Prevalence of periodontal diseases: Latin America and the Caribbean Consensus 2024

CARVAJAL, Paola; CARRER, Fernanda Campos de Almeida; GALANTE, Mariana Lopes; VERNAL, Rolando; SOLIS, Cristina Barboza

doi:10.1590/1807-3107bor-2024.vol38.0116

Tabla de contenido Anterior Actual Siguiente

Critical Review Of Literature/Periodontics • Braz. oral. res. 38 (suppl 1) • Oct 2024 • https://doi.org/10.1590/1807-3107bor-2024.vol38.0116 linkcopy

Prevalence of periodontal diseases: Latin America and the Caribbean Consensus 2024

Authorship SCIMAGO INSTITUTIONS RANKINGS

The aim of this review was to update knowledge about the prevalence of periodontitis in Latin America and the Caribbean. A critical review of was performed of all cross-sectional or cohort studies selected, pertaining to the region, and thirty-five studies conducted in 12 countries were selected. The countries with nationally representative studies were Brazil, Chile, Colombia, and Uruguay. The prevalence of periodontal disease or need for periodontal treatment varied between the different studies and countries depending on the age group, the methodology used, and the case definition. The prevalence of severe periodontitis aged between 5.8% and 49.7% in adults. In adolescents, the prevalence of moderate to severe periodontitis was 15.3%. Furthermore, a high prevalence of gingival bleeding in adolescents was reported. When analyzing the studies that used the Community Periodontal Index (CPI), Centers for Diseases Control and American Academy Periodontology (CDC/AAP) case definition, it was observed that as the age of the individuals analyzed increased, the prevalence of periodontal disease also increased. Whereas this rereview revealed that although the number of regional and nationally representative studies that analyzed the prevalence of periodontitis has risen in recent years, their methodological heterogeneity prevents global conclusions to be drawn concerning the region. Therefore, this ratifies the need to generate alliances between countries with the purpose of joining individual efforts to achieve collective goals which, among other objectives, will translate into conducting multicenter studies. These studies would allow description and monitoring of the epidemiological behavior of periodontitis in Latin America and the Caribbean.

Prevalence; Periodontitis; Gingivitis; Latin America; Caribbean Region; Adults; Adolescent

Authors, year	Country, City	DOI or link	Exclusion criteria
Alonge; Narendran (1999)	St. Vincent and The Grenadines	https://pubmed.ncbi.nlm.nih.gov/11372121/	8
Andrade; Rapp (2002)	District of Barra / Rio Vermelho, Brazil	https://pubmed.ncbi.nlm.nih.gov/12670092/	5
Bonanato et al. (2010)	Belo Horizonte, Minas Gerais, Brazil	https://pubmed.ncbi.nlm.nih.gov/20589245/	2
Carvajal et al. (2016)	South America	doi: 10.1590/1678-775720160178.	2
Castrejón-Pérez et al. (2017)	Mexico	doi: 10.1093/gerona/glw201	3
