Dental plaque and gingival bleeding in adolescents with juvenile idiopathic arthritis and controls: a multilevel analysis

Figures & data

Figure 1. Participant flow diagram of children and adolescents with juvenile idiopathic arthritis (JIA) and controls.

Table 1. Socio-behavioral, and subjective clinical characteristics of 162 individuals with juvenile idiopathic arthritis and 162 controls, aged 10–16 years.

Variable	JIA (n = 162)	Controls (n = 162)	p-value
Educational level of caregivers, n (%)
Mother			.008
High school/vocational school	57 (37.8)	34 (23.5)
University/college	94 (62.3)	111 (76.6)
Father			.001
High school/vocational school	86 (58.1)	56 (39.4)
University/college	62 (41.9)	86 (60.6)
Share household with, n (%)
Two caregivers in the household*	119 (76.8)	130 (81.3)	.329
Only one caregiver in the household	36 (23.2)	30 (18.8)
Frequency of toothbrushing, n (%)
Once a day or less/do not know	33 (21.3)	38 (23.9)	.581
Twice a day, or more	122 (78.7)	121 (76.1)
Frequency of tooth flossing during the last 3 months, n (%)
Daily or more	16 (10.4)	16 (10.1)	.924
Several times weekly or less/do not know	138 (89.6)	143 (89.9)
During toothbrushing, gingival bleeding occurs, n (%)
Sometimes or more/do not know	96 (62.3)	85 (53.5)	.112
Never	58 (37.7)	74 (46.5)
During toothbrushing, pain or discomfort occurs, n (%)
Yes/do not know	20 (13.2)	21 (13.2)	.990
No	132 (86.8)	138 (86.8)
Frequency of intraoral ulceration(s) (≥3 mm), n (%)
Once a month or more	11 (7.5)	17 (10.6)	.348
Several times yearly (but less seldom than once a month) or less/do not know	136 (92.5)	144 (89.4)
Perception of dry mouth on a regular basis, n (%)
Yes	12 (7.9)	4 (2.5)	.030
No/do not know	140 (92.1)	157 (97.5)

*The variable includes living across two households, given two caregivers in both households. Not all participants responded to the questionnaires. Chi-squared test level of significance p<.05.

Significant values are marked in bold.

Figure 2. Mean score of simplified Debris Index (DI-S), simplified Calculus Index (CI-S) and simplified Oral Hygiene Index (OHI-S) among individuals with juvenile idiopathic arthritis (JIA) and controls.

Figure 3. Mean percentage score of Gingival Bleeding Index (GBI) among individuals with juvenile idiopathic arthritis (JIA) and controls.

Table 2. Group affiliation, socio-behavioral, and clinical characteristics in relation to oral hygiene (OHI-S > 0), and gingival bleeding (GBI > 0). Unadjusted and adjusted mixed-effects logistic regression.

