Oral hygiene, prevalence of gingivitis, and associated risk factors among pregnant women in Sarlahi District, Nepal.

BACKGROUND: The oral health status of pregnant women in low-resource communities such as Nepal has not been well characterized. This sub-population is also of specific interest given associations between poor oral health and adverse pregnancy outcomes previously documented in other settings. We explored relationships between gingivitis and risk factors among pregnant women in rural Nepal. METHODS: The design was a community-based, cross-sectional study in a sub-area of Sarlahi District, Nepal. Pregnant women < 26 weeks gestation underwent clinical periodontal exams conducted by community-based oral health workers. Exams included a full mouth assessment measuring bleeding on probing (BOP), probing depth (PD) (six sites per tooth), and gingival recession, the distance from the cemento-enamel junction to the free gingival margin (two direct sites per tooth). Data on participant risk factors were collected through household surveys, including demographic characteristics, oral health behaviors, care seeking, and health attitudes. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors. RESULTS: We enrolled 1452 participants, of which 40% (n = 582) had signs of clinical gingivitis and 60% (n = 870) clinical health. Average participant age was 23. Most participants (88%) had never received oral health care. Participants averaged 10% of sites with BOP with most (79%) having ≥1 site with BOP. Nine percent of participants had ≥1 site with PD ≥4 mm, although very few participants (0.7%) had sites with PD ≥5 mm. Few participants (13%) had any recession (≥1 mm). In the final adjusted model, odds of gingivitis increased by 3% for each year of age (aOR 1.03, 95% CI 1.00, 1.06) and were higher for women of short maternal stature (< 150 cm) (aOR 1.43, 95% CI: 1.14, 1.79) and among women reporting cost to be a barrier to seeking dental care (aOR 2.13, 95% CI: 1.09, 4.15). CONCLUSIONS: Gingivitis was common and associated with age, maternal stature, self-reported high cost of dental care, and other risk factors among pregnant women in rural Nepal. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01177111 (Nepal Oil Massage Study) and NCT02788786 (Pilot Trial).

[Correlation between self-reported gingival bleeding and type 2 diabetes mellitus in aged ≥18 years adults in China].

Objective: To understand the correlation between self-reported gingival bleeding and type 2 diabetes mellitus (T2DM) in adults in China. Methods: The database of China' s 2010 Chronic Disease and Risk Factor Surveillance (CCDRFS) survey among people aged ≥18 years was used to analyze the demographic characteristics of subjects with self-reporting gingival bleeding and the prevalence of major chronic diseases among adults. Correlation and interaction analyses were conducted on the relationships between frequent gingival bleeding and T2DM, hypertension and dyslipidemia, and interaction of age and gingival bleeding, age and hypertension, age and dyslipidemia, age and gender on the prevalence of T2DM. Results: Among 93 647 adults surveyed, 87.4% were in Han ethnic group. The incidence of frequent gingival bleeding was higher in females (63.6%) than in males (36.4%). The incidence of frequent gingival bleeding was highest (30.1%) in adults with middle school education level. Among the adults aged 45-60 years, 12.8%(2 839/22 179) had T2MD but no gingival bleeding, 15.6% (163/1 044) had both frequent gingival bleeding and T2DM, frequent gingival bleeding was correlated with T2DM (OR=1.29, 95%CI: 1.08-1.54) and the interaction with age had influence on T2DM (P<0.005). In males, frequent gingival bleeding was correlated with T2DM (OR=1.30, 95% CI: 1.08-1.56, P=0.005). In hypertension group, frequent gingival bleeding was correlated with T2DM (OR=1.25, 95% CI: 1.07-1.46), and interaction of hypertension and gingival bleeding had influence on T2DM (P<0.05). Conclusions: The positive correlation between frequent gingival bleeding and T2DM was observed in adults surveyed, and the interaction of age and hypertension had influence on prevalence of T2DM. Frequent gingival bleeding was correlated with T2DM in males either.

Oral mucosal disease in an Australian urban Indigenous community using autofluorescence imaging and reflectance spectroscopy.