Chiapinotto et al. (2012)	Brazil, Pelotas	doi: 10.1111/jphd.12001	5
Collins et al. (2019)	Caribbean. Jamaica, Dominican Republic, and Puerto Rico.	doi: 10.1186/s12903-019-0931-1	4
Cortelli et al. (2008)	Brazil	doi: https://doi.org/10.14295/bds.2008.v11i2.448.	3
Cyrino et al. (2011)	Belo Horizonte, Brazil	doi: 10.1902/jop.2011.110015.	3
Duque (2016)	Latin America	http://dx.doi.org/10.1016/j.piro.2016.07.005.	1
Elías-Boneta et al. (2017)	San Juan, Puerto Rico	https://pubmed.ncbi.nlm.nih.gov/28915302/	3
Elías-Boneta et al. (2018)	Caribbean. Jamaica, Dominican Republic, and Puerto Rico.	https://pubmed.ncbi.nlm.nih.gov/29905923/	2
Feldens et al. (2006)	Canoas, Brazil	https://pubmed.ncbi.nlm.nih.gov/16734306/	5
Giacaman et al. (2015)	Maule, Chile	https://pubmed.ncbi.nlm.nih.gov/26108477/	4
Giacaman et al. (2018)	Maule, Chile	doi: 10.22605/RRH4312.	6
Gianopoulos et al. (2014)	Santa Ana, Nicaragua	doi: 10.1111/idh.12043	3
Haas et al. (2015)	Brazil	doi: 10.1590/1980-5497201500020018	4
Haas et al. (2019)	Brazil, Porto Alegre	doi.org/10.1590/1807-3107bor-2019.vol33.0036	2
Ismail; Szpunar (1990)	Mexican Americans, Cuban Americans, and Puerto Ricans	doi: 10.2105/ajph.80.suppl.66.	7
Lock et al. (2020)	Brazil, Porto Alegre	doi: 10.1111/jre.12743	2
Lopez et al. (2002)	Santiago, Chile	doi: 10.1034/j.1600-0765.2002.01377.x.	2
Lorenzo-Erro (2022)	Uruguay	doi: 10.54589/aol.35/3/178.	2
Lorenzo-Erro (2018)	Uruguay	doi: 10.1590/1807-3107bor-2018.vol32.0062.	7
Maltz et al. (2001)	Porto Alegre, Brazil	doi: 10.1007/s007840100122.	4
Medeiros et al. (2022)	Brazil	doi: 10.1002/JPER.21-0433.	4
Medina-Solís et al. (2014)	Mexico	doi: 10.3390/ijerph110303169	4
Moreira et al. 2009	Southeastern Sao Paulo State, Brazil	doi: 10.1590/s1678-77572009000300008.	4
Moreno de Calafell; Esper (2003)	Argentina	https://pesquisa.bvsalud.org/portal/resource/pt/lil-349312	8
Mota et al. (2014)	Minas Gerais, Brazil	doi: 10.1590/1413-81232014197.09312013.	4
Nobre et al. (2016)	Brazil	doi: 10.1007/s40368-016-0248-6.	3
Peres et al. (2012)	Pelotas, Brazil	doi: 10.1902/jop.2011.110250.	4
Rapp et al. (2001)	Bahia, Brazil	https://pubmed.ncbi.nlm.nih.gov/12666945/	3
Nascimento A, et al. (2022)	Brazil	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9568304/	4
Rebelo et al. (2009)	Manaus, AM, Brazil	doi: 10.1590/s1806-83242009000300005.	2
Rojo Botello et al. (2011)	Mexico	https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1870-199X2011000100006	3
Sabogal et al. (2019)	Peru	doi: 10.1155/2019/2357013	3
Santosh et al. (2020)	Caribbean. Jamaica, Dominican Republic, and Puerto Rico.	doi: 10.1177/0272684X19895901.	4
Segundo et al. (2004)	Contagem, Minas Gerais, Brazil	doi: 10.1590/s0102-311x2004000200029.	3
Silva; Maltz (2001)	Porto Alegre, Brazil	https://pubmed.ncbi.nlm.nih.gov/11705268/	4
Silva-Boghossian et al. (2011)	Brazil	https://pubmed.ncbi.nlm.nih.gov/22068186/	3
Souza; Taba Jr. (2004)	Brazil	doi: 10.1590/s0103-64402004000100009.	3
