Epidemiology of necrotizing ulcerative gingival lesions in adolescents.
OBJECTIVE
Relatively little is known about the epidemiology of necrotizing ulcerative gingival lesions (NUG) in adolescent populations. Most studies have comprised special target groups, such as military recruits, HIV patients, or severely malnourished subjects.


METHODS
A multistage random cluster sampling scheme was used to obtain a sample of 9203 students aged 12-21 years from 98 of a total of 618 high schools in Santiago, Chile. Students were given a clinical oral examination and questionnaire information was obtained on smoking and oral hygiene habits, dental attendance patterns, and diabetic status. The diagnostic criteria for NUG were the presence of necrosis and ulceration of at least one interproximal papillae.


RESULTS
The estimated prevalence of NUG was 6.7% (95% CI = [6.2; 7.3]). A multivariable logistic regression analysis showed that last seeing a dentist more than 1 year ago (OR = 1.60), or never (OR = 1.93), and reporting diabetes (OR = 2.12) showed a significant positive association with the presence of NUG; whereas neither gender nor smoking were important predictors. Students aged 18-21 years were more, albeit statistically insignificantly, likely to have NUG than were younger students (OR = 1.40).


CONCLUSIONS
Our observation that reporting to be diabetic was positively associated with the presence of NUG is interesting, as diabetes has never been addressed as a possible risk factor. As the association between diabetes and periodontitis in adults is thought to relate to impaired function of neutrophils, microangiopathy, and impaired wound healing this finding suggests a significant role of the host response also for the occurrence of NUG.
Lopez
R
R
Department of Community Oral Health and Pediatric Dentistry, Faculty of Health Sciences, University of Aarhus, Denmark. rlopez@odont.au.dk
Fernandez
O
O
Jara
G
G
Baelum
V
V
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002677:Chile / Q000453:epidemiology; D016001:Confidence Intervals; D003729:Dental Care / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005892:Gingivitis, Necrotizing Ulcerative / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D009910:Oral Hygiene / Q000706:statistics & numerical data; D010808:Physical Examination; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires