Gingivitis is the mildest form of periodontal disease and affects 50% to 90% of adults worldwide.[5]Albandar JM, Rams TE. Global epidemiology of periodontal diseases. Periodontol 2000. 2002;29:7-10.
http://www.ncbi.nlm.nih.gov/pubmed/12102700?tool=bestpractice.com
It is ubiquitous and affects males and females, young and old.[1]Chapple ILC, Mealey BL, Van Dyke TE, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018 Jun;89 Suppl 1:S74-84.
http://www.ncbi.nlm.nih.gov/pubmed/29926944?tool=bestpractice.com
As defined by gingival bleeding adjacent to ≥1 teeth, about one half of the US population has gingivitis with the prevalence slightly greater in men than women, and in black people and Mexican Americans than in white people.[6]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 Jan;70(1):30-43.
http://www.ncbi.nlm.nih.gov/pubmed/10052768?tool=bestpractice.com
Evidence suggests that the prevalence of gingivitis has been decreasing in developed countries over the last few decades.[7]Hugoson A, Sjödin B, Norderyd O. Trends over 30 years, 1973-2003, in the prevalence and severity of periodontal disease. J Clin Periodontol. 2008 May;35(5):405-14.
http://www.ncbi.nlm.nih.gov/pubmed/18433384?tool=bestpractice.com
[8]Rothlisberger B, Kuonen P, Salvi GE, et al. Periodontal conditions in Swiss army recruits: a comparative study between the years 1985, 1996 and 2006. J Clin Periodontol. 2007 Oct;34(10):860-6.
http://www.ncbi.nlm.nih.gov/pubmed/17850604?tool=bestpractice.com
[9]Daly B, Batchelor P, Treasure ET, et al. Essential Dental Public Health. 2nd ed. Oxford, UK: Oxford University Press; 2013. Globally, there appears to be considerable heterogeneity in the prevalence of gingivitis with higher prevalence reported in certain parts of the world.[5]Albandar JM, Rams TE. Global epidemiology of periodontal diseases. Periodontol 2000. 2002;29:7-10.
http://www.ncbi.nlm.nih.gov/pubmed/12102700?tool=bestpractice.com
[9]Daly B, Batchelor P, Treasure ET, et al. Essential Dental Public Health. 2nd ed. Oxford, UK: Oxford University Press; 2013.[10]Wang QT, Wu ZF, Wu YF, et al. Epidemiology and preventive direction of periodontology in China. J Clin Periodontol. 2007 Nov;34(11):946-51.
http://www.ncbi.nlm.nih.gov/pubmed/17877744?tool=bestpractice.com
[11]Dhar V, Jain A, Van Dyke TE, et al. Prevalence of gingival diseases, malocclusion and fluorosis in school-going children of rural areas in Udaipur district. J Indian Soc Pedod Prev Dent. 2007 Apr-Jun;25(2):103-5.
http://www.jisppd.com/article.asp?issn=0970-4388;year=2007;volume=25;issue=2;spage=103;epage=105;aulast=Dhar
http://www.ncbi.nlm.nih.gov/pubmed/17660647?tool=bestpractice.com
[12]Agbelusi GA, Jeboda SO. Oral health status of 12-year-old Nigerian children. West Afr J Med. 2006 Jul-Sep;25(3):195-8.
http://www.ncbi.nlm.nih.gov/pubmed/17191418?tool=bestpractice.com
[13]Coelho Rde S, Gusmão ES, Jovino-Silveira RC, et al. Profile of periodontal conditions in a Brazilian adult population. Oral Health Prev Dent. 2008;6(2):139-45.
http://www.ncbi.nlm.nih.gov/pubmed/18637391?tool=bestpractice.com
[14]Trombelli L, Farina R, Silva CO, et al. Plaque-induced gingivitis: Case definition and diagnostic considerations. J Periodontol. 2018 Jun;89 Suppl 1:S46-S73.
http://www.ncbi.nlm.nih.gov/pubmed/29926936?tool=bestpractice.com
The prevalence of necrotizing gingivitis (NG) varies widely, and in some countires it is most frequently reported among people living with HIV.[15]Ranganathan K, Hemalatha R. Oral lesions in HIV infection in developing countries: an overview. Adv Dent Res. 2006 Apr 1;19(1):63-8.