Strauss et al. (2009)	Chile	doi.org/10.1186/s12903-019-0975-2	6
Susin; Albandar (2005)	Brazil, Porto Alegre	doi: 10.1902/jop.2005.76.3.468	2
Teixeira et al. (2019)	Sao Paulo, Brazil	https://doi.org/10.6084/m9.figshare.11314157.v1	3
Teixeira et al. (20200	Sao Paulo, Brazil	doi: 10.1590/1807-3107bor-2020.vol34.0058	3
Tinoco EM et al. (1997)	Brazil	doi: 10.1111/j.1600-0722.1997.tb00174.x.	2

Authors (year)	Country, City	Inclusion criteria	Exclusion criteria	Type of studied	Sample size (n)	Periodontal examination protocol	Age interval (years)	Periodontal criteria	Prevalence (CI) (%)	Prevalence by sex (%) female/male
Gamonal et al. (1998)¹³	Chile, Santiago	Adults, 35–44 and 65–74 year-old	NR	Cross sectional, randomly	868 adults and 217 adult seniors	Ten index teeth, CPITN index, WHO probe	35–44 65–74	CPITN = 3 CPITN = 4 CPITN = 3 CPITN = 4	50.2 40.6 28.5 71.4	NR
Susin et al. (2004)¹⁴	Brazil, Porto Alegre	Adults, 30 years and older	Edentolous and participant diagnosed with psychiatric problems or intoxicated with alcohol or drugs	Cross sectional, randomly	853	Six sites per tooth in full- mouth, PCP10-SE periodontal probe	30–103	Cases were defined as individuals with ≥ 30% teeth with CAL ≥ 5 mm	49.7	40.5/54.9
Susin et al. (2005)¹⁵	Brazil, Porto Alegre	Adults, 30 years and older	Edentolous, individuals diagnosed with serious psychiatric problems, or were intoxicated with alcohol or drugs	Cross sectional, randomly	853	Six sites per tooth in full- mouth, PCP10-SE periodontal probe	30–103	At least one tooth with PD:
Susin et al. (2005)¹⁵	Brazil, Porto Alegre	Adults, 30 years and older		Cross sectional, randomly	853		30–103	PD ≥ 4 mm PD ≥ 5 mm PD ≥ 6 mm PD ≥ 7 mm	79.6 65.2 35.3 25.4	72.2/87.8 55.6/75.9 27.6/43.8 20.3/31.0
Lorenzo et al. (2005)¹⁶	Uruguay	Adults and elderly	Edentolous	NRS. Cross sectional, First National Survey of Oral Health 2010-2011	adults = 358 and elderly 411	Six index teeth, CPI index, WHO probe	35–44 and 65–74	Periodontal disease was defined as:
								Moderate to severe when CPI > 2 and CAL ≥ 4 mm	21.8	12.9/30.1
								Severe when CPI > 2 and CAL ≥ 6	9.1	6.5/1.7
Borges-Yáñez et al. (2006)¹⁷	México, three different populations in Central Mexico	Adults, 60 years and older of urban areas of middle and low income level, and a rural area	Edentolous	Cross sectional, randomly	365	Two sites per tooth in partial-mouth, Michigan periodontal probe	60 and older	At least two sites with CAL 4 mm or more	50.7	NR
Romanelli et al. (2007)¹⁸	Argentina	Adults, 18–84 years of age, who spontaneously attended general dental services, with at least two teeth in any sextant	Patients with risk of endocarditis, diabetes or i mmunologic disease, and patients receiving corticoids or i mmunosuppressor drugs	Cross sectional	3,694	Six sites per tooth in full- mouth, CPI index, WHO periodontal controlled pressure probe, Sensor Probe Type C	18–84	CPI = 1 CPI = 2 CPI = 3 CPI = 4	17.2 38.8 26.4 14.3	NR
