were selected for their relevance and contemporary nature re:composition and formation of dental calculus and comparisons of ethnic groups with regard to dental calculus, especially subgingival calculus. Some similar studies were not included. DATA EXTRACTION: Abstracts of studies were kept brief unless particularly important to the review. Population, methodology, statistics and accurate conclusions were used as important guides to the quality and validity of studies. DATA SYNTHESIS: Similarities and differences between supragingival and subgingival calculus in composition and formation were shown. Different morphological types of subgingival calculus were demonstrated. There was evidence for an association between calculus formation and ethnicity with regard to supragingival and subgingival calculus, and an association between subgingival calculus composition and ethnicity was indicated. CONCLUSIONS: An association between ethnicity and subgingival calculus formation and composition was found. Further research into the reasons for these ethnic differences in dental calculus and the role of the mineral constituents especially of subgingival calculus would be valuable.

Oral health status and treatment need of 11-13-year-old urban children in Tibet, China.

OBJECTIVE: To describe the oral health status and treatment need of 11-13-year-old children in urban Tibet and to determine if there was a difference in oral health status between the Tibetan and Han children. SURVEY DESIGN AND SUBJECTS: The two largest primary schools in Lhasa, Tibet, were selected and all children aged between 11 and 13 years were surveyed. Each child was interviewed and clinically examined in the schools, using portable equipment, by one of four calibrated examiners. The examination procedures and diagnostic criteria used followed those recommended by the World Health Organization. RESULTS: 347 children (207 Tibetans and 140 Han) were surveyed. Over 90% of the children claimed to brush their teeth at least once a day. Three-quarters had never visited a dentist. Caries prevalence was 44% in the Tibetans and 24% in the Han (P<0.001). The mean DMFT scores of the Tibetans and Han were 0.8 and 0.4 respectively (P<0.001). Only 1% of the children in both ethnic groups had healthy gums (highest CPI score = 0) and about two-thirds of them had calculus. One-third of the children were in need of treatment for dental caries and most of the required treatment items were one-surface fillings but 10% of the children needed extraction. CONCLUSION: Dental caries and treatment need level of both Tibetan and Han children in Tibet was low but their periodontal health status was unsatisfactory.

The oral health of U.S. Hispanics: evaluating their needs and their use of dental services.

Data from the 1985-1986 National Survey of Oral Health in U.S. Adults and Seniors showed that the oral health of Hispanic American adults and seniors was comparable to that of black adults and seniors. White adults and seniors had better oral health than their minority counterparts for all measures observed and were better able to afford dental care.

Dental caries and periodontal status of 12-year-old school children in rural Qinghai, China.

OBJECTIVES: To describe the dental caries and periodontal status of 12-year-old children in rural Qinghai and to compare the oral health status between the Han and ethnic minority children. METHOD: Children aged 12-years in three primary schools in Hexi Townships, Guide County, Hainan Tibetan Autonomous State, Qinghai Province, China, were invited to participate in the survey conducted during July 2001. Each child was interviewed and clinically examined in the schools, using portable equipment. World Health Organization (WHO) examination procedures and diagnostic criteria were used. SPSS 11.0 was used for data compilation and statistical analysis. RESULTS: All 196 12-year-olds (118 Han and 78 from ethnic minorities, i.e. Muslims and Tibetans) were surveyed. 48% of the children reported never brushing their teeth, while 12% brushed only every 2-3 days. Over ninety per cent (n=182) of the children had never visited a dentist. The DMFT scores in Han and in minority groups were found to be 0.12 and 0.23 respectively. A larger proportion of children in Han group (94%) had no caries experience (DMFT = 0) than that of Muslim and Tibetan (82%) groups (p<0.01). None of the children had healthy gingiva (i.e. highest CPI score=0) and 85% had calculus. CONCLUSION: The prevalence of caries experience in Han children is significantly lower than that in Muslim and Tibetan children in rural Qinghai. Dental caries and caries treatment needs of Han and minority rural schoolchildren in Qinghai are low but their periodontal health status is unsatisfactory. Basic dental health care and preventive education for the children in this part of China is needed.

Periodontal conditions in Vietnamese immigrant children in Sweden.

The aim of the present study was to compare the periodontal health in Vietnamese immigrant children in Sweden with that of native Swedish children. The study groups consisted of 42 6-17-year-old Vietnamese children and 42 age- and sex-matched Swedish children. Information on systemic health was obtained by interview. Clinical examination included recordings of dental plaque, supragingival calculus, bleeding on probing, probing depth, clinical attachment loss and caries. Radiographs were evaluated for presence of marginal bone loss, proximal calculus and proximal caries. In addition, previously obtained and filed radiographs were used as a supplement in order to evaluate if the children at any time point during the ages 4-11 years had experienced proximal calculus or bone loss in the primary dentition. The Vietnamese children showed significantly higher number of sites with bleeding on probing and with probing depths > or = 4 mm. Radiographic calculus was found in 55% of the Vietnamese and in 2% of the Swedish children. 5 Vietnamese children and 1 Swedish child showed periodontal bone loss at the time of examination. In all children except 1, the bone loss was confined to primary teeth. The retrospective analysis of available radiographs from the primary dentition showed that 28% of the Vietnamese children and 5% of the Swedish children had experienced bone loss in their primary teeth during the ages 4-11 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Periodontal health in adopted children of Asian origin living in Sweden.

