A life-course approach to assess the relationship between social and psychological circumstances and gingival status in adolescents.
BACKGROUND
Several models have been proposed to explain the causes of periodontal diseases. None have adopted the life-course approach.


OBJECTIVE
To investigate the relationship between social, psychosocial and biological conditions experienced in early life and through the life course and gingival bleeding on probing.


METHODS
A two-phase study was carried out in Brazil. In Phase I, 652 13-year-olds were clinically examined and interviewed. In Phase II, 311 families were randomly selected for an interview to collect information on the teenager's state at birth and selected impacts in their early years of life. Clinical examination included assessment of dental caries, periodontal and dental trauma status. The data analysis used logistic regression and the models were determined using stepwise procedure.


RESULTS
Adolescents who were born in a non-brick house, who were living in an overcrowded house at 13 years of age, those whose mother had less than 8 years of education, who were at a lower school grade for their age, those who reported high levels of paternal punishment and those who were from reconstituted families were significantly more likely to experience high levels of bleeding gums after probing.


CONCLUSIONS
Early life and life-course experiences were important determinants of the level of gingival bleeding after probing in adolescents.
Department of Epidemiology and Public Health, Royal Free and University College, London Medical School, London WC1E 6BT, UK. belinda.f.nicolau@mcgill.ca
Belinda
B
Nicolau
Wagner
W
Marcenes
Rebecca
R
Hardy
Aubrey
A
Sheiham
D000293:Adolescent; D041923:Adolescent Development / Q000502:physiology; D001938:Brazil; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000145:classification; D003773:Dental Plaque / Q000145:classification; D004522:Educational Status; D005190:Family; D005260:Female; D005884:Gingival Hemorrhage / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000193:education; D010287:Parent-Child Relations; D010512:Periodontal Index; D011678:Punishment; D012923:Social Class; D012931:Social Environment; D018677:Tooth Injuries / Q000145:classification