Corraini et al. (2008)⁴⁴	Brazil, microarea Cajaíba	Adolescents and adults, ≥ 12 year-old	Edentolous	Cross sectional, census	194	Six sites per tooth in full- mouth, PCP-UNC-15, periodontal probe	12–82	At least one site with CAL or PD by age:		NR
Corraini et al. (2008)⁴⁴	Brazil, microarea Cajaíba	Adolescents and adults, ≥ 12 year-old	Edentolous	Cross sectional, census	194		12–82	20-29 CAL ≥ 5 mm CAL ≥ 7 mm PD ≥ 5 mm PD ≥ 7 mm 30–39 CAL ≥ 5 mm CAL ≥ 7 mm PD ≥ 5 mm PD ≥ 7 mm 40–49 CAL ≥ 5 mm CAL ≥ 7 mm PD ≥ 5 mm PD ≥ 7 mm ≥ 50 CAL ≥ 5 mm CAL ≥ 7 mm PD ≥ 5 mm PD ≥ 7 mm	37.1 8.1 30.1 4.8 70.0 20.0 37.5 10.0 83.3 66.7 70.8 29.2 100 83.3 60.0 20.0	NR
								At least one site with CAL:
Gamonal et al. (2010)¹⁹	Chile	Adults, urban, aged 35 to 44 year-old and adult seniors aged 65–74 year-old	Edentolous	Cross sectional, randomly	1,092 adults and 469 adult seniors	Six sites per tooth in full- mouth, PCP-UNC-15, periodontal probe	35–44	CAL > 3 mm CAL > 4 mm CAL > 5 mm CAL > 6 mm	93.4 77.5 58.3 38.6	92.3/94.9, 72.6/836 41.6/66.5, 32.3/46.4
								At least one site with CAL.
							65–74	CAL > 3 mm CAL > 4 mm CAL > 5 mm CAL > 6 mm	97.5 92.7 81.4 69.3	97.3/98.0, 90.9/95.4 76.7/88.2, 62.6/79.1
Frias et al. (2011)²⁰	Brazil, Guarulhos	Adults, 35–44 year-old	NR	Cross sectional, randomly	263		35–44	CPI = 0 CPI = 1 CPI = 2 CPI = 3 CPI = 4	10.6 (7.3–14.8) 9.1 (6.1–13.1) 53.6 (47.6–59.9) 22.4 (17.7–27.8) 4.2 (2.2–7.2)	NR
								At least one site with CAL:
Susin et al. (2011)⁴⁵	Brazil, Porto Alegre	Adolescents and young adults, 14–29 year-old	Subjects with serious neurologic or psychiatric conditions were excluded and Aggressive periodontitis cases	Secondary study from a larger sample representative of the population of Porto Alegre	584 (174, 20-24 year-old and 154, 25-29 year-old)	Six sites per tooth in full- mouth, PCP10-SE periodontal probe	20–24	CAL ≥ 3 mm CAL ≥ 4 mm CAL ≥ 5 mm CAL ≥ 6 mm	53.4 (43.0–63.8) 35.4 (24.2–46.6) 17.2 (9.5–25.0) 9.5 (3.3–15.8)	NR
Susin et al. (2011)⁴⁵	Brazil, Porto Alegre	Adolescents and young adults, 14–29 year-old			584 (174, 20-24 year-old and 154, 25-29 year-old)		20–24	Chronic periodontitis was defined as CAL ≥3 mm affecting two or more teeth.	43.5 (32.0–55.0)	NR
								At least one site with CAL:
							25–29	CAL ≥ 3 mm CAL ≥ 4 mm CAL ≥ 5 mm CAL ≥ 6 mm	79.4 (69.5–89.3) 56.4 (44.1–68.7) 29.0 (24.3–33.6) 13.8 (6.6–20.9)	NR
							25–29	Chronic periodontitis was defined as CAL ≥3 mm affecting two or more teeth.	72.0 (57.4–86.6)	NR
								At least one site with CAL or PD:
Gaio et al. (2012)²¹	Brazil, Porto Alegre	Elderly, 60 years and older	Presence of conditions that may pose health risks, or that may interfere with the clinical examination	Cross sectional, randomly, subsample	217	Six sites per tooth in full- mouth, PCP10-SE periodontal probe	≥ 60	CAL ≥ 4 mm CAL ≥ 5 mm CAL ≥ 6 mm CAL ≥ 7 mm PD ≥ 4 mm PD ≥ 5 mm PD ≥ 6 mm PD ≥ 7 mm	100 94.1 84.4 73.9 74.5 62.6 31.8 22.2	NR
