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'''Epidemiology of periodontal disease''' is the study of patterns, causes, and effects of periodontal diseases. Periodontal disease is a disease affecting the tissue surrounding the teeth. This causes the gums and the teeth to separate making spaces that become infected. The immune system tries to fight the toxins breaking down the bone and tissue connecting to the teeth to the gums. The teeth will have to be removed. This is an advance stage of gum disease that has multiple definitions. Adult periodontitis affects less than 10 to 15% of the population in industrialized countries, mainly adults around the ages of 50 to 60. The disease is now declining world-wide.
[[American Academy of Periodontology]]▼
==Prevalence of periodontal diseases in adults==
Many studies look at the prevalence of “advanced [[periodontitis]]”, but have differing definitions of this term. Generally though, severe forms of periodontitis do not seem to affect more than 15% of the population of [[Industrialization|industrialized]] countries. The proportion of such subjects increases with age and seems to peak between 50 and 60 years. A later decline in prevalence may be due to [[tooth loss]].
There are a number of methodological concerns with prevalence studies, particularly 1) the ability of partial recording to reflect full-mouth conditions and 2) the use of the Community periodontal index of treatment needs (CPITN) recording system.
The performance of a partial recording system is affected by the actual [[prevalence]] of periodontal disease in the population in question. The less frequent the disease, the more difficult it becomes for a partial recording system to detect it and thus may lead to greater underestimation of the disease prevalence. A full-mouth examination remains the best method of accurately assessing the prevalence and severity of [[periodontal disease]] in a population.
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The use of the CPITN system for [[Epidemiology|epidemiological]] purposes has flaws, which are grounded in a number of historical truths. At the time the system was designed, the initiation of periodontal disease was thought to develop from a continuum from an inflammation-free state to [[gingivitis]], to [[Calculus (dental)|calculus deposition]] and pocket formation and then to progressive disease. Treatment concepts were based on the concept of pocket depths being the most critical criterion for surgical versus non-surgical treatments. This index was also designed to screen large populations to determine treatment needs and formulate preventive strategies, not to describe the prevalence and severity of periodontal diseases.
Albandar (1999) reported on data from the Third [[National Health and Nutrition Examination Survey]] (NHANES III).
Hugoson (1998) examined three random samples of 600, 597 and 584 subjects in 1973, 1983 and 1993 respectively. These subjects were aged 20–70 years. The severity of disease was divided into five groups, with group 5 having the most severe disease. There was an apparent increase from 1% to 2% to 3% over the three study periods, which may have been due to an increase of [[Tooth (human)|dentate]] subjects in the older age groups.
Susin 2004 examined a representative sample of 853 dentate individuals in [[Brazil]] who were selected by a multistage probability sampling method. They had a full-mouth clinical examination of six sites per tooth and answered a structured written questionnaire. Seventy-nine percent (79%) and 52% of the subjects and 36% and 16% of the teeth per subject had CAL >5 and >7mm, respectively.{{
Oliver 1998{{
Bourgeois 2007 found that the prevalence of deep pockets (> 5mm) is low (10.21%) in a cross-sectional study.{{
