Study Estimates Nearly Half of American Adults Have Periodontal Disease
Over 47 percent of the U.S. adult population aged 30 years and older have mild, moderate or severe periodontitis, according to new research from the Centers for Disease Control and Prevention (CDC).1 In addition, nearly two-thirds (64%) of adults over age 65 have moderate to severe forms of periodontal disease.
These findings are based on epidemiologic data from the 2009–2010 National Health and Nutrition Evaluation Survey (NHANES), which included full-mouth periodontal examinations to obtain more accurate estimates of the prevalence and extent of periodontal disease in the United States. The study, published online in the October 2012 issue of the Journal of Dental Research, was developed in collaboration with a CDC Periodontal Disease Surveillance workgroup, which included representatives from the American Academy of Periodontology (AAP).
To assess the burden of periodontitis in the U.S., a team of CDC researchers used data from a nationally representative NHANES study sample, which was comprised of 3,742 adults aged 30 years and older. The full-mouth periodontal exams (FMPE) provided to NHANES participants included measurement of attachment loss and probing depth at six sites per tooth for all teeth (except third molars).
The new CDC study is the first to use the FMPE protocol on a national probability sample from the U.S. civilian population. As noted by the study authors, using the FMPE protocol rather than a partial-mouth evaluation provided “optimal surveillance measurements for assessing the burden of periodontitis across the U.S. population.”
Using this national dataset, the CDC researchers determined that an estimated 47.2 percent of 2009–2010 NHANES participants aged 30 years and older exhibit some form of periodontitis (mild, moderate or severe). Given this finding and the weighted sampling of the NHANES program, nearly 65 million U.S. adults over age 30 are estimated to have periodontitis, and 64 percent of adults over age 65 have moderate to severe forms of the disease. Approximately 30 percent of the U.S. adult population are also likely to have moderate periodontitis (defined as two or more interproximal sites with greater than or equal to 4 millimeters of clinical attachment loss, or two or more interproximal sites with pocket depth greater than or equal to 5 millimeters).
The CDC study also found higher prevalence estimates of periodontitis in men (56% versus 38% for women), non-Hispanic Black and Mexican-Americans (58% and nearly 67% respectively), current smokers (64%), and adults below 100% federal poverty levels (65%) or with less than a high school education (nearly 67%). These findings underscore the notable oral health disparities among racial and ethnic groups, and persons with lower education and income. The CDC researchers also indicate that previous national surveys may have significantly underestimated the true burden of periodontitis in the adult U.S. population.
Periodontitis is an inflammatory disease characterized by loss of connective tissue between teeth and gums, but this condition can be successfully treated and managed. Given the considerable burden of periodontitis, dentists are encouraged to include a periodontal assessment in the clinical examination of adults of all ages, especially middle-aged and elderly patients, and to provide or refer patients for appropriate therapy when indicated. To maintain oral health and prevent periodontal disease, the ADA promotes the importance of good oral hygiene and regular dental care. The ADA also encourages dentists to take thorough health histories, evaluate patients for oral diseases, promote tobacco cessation, and identify risk factors that may predispose patients to periodontal disease.
1. Eke P, Dye BA, Wei L, Thornton-Evans GO, Genco RJ. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res 2012; 91(10):914-920. Abstract available at: “http://jdr.sagepub.com/content/91/10/914.abstract”. Accessed September 20, 2012.