Association between four oral diseases in private practices' patient population

Objective: To estimate the concomitant occurrence of dental caries, gingivitis, periodontal disease, and pulp diseases. Methods: Data on the diagnosis and treatment of oral diseases during the previous year were collected in a survey with a systematic random sample of patients 3 to 93 years old (n=1338, 56.7% female; 89% white race) visiting Northwest PRECEDENT general dentists (n=73). Clustering of oral diseases was estimated by comparing the observed frequencies of the number of oral diseases and the expected frequencies if there was no clustering. Associations between two oral diseases were estimated using GEE logistic regression. Results: Fifty-four percent of the participants had dental caries, 58% gingivitis, 33% periodontal disease and 11% irreversible pulpitis. Participants with one or two diseases (64.7%) accounted for 60% of the disease burden, and participants with three or four diseases (19.6%) accounted for 39% of the disease burden. The percentages of participants with 0, 1, 2, 3, and 4 co-morbidities were 16.6%, 33.4%, 30.4%, 16.4% and 3.2%, respectively. The expected percentages were 11.4%, 36.4%, 37.6%, 13.4%, and 1.1%. The odds of having irreversible pulpitis for participants with dental caries was 2.9 times as high [95% Confidence interval (CI): 1.8-4.8] compared to participants without dental caries. Associations were also observed between gingivitis and periodontal disease [Odds ratio (OR): 10.5; 95%CI: 6.9-16.1], and between periodontal disease and irreversible pulpitis (OR: 1.6; 95%CI: 1.0-2.5). No associations were observed between dental caries and periodontal disease or gingivitis. Conclusion: The majority of patients visiting general dentists presented one or two oral diseases; however the presence of 3 and 4 co-morbidities was higher than expected. While the more obvious dental caries-pulpitis and gingivitis-periodontal disease associations were confirmed, a dental caries-periodontal disease association was not. Submitted on behalf of the Northwest PRECEDENT network, with support from: NIDCR grants DE016750 and DE016752.