Baelum 1996 recalculated their previous data from [[Kenya]]n and [[China|Chinese]] populations to conform to the methods of examination and data presentation utilized in six other surveys. They did not find that the data supported the traditional [[generalization]] that prevalence and severity of periodontitis is markedly increased in African and Asian populations.{{
Like measurements of prevalence of periodontitis, the measurement of incidence will vary depending upon the case definition of the disease. Often “incidence” refers to new sites that meet the definition of periodontitis, even if they occur within a person that already has other diseased sites.{{
Beck 1997 found that past disease predicted subsequent CAL, although not usually at the same site. Also, persons with greater [[attachment loss]] at baseline were more likely to lose teeth over the next 5 years.{{
▲Like measurements of prevalence of periodontitis, the measurement of incidence will vary depending upon the case definition of the disease. Often “incidence” refers to new sites that meet the definition of periodontitis, even if they occur within a person that already has other diseased sites.{{fact}}
Beck 1997 – looked at [[incidence density]] such that the [[numerator]] was attachment loss greater or equal to 3mm while the [[denominator]] was the time at risk for each site. The incident density for all subjects was 0.0017 per site per month. In other words, if 1000 sites were followed for one month, 1.7 sites would lose 3mm or greater attachment. In one year, 20.6 sites would be expected to show this degree of loss.{{
▲Beck 1997 found that past disease predicted subsequent CAL, although not usually at the same site. Also, persons with greater [[attachment loss]] at baseline were more likely to lose teeth over the next 5 years.{{fact}}
- blacks has twice the incidence density of whites; males > females.{{
Gilbert 2005 describes a prospective study of persons in [[Florida]] > 45 years old. In-person interviews and examinations were conducted at baseline and 48 months. The study size was 560 persons and at the 48-month examination, 22% of persons and 1.8% of teeth had attachment loss incidence.{{
▲Beck 1997 – looked at [[incidence density]] such that the [[numerator]] was attachment loss greater or equal to 3mm while the [[denominator]] was the time at risk for each site. The incident density for all subjects was 0.0017 per site per month. In other words, if 1000 sites were followed for one month, 1.7 sites would lose 3mm or greater attachment. In one year, 20.6 sites would be expected to show this degree of loss.{{fact}}
▲- blacks has twice the incidence density of whites; males > females.{{fact}}
==Early onset periodontitis==
▲Gilbert 2005 describes a prospective study of persons in [[Florida]] > 45 years old. In-person interviews and examinations were conducted at baseline and 48 months. The study size was 560 persons and at the 48-month examination, 22% of persons and 1.8% of teeth had attachment loss incidence.{{fact}}
Albandar 2002 examined 690 school attendees aged 12–25 years. They found that 2.3% had generalized EOP and 4.2% had localized EOP. This total of 6.5% contrasted with 1.8% for [[Nigeria]], 3.
Tinoco 1997 examined 7843 children between the ages of 12
Lopez 2001 examined
▲Albandar 2002 examined 690 school attendees aged 12–25 years. They found that 2.3% had generalized EOP and 4.2% had localized EOP. This total of 6.5% contrasted with 1.8% for [[Nigeria]], 3.1-3.7% for Brazil, 6.8% in [[India]] and 8% in [[Sudan]]. The prevalence in [[Caucasian]] populations is in the 0.1% to 0.2% range and may indicate that subjects originating from the sub-Saharan countries of Africa may be at higher risk of developing EOP.{{fact}}
Levin 2006 studied 642 young [[Israel]]i army recruits (562 men and 80 women) – clinical periodontal examination of four first molars and eight incisors and [[radiograph]]s were completed. Aggressive periodontitis was found in 5.9% of the subjects (4.3% localized and 1.6% generalized). This was significantly associated with current [[smoking]] and ethnic origin (North African).{{
