Prevalence and Risk Indicators for Periodontal Attachment Loss in a Population of Older Community‐Dwelling Blacks and Whites

Abstract

The extent and severity of periodontal attachment loss are described for a random sample of 690 dentate community‐dwelling adults, aged 65 or over, residing in five counties in North Carolina. In addition, risk indicators for serious levels of loss of attachment and pocket depth in this population are presented. Pocket depths and recession were measured on all teeth by trained examiners during household visits. Blacks had an average of 78% of their sites with attachment loss and the average level of loss in those sites was approximately 4 mm, as compared to 65% and 3.1 mm for whites. Because the extent and severity scores in this population were much higher than in younger groups, a serious condition in this group was defined as having 4 + sites of loss of attachment of 5 + mm with one or more of those sites having a pocket of 4 + mm. Bivariate analyses identified a large number of explanatory variables that were associated with increased likelihood of having the more serious periodontal condition. The logistic regression model for blacks includes the following important explanatory variables and associated odds ratios: use of tobacco (2.9), colony counts of B. gingivalis greater than 2% (2.4) and B. intermedius greater than 2% (1.9), last visit to the dentist greater than 3 years (2.3), and gums bleeding in the last 2 weeks (3.9). The model for whites indicated that tobacco use (6.2), presence of B. gingivalis (2.4) and the combined variable of having not been to the dentist in the last 3 years and having a high BANA score (16.8) were important explanatory variables. These epidemiological analyses confirm that microorganisms are associated with periodontal disease. However, other factors also are associated with serious periodontal conditions and the relationship between potential predictors of serious conditions may be complex in older adult populations. J Periodontol 1990; 61:521–528.