BACKGROUND: The aim of this study was to document the oral mucosal burden in an urban Indigenous community and to evaluate the efficacy of an adjunctive optical device (Identafi(™) ) in a general dental practice. METHODS: Three hundred and forty-two patients who presented to an urban Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) were examined using conventional oral examination (COE) and with a multispectral device (Identafi(™) ). Loss of autofluorescence (LAF) and the visibility of diffuse vasculature were noted. RESULTS: The urban Indigenous community assessed did not display significantly higher rates of smoking, alcohol consumption or lesion prevalence compared to non-Indigenous counterparts. The white and violet light functions of Identafi(™) provided excellent lesion visibility in 84.5% and 77.9% of cases respectively compared to 75% with COE, and were capable of highlighting new lesions not seen during COE. CONCLUSIONS: The urban Indigenous community does not appear to display a significantly higher prevalence of risk factors such as smoking and alcohol consumption compared to their non-Indigenous counterparts living in the same region, nor are they more likely to have oral mucosal lesions. The incidence of intraoral pigmentation has the potential to complicate use of autofluorescence screening devices, emphasizing the importance of skill and training when using this technology.

Occurrence of periodontal pathogens in ethnic groups from a native Brazilian reservation.

OBJECTIVE: The present study was designed to evaluate the occurrence of periodontal pathogens in the subgingival biofilm of 100 native Brazilians living at the Umutina Indian Reservation, Mato Grosso State, Brazil. METHODS: Periodontal clinical examinations were carried out prior to collection of subgingival biofilm, and the presence of 14 periodontal microorganisms was evaluated by polymerase chain reaction (PCR). The prevalence and risk analysis was performed using Cochran and Mantel-Haenszel statistics for dichotomous variables or Pearson's chi-squared test for analysis of proportions when variables had three or more categories. The interrelations between clinical and microbiological parameters were assessed using Fisher's exact test and the Mann-Whitney U test. RESULTS: Individuals with chronic periodontitis were frequently colonized by the association between Porphyromonas gingivalis and Campylobacter rectus, P. gingivalis and Prevotella intermedia, or P. gingivalis and Tannerella forsythia. Patients with chronic periodontitis were also colonized by Porphyromonas gulae and P. intermedia or by the association between P. gulae and T. forsythia. P. gulae was detected only in the subgingival samples from natives on a traditional diet. Gingival bleeding was associated with Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, T. forsythia, P. gingivalis, P. gulae, Porphyromonas endodontalis, P. intermedia, and Prevotella nigrescens. Treponema denticola was uncommon. CONCLUSIONS: Peculiar microbiota was demonstrated to be associated with different periodontal disease statuses in native Brazilians, with modest occurrence of certain pathogens, such as T. denticola, and the presence of P. gulae in natives with gingivitis or chronic periodontitis.

Enfermedades bucales en estudiantes chinos / Oral diseases in Chinese students

Introducción: desde hace algunos años se observa en nuestras universidades de ciencias médicas estudiantes chinos de forma masiva, evento sin precedentes en nuestro país. Para el dominio de todo lo referente a su salud bucal y al proceso salud-enfermedad de los mismos. Objetivo: identificar las principales enfermedades bucales en estudiantes chinos para que de esta forma se logre una calidad en la atención de los mismos. Métodos: se realizó una investigación descriptiva transversal. Se tomó una muestra de 185 estudiantes chinos. Se le realizó un examen bucal y facial y una entrevista para obtener las variables de interés en la investigación. Resultados: las gingivitis y las maloclusiones fueron las enfermedades bucales más prevalecientes; la caries dental fue la que menos se manifestó. Tanto el sexo masculino como el femenino prevalecieron como enfermos y el origen social rural aportó los únicos pacientes discapacitados deficientes. Conclusiones: la higiene bucal es el factor de riesgo más relacionado con las Gingivitis y Caries Dental, así como el origen social rural determinó una peor condición epidemiológica(AU)

Introduction: recently, Chinese students are being massively received in our medical universities. This is an unprecedented event in our country. For mastering everything about their oral health and their health-disease process, a stomatologic study was conducted on them. Objective: to identify the main oral diseases in these subjects to provide quality health care for them. Methods: a descriptive study was conducted, taking a sample of 185 Chinese students. They had oral and facial examination and an interview for this investigation variables was applied. Results: gingivitis and malocclusions were the most prevalent oral diseases, dental caries manifested the least. Both male and female subjects prevailed as patients. Rural social background provided the only poor disabled patients. Conclusions: oral hygiene is the risk factor most related to gingivitis y dental caries. The rural social origin determined a worse epidemiological condition(AU)

