Epidemiology of periodontitis in the Study of Health in Pomerania

Objectives: Though periodontal disease has a considerable impact on public health, accurate information on prevalence and extent in Germany are lacking. Thus, we investigated prevalence and extent of periodontitis using population-based data from Study of Health in Pomerania (SHIP). Furthermore, the age-dependent association between gingival recession (GR), probing depth (PD) and attachment loss (AL) was evaluated.

Methods: SHIP is a cross-sectional survey based on 4310 subjects examined in northeast Germany, 1997 through 2001. Periodontal status was assessed using AL, PD and GR measurements applying a half-mouth recording at four sites per tooth. For data analyses the complex sample design and weights were considered.

Results: Of all subjects 89.4% had at least one site with AL³3mm. On average 62.5% of teeth had AL³3mm. Prevalence and extent of AL increased significantly with age independently on the threshold used (p<0.05). Prevalence of PD³4mm was 69.3% with 31.1% of teeth being affected. 25.5% of subjects presented severe PD (³6mm). Both prevalence and extent of PD³4mm increased from the youngest age group until the 40-49 years age group (p<0.001) and then remained consistent. AL and PD values ³4mm were more prevalent in males than in females, regardless of the age cohort (p<0.05). Mean GR was negligible in subjects aged 20-39 years, but increased consistently in the upper age cohorts from 0.07mm (40-49 years) to 1.9mm (70-81 years). This was well reflected in the age-dependent association between AL and PD. In subjects >49 years GR mainly contributed to AL rather than PD.

Conclusion: High prevalence and extent of periodontitis constitute a major public health problem in East Germany. In the older ones GR, rather than PD, mainly contributes to AL. This result contrasts the current decision criteria for the periodontoal therapy initiation in Germany, which refer to PD rather than AL.

Supported by BMBF-01-ZZ-9603/0, Gaba, Schwitzerland.