	OHI-S > 0^a				GBI > 0^b
	Unadjusted analyses		Adjusted analyses^c		Unadjusted analyses		Adjusted analyses^d
	OR (95% CI)	p-value	OR (95% CI)	p-value	OR (95% CI)	p-value	OR (95% CI)	p-value
Health status
Control group	1	ref	1	ref	1	ref	1	ref
JIA	1.92 (1.35 − 2.73)	<.001	2.33 (1.47 − 3.67)	<.001	1.62 (1.19 − 2.20)	.002	1.54 (1.10 − 2.16)	.013
Educational level of mother
University/college	1	ref			1	ref	1	ref
High school/vocational school	1.04 (0.70 − 1.56)	.844			1.47 (1.04 − 2.07)	.030	1.38 (0.96 − 1.98)	.081
Educational level of father
University/college	1	ref			1	ref
High school/vocational school	0.74 (0.50 − 1.07)	.109			1.04 (0.74 − 1.46)	.815
Household structure
Two caregivers^e	1	ref			1	ref
One caregiver	1.01 (0.65 − 1.58)	.950			1.24 (0.84 − 1.81)	.277
Frequency of toothbrushing
Twice a day or more	1	ref			1	ref
Once a day or less^f	1.70 (1.11 − 2.61)	.015			1.27 (0.88 − 1.83)	.209
Frequency of tooth flossing during the last 3 months
Daily or more	1	ref			1	ref
Several times weekly or less^f	1.23 (0.66 − 2.28)	.513			1.40 (0.82 − 2.38)	.220
During toothbrushing, gingival bleeding occurs
Never	1	ref			1	ref
Sometimes or more^f	1.21 (0.83 − 1.75)	.320			1.57 (1.14 − 2.17)	.006
During toothbrushing, pain or discomfort occurs
No	1	ref			1	ref
Yes^f	1.06 (0.61 − 1.83)	.842			0.94 (0.59 − 1.51)	.796
Frequency of intraoral ulceration(s) (>3mm)
Several times yearly (but less seldom than once a  month) or less/do not know	1	ref			1	ref
Once a month or more	0.53 (0.28 − 0.98)	.043			1.01 (0.58 − 1.75)	.971
Perception of dry mouth on a regular basis
No/do not know	1	ref			1	ref
Yes	1.59 (0.72 − 3.50)	.249			1.70 (0.86 − 3.37)	.125
Jaw
Mandible	1	ref	1	ref	1	ref	1	ref
Maxilla	0.59 (0.47 − 0.73)	<.001	1.02 (0.67 − 1.56)	.914	0.46 (0.39 − 0.54)	<.001	0.51 (0.37 − 0.72)	<.001
Side
Right side	1	ref			1	ref
Left side	0.95 (0.77 − 1.18)	.665			1.10 (0.94 − 1.29)	.230
Anterior/posterior
Incisors	1	ref	1	ref	1	ref	1	ref
Molars	8.48 (6.36 − 11.32)	<.001	5.43 (3.73 − 7.91)	<.001	2.13 (1.77 − 2.56)	<.001	1.78 (1.31 − 2.42)	<.001
Surface (tooth)
Buccal (11, 31, 16, 26)	1	ref	1	ref	1	ref	1	ref
Lingual (36, 46)	5.60 (4.27 − 7.35)	<.001	2.81 (1.67 − 4.73)	<.001	2.63 (2.24–3.10)	<.001	1.24 (0.83 − 1.83)	.291
Site (surface)
A: Mesial (buccal, lingual)					1^BC	<.001^g	1^BC	<.001^g
B: Medial (buccal, lingual)					1.45 (1.19 − 1.77)^A	.001	1.55 (1.26-1.92)^A	<.001
C: Distal (buccal, lingual)					1.47 (1.21 − 1.80)^A	.001	1.49 (1.20–1.84)^A	.001
ICC individual level	0.32		0.45		0.29		0.30
ICC tooth level					0.43		0.41
AIC	2311.34		1987.75		4466.88		3911.16

^aDichotomised outcome variable (present or absent) of the modified version of the simplified oral hygiene index (OHI-S). OHI-S consists of two components, the simplified Debris Index (DI-S) and the simplified Calculus Index (CI-S) [16]. 144 individuals with JIA and 154 controls were evaluated according to the modified OHI-S.

^bDichotomised outcome variable (present or absent) of the modified version of Gingival Bleeding Index (GBI) [17]. 159 individuals with JIA and 161 controls were evaluated according to the modified GBI.

^cAdjusted for: Health status (main exposure variable), jaw, anterior/posterior, surface (tooth).

^dAdjusted for: Health status (main exposure variable), educational level of mother, jaw, anterior/posterior, surface (tooth), site (surface).

^eAlso includes living across two households, given two caregivers in both households.

^fThe answer option “Do not know” are included in the variable associated with negative impact on oral health.

^gOverall p-value. Surfaces and sites statistically significant in Post hoc analyses are marked using superscript uppercase letters. Scheffe adjusted p-values in Post hoc analysis p<.05.

Significant values are marked in bold.

Abbreviations: JIA: Juvenile idiopathic arthritis; ICC: intraclass correlation coefficient; AIC: Aikake Information Criteria.

Figure 4. Percentage (95% confidence interval represented as error bars) of plaque or calculus (OHI-S > 0) at surface level among individuals with juvenile idiopathic arthritis (JIA) and controls.

Figure 5. Percentage (95% confidence interval represented as error bars) of gingival bleeding (GBI > 0) at site level among individuals with juvenile idiopathic arthritis (JIA) and controls.

Table 3. Oral variables including side, jaw, and surfaces in relation to oral hygiene (OHI-S > 0), and side, jaw, surfaces, and sites in relation to gingival bleeding (GBI > 0) by group affiliation. Unadjusted mixed-effects logistic regression.

