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 Table of Contents 
ORIGINAL ARTICLE
Year : 2019  |  Volume : 8  |  Issue : 8  |  Page : 2696-2698  

The effect of gingival bleeding on oral home care practices in Saudi Arabia


1 Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Al Kharj, Kingdom of Saudi Arabia
2 Head of Dental Department, Qusaybah General Hospital, Ministry of Health, Al Kharj, Kingdom of Saudi Arabia
3 Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Al Kharj, Kingdom of Saudi Arabia

Date of Submission24-Apr-2019
Date of Decision24-May-2019
Date of Acceptance24-May-2019
Date of Web Publication28-Aug-2019

Correspondence Address:
Dr. Mohammed Alasqah
Assistant Professor Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University,Al Kharj
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_335_19

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  Abstract 


Aim: The aim of this study was to determine the relationship between self-reported gingival bleeding, oral health perception, practices, and concerns. Materials and Methods: This cross-sectional survey among undergraduates of University of Prince Sattam Bin Abdulaziz, Al-Kharj, Saudi Arabia using a self-administered item structured questionnaire. Data analysis was done using Statistical Packages for the Social Sciences and P < 0.05 was considered significant. Results: The response rate was 96.3%. The prevalence of self-reported gingival bleeding among respondents was 48.79%. Individuals with gingival bleeding were significantly more likely to rate their dental and gingival health as fair/poor, use of strong brushing stroke during tooth brushing and worsening condition of teeth despite daily tooth brushing. They also expressed worry about the gingival color and less likely to be satisfied about the appearance of their teeth and to have received professional instruction on tooth brushing. Conclusion: Data from this survey revealed an established relationship between gingival bleeding, perceived dental and gingival health, worry about the color of gingiva, satisfaction with the appearance of the teeth, and visiting dental office because of gingival bleeding.

Keywords: Gingival bleeding, gingival color, perceived dental health, perceived gingival health, teeth appearance, tooth brushing


How to cite this article:
Alasqah M, Almalki S, Gufran K, Alkhaibari Y, Bossayes AR, Alshammari M. The effect of gingival bleeding on oral home care practices in Saudi Arabia. J Family Med Prim Care 2019;8:2696-8

How to cite this URL:
Alasqah M, Almalki S, Gufran K, Alkhaibari Y, Bossayes AR, Alshammari M. The effect of gingival bleeding on oral home care practices in Saudi Arabia. J Family Med Prim Care [serial online] 2019 [cited 2019 Sep 19];8:2696-8. Available from: http://www.jfmpc.com/text.asp?2019/8/8/2696/265571




  Introduction Top


Gingival bleeding is associated with various forms of periodontal diseases[1] and also results from direct trauma, viral, fungal or bacterial infection, drugs, pregnancy, dermatoses, and systemic conditions.[2],[3] However, persistent gingival bleeding may be due to serious medical conditions such as leukemia and bleeding and platelet disorders.[4],[5]

Gingiva is pink and firm, tapered, contoured tissue surrounding the teeth which in health does not bleed on probing and tooth brushing. Gingival bleeding occurs mainly due to inadequate plaque removal which results in the thinning, ulceration, necrosis of gingival epithelia coupled with engorgement of blood vessel. Gingival bleeding on tooth brushing is a form of provoked gingival bleeding, a vital feature and probably one of the most frequent complaints among patients with periodontal disease. Gingival bleeding occurs alongside other manifestations of periodontal diseases like gingival swelling, halitosis, food packing, pain, gingival recession, and tooth mobility.[3]

Maintenance of good oral hygiene helps to prevent dental problems mainly periodontal disease and dental caries. Poor oral hygiene and frequent consumption of sugars is known for many years as key behavioral risk factors for these two oral diseases.[6] Daily oral self-care to control the supragingival plaque may assist in slowing or reducing the shift to a pathogenic environment.[7]

Plaque removal from all tooth surfaces through regular oral self-care, including tooth brushing and flossing, is essential to prevent the onset or development of inflammatory periodontal diseases and dental caries.[8]

As a result of tooth brushing some people may traumatize the gingival tissues, which can in time lead to gingival recession.[9] Several experimental and clinical studies support the assumption that excessive force in brushing is partly responsible for the origin of toothbrush trauma.[10] Hence, the aim of this study is to determine the awareness of people about the periodontal health, to investigate if gingival bleeding prevent patients from oral home care practices and to determine the relationship between self-reported gingival bleeding, oral health perception, practices, and concerns.