In the present study the periodontal condition of a group of adopted 6-17 year-old children of Asian origin living in Sweden was compared with that of age- and sex matched Sweden children. Thirty-one Asian children and 31 Swedish children participated. Data on general health for all the children and on age at arrival for the Asian children was collected by interview. A clinical examination included recording of presence of plaque, supragingival calculus, bleeding on probing, probing depth, and caries. Radiographs were used to determine marginal bone loss (distance between the cemento-enamel junction and the marginal bone level > 2 mm), proximal calculus, and proximal caries. In addition, previously taken and filed radiographs of the primary dentition of the older children and current radiographs of the younger children with primary teeth were analysed to determine the prevalence of bone loss and calculus. The children of Asian origin showed a significantly higher number of surfaces with plaque and bleeding on probing. No significant differences were noted in the number of individuals with probing depths > or = 4 mm, supragingival calculus, or radiographic calculus. Three of the Asian and none of the Swedish children displayed radiographic bone loss. The retrospective analysis of all available radiographs from the primary dentition showed that 9 of 29 (31%) Asian children and 2 of 29 (7%) Swedish children had experienced bone loss in primary teeth.

Oral health and medical status in dentate low-income older persons.

Oral and medical conditions of 295 low-income dentate older persons (17% African-Americans, 14.5% Asians, 11.5% Hispanics, and 57% Caucasians) were studied. The mean age was 72 (SD +/- 6.8; range, 60-91). Oral examinations were performed, stimulated saliva was collected, and interviews were conducted regarding oral health attitudes, knowledge, and behaviors. Past history of restorative care, defined by filled coronal surfaces, differed by ethnicity, with Caucasian elders having most filled surfaces (p < 0.001). Ethnic minority elders had significantly poorer periodontal health (p < 0.001), with the worst conditions in Asians. Low salivary flow (< 0.01 mL/min) was found in 31% using medications known to cause hyposalivation. Frequent diseases were arthritis (46%), hypertension (39%), heart disease (25.2%), and diabetes (8.5%). Hypothyroidism was associated with low flow rate (F = 13.2, p < 0.0003). Seventy percent reported that they had never smoked. Smokers had deeper probing depths (chi 2 = 11.98, p < 0.05) and more gingival recession (F = 8.08, p < 0.001). Women on hormone replacement therapy (HRT) had less calculus (F = 11.33, p < 0.01) and fewer sites with probing depths > 5 mm (F = 8.99, p < 0.003). The present study found few associations between physical and oral health and ethnicity. The benefits of HRT for women's periodontal health and the effects of hypothyroidism on stimulated salivary flow are noteworthy.

The detection of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia using an ELISA in an adolescent population with early periodontitis.

The aim of the study was to compare the occurrence and levels of A. actinomycetemcomitans, P. gingivalis, and P. intermedia in the subgingival plaque from sites with and without early periodontitis in adolescents using an ELISA. 47, 15- to 16-year-old adolescents (39 Indo-Pakistani, 8 white Caucasian) were examined for clinical attachment level, probing depth, supragingival plaque, subgingival calculus and bleeding on probing on the mesio-buccal and disto-buccal aspects of the 1st molars and the incisors. Based on the clinical data, 2 sites per subject were selected for subgingival plaque sampling 3 weeks later: in 32 subjects with loss of attachment > or = 1 mm, a diseased site (D) and a healthy comparison control site (C) were sampled; in 15 subjects in whom loss of attachment had not yet developed, 1 of the upper molar sites was selected, called the at-risk site (R), together with a C site. The presence and levels of A. actinomycetemcomitans, P. gingivalis, and P. intermedia were determined using an ELISA. The loss of attachment subgroup had significantly more pockets > or = 4 mm, subgingival calculus and bleeding on probing (p < 0.05). Significantly more of the D than C sites had P. gingivalis both at detectable and at measurable levels (p < 0.05). In subjects who had no loss in clinical attachment levels, fewer sampled sites harboured any of the suspected periodontopathogens investigated, and no significant differences were found between the R or C sites (p > 0.05). Although there was a significantly higher prevalence and extent of loss of attachment > or = 1 mm in the Indo-Pakistani subjects compared with the Caucasians (p < 0.05), no differences could be identified in the distribution of the bacteria. It is concluded that monitoring of the subgingival plaque may be useful in studies of early periodontitis in adolescents, and the role of P. gingivalis needs to be elucidated in prospective longitudinal investigations.

Oral health status and treatment needs of black college students at Khayelitsha.

Descriptive information on the oral health status and treatment needs of black students at a teacher training college in Khayelitsha was collected to facilitate the planning of appropriate preventive and therapeutic programmes. A random sample of 96 subjects was drawn from the college population. The average age of the group was 27.3 years; 83.3 per cent were females and 90.6 per cent had experienced caries. The mean DMFT was high (11.14), the mean score for males was almost half that for females (p = 0.0247). 54.2 per cent needed treatment for caries such as fillings (47.9 per cent) and extractions (25.0 per cent). No students had shallow pocketing and deep pockets were recorded in only 3.4 per cent. However more than 4 segments on average showed signs of bleeding or higher scores for periodontal disease. A significant difference existed between the sexes for the presence of calculus (p less than 0.005). Oral hygiene instruction and prophylaxis were needed by the majority of students namely 92.1 per cent and 70.8 per cent respectively. The high number of students with bleeding and calculus indicates that an intensive program of oral health education is required by this group.