	OHI-S > 0^a				GBI > 0^b
	JIA		Controls		JIA		Controls
	OR (95% CI)	p-value	OR (95% CI)	p-value	OR (95% CI)	p-value	OR (95% CI)	p-value
Side
Right side	1	ref	1	ref	1	ref	1	ref
Left side	0.93 (0.68 − 1.26)	.673	0.98 (0.73 − 1.31)	.881	1.11 (0.90 − 1.37)	.331	1.09 (0.86 − 1.38)	.480
Jaw
Mandible	1	ref	1	ref	1	ref	1	ref
Maxilla	0.91 (0.67 − 1.23)	.530	0.39 (0.28 − 0.53)	<.001	0.50 (0.40 − 0.62)	<.001	0.41 (0.32 − 0.52)	<.001
Surface (tooth)
A: Buccal surface of maxillary 1. molars (16, 26)	1^CD	<.001^c	1^BCD	<.001^c	1^BC	<.001^c	1^B	<.001^c
B: Lingual surface of mandibular 1. molars (36, 46)	1.35 (0.89 − 2.06)^CD	.164	5.63 (3.57 − 8.88)^ACD	<.001	1.98 (1.54 − 2.54)^ACD	<.001	2.77 (2.06 − 3.73)^ACD	<.001
C: Buccal surface of maxillary central (11)	0.20 (0.12 − 0.34)^AB	<.001	0.14 (0.08 − 0.26)^AB	<.001	0.43 (0.29 − 0.64)^ABD	<.001	0.62 (0.39 − 0.97)^B	.036
D: Buccal surface of mandibular central (31)	0.17 (0.10 − 0.28)^AB	<.001	0.18 (0.10 − 0.31)^AB	<.001	0.95 (0.68 − 1.32)^BC	.750	1.11 (0.75 − 1.65)^B	.611
Site (tooth)
A: Mesiobuccal site of maxillary 1. molars (16, 26)					1^E	<.001^c	1^EF	<.001^c
B: Mediobuccal site of maxillary 1. molars (16, 26)					1.27 (0.78 − 2.09)^E	.338	1.00 (0.51 − 1.96)^EF	1.000
C: Distobuccal site of maxillary 1. molars (16, 26)					2.18 (1.36 − 3.48)	.001	2.97 (1.66 − 5.33)	<.001
D: Mesiolingual site of mandibular 1. molars (36, 46)					2.13 (1.33 − 3.40)	.002	3.07 (1.72 − 5.49)	<.001
E: Mediolingual site of mandibular 1. molars (36, 46)					4.60 (2.93 − 7.21)^ABGHIKL	<.001	6.75 (3.87 − 11.77)^ABGH	<.001
F: Distolingual site of mandibular 1. molars (36, 46)					2.26 (1.42 − 3.60)	.001	3.78 (2.13 − 6.71)^AB	<.001
G: Mesiobuccal site of maxillary central (11)					0.44 (0.20 − 0.94)^E	.034	0.51 (0.19 − 1.35)^E	.172
H: Mediobuccal site of maxillary central (11)					0.60 (0.30 − 1.20)^E	.147	0.81 (0.35 − 1.92)^E	.636
I: Distobuccal site of maxillary central (11)					0.84 (0.44 − 1.61)^E	.596	1.67 (0.80 − 3.48)	.172
J: Mesiobuccal site of mandibular central (31)					1.83 (1.04 − 3.23)	.036	1.69 (0.81 − 3.52)	.162
K: Mediobuccal site of mandibular central (31)					0.99 (0.53 − 1.86)^E	.971	1.69 (0.81 − 3.52)	.162
L: Distobuccal site of mandibular central (31)					1.34 (0.74 − 2.42)^E	.338	1.84 (0.89 − 3.81)	.099
ICC individual level	0.30		0.31		0.28		0.29
ICC tooth level					0.48		0.44
AIC	1095.35		1206.67		2459.39		2002.14

^aDichotomised outcome variable (present or absent) of the modified version of the simplified oral hygiene index (OHI-S) [16]. 144 individuals with JIA and 154 controls were evaluated according to the modified OHI-S.

^bDichotomised outcome variable (present or absent) of the modified version of Gingival Bleeding Index (GBI) [17]. 159 individuals with JIA and 161 controls were evaluated according to the modified GBI.

^cOverall p-value. Surfaces and sites statistically significant in Post hoc analyses are marked using superscript uppercase letters. Scheffe adjusted p-values in Post hoc analysis p<.05.

Significant values are marked in bold.

