Epidemiology of periodontal diseases in adults from Latin America.

A decade has passed since we first reviewed the epidemiology of periodontal diseases in Latin America. At that time, lack of population-based studies was the norm and our conclusions were based on very limited evidence. The aim of the present comprehensive review was to update and expand our previous work by providing a broad overview of Latin America and its current social, economic and demographic status and by focusing on the epidemiology of periodontal diseases in Latin American adults published in the last 15 years. The amount of periodontal epidemiological data available has increased but is still restricted to a few countries only. The scope of the literature available has also broadened to include oral health-related quality of life and systemic interactions; however, most studies had methodological limitations that might have biased their results. In general, periodontitis was very prevalent, but severe periodontal destruction was localized. Besides being associated with well-established risk factors, periodontitis was associated with demographics and socio-economic factors in Latin American populations. To advance epidemiological knowledge, population-based cross-sectional and longitudinal studies, using appropriate methodologies, should be the future focus of the research agenda of researchers and public health planners in Latin American countries.

Prevalence and risk indicators for chronic periodontitis in adolescents and young adults in south Brazil.

AIM: To describe the distribution of clinical attachment loss (CAL) and to study risk indicators for chronic periodontitis in a large population-based sample of adolescents and young adults from south Brazil. MATERIAL AND METHODS: This cross-sectional study used a subset of data from a larger survey representative of Porto Alegre, Brazil. The sample consisted of 612 individuals (291 males/321 females) aged 14-29 years. Full-mouth, six sites per tooth clinical examinations were performed by calibrated periodontists. Chronic periodontitis was defined as CAL 3mm affecting two or more teeth. Aggressive periodontitis cases were excluded from the analysis. RESULTS: CAL 3 and 5mm affected 50.4% and 17.4% of subjects and 9.7% and 1.1% of teeth, respectively. Prevalence of chronic periodontitis ranged between 18.2% and 72.0% among subjects 14-19 and 24-29 years old, respectively. In the multivariable logistic regression analysis, older age [odds ratio (OR)=2.6, 95% confidence interval (CI)=1.7-3.9 and OR=7.2, 95% CI=3.7-14.0 for 20-24 and 25-29 years old, respectively], low socioeconomic status (OR=1.9, 95% CI=1.4-2.7), heavy smoking (OR=1.7, 95% CI=1.1-2.7) and larger amounts of calculus (OR=2.0, 95% CI=1.2-3.2) were significantly associated with chronic periodontitis. CONCLUSION: This population of adolescents and young adults had a high prevalence of chronic periodontitis, and its presence was associated with age, socioeconomic status, smoking and calculus.

Tooth loss and associated risk indicators in an adult urban population from south Brazil.

The aim of the present study was to assess the prevalence, extent, and risk indicators of tooth loss in a representative adult, urban population in the Brazilian state of Rio Grande do Sul. A sample of 974 subjects (ages 30 to 103 years, mean 48.7, SD 13.4) representative of the metropolitan area of Porto Alegre, Brazil was selected by a multi-stage probability cluster sampling strategy. In all, 94% of the subjects had experienced tooth loss. The mean tooth loss was 11.2 teeth, and varied between 5.5 and 20.2 teeth in the 30-39 and 60 + years age groups, respectively. The multivariable analysis, adjusted for age, showed that subjects who had lost 7-13 or > or = 14 teeth were more likely to be females (odds ratio (OR) = 1.4, 2.4), of low (OR = 2.8, 5.1) or middle socio-economic status (OR = 2.3, 3.4), and heavy smokers (OR= 2.0, 2.3) than those with 6 or fewer missing teeth. Furthermore, loss of > or = 14 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR= 5.7), and loss of 7-13 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR = 2.4) and having 15-30% or > 30% decayed-filled teeth (OR = 2.7 and 4.1). In conclusion, tooth loss is highly prevalent in this urban Brazilian population. Gender, socio-economic status, cigarette smoking, caries experience, and attachment loss are important risk indicators. A reduction in the population's tooth loss may be achieved by the implementation of community programs for the prevention and treatment of dental caries and periodontal diseases.

Occurrence and risk indicators of increased probing depth in an adult Brazilian population.

