Epidemiology

Gingivitis is the mildest form of periodontal disease and affects 50% to 90% of adults worldwide.[5] It is ubiquitous and affects males and females, young and old.[1] 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] Evidence suggests that the prevalence of gingivitis has been decreasing in developed countries over the last few decades.[7][8][9]​ Globally, there appears to be considerable heterogeneity in the prevalence of gingivitis with higher prevalence reported in certain parts of the world.[5][9]​​[10][11][12][13]​​[14]

The prevalence of necrotizing gingivitis (NG) varies widely, and in some countires it is most frequently reported among people living with HIV.[15][16][17][18] Studies including outpatients, particularly after introduction of antiretroviral therapy, have shown relatively low prevalence figures, similar to those of the general population.[17][19] 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][20] 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][21][22] 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] In developed countries, adolescents and young adults (15-34 years old) are at higher risk of suffering from NG.[18]

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