http://www.ncbi.nlm.nih.gov/pubmed/16672552?tool=bestpractice.com
[16]Albandar JM, Tinoco EM. Global epidemiology of periodontal diseases in children and young persons. Periodontol 2000. 2002;29:153-76.
http://www.ncbi.nlm.nih.gov/pubmed/12102707?tool=bestpractice.com
[17]Herrera D, Alonso B, de Arriba L, et al. Acute periodontal lesions. Periodontol 2000. 2014 Jun;65(1):149-77.
http://www.ncbi.nlm.nih.gov/pubmed/24738591?tool=bestpractice.com
[18]Herrera D, Retamal-Valdes B, Alonso B, et al. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Periodontol. 2018 Jun;89 Suppl 1:S85-S102.
http://www.ncbi.nlm.nih.gov/pubmed/29926942?tool=bestpractice.com
Studies including outpatients, particularly after introduction of antiretroviral therapy, have shown relatively low prevalence figures, similar to those of the general population.[17]Herrera D, Alonso B, de Arriba L, et al. Acute periodontal lesions. Periodontol 2000. 2014 Jun;65(1):149-77.
http://www.ncbi.nlm.nih.gov/pubmed/24738591?tool=bestpractice.com
[19]Coogan MM, Greenspan J, Challacombe SJ. Oral lesions in infection with human immunodeficiency virus. Bull World Health Organ 2005 Sep;83(9):700-6.
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862005000900016&lng=en&nrm=iso&tlng=en
http://www.ncbi.nlm.nih.gov/pubmed/16211162?tool=bestpractice.com
This disease is frequently seen in developing countries, especially in sub-Saharan Africa, where it occurs almost exclusively among children, usually between the ages of 3 and 10 years, from low socioeconomic backgrounds.[17]Herrera D, Alonso B, de Arriba L, et al. Acute periodontal lesions. Periodontol 2000. 2014 Jun;65(1):149-77.
http://www.ncbi.nlm.nih.gov/pubmed/24738591?tool=bestpractice.com
[20]Folayan MO. The epidemiology, etiology, and pathophysiology of acute necrotizing ulcerative gingivitis associated with malnutrition. J Contemp Dent Pract. 2004 Aug 15;5(3):28-41.
http://www.ncbi.nlm.nih.gov/pubmed/15318254?tool=bestpractice.com
Its prevalence has been reported to be about 0.5% in developed countries and 3% in a South African population, and has been found to be as high as 27% among Nigerian children aged <12 years at a west Nigerian dental clinic.[17]Herrera D, Alonso B, de Arriba L, et al. Acute periodontal lesions. Periodontol 2000. 2014 Jun;65(1):149-77.
http://www.ncbi.nlm.nih.gov/pubmed/24738591?tool=bestpractice.com
[21]Arendorf TM, Bredekamp B, Cloete CA, et al. Seasonal variation of acute necrotizing ulcerative gingivitis in South Africans. Oral Dis. 2001 May;7(3):150-4.
http://www.ncbi.nlm.nih.gov/pubmed/11495190?tool=bestpractice.com
[22]Taiwo JO. Oral hygiene status and necrotizing ulcerative gingivitis in Nigerian children. J Periodontol. 1993 Nov;64(11):1071-4.
http://www.ncbi.nlm.nih.gov/pubmed/8295093?tool=bestpractice.com
In this population, prevalence of this disease increases from 2% to 3% of children with good oral hygiene to 67% of children with very poor oral hygiene.[22]Taiwo JO. Oral hygiene status and necrotizing ulcerative gingivitis in Nigerian children. J Periodontol. 1993 Nov;64(11):1071-4.
http://www.ncbi.nlm.nih.gov/pubmed/8295093?tool=bestpractice.com
In developed countries, adolescents and young adults (15-34 years old) are at higher risk of suffering from NG.[18]Herrera D, Retamal-Valdes B, Alonso B, et al. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Periodontol. 2018 Jun;89 Suppl 1:S85-S102.
http://www.ncbi.nlm.nih.gov/pubmed/29926942?tool=bestpractice.com