Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994

Background: The aim of this study was to assess the prevalence and extent o f gingival recession, gingival bleeding, and dental calculus in United Stat es adults, using data collected in the third National Health and Nutrition Examination Survey (NHANES III). Methods: The study group consisted of 9,689 persons 30 to 90 years of age o btained by a stratified, multi-stage probability sampling method in 1988 to 1994. The weighted sample is representative of U.S. adults 30 years or old er and represents approximately 105.8 million civilian, non-institutionaliz ed Americans. Gingival recession, gingival bleeding, and dental calculus we re assessed at the mesio-buccal and mid-buccal surfaces in 2 randomly selec ted quadrants, one maxillary and one mandibular. Data analysis accounted fo r the complex sampling design used. Results: We estimate that 23.8 million persons have one or more tooth surfa ces with greater than or equal to 3 mm gingival recession; 53.2 million hav e gingival bleeding; 97.1 million have calculus; and 58.3 million have subg ingival calculus; and the corresponding percentages are 22.5%, 50.3%, 91.8% , and 55.1% of persons, respectively. The prevalence, extent, and severity of gingival recession increased with age, as did the prevalence of subgingi val calculus and the extent of teeth with calculus and gingival bleeding. M ales had significantly more gingival recession, gingival bleeding, subgingi val calculus, and more teeth with total calculus than females. Of the 3 rac e/ethnic groups studied, non-Hispanic blacks had the highest prevalence and extent of gingival recession and dental calculus, whereas Mexican American s had the highest prevalence and extent of gingival bleeding. Mexican Ameri cans had similar prevalence and extent of gingival recession compared with non-Hispanic whites. Gingival recession was much more prevalent and also mo re severe at the buccal than the mesial surfaces of teeth. Gingival bleedin g also was more prevalent at the buccal than mesial surfaces, whereas calcu lus was most often present at the mesial than buccal surfaces. Conclusions: Dental calculus, gingival bleeding, and gingival recession are common in the U.S. adult population. In addition to their unfavorable effe ct on esthetics and self-esteem, these conditions also are associated with destructive periodontal diseases and root caries. Appropriate measures to p revent or control these conditions are desirable, and this may also be effe ctive in improving the oral health of the U.S. adult population.