Abbreviations: JIA: Juvenile idiopathic arthritis; ICC: intraclass correlation coefficient; AIC: Aikake Information Criteria.

Table 4. Disease-specific features and oral variables in relation to oral hygiene (OHI-S > 0) and gingival bleeding (GBI > 0) among participants with juvenile idiopathic arthritis (JIA). Unadjusted and adjusted mixed-effects logistic regression.

	OHI-S > 0^a					GBI > 0^b
		Unadjusted analyses		Adjusted analyses^c		n	Unadjusted analyses		Adjusted analyses^c
	n	OR (95% CI)	p-value	OR (95% CI)	p-value		OR (95% CI)	p-value	OR (95% CI)	p-value
JIA category
Oligoarthritis persistent	50	1	.039^d	1	.089^d	55	1	.735^d	1	.774^d
Systemic arthritis	5	6.24 (1.30 − 30.07)	.022	5.20 (1.07 − 25.32)	.041	5	1.02 (0.30 − 3.42)	.979	1.18 (0.34 − 4.05)	.791
Oligoarthritis extended	11	0.93 (0.36 − 2.38)	.876	1.09 (0.42 − 2.83)	.858	14	1.48 (0.68 − 3.22)	.320	1.43 (0.65 − 3.14)	.377
Polyarthritis, RF positive	3	0.54 (0.10 − 2.82)	.464	0.62 (0.12 − 3.26)	.573	4	3.38 (0.95 − 12.02)	.060	3.42 (0.95 − 12.30)	.060
Polyarthritis, RF negative	29	1.75 (0.89 − 3.45)	.104	1.77 (0.90 − 3.47)	.099	33	1.30 (0.73 − 2.32)	.365	1.36 (0.77 − 2.42)	.293
Psoriatic arthritis	5	2.00 (0.50 − 8.02)	.328	2.41 (0.59 − 9.80)	.218	5	2.03 (0.64 − 6.51)	.232	1.89 (0.59 − 6.10)	.286
Enthesitis-related arthritis	21	1.31 (0.62 − 2.77)	.475	1.18 (0.56 − 2.50)	.669	21	1.21 (0.62 − 2.37)	.571	1.22 (0.62 − 2.40)	.570
Undifferentiated arthritis	20	0.89 (0.42 − 1.88)	.752	0.86 (0.40 − 1.81)	.683	22	1.12 (0.58 − 2.17)	.737	1.17 (0.60 − 2.26)	.648
Human leukocyte antigen B27 (HLA-B27)
Negative	105	1	ref	1	ref	116	1	ref	1	ref
Positive	39	1.05 (0.60 − 1.83)	.874	1.03 (0.59 − 1.79)	.916	43	1.18 (0.74 − 1.88)	.495	1.21 (0.76 − 1.93)	.421
Antinuclear antibodies (ANA)^e
Negative	77	1	ref	1	ref	85	1	ref	1	ref
Positive	26	0.96 (0.52 − 1.79)	.893	1.11 (0.58 − 2.12)	.749	32	0.84 (0.48 − 1.45)	.526	0.75 (0.42 − 1.34)	.338
Rheumatoid factor (RF)^f
Negative	135	1	ref	1	ref	150	1	ref	1	ref
Positive	5	0.55 (0.15 − 2.08)	.376	0.55 (0.15 − 2.05)	.372	5	1.33 (0.41 − 4.38)	.635	1.34 (0.41 − 4.39)	.625
Anti-cyclic citrullinated peptide (anti-CCP)^g
Negative	122	1	ref	1	ref	136	1	ref	1	ref
Positive	7	1.12 (0.35 − 3.57)	.842	1.18 (0.38 − 3.72)	.774	8	1.21 (0.47 − 3.10)	.698	1.11 (0.44 − 2.82)	.825
Serum C-reactive protein (CRP)^h
<5 mg/L	133	1	ref	1	ref	147	1	ref	1	ref
≥5 mg/L	8	0.85 (0.29 − 2.46)	.757	0.76 (0.26 − 2.21)	.613	9	0.90 (0.35 − 2.30)	.827	0.89 (0.35 − 2.26)	.802
Erythrocyte sedimentation rate (ESR)
<20 mm/h	139	1	ref	1	ref	153	1	ref	1	ref
≥20 mm/h	5	0.91 (0.24 − 3.42)	.886	0.84 (0.23 − 3.14)	.798	6	0.74 (0.24 − 2.27)	.597	0.75 (0.24 − 2.29)	.609
Age at JIA onset
≤6 years	50	1	ref	1	ref	59	1		1
>6 years	94	1.84 (1.10 − 3.07)	.020	1.80 (1.08 − 3.00)	.025	100	1.26 (0.81 − 1.94)	.307	1.23 (0.79 − 1.91)	.354
Disease duration
≤5 years	74	1	ref	1	ref	80	1		1
>5 years	70	0.61 (0.37 − 1.00)	.050	0.64 (0.39 − 1.04)	.071	79	1.04 (0.69 − 1.59)	.847	1.04 (0.69 − 1.58)	.850
