Periodontal Disease in Puerto Rican Older Adults

The Puerto Rican Elderly Dental Health Study (PREDHS) is the first study that evaluates the periodontal status of a representative sample in Puerto Rico since this island has been excluded from the U.S. National clinical health surveys. Objective: To assess the periodontal status among the elderly population in San Juan. Methods: Three dentists were trained and standardized by the National Health and Nutrition Examination Survey (NHANES) reference examiner. They examined a sub-sample of 183 elders aged 70-97 in the San Juan Area from participants in an ongoing representative cohort of the Puerto Rican elderly. Probing depth (PD), attachment loss (AL), and tooth mobility were assessed on the dentate participants using a full-mouth, 4-sites (mesio-facial, facial, disto-facial, and disto-lingual) exam excluding third molars. We used the CDC-AAP definitions for moderate periodontitis (≥2 teeth with AL ≥4mm at interproximal sites OR ≥2 teeth with PD ≥ 5mm at interproximal sites) and severe periodontitis (≥2 teeth with AL ≥6mm at interproximal sites AND ≥1 teeth with PD ≥5mm at interproximal sites). Results: The participation rate was 63%, mean age was 77.9 ± 5.9, mean number of teeth was 15.8 ± 6.8, and 67% were females. We observed tooth mobility in 18% of the participants. Mean PD was 1.5 ± 0.6 and mean AL was 2.8 ± 1.5. The frequency of moderate and severe periodontitis (CDC-AAP) was three times higher in PREDHS (61.7% vs. 20.8%) as compared to recently published data from NHANES 1999-2004 among those 75 years and older in the U.S. Conclusions: Our study showed high levels of severe and moderate periodontal disease among Puerto Rican older adults. Further research is needed to understand the reasons for the high prevalence. This investigation was supported by NIH Grants R25RR17589, RO1AG1620904, G12RR03051, K24DE16884, and the University of Costa Rica.