Self-assessment and clinical evaluation of gingival health among polish adolescents: a cross-sectional study.

AIM: To evaluate how accurately adolescents assess their gingival health compared with clinical findings, and to examine demographic associations. MATERIALS AND METHODS: A cross-sectional study included 4,213 Polish adolescents aged 12, 15, and 18 years within a school-based monitoring program. A self-administered questionnaire covered perceived gingival condition, oral-hygiene habits, and treatment needs. Standardized WHO-based clinical exams recorded gingival bleeding, calculus, periodontal pockets, and clinical attachment loss. Associations between self-reports and clinical findings were tested with chi-square and Spearman correlations. RESULTS: Gingival bleeding increased with age (20.1% at 12 years, 25.1% at 15 years, 30.9% at 18 years; p < 0.05). Boys consistently showed higher bleeding prevalence than girls, notably at 18 years (34.8% vs. 27.3%). Calculus was common in late adolescence (36.9% at 18 years). Periodontal pockets ≥ 4 mm and attachment loss were rare (< 1.5%). Most adolescents rated their gingival health as “good/very good,” with boys more often choosing “average.” Self-reported need for better brushing correlated with clinical bleeding (ρ up to 0.45), and reported bleeding gums correlated with calculus (ρ up to 0.39). However, many with clinical signs did not perceive problems, indicating limited sensitivity of self-assessment. CONCLUSION: Adolescents’ self-assessment of gingival health showed only partial agreement with clinical findings, suggesting that self-assessment may miss a proportion of clinically detectable signs. Self-assessment may support population-level monitoring and targeted prevention, but it should not replace clinical examination; observed demographic differences suggest the need for tailored educational strategies.