Objectives: The purpose of the present study was to examine longitudinal changes in the gingival health conditions of children. Methods: A total of 257 children, ranging in age from 7 to 12 years old and parents of Hiroshima University Hospital, were studied over a period of 2 years, after receiving informed consent from both the subjects and their parents. Examinations were performed using an artificial light, with the child seated in a chair, and an oral rating index for children (ORI-C) employed for the assessment of gingival health, which was determined according to an ordinal scale from -2 (very poor) to +2 (excellent) and recorded. Oral hygiene instruction and professional tooth cleaning were given to the subjects by dental hygienists at every visit throughout the study. Results: The very healthy group (baseline and final ORI-C scores of +1 or +2) was composed of 2.7% of the subjects, while the healthy group (BS -2, -1 or FS +1 or +2) was 8.2%, the unhealthy group (BS +1, +2, or 0, FS -1 or -2) was 3.1%, and the very unhealthy group (BS and FS of -2 or -1) was 20.2%. The majority of subjects (65.8%) were in the middle group (BS and FS between -2 and +1). In the healthy group, the mean age was 10.5 years old and the mean number of visits to the dental clinic required for a change toward a better condition (ORI-C of +1 or +2) was 6.2. In the unhealthy group, the mean age was 10.3 years old and the mean number of visits was 6.4. Conclusions: The present results suggest that children aged 10 years and over should take care for their gingival health and that oral hygiene instruction should be given to all children to motivate the desire for self-care.

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