Gingivitis Susceptibility and its Relation to Periodontitis in Men

/Home/Specific Dental and Oral Health Concerns/Men and Dental Care

Gingivitis Susceptibility and its Relation to Periodontitis in Men
2006
T. Dietrich1,2,*, E. Krall Kaye1, M.E. Nunn1, T. Van Dyke2, and R.I. Garcia1,3
Journal of Dental Research

© 2006 International and American Associations for Dental Research

1 Dept. of Health Policy and Health Services Research and
2 Dept. of Periodontology and Oral Biology, Boston University Goldman School of Dental Medicine, 715 Albany St., 560, Boston, MA 02118, USA; and
3 VA Boston Healthcare System, Boston, MA, USA

* corresponding author, tdietric@bu.edu

ABSTRACT

The objective of this cross-sectional study was to evaluate whether gingivitis susceptibility is associated with periodontitis. We analyzed data of 462 men in the VA Dental Longitudinal Study aged 47 to 92 years who had never smoked or had quit smoking 5+ years previously. Multiple logistic regression models, with tooth-level bleeding on probing at sites with attachment loss 2 mm as the dependent variable, were derived with adjustment for plaque, calculus, crown coverage, age, income, education, marital status, body mass index, diabetes, and vitamin C intake, and stratification by age (< 65, 65+ years). Periodontitis and mean attachment loss were positively associated with bleeding on probing, with stronger associations among men < 65 years old (for periodontitis, OR 2.1; 95% CI 1.5, 3.1) than men 65+ years of age (OR 1.2; 95% CI 0.9, 1.6). Our results suggest that among never and former smokers, gingivitis susceptibility is higher among men with periodontitis compared with that in men without periodontitis.


KEY WORDS: gingivitis Ô pathogenesis Ô periodontitis Ô susceptibility

INTRODUCTION

The classic experimental gingivitis study (Làe et al., 1965) established the causal relationship between the quantity of bacterial plaque and the degree of gingivitis. In contrast, the role of gingivitis in the pathogenesis of periodontitis remains controversial. For many years, gingivitis and periodontitis have been regarded by many as a continuum, where longstanding gingivitis eventually progresses to periodontitis over time. However, epidemiologic studies have clearly demonstrated that not all gingivitis progresses to periodontitis. Furthermore, advances in the understanding of the pathogenesis of periodontitis have identified various host factors that determine susceptibility to periodontitis. Consequently, plaque-induced gingivitis is considered a necessary, but insufficient, cause of periodontitis. In turn, whether susceptibility to gingivitis is related to periodontitis susceptibility is unknown. The subject has recently been thoroughly reviewed (Tatakis and Trombelli, 2004; Trombelli, 2004).

In experimental gingivitis experiments, virtually every participant developed some degree of gingival inflammation in response to plaque accumulation. However, gingivitis susceptibility (as measured by the degree of gingival inflammation that develops in response to a given quantity of plaque) varied considerably between participants (Trombelli et al., 2004).

The purpose of the present study was, using clinical periodontal data from the VA Dental Longitudinal Study (DLS), to evaluate the hypothesis that susceptibility to gingivitis is higher among participants with greater susceptibility to periodontitis.

Complete article may be viewed online.