Enfermedades bucales en estudiantes chinos / Oral diseases in Chinese students

Desde hace algunos años se observa en nuestras universidades de ciencias médicas estudiantes chinos de forma masiva, evento sin precedentes en nuestro país. Para el dominio de todo lo referente a su salud bucal y al proceso salud-enfermedad de los mismos. Objetivo: identificar las principales enfermedades bucales en estudiantes chinos para que de esta forma se logre una calidad en la atención de los mismos. Métodos: se realizó una investigación descriptiva transversal. Se tomó una muestra de 185 estudiantes chinos. Se le realizó un examen bucal y facial y una entrevista para obtener las variables de interés en la investigación. Resultados: las gingivitis y las maloclusiones fueron las enfermedades bucales más prevalecientes; la caries dental fue la que menos se manifestó. Tanto el sexo masculino como el femenino prevalecieron como enfermos y el origen social rural aportó los únicos pacientes discapacitados deficientes. Conclusiones: la higiene bucal es el factor de riesgo más relacionado con las Gingivitis y Caries Dental, así como el origen social rural determinó una peor condición epidemiológica(AU)

Recently, Chinese students are being massively received in our medical universities. This is an unprecedented event in our country. For mastering everything about their oral health and their health-disease process, a stomatologic study was conducted on them. Objective: to identify the main oral diseases in these subjects to provide quality health care for them. Methods: a descriptive study was conducted, taking a sample of 185 Chinese students. They had oral and facial examination and an interview for this investigation variables was applied. Results: gingivitis and malocclusions were the most prevalent oral diseases, dental caries manifested the least. Both male and female subjects prevailed as patients. Rural social background provided the only poor disabled patients. Conclusions: oral hygiene is the risk factor most related to gingivitis y dental caries. The rural social origin determined a worse epidemiological condition(AU)

A review of factors influencing the incidence and severity of plaque-induced gingivitis.

An individual variation in the gingival inflammatory response to the dental biofilm has been demonstrated. This variability can be observed between individuals with neither quantitative nor qualitative differences in plaque accumulation. The reported significant differences in gingival inflammatory response under quantitatively and/or qualitatively almost identical bacterial challenge suggest that the gingival response to plaque accumulation may be an individual trait, possibly genetic in origin. The most recent classification of periodontal diseases acknowledges that the clinical expression of plaque-induced gingival inflammation can be substantially modified by systemic factors, either inherent to the host or related to environmental influences. The aim of the present literature review is to describe (i) the factors influencing the development of plaque-induced gingivitis as well as (ii) those metabolic, environmental and systemic factors which have a direct impact on the etiopathogenetic pathway of plaque-induced gingivitis, thus altering the nature or course of the gingival inflammatory response to dental biofilm.

Latin America: native populations affected by early onset periodontal disease.

Millions of individuals are affected by early onset periodontal disease in Latin America, a continent that includes more than 20 countries. The decision-makers claim that the disease is not commonly encountered. In 2009, 280,919 authorized immigrants were registered in the United States versus 5,460,000 unauthorized (2,600,000 in California). The objective of the present article is to raise awareness about the high prevalence of the disease among Latin Americans and the good prognosis of preventive measures associated with minimal financial cost.

Prevalence of periodontopathogens in a black Brazilian secluded community matched with a black urban population.

OBJECTIVE: To evaluate the prevalence of periodontopathogens according to periodontal profile in a black Brazilian secluded community matched with an urban black population. PARTICIPANTS: A total of 84 subjects were selected, 42 (mean age 25.7 sd 18.0 years) from a secluded community called Santo Antonio do Guapore (SAG) and 42 (mean age 25.4 sd 18.1 years) from an urban area of Sao Paulo State (SPT). METHODS: Participants received clinical examinations as follows: periodontal pocket depth; clinical attachment loss; plaque and gingival indexes. After examination, the secluded population was classified as periodontal health (13), gingivitis (15) or periodontitis (14). Then, 182 urban volunteers were screened and 42 subjects were selected matched for the variables: periodontal diagnosis, age (+/- 2 years) and gender. Samples were taken for microbial analysis. Genomic DNA for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus, Tannerella forsythia and Prevotella intermedia was provided by polymerase chain reaction. RESULTS: Except for C. rectus, all pathogens were present in both groups with no statistically significant difference. In particular, C. rectus was more prevalent only in gingivitis subjects from the SPT group (p<0.05). A high frequency of periodontopathogens was related to the severity of periodontal disease. CONCLUSION: In general, the prevalence of the examined periodontopathogens in this study did not differ between a secluded black Brazilian population and an urban black population.

Pregnancy and oral health: utilisation of dental services during pregnancy in northern Greece.

