Abstract
Background Periodontal disease during adolescence is increasingly recognised as a public health concern due to
its high global prevalence and long-term health implications. Despite this, no large-scale studies have assessed its
burden among adolescents in Palestine. This study aimed to estimate the prevalence of periodontal diseases among
9th-grade students in the northern West Bank and examine its association with key behavioural and socioeconomic
factors.
Methods A cross-sectional study was conducted among 3,352 15-year-old students, selected through stratified
proportional random sampling from governmental and private schools. Periodontal health was assessed using the
WHO Community Periodontal Index for Treatment Needs, and oral hygiene status was measured with the Simplified
Oral Hygiene Index. Participants also completed a structured questionnaire that assessed their socioeconomic status,
oral hygiene practices, dietary habits, and smoking habits. Data were analysed using descriptive statistics, bivariate
analysis, and multivariate logistic regression.
Results The prevalence of periodontal diseases was 86.8% among the participating students. Gingival bleeding
affected 44.6% of the sample, and calculus was present in 42.2%. Brushing frequency and oral hygiene status were
identified as the most significant predictors that greatly increased the risk of periodontal disease, with Adjusted Odds
Ratios of 2.05 and 1.6, respectively. Using medium-bristled toothbrushes was a protective factor for the likelihood
of having healthy gums (AOR=1.79). Frequent fish consumption also had a protective association (AOR=2.04).
Conversely, smoking water pipes was negatively associated with periodontal health (AOR=0.63), indicating a higher
risk of disease among users.
Conclusion This study revealed a high prevalence of early periodontal disease among 9th-grade students in
the northern governorates of the West Bank, with only 13.2% exhibiting healthy gingiva. Several modifiable
determinants—such as oral hygiene practices, toothbrush type, dietary habits, and water-pipe smoking—were

Title

BMC Oral Health

Publisher

Springer Nature publishing group

Publisher Country

United Kingdom

Indexing

Scopus

Impact Factor

3.1

Publication Type

Online only

Volume

25

Year

2025

Pages

14