title: Professional toothbrushing as a method for diagnosing gingivitis in 3- to 6-year-old preschool children.
abstract: OBJECTIVE
  The aim of the present crossover study was to evaluate professional toothbrushing as a method for diagnosing gingivitis in children.
  
  
  METHODS
  Thirty-four preschool children who had gingival bleeding > or = 10% and without proximal restorations/carious lesions were included in the study. Examinations comprised two gingival indices recorded at a 15-min interval, in the following sequences: the Ainamo and Bay gingival bleeding index (GBI1) followed by the brushing index (BI2) and vice versa (BI1-GBI2). Half of the children started the study in the first sequence and the other half in the second. After a 3- to 4-day washout period, the indices were again recorded with individuals changing the sequences. Data analysis considered GBI as the gold standard, and sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) were also calculated.
  
  
  RESULTS
  The overall mean value of gingival bleeding at the first examination was 18.85 +/- 9.24%. Validation of toothbrushing performed after GBI (BI2) resulted in values for SE, SP, PPV and NPV of 0.59 (95% CI, 0.55 to 0.63), 0.92 (95% CI, 0.91 to 0.93), 0.64 (95% CI, 0.60 to 0.69) and 0.90 (95% CI, 0.89 to 0.92), respectively. BI performed before GBI (BI1) resulted in similar SE, SP, PPV and NPV. Percentage agreement of GBI1-BI2 and BI1-GBI2 was 83.5% and 85.9%, respectively.
  
  
  CONCLUSIONS
  Professional toothbrushing can be suggested as a method for the diagnosis of gingival inflammatory status in children, especially as an indicator of gingival health.
authors.affiliation: Department of Pediatric Dentisty, Federal University of Rio Grande de Sul, Porto Alegre, RS, Brazil.
authors.forename: Adriela Azevedo Souza
authors.initials: AA
authors.lastname: Mariath
authors.forename: Alex Nogueira
authors.initials: AN
authors.lastname: Haas
authors.forename: Cláudia Martinewski
authors.initials: CM
authors.lastname: Fischer
authors.forename: Fernando Borba
authors.initials: FB
authors.lastname: de Araujo
authors.forename: Cassiano Kuchenbecker
authors.initials: CK
authors.lastname: Rösing
mesh_terms: D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D005884:Gingival Hemorrhage / Q000175:diagnosis; D005891:Gingivitis / Q000175:diagnosis*; D006801:Humans; D010512:Periodontal Index; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014099:Toothbrushing / Q000379:methods*