BACKGROUND: Recent studies have shown that gingivitis and periodontal infection during pregnancy represent an independent risk factor for pre-term birth. However, little is known about the prevalence and correlates of dental attendance during pregnancy. METHODS: During the first 3 days postpartum, an anonymous questionnaire was administered to 425 women in order to explore their dental condition and utilisation of dental health services during pregnancy, as well as their perceptions on the potential associations between dental care during pregnancy and pregnancy outcomes. RESULTS: Almost half of the respondents (46.8%) reported symptoms of gingivitis during their pregnancy. Pregnancy gingivitis was independently associated with non-Greek ethnicity (p=0.008), multiparity versus primiparity (p<0.005), lower economic class versus middle and upper classes (p=0.001), and the lack of routine primary dental care (p=0.005). Some 27.3% reported a visit to the dentist during their pregnancy. The majority (72.2%) believed that dental treatment during pregnancy might have a negative affect on pregnancy outcome. The presence of pregnancy gingivitis and the belief that dental treatment during pregnancy is safe were both independently associated with visiting a dentist during pregnancy (p<0.0005 for both). CONCLUSIONS: Despite the increased prevalence of dental problems among pregnant women, few women seek dental services in this population, which can be primarily attributed to women's erroneous beliefs regarding the safety of dental examination. Therefore, there is an imperative need to offer oral health education and develop preventive programs for women of reproductive age.

Use of medicinal plants for the treatment of oral diseases in Burkina Faso.

This paper presents the findings of an investigation into the treatment of oral diseases with medicinal plants in the Kadiogo province, Burkina Faso. Although the region is mainly urban, it appears that traditional healers who live there, and the general population, continue to rely on plant products when dealing with a broad range of oral health concerns. Sixty-two relevant species belonging to 29 families were identified, and each was documented with regard to its local name, part used, indication, mode of administration, and the collection and storage procedure used (when those data were available). A number of ideas for research topics emerged from this work, some of which promise to help selection and prescription of improved traditional remedies for oral diseases at the primary health care level in Burkina Faso.

Anangu oral health: the status of the Indigenous population of the Anangu Pitjantjatjara lands.

OBJECTIVE: To describe oral health in the Anangu Pitjantjatjaraku lands in South Australia and to compare with earlier surveys and national data. DESIGN: Descriptive. SETTING: Data were collected at the time of dental care service provision, according to World Health Organization protocols, at the request of the Nganampa Health Council on optical mark reader forms. PARTICIPANTS: There were 356 Anangu adults and 317 children surveyed. RESULTS: The mean number of teeth affected by dental caries in the deciduous dentition in young children, aged 5-6 years, was double (mean 3.20) that of the overall Australian child population aged 5-6 years (mean 1.44). In contrast to the decline in deciduous caries in Australian children generally, Anangu children aged 5-9 years had a 42% increase in the mean number of teeth affected since 1987. Adults experienced low levels of dental caries, but severe periodontal disease was more prevalent among diabetics (79%) compared with-non-diabetics (13.8%). Tooth loss was found more frequently among adults with diabetes (mean 5.51) than non-diabetics (mean 1.53). CONCLUSIONS: Oral health promotion strategies, in association with general health strategies, need to be developed to improve oral health in this remote Aboriginal population.

Applicability of a computer-assisted image analysis system for the evaluation of gingival status in subjects from Asian and Caucasian backgrounds.

We have recently developed a computer program to allow the automatic evaluation of the degree of gingival inflammation. The aim of the present study was to determine the efficiency of our system, which consisted of a digital camera, computer and our original program, in a sample population of various ethnic backgrounds. Digital images of frontal views of maxillary incisors were taken for 141 subjects and then subjected to computer-assisted analysis to determine the degree of redness (colorimetric assessment) and swelling (morphometric assessment) and was compared with the visual assessment of the PMA gingival score. The age of subjects ranged from 19 to 65 (Mean 33.9 SD12.8), and consisted of slightly more females (81) than males (60). Within the study group 78% of subjects classified themselves as Caucasian (European, South American, Middle Eastern), 21% were Asian or Pacific Islander, and 1% was African. The subjects were separated into 9 groups according to their PMA score. In addition, colorimetric and morphometric score were plotted against each other. The colorimetric scores ranged between 55.1 to 64.8 (arbitrary units) and morphometric scores ranged between 0.175 to 0.313 (arbitrary units). There were no ethnic differences with respect to colour and contour when two groups of European (90) and Asian (17), who were scored as 000 using the PMA index, were compared. There was no significant correlation between PMA score and morphometric score (P = 0.0711), but the correlation coefficient between PMA score and colorimetric score was 0.130 (P = 0.0122). Comparison of the highly scored image samples and the lower scored images with the visual assessment codes showed very good correlation. These preliminary findings suggest that the developed computer-assisted image analysis system shows promise for assessing gingival inflammation via an automated method.

