Prevalence and risk indicators for destructive periodontal diseases in 3 urban American minority populations

Background, aims: Destructive periodontal diseases have been reported dispr oportionately more prevalent and severe in African-Americans relative to ot her American populations. Differences in subgingival microbiota and host im mune response have also been reported for African-Americans, implying that risk factors for disease progression may also differ for these populations. Since it is not clear whether these differences are truly genetic or due t o confounding variables such as social economic status, we examined a serie s of clinical, environmental, demographic, and microbiologic features assoc iated with periodontal disease status in a group of 185 urban minority subj ects resident within the greater New York metropolitan area. Methods: The study population consisted of 56 Asian-American, 7 1 African-A merican and 58 Hispanic subjects. Clinical data recorded included pocket de pth, attachment level, gingival erythema, bleeding upon probing, suppuratio n, and the presence of supragingival plaque. Environmental and demographic data recorded included smoking history, years resident in the United states , whether the subject reported a private dentist and occupational status. s ubgingival plaque was sampled from the mesial aspect of all teeth exclusive of third molars and the levels of 40 subgingival species enumerated using checkerboard DNA-DNA hybridization. Results: The African-American group had more missing teeth, deeper periodon tal pocket depth and more attachment loss than the Asian-American or Hispan ic groups. However, the African-American group were less likely to report h aving a private dentist, had a greater proportion of smokers and a greater proportion of unskilled individuals. The profile of subgingival species dif fered among the three ethnic/racial groups with A. actinomycetemcomitans, N . mucosa, S. noxia and T. socranskii significantly elevated in the Asian-Am erican group and P. micros significantly elevated in the African-American g roup. When subset by occupational status, numbers of missing teeth, pocket depth, attachment level and prior disease activity were all found increased in the unskilled relative to the professional group. Local factors includi ng the mean % of sites with plaque, marginal gingival erythema, bleeding up on probing and suppuration were also elevated in the unskilled group. The m icrobial profile differed among the 3 occupational groups with the unskille d group having elevated numbers of species associated with destructive peri odontal diseases. Conclusions: Although greater destructive periodontal disease prevalence an d severity were found in the African-American group, these results suggest that environmental and demographic variables, such as occupational status, may have a greater influence on risk indicators associated with disease pre valence and progression in these populations.