title: Professional flossing as a diagnostic method for gingivitis in the primary dentition.
abstract: The aim of this study was to evaluate flossing as a diagnostic method for interproximal gingival bleeding in children. For this crossover study, 23 pre-schoolchildren presenting neither restorations nor approximal carious cavities and with at least 15% of gingival bleeding sites were selected. Examinations were performed at three different moments (3-4 days interval). Examinations comprised repeated measurements of two gingival indices with a 10-minute interval in the following sequences: the Ainamo & Bay Gingival Bleeding Index (GBI) followed by the Carter & Barnes flossing index (CBI); CBI followed by GBI; and GBI followed by GBI. Data analysis was performed only for the interproximal sites, considering the GBI as the gold-standard. Agreement between indices, sensitivity (SE), specificity (SP), positive (PPV) and negative predictive values (NPV) were estimated. Percentage agreements in sequences GBI-CBI, CBI-GBI and GBI-GBI were 70.3%, 76.4% and 84.5%, respectively. Validation of flossing in the first sequence (GBI-CBI) resulted in values of 0.61 (95%CI 0.53 - 0.68), 0.72 (95%CI 0.69 - 0.76), 0.33 (95%CI 0.28 - 0.39) and 0.89 (95%CI 0.86 - 0.92) respectively for SE, SP, PPV and NPV. It can be concluded that professional flossing is a useful tool in the diagnosis of interproximal gingival inflammatory status in children, especially in conditions of gingival health.
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, University of Rio Grande do Sul, Porto Alegre, Brazil. adriela.mariath@uol.com.br
authors.forename: Adriela Azevedo Souza
authors.initials: AA
authors.lastname: Mariath
authors.forename: Ana Eliza Lemes
authors.initials: AE
authors.lastname: Bressani
authors.forename: Alex Nogueira
authors.initials: AN
authors.lastname: Haas
authors.forename: Fernando Borba de
authors.initials: FB
authors.lastname: Araujo
authors.forename: Cassiano Kuchenbecker
authors.initials: CK
authors.lastname: Rösing
mesh_terms: D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000517:prevention & control*; D005884:Gingival Hemorrhage / Q000175:diagnosis*; D005891:Gingivitis / Q000175:diagnosis* / Q000517:prevention & control; D006801:Humans; D010512:Periodontal Index; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014094:Tooth, Deciduous