Update on Prevalence of Periodontitis in Adults in the United States: NHANES 2009 to 2012

• Autores: Paul I. Eke, Bruce A. Dye, Liang Wei, Gary D. Slade, Gina Thornton-Evans
• Localización: Journal of periodontology, ISSN 0022-3492, Vol. 86, Nº. 5, 2015, págs. 611-622
• Idioma: inglés
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• Resumen

  • Background: This report describes prevalence, severity, and extent of periodontitis in the US adult population using combined data from the 2009 to 2010 and 2011 to 2012 cycles of the National Health and Nutrition Examination Survey (NHANES).

    Methods: Estimates were derived for dentate adults, aged ≥30 years, from the US civilian non-institutionalized population. Periodontitis was defined by combinations of clinical attachment loss (AL) and periodontal probing depth (PD) from six sites per tooth on all teeth, except third molars, using standard surveillance case definitions. For the first time in NHANES history, sufficient numbers of non-Hispanic Asians were sampled in 2011 to 2012 to provide reliable estimates of their periodontitis prevalence.

    Results: In 2009 to 2012, 46% of US adults, representing 64.7 million people, had periodontitis, with 8.9% having severe periodontitis. Overall, 3.8% of all periodontal sites (10.6% of all teeth) had PD ≥4 mm, and 19.3% of sites (37.4% teeth) had AL ≥3 mm. Periodontitis prevalence was positively associated with increasing age and was higher among males. Periodontitis prevalence was highest in Hispanics (63.5%) and non-Hispanic blacks (59.1%), followed by non-Hispanic Asian Americans (50.0%), and lowest in non-Hispanic whites (40.8%). Prevalence varied two-fold between the lowest and highest levels of socioeconomic status, whether defined by poverty or education.

    Conclusions: This study confirms a high prevalence of periodontitis in US adults aged ≥30 years, with almost fifty-percent affected. The prevalence was greater in non-Hispanic Asians than non-Hispanic whites, although lower than other minorities. The distribution provides valuable information for population-based action to prevent or manage periodontitis in US adults.

    Periodontal disease is highly prevalent among adults in the United States and is an important dental public health problem.1 The monitoring and reduction of moderate and severe periodontitis in the adult US population through national disease surveillance and health promotion activities is part of the Healthy People 2020 national health objective2 and is an important strategic objective of the Centers for Disease Control and Prevention (CDC).3,4 The burden of periodontitis in the adult US population is currently assessed through the National Health and Nutrition Examination Survey (NHANES). Since 1999, NHANES has been a continuous, annual survey capable of producing national estimates on selected health characteristics within 2-year periods. However, the protocol for assessing periodontitis has varied. Beginning in 2009 and ending in 2014, NHANES will have applied a full-mouth periodontal examination (FMPE) protocol to collect probing measurements from six sites per tooth for all teeth (except third molars).1 The FMPE optimizes clinical measurements for surveillance of periodontitis and represents better accuracy in detecting cases of periodontitis compared with estimates derived from partial-mouth periodontal examination (PMPE) protocols used in previous NHANES surveys, such as 1999 to 2004 or 1988 to 1994.5-9 Also, the FMPE protocol optimizes the use of standard case definitions for surveillance of periodontitis, minimizes misclassification of periodontitis cases, and can be applied to various case definitions owing to the comprehensive measurements.10-14 With use of the FMPE protocol, it was estimated in 2009 to 2010 that 47% of US dentate adults aged ≥30 years (representing ≈65 million adults) had periodontitis, with 38% of the adult population aged ≥30 years and 64% of adults ≥65 years having either severe or moderate periodontitis.1 These initial findings revealed a much higher burden of periodontitis in US adults than previously reported.1 In this report, the authors provide updated prevalence estimates using combined data from the NHANES survey periods 2009 to 2010 and 2011 to 2012. Based on a larger sample size, the 4-year combined data provide more stable estimates, especially for smaller subpopulations, than the individual data sets. Importantly, the 2011 to 2012 data provide the first occasion at which NHANES data generated reliable estimates of periodontitis among non-Hispanic Asian Americans.