Steroids, ongoing
No steroids ongoing	141	1	ref	1	ref	155	1	ref	1	ref
Steroids ongoing	3	3.96 (0.57 − 27.31)	.162	2.85 (0.40 − 20.10)	.294	4	0.47 (0.11 − 1.96)	.302	0.52 (0.13 − 2.17)	.371
Steroids, ever used
No steroids ever used	112	1	ref	1	ref	124	1	ref	1	ref
Steroids ever used	32	1.41 (0.77 − 2.59)	.265	1.37 (0.75 − 2.50)	.306	35	0.93 (0.56 − 1.54)	.773	0.95 (0.58 − 1.58)	.851
DMARDs, ongoing
No sDMARDs nor bDMARDs ongoing	55	1	.768^d	1	.784^d	60	1	.252^d	1	.250^d
sDMARDs, but no bDMARDs ongoing	37	1.07 (0.57 − 2.03)	.827	1.12 (0.59 − 2.13)	.731	40	0.64 (0.37 − 1.11)	.113	0.64 (0.36 − 1.11)	.113
bDMARDs ongoing^i	52	1.24 (0.69 − 2.20)	.473	1.23 (0.69 − 2.17)	.487	59	0.76 (0.47 − 1.22)	.254	0.76 (0.47 − 1.22)	.251
DMARDs, ever used
No sDMARDs nor bDMARDs ever used	42	1	.644^d	1	.660^d	45	1	.698^d	1	.718^d
sDMARDs, but no bDMARDs ever used	49	1.16 (0.62 − 2.17)	.648	1.19 (0.64 − 2.22)	.591	53	0.82 (0.48 − 1.40)	.468	0.82 (0.48 − 1.41)	.481
bDMARDs ever used^i	53	1.34 (0.73 − 2.48)	.350	1.33 (0.72 − 2.44)	.362	61	0.81 (0.49 − 1.36)	.429	0.82 (0.49 − 1.37)	.451
Remission status^j
Inactive disease/remission on/off medication	86	1	ref	1	ref	95	1	ref	1	ref
Continued activity/flare	58	0.94 (0.56 − 1.56)	.798	1.02 (0.61 − 1.70)	.951	64	0.94 (0.62 − 1.45)	.793	0.93 (0.61 − 1.43)	.748
MDgloVAS
VAS = 0	92	1	ref	1	ref	101	1	ref	1	ref
VAS > 0	52	0.93 (0.56 − 1.57)	.796	1.03 (0.61 − 1.73)	.920	58	1.06 (0.68 − 1.63)	.811	1.04 (0.67 − 1.61)	.853
PRgloVAS
VAS = 0	72	1	ref	1	ref	79	1	ref	1	ref
VAS > 0	68	0.86 (0.52 − 1.42)	.552	0.86 (0.52 − 1.40)	.534	76	0.97 (0.63 − 1.48)	.879	0.98 (0.64 − 1.50)	.924
CHAQ hygiene item Tooth brushing^k
Without any difficulty	134	1	ref	1	ref	148	1	ref	1	ref
With some/much difficulty/unable to do/not applicable	6	1.50 (0.44 − 5.17)	.518	1.53 (0.45 − 5.20)	.497	7	2.70 (1.05 − 6.94)	.040	2.92 (1.14 − 7.45)	.025
Jaw
Mandible	–	1	ref	1	ref	–	1	ref	1	ref
Maxilla	–	0.91 (0.67 − 1.23)	.530	0.91 (0.67 − 1.23)	.530	–	0.50 (0.40 − 0.62)	<.001	0.50 (0.40 − 0.62)	<.001
Side
Right side	–	1	ref	1	ref	–	1	ref	1	ref
Left side	–	0.93 (0.68 − 1.26)	.637	0.93 (0.68 − 1.26)	.637	–	1.11 (0.90 − 1.37)	.331	1.11 (0.90 − 1.37)	.332
Anterior/posterior
Incisors	–	1	ref	1	ref	–	1	ref	1	ref
Molars	–	6.26 (4.26 − 9.19)	<.001	6.27 (4.27 − 9.21)	<.001	–	2.15 (1.68 − 2.74)	<.001	2.15 (1.68 − 2.74)	<.001
Surface (teeth)
Buccal (11, 31, 16, 26)	–	1	ref	1	ref	–	1	ref	1	ref
Lingual (36, 46)	–	2.99 (2.09 − 4.29)	<.001	2.99 (2.09 − 4.29)	<.001	–	2.38 (1.92 − 2.96)	<.001	2.38 (1.92 − 2.96)	<.001
Site (surface)
A: Mesial (buccal, lingual)	–	–	–	–	–	–	1^B	.025^d	1^B	.025^d
B: Medial (buccal, lingual)	–	–	–	–	–	–	1.39 (1.07 − 1.80)^A	.013	1.39 (1.07 − 1.80)^A	.013
C: Distal (buccal, lingual)	–	–	–	–	–	–	1.33 (1.02 − 1.72)	.034	1.33 (1.02 − 1.72)	.034
ICC individual level	–	0.30	–	0.29	–	–	0.28	–	0.27	–
ICC tooth level	–	–	–	–	–	–	0.42	–	0.41	–
AIC	–	1095.35	–	1095.69	–	–	2459.39	–	2461.42	–

