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Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009-2014

https://doi.org/10.1016/j.adaj.2018.04.023Get rights and content

Abstract

Background

This report presents weighted average estimates of the prevalence of periodontitis in the adult US population during the 6 years 2009-2014 and highlights key findings of a national periodontitis surveillance project.

Methods

Estimates were derived for dentate adults 30 years or older from the civilian noninstitutionalized population whose periodontitis status was assessed by means of a full-mouth periodontal examination at 6 sites per tooth on all non–third molar teeth. Results are reported according to a standard format by applying the Centers for Disease Control and Prevention/American Academy of Periodontology periodontitis case definitions for surveillance, as well as various thresholds of clinical attachment loss and periodontal probing depth.

Results

An estimated 42% of dentate US adults 30 years or older had periodontitis, with 7.8% having severe periodontitis. Overall, 3.3% of all periodontally probed sites (9.1% of all teeth) had periodontal probing depth of 4 millimeters or greater, and 19.0% of sites (37.1% of teeth) had clinical attachment loss of 3 mm or greater. Severe periodontitis was most prevalent among adults 65 years or older, Mexican Americans, non-Hispanic blacks, and smokers.

Conclusions

This nationally representative study shows that periodontitis is a highly prevalent oral disease among US adults.

Practical Implications

Dental practitioners should be aware of the high prevalence of periodontitis in US adults and may provide preventive care and counselling for periodontitis. General dentists who encounter patients with periodontitis may refer these patients to see a periodontist for specialty care.

Section snippets

Methods

We analyzed data from NHANES 2009-2014.17 NHANES is a stratified multistage probability sample of the civilian noninstitutionalized population in the 50 US states and the District of Columbia. The CDC’s National Center for Health Statistics Ethics Review Board (an institutional review board equivalent) approved the oral health data collection protocols, and all survey participants provided written informed consent.18, 19

Trained examiners, who during the 2009-2010 cycles were registered dental

Results

The NHANES 2009-2014 data contained complete periodontal measurements for 10,683 dentate participants, representing a weighted population of approximately 143.8 million civilian noninstitutionalized US adults 30 years or older. The mean age of the US population examined periodontally was 50.8 years, and approximately 49% were male (Table 1). About 17% were current smokers, and 9.6% reported having diabetes. An estimated 34.6% had a complete 28-tooth dentition, with an overall population mean of

Discussion

In this report, we present findings regarding the burden and population characteristics of periodontitis from an unprecedented 6-year (2009-2014), cross-sectional, nationally representative, comprehensive survey of periodontitis in US adults 30 years or older that for the first time included a clinical periodontal examination at 6 sites around all teeth other than third molars.

Using the CDC/AAP case definitions and other commonly applied thresholds for periodontitis at the individual, tooth,

Conclusions

Periodontitis is highly prevalent and is an important oral health problem among US adults. This study provides the most comprehensive and reliable estimates of the burden and population characteristics of periodontitis in the adult US population 30 years or older. This information serves to increase awareness of periodontitis and can be useful in public health action to prevent and control periodontitis in US adults through dental practitioners’ providing preventive and management care,

Dr. Eke is a senior health scientist, Office of the Director, Division of Population Health, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341.

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    Dr. Eke is a senior health scientist, Office of the Director, Division of Population Health, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341.

    Dr. Thornton-Evans is a dental officer, Division of Oral Health, Centers for Disease Control and Prevention, Atlanta, GA.

    Mr. Wei is a statistician, DB Consulting Group, Atlanta, GA.

    Dr. Borgnakke is a senior research associate and adjunct clinical assistant professor, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI.

    Dr. Dye is a dental officer, Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD.

    Dr. Genco is a distinguished professor of Oral Biology and Microbiology and the director, UB Center for Microbiome Research, The State University of New York, University at Buffalo, Amherst, NY.

    Disclosure. None of the authors reported any disclosures.

    The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention

    The authors acknowledge the contributions from the CDC/AAP Periodontal Disease Surveillance Workgroup.

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