  Materials and Methods Top


Cross-sectional survey was performed to assess the effect of gingival bleeding on usage of oral home care practices in Saudi Arabia. The study was carried out on Prince Sattam Bin Abdulaziz University Students in Al-Kharj, Saudi Arabia.

A self-administered questionnaire was used for data collection. Study was subject 18 years old and older who haven't been diagnosed with any systematic diseases or medications that can affect the bleeding status.

The questionnaire had questions related to personal and socio-demographic background, experience of gingival bleeding during brushing, smoking behavior, awareness of bad breath, and awareness regarding proper way of tooth brushing.


  Result Top


Out of the 300 questionnaires, 289 were returned filled giving a retrieval rate of 96.3%. The prevalence of gingival bleeding among respondents in this study was 48.79% [Table 1]. 72.7% of participants who evaluated their gums health as poor or fair also suffered from bleeding gums when brushing teeth, while only 34.1% from those who evaluated their gums health as good or excellent reported suffering from bleeding gums when brushing teeth [Table 2]. Totally, 58.9% of participants who suffer from bleeding gums when brushing teeth were also upset about the color of their gums, compared to only 41.9% among those who do not suffer from bleeding gums when brushing teeth [Table 3]. 56.7% of participants who suffered from bleeding gums when brushing teeth were also upset about the color of their teeth, compared to only 43.3% of those who do not suffer from bleeding gums when brushing teeth [Table 4]. 57.7% of participants who suffered from bleeding gums while brushing didn't think that this problem requires dental visit, while 60.3% of those who didn't suffer from bleeding gums thought it is important to visit the dentist for such a problem [Table 5].
Table 1: Prevalence of gingival bleeding when brushing among the respondents

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Table 2: Perceived oral health status and gingival bleeding experience among the respondents

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Table 3: Relationship between satisfaction with the color of the gum and gingival bleeding experience among the respondents

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Table 4: Relationship between satisfaction with appearance of teeth and gingival bleeding experience among the respondents

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Table 5: Relationship between respondents opinions about visiting dental office because of gingival bleeding and gingival bleeding experience

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  Discussion Top


In this study, the prevalence of gingival bleeding was 48.79% which is higher than the findings reported among dental students from King Saud University, College of Dentistry, Riyadh, Saudi Arabia (19.2%),[11] adults in Kuwait 27.9%,[12] secondary school students in Ethiopia (17.4%)[13] and patients attending a tertiary Hospital in South-West[14] and South-East regions of Nigeria[15] respectively. The higher prevalence recorded in this study may be connected with the fact that the study respondents did not educate well about the daily home care practices.

In this study, individuals with gingival bleeding were significantly more likely to rate their dental and gingival health as fair/poor, upset about the color of their gums, didn't think that bleeding gum problems require visiting the dentist. The gingival bleeding which occurs in conjunction with other features of periodontal disease may have influenced the sufferers about their dental and gingival health.

The higher non receipt of professional instruction on tooth brushing among individuals with gingival bleeding may explain the inadequate tooth brushing technique such as use of excessive force during tooth brushing and also the perceived worsening condition of teeth despite daily tooth brushing. Individuals with gingival bleeding were also more likely to express worry about the color of their gingiva and less likely to be satisfied about the appearance of their teeth. This may be hinged on the fact that gingival bleeding exerts unfavorable effect on esthetics and self-esteem,[16] self-control,[17] oral health-related quality of life,[18] and occurs with other indicator of poor oral health like poor oral hygiene, altered gingival appearance, halitosis, toothache, gingival recession, and tooth mobility.


