Community Dent Oral Epidemiol 2000; 28: 407–13 Copyright C Munksgaard 2000 Printed in Denmark . All rights reserved ISSN 0301-5661 Stefano Petti, Giulia Cairella and Gianfranco Tarsitani Nutritional variables related to ‘‘G. Sanarelli’’ Hygiene Institute, ‘‘La Sapienza’’ University, Rome, Italy gingival health in adolescent girls Petti S, Cairella G, Tarsitani G: Nutritional variables related to gingival health in adolescent girls. Community Dent Oral Epidemiol 2000; 28: 407–13. C Munks- gaard, 2000 Abstract – In order to study the nutritional variables associated with gingival health, a case-control study was designed to control strong variables whose effect on gingival status may obscure the potential effect of weaker ones, such as nutri- tion. Two groups of 27 gingivitis-affected and -unaffected female adolescents were selected. All were aged 17–19 years, with mean age of the two groups statistically not different. All were non-smokers, all reported daily toothbrushing frequency of twice/day or more, and none had clinical signs of hyponutrition. Mean DMFT Key words: adolescents; diet; fibre; gingivitis; of the two groups was statistically not different. The effect of nutritional variables, milk obtained by a three-day food record and by assessing the nutritional status of Dr. Stefano Petti, ‘‘G. Sanarelli’’ Hygiene the girls, on presence/absence of gingivitis was evaluated by a variety of stepwise Institute, ‘‘La Sapienza’’ University, logistic regression analyses. Age (positive correlation), riboflavin, calcium and P.le Aldo Moro 5, I-00185, Rome, Italy frequency of fibre intake (negative correlations) significantly explained the risk for Tel: π39 6 4991 4667 gingivitis. Strong intercorrelation between riboflavin and calcium was also found, Fax: π39 6 490 470 e-mail: spetti/axrma.uniroma1.it due to the high quantity of milk consumed by the girls, since this food provided the main source of riboflavin and calcium. The data suggest that some dietary Submitted 27 January 1999; accepted 1 March measures may be useful for the maintenance of healthy gingival status. 2000 The relationship between nutritional deficiencies and periodontal health goes back to the 18th century when Lind, a dental officer serving in the British Navy, discovered that supplementation of ascorbic acid both prevented and cured the oral symptoms of scurvy (cited by 1). More recently, early animal stud- ies showed that deficiencies in nicotinic acid, panto- thenic acid (2), riboflavin (3), folic acid (4) resulted in gingival inflammation, while deficiencies in calcium, vitamin D (5) and vitamin A (6) resulted in alveolar bone absorption. These findings have been confirmed by further human studies (7–10). Severe nutritional deficiencies, so common in de- veloping countries, are rare in western societies, where the most frequent type of malnutrition is re- lated to hypernutrition (11) and many hypernouri- shed people have an unvaried and unbalanced diet, which may lead to marginal deficiencies in some micronutrients (12). The study of nutritional variables potentially af- fecting gingival health in western countries is diffi- cult, due to the dominating presence of stronger cor- 407 relates which may obscure the effect of the weaker nutritional variables. The stronger correlates in- clude good oral hygiene practice, which is an effec- tive gingivitis preventing method (13), whereas smoking (14) and presence of imperfect restorations (15, 16) may predispose to gingivitis. Moreover, the effect of gender is to be taken into account, as differ- ences in gingival status between women and men are reported (see, for example, 17). In order to identify the main nutritional variables related to gingival health in a sample of healthy adolescents from Italy, a case-control study was de- signed to restrain the other main gingivitis related factors. Material and methods Sampling procedure The daily nutrient intakes of a case group of sub- jects affected by gingivitis were compared to those of an equal number of subjects unaffected by the disease (control group). The subjects of both