Bonfim et al. (2013)²²	Brazil, Southern region	Adults in urban area, 35–44 year-old	Edentulism, refusal to participate, being bedridden, inability to answer the questions	Secondary study from a larger sample representative of the population	743	CPI index, WHO probe	35–44	CPI = 0 CPI = 1 CPI = 2 CPI = 3 CPI = 4	36.5 2.0 47.1 9.5 2.1	NR
Vettore et al. (2013)²³	Brazil	Adults, 35–44 year-old	Without complete data	NRS. Secondary study from Brazilian Oral Health Survey 2010	4,594	Six ndex teeth, CPI index and CAL, WHO probe	35–44	Moderate-to-severe (CPI > 2 and CAL ≥ 4 mm)	15.3	13.5/14.9
Vettore et al. (2013)²³	Brazil	Adults, 35–44 year-old	Without complete data	NRS. Secondary study from Brazilian Oral Health Survey 2010	4,594	Six ndex teeth, CPI index and CAL, WHO probe	35–44	Severe periodontal disease (CPI > 2 and CAL ≥ 6 mm)	5.8	3.6/5.7
Giacaman et al. (2016)⁴⁶	Chile, Maule region	Population from Maule region urban and rural, 15, 35–44 and 65–74 year-old	NR	Cross sectional, randomly	2,414	Six index teeth, CPI index, WHO probe	35–44 and 65–74	CPI = 1 CPI = 2 CPI = 3 CPI = 4 CPI = 1 CPI = 2 CPI = 3 CPI = 4	2.9 77.2 17.2 2.5 1.5 65.8 25.0 3.8	2.9/3.1, 77.3/76.6 16.9/18.8, 2.6/1.6 2.1/0.0, 68.7/56.9 23.6/29.2, 3.1/6.2
Schuch et al. (2018)²⁴	Brazil, Pelotas	Adults, 31 year-old	NR	Secondary study from the 1982 Pelotas Birth Cohort Study	539	Six sites per tooth in full- mouth, PCP2 periodontal probe with 2- mm banding	31	CDC-AAP (2012) case definition periodontitis
								Any periodontitis	37.3	31.6/42.9
								Moderate-to-severe	14.3	10.1/18.3
Serrano Suarez (2019)²⁵	Colombia	Adults, 18 years and older	Presence of uncontrolled diseases, severe physical or mental disability, and health conditions that would require antibiotic. Edentolous, >79 year-old	NRS. Cross sectional, randomly	9,255	Six sites per tooth in full- mouth, PCP-UNC-15, periodontal probe	18–79	CDC-AAP (2012) case definition periodontitis
								Mild	7.3	7.8/6.2
								Moderate	43.6	42.0/45.3
								Severe	10.6	7.5/13.9
Arantes et al. (2021)²⁶	Brazil, Central-West	Adults, 35–44 year-old non-Indigenous	NR	NRS. Secondary study from Brazilian Oral Health Survey 2010	1,83	Six ndex teeth, CPI index and CAL, WHO probe	35–44	CPI = 2 CPI = 3 + CPI = 4	43.9 (37.4-50.7) 30.5 (28.2-32.9)	NR
Hugo et al. (2022)²⁷	Brazil	NR	NR	Secondary study from Global Burden Disease 2019	NR	NR	NR	CPITN = 4 or CAL > 6 mm or PD > 5 mm	11.9 (8.6-15.4)	NR
Morales et al. (2022)⁴⁷	Chile	Adults, urban, aged 35–44 and 65–74 year-old	Edentolous	NRS. Secondary study from First Chilean National Examination Survey 2007-2008	1,456 adults	Six sites per tooth in full- mouth, PCP-UNC-15, periodontal probe	35–44 and 65–74	CDC-AAP (2012) case definition		NR
								Mild	1.4
								Moderate	57.2
								Severe	29.7
								AAP/EPP (2018) stage of periodontitis
								Stage I	0.1
								Stage II	4.7
								Stage III	12.8
