ASSESSMENT OF RISK FOR PERIODONTAL-DISEASE .2. RISK INDICATORS FOR ALVEOLAR BONE LOSS

THIS STUDY EXAMINED THE RISK INDICATORS for alveolar bone loss associa ted with periodontal infection. A cross-section of 1,361 subjects aged 25 to 74 years, from Erie County, NY were evaluated for interproximal alveolar bone loss and potential explanatory variables including age, gender, history of systemic diseases, smoking, and presence of 8 subg ingival bacteria. Interproximal alveolar bone loss was measured from t he alveolar crest to the CEJ and a mean computed for each subject. The mean bone loss per subject (BL) ranged from 0.4 to 8.8 mm, and this o utcome variable was grouped into 4 ordered categories. The degree of a ssociation between the explanatory variables and BL was examined utili zing an ordinal stepwise logistic regression model. Factors which were positively associated with more severe bone loss included subgingival colonization with B. forsythus (O.R, 2.52; 95% CI: 1.98 to 3.17) or P . gingivalis (O.R. 1.73; 95% CI: 1.27 to 2.37), race (Native American, Asian, or Pacific Islanders) with an O.R. 2.40 (95% CI: 1.21 to 4.79) , and gender with males having higher odds than females. Smokers had g reater odds for more severe bone loss compared to non-smokers ranging from 3.25 (95% CI: 2.33 to 4.54) to 7.28 (95% CI: 5.09 to 10.31) for l ight and heavy smokers, respectively. Individuals at older ages also s howed more severe levels of bone loss. History of kidney disease (O.R. 0.55; 95% CI: 0.35 to 0.89) and history of allergies (O.R. 0.76; 95% CI: 0.59 to 0.98) were inversely associated with severity of bone loss . Severity of alveolar bone loss is associated with increasing age, sm oking, race, and colonization with subgingival B. forsythus or P. ging ivalis. This and other studies directed to identifying true risk facto rs associated with periodontal disease may lead to preventive measures directed to reducing the deleterious effects of modifiable risk facto rs.