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.

Does the ethnicity of teenage children influence oral self perception and prevalence of dental disease?

AIM: The primary aim was to evaluate the effect of ethnicity, social deprivation and oral health on oral self perceptions of 14-15-year-old Asians and Whites. A secondary aim was to assess the influence of ethnicity and social deprivation on oral treatment need in the same sample. DESIGN: A cross-sectional epidemiological study. DATA SOURCE: A stratified, random sample of 408 14-15-year-old Asian and White children from schools in Manchester. METHOD: Information was collected on oral self perceptions using a questionnaire and on oral treatment need with a clinical examination. RESULTS: Multivariate data analysis revealed that oral treatment need, but not ethnicity or social deprivation, was an important predictive variable with respect to oral self perceptions. Ethnicity was the only variable to influence periodontal treatment need. Social deprivation influenced the level of untreated caries. CONCLUSIONS: 1. Socially deprived children have higher caries levels than their more affluent counterparts and this is evident regardless of ethnic background. 2. Although Asian 14-15-year-old children have a higher periodontal treatment need than Whites, there was no ethnic influence on how they perceive their oral health. 3. Oral treatment need is an important factor with respect to oral self perceptions.

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.

Gingivitis en gestantes y puerperas de altura y del nivel del mar / Gingivitis in pregnants and puerpereas at high altitude and at sea level

Se estudiaron gestantes del primer, segundo y tercer trimestre, puerperas y no gestantes nativas y residentes en altitud y del nivel del mar, respecto al grado de severidad de la gingivitis; todas las pacientes estudiadas tuvieron un Indice de Placa Blanda de Sillnes y Loe (IPB) menor o igual a 0.5 en el momento del examen gingival. Se encontró algún grado de gingivitis en todos los casos estudiados, sin embargo, la severidad fue menor en la altura que al nivel del mar. En ambas altitudes la severidad de gingivitis aumenta progresivamente con la edad gestacional, disminuyendo después del parto a niveles de gingivitis no menores a los determinados en el segundo trimestre gestacional.

Periodontal disease in an Amish population.

Epidemiological studies of periodontal disease have attempted to focus on defined groups in which the variables thought to be responsible for disease could be controlled or more easily identified. This study documents periodontal disease parameters in a unique population of Amish farmers. A total of 371 Amish were contacted and 282 were examined in their homes giving a participation rate of 76%. Ages ranged from 18 to 79 years. Overall means for periodontal conditions were 1.54 mm for attachment loss, 2.63 mm for pocket depth, 0.17 for calculus, 0.63 for plaque and 0.61 for gingivitis. One dental examiner conducted all examinations. Prevalence of periodontal disease tended to be higher among males and increased with age. The majority of Amish examined had little evidence of destructive periodontal disease; about 3.4% of teeth examined had attachment loss of 6 mm or more. These findings indicate a modest level of periodontal disease among the Amish. It is of interest that this population does not generally seek routine dental care. Preliminary analyses of health behavior data collected indicate a lack of regular oral hygiene practices. It appears that the Amish may have protective factors which affect their level of disease.

The influence of race and gender on periodontal microflora.

Previous studies have demonstrated that demographic characteristics of subject populations influence both the incidence of periodontal diseases and various aspects of host responses to periodontal bacteria. In this study we analyzed the components of the subgingival microflora from individuals with adult periodontitis, early onset periodontitis, gingivitis, and periodontal health as a function of gender and race (black and white). Clinical categories were analyzed individually so that there were no differences in the clinical characteristics of the sampled sites. No significant differences were noted in the subgingival microflora between males and females. When either the first two bacterial samples from each subject or all bacterial samples taken from each subject were included in the analysis, it was found that Porphyromonas gingivalis was more significantly associated with black subjects in the adult periodontitis group. When all samples were considered in the analysis, it was found that Peptostreptococcus anaerobius was associated with black subjects in the adult periodontitis group, while Fusobacterium nucleatum was associated with white subjects in both the adult periodontitis and early onset periodontitis groups. Thus a limited number of important bacterial components of the subgingival microflora are influenced by the race and diagnosis of the subject group.