								Stage IV	81.3
Filgueiras et al. (2023)²⁸	Brazil	Adults users of public services, 35–44 year-old	Edentolous and insufficient dental sextants for CAL examination	NRS. Secondary study from Brazilian Oral Health Survey 2010	3,426	Six ndex teeth, CPI index and CAL, WHO probe	35–44	At least two sites with CAL > 3 mm, and at least one site with PD > 3 mm, not necessarily at the same site	14.5	NR
León et al. (2023)²⁹	Chile	Elderly, 65 years and older	NR	Secondary study from Global Burden Disease 2019	NR	NR	65–69 70–74 75–79 80–84 85–89 90–94 > 94	CPI = 4 (probing score > 5.5 mm)	29.1 (22.0–37-5) 26.8 (20.2-34.9) 25.4 (19.2–32.1) 24.4 (18.1–30.7) 23.8 (16.9–30.3) 23.2 (15.9–30.0) 22.7 (14.7–30.8)	NR

Authors (year)	Country, City	Inclusion criteria	Exclusion criteria	Type of studied	Sample size (n)	Periodontal examination protocol	Age interval (years)	Periodontal criteria	Prevalence (CI) (%)	Prevalence by sex (%) female/male
Leake et al. (1990)³⁰	Dominica	Children, 12 year-old, attending scholl	NR	Cross sectional, randomly	332	Six index teeth, CPITN index, WHO probe	12	CPITN = 0 CPITN = 1 + CPITN = 2	17	NR
Leake et al. (1990)³⁰	Dominica	Children, 12 year-old, attending scholl	NR	Cross sectional, randomly	332	Six index teeth, CPITN index, WHO probe	12	CPITN = 0 CPITN = 1 + CPITN = 2	62	NR
Vignarajah (1994)³¹	Caribbean Island Antigua y Barbuda	Children and adolescents, attending urban and rural schools, 12, 15–19 year-old	NR	Cross sectional, randomly	246, and 456	Six index teeth, CPITN index, WHO probe	12	CPITN = 0 CPITN = 1 CPITN = 2	26.0 28.0 43.0	NR
Vignarajah (1994)³¹	Caribbean Island Antigua y Barbuda		NR	Cross sectional, randomly	246, and 456	Six index teeth, CPITN index, WHO probe	15–19	CPITN = 0 CPITN = 1 CPITN = 2 CPITN = 3 CPITN = 4	14.0 13.0 56.0 14.0 3.0	NR
Lopez et al. (1996)³²	Chile, Santiago	Adolescents, 15–19 year-old attending high school		Cross sectional, randomly	2,4	Six index teeth, CPITN index, WHO probe	15–19	CPITN = 0 CPITN = 1 CPITN = 2 CPITN = 3 CPITN = 4	5.4 14.8 62.2 9.5 0.9	NR
Lopez et al. (2001)³³	Chile, Province Santiago	Adolescents, 12–21 year-old attending high school	Not be examined due to constraints such a trismus	Cross sectional, randomly	9,162	Six sites of first and second molars and incisors	12–14	At least one site with CAL ≥ 3 mm	2.5	2.2/2.9
							15–17		3.7	4.7/2.8
							18–21		6.8	5.2/7.9
Collins et al. (2005)³⁴	Dominican Republic, Santo Domingo	Adolescents, 12–21 year-old attending high school	No CAL detected	Cross sectional, randomly	1,963	Six sites of first and second molars and incisors	12–21	At least one site with
Collins et al. (2005)³⁴	Dominican Republic, Santo Domingo	Adolescents, 12–21 year-old attending high school	No CAL detected	Cross sectional, randomly	1,963	Six sites of first and second molars and incisors	12–21	CAL ≥ 1 mm CAL ≥ 2 mm CAL ≥ 3 mm	49.5 15.0 4.0	49.3/49.6 15.1/14.9 4.2/3.7