  Conclusion Top


Data from this survey showed some relationship between gingival bleeding, perceived dental and gingival health, worry about the color of gingiva, satisfaction with the appearance of the teeth, and visiting dental office because of the gingival bleeding. More longitudinal studies are needed to evaluate the specificity and sensitivity of this survey.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Newbrun, E. Indices to measure gingival bleeding. J Periodontol 1996;67:555-61.  Back to cited text no. 1
    
2.
Darby I. Drugs and gingival bleeding. Aust Prescr 2006;29:154-5.  Back to cited text no. 2
    
3.
Eley BM, Manson JD. Periodontics. 6th ed. Edinburgh (Scotland): Wright Publishing; 2010. p. 144-8.  Back to cited text no. 3
    
4.
Akinbami BO, Uchendu SN. Acute leukemia presenting with gingival bleeding. A case report. Nig Med Pract 2007;51:51-3.  Back to cited text no. 4
    
5.
Toygar HU, Guzeldemir E. Excessive gingival bleeding in two patients with Glanzmann thrombasthenia. J Periodontol 2007;78:1154-8.  Back to cited text no. 5
    
6.
Vanagas G, Milasauskiene Z, Grabauskas V, Mickeviciene A. Associations between parental skills and their attitudes toward importance to develop good oral hygiene skills in their children. Medicina (Kaunas) 2009;45:718-23.  Back to cited text no. 6
    
7.
Imai PH, Yu X, MacDonald D. Comparison of interdental brush to dental floss for reduction of clinical parameters of periodontal disease: A systematic review. Can J Dent Hygiene 2012;46:63-78.  Back to cited text no. 7
    
8.
Yuen HK, Tress ME, Salinas CF, Slate EH. Effectiveness of oral self-care among adult Gullah-speaking African Americans with diabetes. Spec Care Dentist 2009;29:128-33.  Back to cited text no. 8
    
9.
Abbas F, Voss S, Nijboer A, Hart AAM, Van der Velden U. The effect of mechanical oral hygiene procedures on bleeding on probing. J Clin Periodontol 1990;17:199-203.  Back to cited text no. 9
    
10.
Arnim S, Blackburn EM. Dentifriceabrasion. Report of a case. J Periodont 1961;32:43-8.  Back to cited text no. 10
    
11.
Almas K, Al-Hawish A, Al-Khamis W. Oral hygiene practices, smoking habit, and self-perceived oral malodor among dental students. J Contemp Dent Pract 2003;4:77-90.  Back to cited text no. 11
    
12.
Al-Shammari KF, Al-Ansari JM, Al-Khabbaz AK, Dashti A, Honkala EJ. Self-reported oral hygiene habits and oral health problems of Kuwaiti adults. Med Princ Pract 2007;16:15-21.  Back to cited text no. 12
    
13.
Emmanuel A, Chang'endo E. Oral health related behaviour, knowledge, attitudes and beliefs among secondary school students in Iringa municipality. DMSJ 2010;17:24-30.  Back to cited text no. 13
    
14.
Savage KO, Arowojolu MO. Perception of gingival bleeding by Nigerians. Afr J Med Med Sci 1997;26:91-3.  Back to cited text no. 14
    
15.
Udoye CI. Oral health attitudes and behaviour among patients in a tertiary hospital. Odontostomatol Trop 2006;29:19-22.  Back to cited text no. 15
    
16.
Albandar JM, Kingman A. Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994. J Periodontol 1999;70:30-43.  Back to cited text no. 16
    
17.
Dumitrescu AL, Dogaru BC, Dogaru CD. Self-control and self-confidence: Their relationship to self-rated oral health status and behaviours. Oral Health Prev Dent 2009;7:155-62.  Back to cited text no. 17
    
18.
Castro Rde A, Portela MC, Leão AT, de Vasconcellos MT. Oral health-related quality of life of 11- and 12-year-old public school children in Rio de Janeiro. Community Dent Oral Epidemiol 2011;39:336-44.  Back to cited text no. 18
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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