GUM DISEASE AND THE POPULATION
One out of every two American adults aged 30 and over has periodontal disease, according to recent findings from the Centers for Disease Control and Prevention (CDC). A study titledPrevalence of Periodontitis in Adults in the United States: 2009 and 2010estimates that 47.2 percent, or 64.7 million American adults, have mild, moderate or severe periodontitis, the more advanced form of periodontal disease. In adults 65 and older, prevalence rates increase to 70.1 percent. This study is published in the Journal of Dental Research, the official publication of the International and American Associations for Dental Research.
Periodontal disease is a chronic inflammatory disease that affects the gum tissue and bone supporting the teeth, according to theAmerican Academy of Periodontology (AAP). If left untreated, periodontal disease can lead to tooth loss. Research has also shown that periodontal disease is associated with other chronic inflammatory diseases, such as diabetes and cardiovascular disease. The AAP has worked closely with CDC since 2003 on periodontal disease surveillance.
The findings are based on data collected as part of CDC’s 2009-2010 National Health and Nutrition Examination Survey (NHANES), designed to assess the health and nutritional status of adults and children in the United States. The 2009-2010 NHANES included for the first time a full-mouth periodontal examination to assess for mild, moderate, or severe periodontitis, making it the most comprehensive survey of periodontal health ever conducted in the U.S. Researchers measured periodontitis because it is the most destructive form of periodontal disease. Gingivitis, the earliest stage of periodontal disease, was not assessed.
Previous NHANES relied on partial mouth periodontal examinations and may have missed disease in teeth that were not examined. Since periodontal disease is not evenly distributed in the mouth, estimates based on partial mouth examinations may have underestimated actual prevalence rates in the U.S. population by as much as 50 percent.
“This is the most accurate picture of periodontal disease in the U.S. adult population we have ever had,” said Pamela McClain, DDS, President of the American Academy of Periodontology and a practicing periodontist in Aurora, Colorado. “For the first time, we now have a precise measure of the prevalence of periodontal disease, and can better understand the true severity and extent of periodontal disease in our country. The AAP values its collaboration with CDC to better understand the burden of periodontal disease in Americans.”
The findings also indicate disparities among certain segments of the U.S. population. Periodontal disease is higher in men than women (56.4 percent vs. 38.4 percent) and is highest in Mexican-Americans (66.7 percent) compared to other races. Other segments with high prevalence rates include current smokers (64.2 percent); those living below the federal poverty level (65.4 percent); and those with less than a high school education (66.9 percent).
According to Paul Eke, MPH, PhD, lead author and CDC epidemiologist, the findings may drive public health policy. “We have demonstrated a high burden of periodontal disease in the adult U.S. population, especially among adults 65 and older. Periodontal disease is associated with age, and as Americans live longer and retain more of their natural teeth, periodontal disease may take on more prominence in the oral health of the U.S adult population. Maintaining good periodontal health is important to the overall health and well-being of our aging population. Our findings support a need for public health programs to improve the oral health of adults.”
Co-author Robert Genco, DDS, PhD, Distinguished Professor at The State University of New York at Buffalo and Past President of the American Association for Dental Research (AADR) and the International Association for Dental Research (IADR), believes these findings elevate periodontal disease as a public health concern. “We now know that periodontal disease is one of the most prevalent non-communicable chronic diseases in our population, similar to cardiovascular disease and diabetes.”
Dr. McClain noted that these findings support the need for comprehensive periodontal evaluations annually. “To really know if you have periodontal disease, a dental professional must examine each tooth above and below the gum line. A visual examination alone, even by the most qualified dentist, is not enough. These findings suggest that many more people have periodontal disease than previously thought, so it is more important than ever to receive a comprehensive periodontal evaluation from your dental professional every year.”
Surveillance of periodontal disease in U.S. adults will continue through the 2014 NHANES to include more racial and ethnic segments of the population. Both CDC and AAP support additional efforts to continue to understand periodontal disease prevalence trends. This data will guide public health policy decisions including appropriate prevention and treatment recommendations.
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