Corraini et al. (2008)⁴⁴	Brazil, microarea Cajaíba	Adolescents and adults, ≥ 12 year-old	Edentolous	Cross sectional, census	194	Six sites per tooth in full- mouth, PCP-UNC-15, periodontal probe	12–82	At least one site with CAL or PD by age: 12-19		NR
Corraini et al. (2008)⁴⁴	Brazil, microarea Cajaíba	Adolescents and adults, ≥ 12 year-old	Edentolous	Cross sectional, census	194		12–82	CAL ≥ 5 mm CAL ≥ 7 mm PD ≥5 mm PD ≥7 mm	7.7 5.1 5.1 5.1	NR
Antunes et al. (2008)³⁵	Brazil, Sao Paulo	Adolescents, 15–19 year-old	Asian and Amerindian categories	Cross sectional, randomly	1,799	Six index teeth, CPI index, WHO probe	15–19	CPI = 0 CPI = 1 CPI = 2	65,7 (63.5-67.9) 21.6 (19.7-23.6) 19.4 (17.6-21.3)	NR 19.5/24.5 17.4/22.1
Susin et al. (2011)⁴⁵	Brazil, Porto Alegre	Adolescents and young adults, 14–29 year-old	Subjects with serious neurologic or psychiatric conditions were excluded and Aggressive periodontitis cases	Secondary study from a larger sample representative of the population of Porto Alegre	584	Six sites per tooth in full- mouth, PCP10-SE periodontal probe	14–19	At least one site with CAL:
					(256 14–19 year-old)			CAL ≥ 3 mm CAL ≥ 4 mm CAL ≥ 5 mm CAL ≥ 6 mm	22.3 (12.2–32.5) 7.4 (2.0–12.8) 2.5 (0.4–4.6) 18.2 (7.9–28.4)	NR NR NR NR
					(256 14–19 year-old)			Chronic periodontitis was defined as CAL ≥ 3 mm affecting two or more teeth.		NR
Wauters et al. (2014)³⁶	Chile, Castro	Children aged 12 year-old attending urban, public and private-subsidized schools	Students with fixed orthodontics appliances and/or a pathology, such as Down syndrome, trismus and epilepsy	Cross sectional, randomly	242	Six index teeth, CPITN index, WHO probe	12	CPITN = 0 CPITN = 1 CPITN = 2 CPITN = 3	0.0 42.2 44.2 13.6	0.0/0.0 45.0/38.9 42.6/46.0 12.4/15.0
Leão et al. (2015)³⁷	Brazil, Caiuá, São Paulo	Adolescents, 10–19 year-old, rural school	Refused study participation	Cross sectional, census	180	Six index teeth, CPI index, WHO probe	10–19	CPI = 1 CPI = 2 CPI = 3	77.7 20.8 1.5	NR
Leão et al. (2015)³⁷	State	Adolescents, 10–19 year-old, rural school	Refused study participation	Cross sectional, census	180	Six index teeth, CPI index, WHO probe	10–19	CPI = 1 CPI = 2 CPI = 3	77.7 20.8 1.5	NR
Fonseca (2015)³⁸	Brazil, Vale do Jequitinhonha	Adolescents, 15–19 year-old	Individuals with difficulties cognitive or mentalis	Cross sectional, randomly	450	CPI index with some modifications	15–19	CPI = 0 CPI = 1 CPI = 2	3.5 51.5 8.4	3.3/3.8 57.8/44.2 6.6/10.5
Morales et al. (2015)³⁹	Latin America, Capital cities from countries in South America, Argentina, Chile, Colombia, Ecuador and Uruguay	Adolescents, 15–19 year-old attending public and private high school	Subjects undergoing fixed orthodontic treatments or with any condition that required antibiotic prior to the periodontal examination	Cross sectional, randomly, multicenter	1,07	Six sites per tooth in full- mouth, PCP-UNC-15, periodontal probe	15–19	At least one site with CAL or PD:
Morales et al. (2015)³⁹				Cross sectional, randomly, multicenter	1,07		15–19	CAL ≥ 3 mm PD ≥ 4 mm BoP ≥ 25%	32.6 59.3 28.6	35.8/29.1 58.9/59.6 34.1/22.7
Tomazoni et al. (2016)⁴⁰	Brazil, Santa Maria	Children aged 12 year-old attending public schools	NR	Cross sectional, randomly	1,134	Six index teeth, CPI index, WHO probe	12	Gingivitis was considered if:		NR
								At least one surface showed CPI = 1	96.2 (95.1–97.3)
								Using a cut-off point of > 15% bleeding	26.2 (23.7–28.8)
Giacaman et al. (2016)⁴⁶	Chile, Maule region	Population from Maule region urban and rural, 15, 35–44 and 65–74 year-old	NR	Cross sectional, randomly	2,414	Six index teeth, CPI index, WHO probe	15	CPI = 1 CPI = 2 CPI = 3 CPI = 4	8.7 74.4 16.3 0.0	11.0/6.8 71.1/77.0 17.0/15.8 0.0/0.0
Elias-Boneta et al. (2018)⁴¹	Puerto Rico	Children, 12 year-old, attending public and private schools, physical status ASA I and ASA II	Participants with conditions requiring antibiotic prophylaxis	Cross sectional, randomly	1,586	Gentle probing into gingival sulcus of the buccal surface, PCP UNC 126 periodontal probe	12	At least one site presented gingival bleeding.	80.4	79.5/81.2
								Gingivitis limited: 2–4 teeth or 25%–49% of the teeth examined presented gingival bleeding	19.5	18.7/20.4
								Extensive gingivitis: > 5 teeth or > 50% of the teeth examined presented gingival bleeding	60.8	60.8/60.8
Knack et al. (2019)⁴²	Brazil	Adolescents, 12, 15–19 year-old	NR	NRS. Secondary study from Brazilian Oral Health Survey 2010	12,773 (7,328 12-year-old and 5,445 15–19)	Six ndex teeth, CPI index and CAL, WHO probe	12, 15–19	CPI = 1 CPI = 2 CPI = 3 CPI = 4	32.0 33.1 4.5 0.3	31.8/32.2 31.6/34.6 NR NR
Michel-Crosato et al. (2019)⁴³	Ecuador, Quito	Children aged 12 year-old attending public and urban schools	NR	Cross sectional, randomly	1,1	Six index teeth, CPIT index, WHO probe	12	CPITN = 1	92.0	NR
Morales et al. (2022)⁴⁷	Capital cities from countries in South America, Argentina, Chile, Colombia, Ecuador and Uruguay	Adolescents from South America, attending schools, 15–19 year-old	Edentolous	Secondary study from a sample of adolescents from different countries in South America 2010-2012	1,07	Six sites per tooth in full- mouth, PCP-UNC-15, periodontal probe	15–19	CDC-AAP (2012) case definition
								Mild Moderate Severe	11.4 15.3 0.5	NR
								AAP/EPP (2018) stage of periodontitis
								Stage I Stage II Stage III Stage IV	39.3 28.2 7.6 0.5	NR

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[TFN1] The studies described in Table 1 are not included in the “references” section. These studies were excluded in the selection process. This table was kept in the manuscript to ensure transparency for the reader.

[TFN2] Reasons for exclusion: 1 - Reviews; 2 - Unclear or unsuitable case definition; 3 - Convenience sample; 4 - Lack prevalence data; 5 - Children population < 12-year-old; 6 - Same data from other study; 7 - Unrelated; 8 - Full text not accessed.