Evaluation of gingival bleeding awareness by comparison of self-reports and clinical measurements of freshman dental students

ABSTRACT

Objective: The aims of this descriptive, cross-sectional investigation were to evaluate the gingival health awareness of dental students by comparing their clinical gingival bleeding scores and self-reports, and to compare differences in awareness between males and females. Methods: In total, 100 (51 males, 49 females) freshman dental students were included in the study. Periodontal indices recorded were: Presence of plaque percentage (plaque index [PI], %), percentage of sites of bleeding on probing (BOP, %), probing depth, and community periodontal index (CPI). Percent agreement, kappa agreement, sensitivity, and specificity were calculated by comparing their self-reported gingival bleeding and BOP%. Results: The self-reports of gingival bleeding exhibited statistically significant correlations with BOP% in females (r = 0.42, P = 0.003). Female students showed a higher degree of awareness when kappa agreement, 0.23 (males: 0.16, females: 0.39), sensitivity, 48% (males: 42%, females: 51%), and specificity, 95% (males: 90%, females: 100%) were calculated. Although male dental students had higher PI and CPI scores, there was no significant difference by gender in the clinical measurements. Conclusions: According to our results, the validity of self-reported gingival bleeding was higher among dental students than in previous population-based studies. Female dental students showed a higher degree of awareness than males of their gingival health. Half of the included dental students could not differentiate whether they had gingival bleeding when there was actual bleeding. More emphasis should be given to the education of dental students regarding the relationship between gingival bleeding and active periodontal disease.

Key words:

Awareness - dental - gingival bleeding - gingivitis - self-report - sex differences - students

• REFERENCES

• 1 Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999; 4: 1-6
• 2 Parameter on plaque-induced gingivitis. American Academy of Periodontology. J Periodontol 2000; 71 (Suppl. 05) 851-2
• 3 Polson AM, Caton JG. Current status of bleeding in the diagnosis of periodontal diseases. J Periodontol 1985; 56: 1-3
• 4 Newell SA, Girgis A, Sanson-Fisher RW, Savolainen NJ. The accuracy of self-reported health behaviors and risk factors relating to cancer and cardiovascular disease in the general population: A critical review. Am J Prev Med 1999; 17: 211-29
• 5 Wright FV, Law M, Crombie V, Goldsmith CH, Dent P. Development of a self-report functional status index for juvenile rheumatoid arthritis. J Rheumatol 1994; 21: 536-44
• 6 Dietrich T, Stosch U, Dietrich D, Schamberger D, Bernimoulin JP, Joshipura K. The accuracy of individual self-reported items to determine periodontal disease history. Eur J Oral Sci 2005; 113: 135-40
• 7 Blicher B, Joshipura K, Eke P. Validation of self-reported periodontal disease: A systematic review. J Dent Res 2005; 84: 881-90
• 8 Khami MR, Virtanen JI, Jafarian M, Murtomaa H. Oral health behaviour and its determinants amongst Iranian dental students. Eur J Dent Educ 2007; 11: 42-7
• 9 Kawamura M, Yip HK, Hu DY, Komabayashi T. A cross-cultural comparison of dental health attitudes and behaviour among freshman dental students in Japan, Hong Kong and West China. Int Dent J 2001; 51: 159-63
• 10 Rahman B, Kawas SA. The relationship between dental health behavior, oral hygiene and gingival status of dental students in the United Arab Emirates. Eur J Dent 2013; 7: 22-7
• 11 Polychronopoulou A, Kawamura M, Athanasouli T. Oral self-care behavior among dental school students in Greece. J Oral Sci 2002; 44: 73-8
• 12 Al-Omiri MK, Barghout NH, Shaweesh AI, Malkawi Z. Level of education and gender-specific self-reported oral health behavior among dental students. Oral Health Prev Dent 2012; 10: 29-35
• 13 Yildiz S, Dogan B. Self reported dental health attitudes and behaviour of dental students in Turkey. Eur J Dent 2011; 5: 253-9
• 14 Peker I, Alkurt MT. Oral Health Attitudes and Behavior among a Group of Turkish Dental Students. Eur J Dent 2009; 3: 24-31
• 15 Cortes FJ, Nevot C, Ramon JM, Cuenca E. The evolution of dental health in dental students at the University of Barcelona. J Dent Educ 2002; 66: 1203-8
• 16 Belloc NB, Breslow L. Relationship of physical health status and health practices. Prev Med 1972; 1: 409-21
• 17 World Health Organization. Oral Health Survey Basic Methods. 4th ed.. Geneva, Delhi: WHO, AITBS Publisher and Distributors; 1997: p. 16-20
• 18 Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J 1975; 25: 229-35
• 19 Gilbert AD, Nuttall NM. Self-reporting of periodontal health status. Br Dent J 1999; 186: 241-4
• 20 Buhlin K, Gustafsson A, Andersson K, Håkansson J, Klinge B. Validity and limitations of self-reported periodontal health. Community Dent Oral Epidemiol 2002; 30: 431-7
• 21 Ostberg AL, Halling A, Lindblad U. Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents. Acta Odontol Scand 1999; 57: 231-6
• 22 Furuta M, Ekuni D, Irie K, Azuma T, Tomofuji T, Ogura T. et al. Sex differences in gingivitis relate to interaction of oral health behaviors in young people. J Periodontol 2011; 82: 558-65
• 23 Fukai K, Takaesu Y, Maki Y. Gender differences in oral health behavior and general health habits in an adult population. Bull Tokyo Dent Coll 1999; 40: 187-93
• 24 Danielsen B, Manji F, Nagelkerke N, Fejerskov O, Baelum V. Effect of cigarette smoking on the transition dynamics in experimental gingivitis. J Clin Periodontol 1990; 17: 159-64
• 25 Baser U, Cekici A, Tanrikulu-Kucuk S, Kantarci A, Ademoglu E, Yalcin F. Gingival inflammation and interleukin-1 beta and tumor necrosis factor-alpha levels in gingival crevicular fluid during the menstrual cycle. J Periodontol 2009; 80: 1983-90
• 26 Lang NP, Schätzle MA, Löe H. Gingivitis as a risk factor in periodontal disease. J Clin Periodontol 2009; 36 (Suppl. 10) 3-8
• 27 Lang NP, Joss A, Orsanic T, Gusberti FA, Siegrist BE. Bleeding on probing. A predictor for the progression of periodontal disease?. J Clin Periodontol 1986; 13: 590-6
• 28 Lang NP, Adler R, Joss A, Nyman S. Absence of bleeding on probing. An indicator of periodontal stability. J Clin Periodontol 1990; 17: 714-21
• 29 Offenbacher S, Barros SP, Singer RE, Moss K, Williams RC, Beck JD. Periodontal disease at the biofilm-gingival interface. J Periodontol 2007; 78: 1911-25