Nine risk indicators for periodontal disease

Severe periodontal disease causes tooth loss and affects a certain group of people that appear to exhibit increased susceptibility to periodontal destruction, according to a study that appeared in the November Journal of Periodontology.

Researchers found that tooth loss due to periodontal disease is associated with the risk indicators of age, male gender, smoking, lack of professional maintenance, inadequate oral hygiene, diabetes mellitus, hypertension, rheumatoid arthritis and anterior tooth type.

"In this study we evaluated 1,775 patients who had 3,694 teeth extracted," said Dr. Khalaf F. Al-Shammari, Ministry of Health, Kuwait. "More teeth per patient were lost due to periodontal disease than for any other reason (those with periodontal disease lost 2.8 teeth versus 1.8 teeth lost for those without periodontal disease)."

Periodontal disease accounted for the majority of tooth extractions in patients older than 35 years (57 percent of teeth were lost for periodontal reasons compared to 43 percent lost for other reasons). Other findings are as follows:

• The most common medical history finding in all patients was diabetes mellitus at 19.2 percent followed by hypertension at 13.6 percent.
• A greater proportion of men lost their teeth due to periodontal reasons than women (33 percent for men versus 27 percent for women).
• Current and past smokers accounted for almost 31 percent
• 39 percent reported that they have never had a dental prophylaxis or periodontal maintenance visit.
• Self-reported tooth brushing frequency of the patients was low with only 16 percent brushing their teeth twice or more daily,
• Almost 60 percent either never brushed their teeth or used a toothbrush irregularly.
• "Risk assessment is an important component of modern dental therapy," said Kenneth A. Krebs, DMD and AAP president. "Identification of subjects with the greatest risk for periodontal disease severity and progression is essential for the proper allocation of preventive therapeutic measures to those individuals who would benefit most from such measures."

Periodontal disease is one of the main causes of tooth loss worldwide. Periodontal therapy has proven to be effective in reducing the rate of tooth loss and establish the importance of patient compliance with maintenance therapy and proper oral hygiene measures.