Incidence of Attachment Loss in Community‐Dwelling Older Adults

Abstract

Since 1985, only four studies have been published that present data on attachment loss in populations. The purpose of this study was to present the incidence of attachment loss over an 18‐month period in a representative sample of community‐dwelling older adults. In addition, the utility of multivariate prediction models to distinguish between people who will and will not experience disease progression was explored. The Piedmont 65 + Dental Study of the Elderly is a longitudinal investigation of a random sub‐sample of over 1,000 community‐dwelling people over the age of 65 in five contiguous North Carolina counties. The five dentists who conducted the in‐home examinations and interviews at baseline also participated at 18 months and examined the same subjects. The overall attrition rate for blacks was 27% and the rate for whites was 23%. At 18‐months, the baseline attachment level scores for those subjects who were lost from the study were not significantly different from the scores of those who remained in the study. A change in attachment loss of 3 mm or more over the 18 months was set as a conservative estimate of actual change taking place. Blacks were significantly more likely to experience attachment loss irrespective of the number of sites involved (P <.05). Approximately half the people had at least one losing site and about one‐third of the blacks and one‐fourth of the whites had at least two losing sites. A total of 24% of blacks and 16% of whites had 3 or more losing sites. The multivariate etiologic model for blacks implicates the presence of P. gingivalis and P. intermedia in concentrations greater than 2%. In addition, people who indicate that they do not floss regularly, that their memory is getting worse, and had dental visits more than 3 years ago were at higher risk of attachment loss over the 18‐month period. The etiologic model for whites indicates that people who had P. gingivalis present in concentrations greater than 2% were at higher risk for attachment loss than people who did not have P. gingivalis; that people who sought medical care in the last 6 months were at higher risk; that people who felt depressed were at higher risk; and that people who smoke cigarettes regularly were at higher risk. J Periodontol 1994; 65:316–323.

Oxantel Disrupts Polymicrobial Biofilm Development of Periodontal Pathogens

“…This proposal has more recently been modified to emphasize the importance of synergistic interactions between potentially pathogenic bacterial species that result in the formation of a pathogenic polymicrobial plaque that is composed of one or more primary and a number of accessory bacterial pathogens expressing community virulence factors that elicit a nonresolving and tissue-destructive host response (12). We have previously demonstrated in a longitudinal human study that the imminent progression of chronic periodontitis could be predicted by increases in the relative proportions of P. gingivalis and T. denticola in subgingival plaque (14), which is consistent with other clinical studies demonstrating that the proportion of P. gingivalis in the subgingival plaque bacterial load is predictive of human disease progression (15,16). When coinoculated in small animal models of periodontitis, P. gingivalis and T. denticola exhibit a synergistic virulence (17)(18)(19).…”

The interplay between iron, haem and manganese in Porphyromonas gingivalis

“…Based on animal model data P. gingivalis has recently been proposed to be a "keystone pathogen" that manipulates the host response to favour the proliferation of a pathogenic polymicrobial biofilm (dysbiosis) and development of disease [19]. We have previously demonstrated in a longitudinal human study that the imminent progression of chronic periodontitis could be predicted by increases in the relative levels of P. gingivalis and/or Treponema denticola in subgingival plaque [21], which is consistent with other clinical studies demonstrating that P. gingivalis levels in subgingival plaque are predictive of human disease progression [22][23][24]. P. gingivalis is also capable of causing periodontitis in animal models of disease [25,26].…”

Evaluating the Periodontal Status and Oral Hygiene Habits Among Dental Patients

“…In most studies examining the relationship between gender and periodontal disease, it has been shown that the severity of periodontal disease is higher among males (18,19). Due to these results, gender differences in the prevalence and severity of periodontal disease are believed to be associated with attention and oral health care habits rather than genetic factors.…”