^aDichotomised outcome variable (present or absent) of the modified version of the simplified oral hygiene index (OHI-S) [16]. 144 individuals with JIA were evaluated according to the modified OHI-S.

^bDichotomised outcome variable (present or absent) of the modified version of Gingival Bleeding Index (GBI) [17]. 159 individuals with JIA were evaluated according to the modified GBI.

^cAdjusted for: Gender and age.

^dOverall p-value.

^eResponses (n = 42) are missing.

^fResponses (n = 4) are missing.

^gResponses (n = 15) are missing.

^hResponses (n = 3) are missing.

ⁱWith or without sDMARDs.

^jDisease activity according to Wallace and the American College of Rheumatology (ACR) provisional criteria [19, 20].

^kResponses (n = 4) are missing.

Surfaces statistically significant in Post hoc analysis is marked using superscript uppercase letters.

Scheffe adjusted p-values in Post hoc analysis p<.05. Regarding JIA category and other medication ongoing and ever used Post hoc analysis showed no difference (all p-values >.05).

Significant values are marked in bold.

Abbreviations: RF: Rheumatoid Factor; sDMARDs: synthetic disease-modifying antirheumatic drugs; bDMARDs: biologic disease-modifying antirheumatic drugs; MDgloVAS: Physician's global assessment of disease activity; PRgloVAS: Patient's global assessment of overall wellbeing; CHAQ: Childhood Health Assessment Questionnaire; ICC: intraclass correlation coefficient; AIC: Aikake Information Criteria.

Table 5. Other clinical characteristics of oral cavity among individuals with juvenile idiopathic arthritis (JIA) and controls ≥10 years.

Variable	JIA (n = 162)	Controls (n = 162)	p-value
Fissure of lip and/or corner of lip, n (%)
No clear findings	154 (98.1)	155 (95.7)	.217
Yes	3 (1.9)	7 (4.3)
Gingival ulcers with discontinuation of epithelia of at least 3 mm, n (%)
No	154 (98.7)	156 (96.3)	.168
Yes	2 (1.3)	6 (3.7)
Buccal mucosa ridging, n (%)
No	133 (84.7)	133 (82.1)	.531
Yes	24 (15.3)	29 (17.9)
Tongue indentation, n (%)
No	145 (93.0)	140 (86.4)	.056
Yes	11 (7.1)	22 (13.6)
Gingival hyperplasia (buccal side of the lower and upper anterior teeth), n (%)
No clear findings	156 (97.5)	152 (93.8)	.106
Yes	4 (2.5)	10 (6.2)
Dental mirror sticks to buccal mucosa, n (%)^a
No	158 (98.1)	162 (100.0)	.081
Yes	3 (1.9)	0 (0.0)

^aPotential mouth dryness was recorded by evaluating if dental mirror sticks to buccal mucosa. Some registrations are missing.

Significant values are marked in bold.

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Data availability statement

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.