BACKGROUND/AIMS: There is little information about the occurrence and risk indicators for periodontal diseases in Latin America. The present study describes the prevalence, extent and severity of periodontal probing depth (PPD) and assesses the association between demographic, behavioural and environmental risk indicators and the extent and severity of PPD in this population. MATERIALS AND METHODS: The target population was urban adults aged > or =30 years in Rio Grande do Sul state in South Brazil. A representative sample was selected using a multi-stage, probability, cluster sampling strategy and included 853 dentate subjects 30-103 years of age. A full-mouth clinical examination was carried out at six sites per tooth on all permanent teeth, excluding third molars, and was conducted in a mobile examination centre. RESULTS: Approximately 65% and 25% of the subjects and 19% and 5% teeth per subject had PPD > or =5 and > or =7 mm, respectively. 31.6%, 33.7% and 34.7% subjects had generalized, localized or no PPD > or =5 mm, respectively. Probing depth increased in prevalence with increasing age, and leveled off at around 50 years of age and beyond. PPD > or =5 mm was significantly higher in males than in females, and in non-Whites than in Whites. Cigarette smokers had a significantly higher occurrence of PPD > or =5 mm than non-smokers, and this relationship was dose dependent. A multivariate model showed that generalized PPD > or =5 mm was associated with subjects aged > or =40 years, males, non-Whites and moderate or heavy cigarette smokers (relative risk ratios: 2.0, 2.0, 2.2, 2.4 and 6.8, respectively). CONCLUSION: Moderate and deep probing depth was a common finding in this urban adult Brazilian population. Older age, male gender, non-White race and moderate and heavy cigarette smoking were significant risk indicators of increased PPD, and these may be useful indicators of periodontal disease high-risk groups.

Gingival recession: epidemiology and risk indicators in a representative urban Brazilian population.

BACKGROUND: Gingival recession is a common manifestation of periodontal disease, but it is also associated with other risk factors. A few studies have investigated the epidemiology and risk factors of this condition. This study describes the epidemiology of gingival recession in a representative, urban Brazilian population and assesses various risk indicators. METHODS: A representative sample of 1,460 subjects was selected using a multi-stage, probability, cluster sampling strategy. The subjects were interviewed using a structured questionnaire and had a full-mouth clinical examination in a mobile examination center. RESULTS: More than half (51.6%) and 22.0% of the individuals and 17.0% and 5.8% of teeth per individual showed gingival recession > or = 3 mm and > or = 5 mm, respectively. The prevalence, extent, and severity of recession correlated with age. Recession showed a nonlinear relationship with age, with 25 to 50 year olds showing the highest level of recession. Males aged > or = 30 years showed significantly higher prevalence and extent of gingival recession than females. The percentage of teeth with recession was significantly higher in the lower socioeconomic groups irrespective of age, and in subjects > or = 30 years of age with irregular dental care than in subjects with regular care. Using a multivariable model, cigarette smoking and presence of supragingival calculus were the factors most significantly associated with localized and generalized recession, whereas gender, dental visits, and socioeconomic status were not significant risk indicators. CONCLUSIONS: The high level of gingival recession in this Brazilian population may be primarily related to destructive periodontal disease and is significantly associated with a high level of supragingival dental calculus and cigarette smoking. Population-based programs aimed at the prevention of periodontal diseases may reduce the prevalence of severe gingival recession in this and similar populations.

Periodontal attachment loss in an urban population of Brazilian adults: effect of demographic, behavioral, and environmental risk indicators.

BACKGROUND: There is little information about the occurrence and risk factors of periodontal diseases in developing countries. This study describes the clinical attachment loss (CAL) in an adult Brazilian population and performs a risk assessment of demographic, behavioral, and environmental exposures. METHODS: A representative sample of 853 dentate individuals (age: 30 to 103 years) was selected by a multistage probability sampling method. The subjects had a full-mouth clinical examination of six sites per tooth and were interviewed using a structured written questionnaire. RESULTS: Seventy-nine percent (79%) and 52% of the subjects and 36% and 16% of the teeth per subject had CAL > or = 5 and > or = 7 mm, respectively. A multivariable model showed that 40 to 49 and > or = 50 years olds had 3.0 and 5.9 times higher risk for moderate CAL and 7.4 and 25.4 times higher risk for severe CAL, compared to the 30 to 39 years olds. Moderate cigarette smokers had a significantly higher risk for moderate (relative risk ratio [RRR] = 2.1) and severe CAL (RRR = 3.4), and heavy smokers had a higher risk for moderate (RRR = 3.0) and severe CAL (RRR = 8.2) compared to non-smokers. A significantly higher risk for severe CAL was also present in males (RRR = 1.6), subjects with low (RRR = 1.8) or medium socioeconomic status (RRR = 1.6), and those with a history of irregular dental visits (RRR = 2.1). Diabetic status and race did not show significant associations with CAL after adjusting for other effects. CONCLUSIONS: This Brazilian population had a high occurrence of attachment loss. A population-based strategy that includes the establishment of prevention and health promotion programs targeting high-risk groups is highly desirable for controlling the high occurrence of attachment loss in this population.