Predicting gingivitis using visual gingival redness examination on 11 years old Japanese schoolchildren: A ROC analysis

Aims: To identify more reliable and cost-effective methods to detect gingivitis, such as visual examinations, questionnaires, and salivary occult blood tests (SOBT). Methods: Sixty-five elementary school students in Yahiko Village, Niigata, Japan were recruited. Questionnaire was used to assess subjective gingival status. Hemoglobin (Hb) and lactate dehydrogenase (LDH) levels were measured by SOBT. Bleeding on marginal probing (BOMP) method at three labial sites per tooth for all anterior teeth was used to examine clinical gingiva condition. Occurrence of at least 1 site with BOMP positive was defined as gingivitis. Visual gingival redness examination was done at the same sites examined by probing. Results: Participants with gingivitis had higher numbers of sites with redness than those without 6 (0.25-12) vs 0 (2), p < 0.001. Participants with more sites with redness had a 1.29-fold higher risk of suffering from gingivitis (p = 0.002). The overall model had a 77.3% probability of predicting a gingivitis event by the number of sites with gingival redness (p < 0.001). Highest Youden Index was 1.453, yielded from the cut-off value of 4-5 sites with gingival redness. Conclusion(s): This study found that a predictive model using visual gingival redness examination is a viable non-invasive screening test for gingivitis. © 2019 Japanese Society of Pediatric Dentistry