Correlates of Periodontal Decline and Biological Markers in Older Adults

Objectives: To determine what distinguishes older people who decline or improve in their periodontal status.

Methods: Older adults (mean age=67), from a five-year clinical trial were examined approximately 24 months later if they were in the 20% of the sample who declined the most clinically (AP) or the 20% who improved most (SP). Subjects were classified as AP if they had > 5 teeth with > 5 mm probing pocket depth (PPD), and were compared on demographics, PPD, clinical attachment levels, 40 subgingival bacteria, serum C-rp, IL-1b, IL-6, and systemic diseases.

Results: 10 AP and 24 SP subjects were identified; 13% of all women and 44% of men were in the AP group (p<0.05). Asians were more likely to be in the SP, and Caucasians and African-Americans in the AP group (p<0.01). Osteoporosis rates were higher in the AP group (p<0.01). This group also had elevated serum C-rp levels (p<0.07), but IL-1b and IL-6 levels did not differ by group. Bacterial counts were higher in the AP group for 5 of 40 species: Parvimonass micra (7.7x 10^5 cells vs. 3.8, p<0.05), Prevotella intermedia (25.7 x 10^5 cells vs. 9.8, p<0.01), Prevotella nigrescens (16.8 x 10^5 cells vs. 10.1, p<0.05), Tanerella forsythia (16.2 x 10^5 cells vs. 8.0, p<0.05), and Streptococcus mutans (6.2 x 10^5 cells vs. 2.0, p<0.01). PPD was correlated with T. forsythia (p< 0.05), and P. micros (p<0.05).

Conclusions: Osteoporosis, gender, ethnicity, serum C-rp levels, and subgingival levels of 5 bacterial species were indicative of periodontal decline in this older sample.

This research was supported by a Hack Estate Grant from the University of Washington, NIDCR grant R01 DE 12215, and the Clinical Research Foundation (CRF) of the University of Berne, Switzerland.