▲Tinoco 1997 examined 7843 children between the ages of 12 to 19 in Brazil with strict clinical and radiographic criteria. A 0.3% prevalence of [[localized juvenile periodontitis]] was found, with different subpopulations exhibiting a range between 0.1% to 1.1%. This study found that LJP was highly associated with [[Actinobacillus actinomycetemcomitans]].{{fact}}
Eres 2009 examined
▲Lopez 2001 examined 9162 high school children for clinical attachment loss in 6 sites of first and second [[molar]]s and [[incisor]]s. Overall, CAL >1mm was seen in 69.2% of the students; >2mm in 16% of the students and >3mm in 4.5%. They noted that while the distribution of CAL was markedly skewed, it followed a continuum of [[disease severity]]. No sharp distinction exists between periodontal health and disease among [[Chile]]an adolescents.{{fact}}
▲Levin 2006 studied 642 young [[Israel]]i army recruits (562 men and 80 women) – clinical periodontal examination of four first molars and eight incisors and [[radiograph]]s were completed. Aggressive periodontitis was found in 5.9% of the subjects (4.3% localized and 1.6% generalized). This was significantly associated with current [[smoking]] and ethnic origin (North African).{{fact}}
Baelum 1997 reported on the incidence of tooth loss over 10 years among adult and elderly Chinese and looked at some [[predictive factor]]s. There were 440 subjects, 8 of which were [[edentulous]] at baseline and 31 who lost all remaining teeth during the study period. Of the 401 who remained dentate, the incidence of tooth loss ranged from 45% in the 20-
▲Eres 2009 examined 3056 students between the ages of 13 to 19 years at [[State school|public school]]s in [[Turkey]]. Their mouths were coded according to the recommendations of the CPITN ([[Community Periodontal Index of Treatment Needs]]). Among the 3056 students screened, 170 were scheduled for further examination and 18 were diagnosed with localized aggressive periodontitis. Thus, the prevalence of LAgP was 0.6% with a female to male ratio of 1.25:1.{{fact}}
▲;Tooth Loss
▲Baelum 1997 reported on the incidence of tooth loss over 10 years among adult and elderly Chinese and looked at some [[predictive factor]]s. There were 440 subjects, 8 of which were [[edentulous]] at baseline and 31 who lost all remaining teeth during the study period. Of the 401 who remained dentate, the incidence of tooth loss ranged from 45% in the 20-29 year old group to 96% in the 60 years plus group. He found that the best baseline predictors of tooth loss of all remaining teeth was that at least one tooth had attachment loss greater or equal to 7mm. As in other studies, a major portion of the total number of teeth lost was accounted for by a small group of persons. In this study, [[dental caries]] was the dominant reason for tooth loss.
==References==
{{reflist|30em}}
==Further reading==
{{refbegin|30em}}
*{{cite journal |last1=Albandar |first1=JM |last2=Brown |first2=LJ |last3=Löe |first3=H |title=Dental caries and tooth loss in adolescents with early-onset periodontitis |journal=Journal of periodontology |volume=67 |issue=10 |pages=960–7 |year=1996 |pmid=8910834}}▼
*{{cite journal |last1=Albandar |first1=JM |last2=
* {{cite journal |last1=Albandar |first1=JM |last2=Brunelle |first2=JA |last3=Kingman |first3=A |title=Destructive periodontal disease in adults 30 years of age and older in the United States, 1988-1994 |journal=Journal of Periodontology |volume=70 |issue=1 |pages=13–29 |year=1999 |pmid=10052767 |doi=10.1902/jop.1999.70.1.13}}
▲*{{cite journal |doi=10.1034/j.1600-051X.2002.290906.x |last1=Albandar |first1=JM |last2=
*{{cite journal |doi=10.1111/j.1600-0765.1996.tb00459.x |last1=Baelum |first1=V |last2=Chen |first2=X |last3=Manji |first3=F |last4=Luan |first4=WM |last5=Fejerskov |first5=O |title=Profiles of destructive periodontal disease in different populations |journal=Journal of Periodontal Research |volume=31 |issue=1 |pages=17–26 |year=1996 |pmid=8636871}}
