Assessment of Risk for Periodontal Disease. I. Risk Indicators for Attachment Loss

TLDR

The study sample displayed a wide range of periodontal disease experience, characterized by varying levels of attachment loss. The authors aimed to assess associations between periodontal attachment loss and patient characteristics such as age, smoking, systemic diseases, occupational exposures, and subgingival microbial flora, and to determine whether these indicators are true risk factors. They evaluated specific risk indicators in a cross‑sectional sample of 1,426 adults aged 25–74 from Erie County, New York, and surrounding areas. Age, smoking, diabetes mellitus, and the presence of Porphyromonas gingivalis and Bacteroides forsythus were identified as significant risk indicators for attachment loss, with odds ratios ranging from 1.72 to 9.01 for age, 2.05 to 4.75 for smoking, 2.32 for diabetes, and 1.59 to 2.45 for the bacteria,.

Abstract

S pecific risk indicators associated with either susceptibility or resistance to severe forms of periodontal disease were evaluated in a cross‐section of 1,426 subjects, 25 to 74 years of age, mostly metropolitan dwellers, residing in Erie County, New York, and surrounding areas. The study sample exhibited a wide range of periodontal disease experience defined by different levels of attachment loss. Therefore, it was possible to accurately assess associations between the extent of periodontal disease and patient characteristics including age, smoking, systemic diseases, exposure to occupational hazards, and subgingival microbial flora. Age was the factor most strongly associated with attachment loss, with odds ratios for subjects 35 to 44 years old ranging from 1.72 (95% CI: 1.18 to 2.49) to 9.01 (5.86 to 13.89) for subjects 65 to 74 years old. Diabetes mellitus was the only systemic disease positively associated with attachment loss with an odds ratio of 2.32 (95% CI: 1.17–4.60). Smoking had relative risks ranging from 2.05 (95% CI: 1.47–2.87) for light smokers increasing to 4.75 (95% CI: 3.28–6.91) for heavy smokers. The presence of two bacteria, Porphyromonas gingivalis and Bacteroides forsythus , in the subgingival flora represented risks of 1.59 (95% CI: 1.11–2.25) and 2.45 (95% CI: 1.87–3.24), respectively. Our results show that age, smoking, diabetes mellitus, and the presence of subgingival P. gingivalis and B. forsythus are risk indicators for attachment loss. These associations remain valid after controlling for gender, socioeconomic status, income, education, and oral hygiene status expressed in terms of supragingival plaque accumulation and subgingival calculus. Longitudinal, intervention, and etiology‐focused studies will establish whether these indicators are true risk factors. J Periodontol 1994;65:260–267 .