*{{cite journal |doi=10.1111/j.1600-0528.1997.tb00927.x |last1=Baelum |first1=V
*{{cite journal |doi=10.1111/j.1600-0528.1997.tb00938.x |last1=Baelum |first1=V |last2=Luan |first2=WM |last3=Chen |first3=X |last4=Fejerskov |first4=O |title=Predictors of destructive periodontal disease incidence and progression in adult and elderly Chinese |journal=Community Dentistry and Oral Epidemiology |volume=25 |issue=4 |pages=265–72 |year=1997 |pmid=9332802}}
*{{cite journal |doi=10.1111/j.1600-0765.1997.tb00567.x |last1=Beck |first1=JD |last2=Sharp |first2=T |last3=Koch |first3=GG |last4=Offenbacher |first4=S |title=A 5-year study of attachment loss and tooth loss in community-dwelling older adults |journal=Journal of Periodontal Research |volume=32 |issue=6 |pages=516–23 |year=1997 |pmid=9379319}}
*{{cite journal |last1=Bourgeois |first1=DM |last2=Doury |first2=J |last3=Hescot |first3=P |title=Periodontal conditions in 65-74 year old adults in France, 1995 |journal=International Dental Journal |volume=49 |issue=3 |pages=182–6 |year=1999 |pmid=10858752 |doi=10.1002/j.1875-595x.1999.tb00904.x|doi-access=free }}
*{{cite journal |last1=Bourgeois |first1=D |last2=Bouchard |first2=P |last3=Mattout |first3=C |title=Epidemiology of periodontal status in dentate adults in France, 2002-2003 |journal=Journal of Periodontal Research |volume=42 |issue=3 |pages=219–27 |year=2007 |pmid=17451541 |doi=10.1111/j.1600-0765.2006.00936.x}}
*{{cite journal |last1=Burt |first1=B |author2=Research, Science and Therapy Committee of the American Academy of Periodontology |title=Position paper: epidemiology of periodontal diseases |journal=Journal of Periodontology |volume=76 |issue=8 |pages=1406–19 |year=2005 |pmid=16101377 |doi=10.1902/jop.2005.76.8.1406|doi-access=free }}
*{{cite journal |last1=
* {{cite journal |doi=10.1111/j.1600-051X.1998.tb02485.x |last1=Hugoson |first1=A |last2=Norderyd |first2=O |last3=Slotte |first3=C |last4=Thorstensson |first4=H |title=Distribution of periodontal disease in a Swedish adult population 1973, 1983 and 1993 |journal=Journal of Clinical Periodontology |volume=25 |issue=7 |pages=542–8 |year=1998 |pmid=9696253 }}
*{{cite journal |vauthors=Hugoson A, Sjödin B, Norderyd O |title=Trends over 30 years, 1973-2003, in the prevalence and severity of periodontal disease |journal=J. Clin. Periodontol. |volume=35 |issue=5 |pages=405–14 |date=May 2008 |pmid=18433384 |doi=10.1111/j.1600-051X.2008.01225.x }}
*{{cite journal |vauthors=Levin L, Baev V, Lev R, Stabholz A, Ashkenazi M |title=Aggressive periodontitis among young Israeli army personnel |journal=J. Periodontol. |volume=77 |issue=8 |pages=1392–6 |date=August 2006 |pmid=16881808 |doi=10.1902/jop.2006.050323 }}
*{{cite journal |vauthors=Levy SM, Warren JJ, Chowdhury J |title=The prevalence of periodontal disease measures in elderly adults, aged 79 and older |journal=Spec Care Dentist |volume=23 |issue=2 |pages=50–7 |year=2003 |doi=10.1111/j.1754-4505.2003.tb00290.x |pmid=14620763 |display-authors=etal}}
*{{cite journal |vauthors=López R, Fernández O, Jara G, Baelum V |title=Epidemiology of clinical attachment loss in adolescents |journal=J. Periodontol. |volume=72 |issue=12 |pages=1666–74 |date=December 2001 |pmid=11811502 |doi=10.1902/jop.2001.72.12.1666 }}
*{{cite journal |vauthors=Oliver RC, Brown LJ, Löe H |title=Periodontal diseases in the United States population |journal=J. Periodontol. |volume=69 |issue=2 |pages=269–78 |date=February 1998 |pmid=9526927 |doi=10.1902/jop.1998.69.2.269}}
*{{cite journal |vauthors=Susin C,
{{refend}}
{{Global epidemiology}}
{{DEFAULTSORT:Epidemiology Of Periodontal Diseases}}
[[Category:Epidemiology|Periodontal]]
[[Category:Periodontal disorders]]
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