Evaluation of Trends in Periodontal Health Among U.S. Navy Personnel

Neither the prevalence of periodontal disease nor long-term trends in periodontal health among U.S. military personnel has been well-studied. Objective: The authors analyzed dental records to assess the prevalence and severity of periodontal disease, characterize changes in periodontal health, and determine impact of age, race, gender, and tobacco use on periodontal status among U.S. Navy personnel. Methods: Dental records from 1107 personnel who entered military service in 1997 were gathered from eight U.S. Navy dental treatment facilities. Demographic information, tobacco use, and periodontal health, as reflected by Periodontal Screening and Recording (PSR) information recorded at each dental examination during the four-year observational period (1997-2001), were collected. Results: Over 98% of personnel exhibited some level of periodontal disease at initial examination. Most (76%) exhibited gingivitis of varying severity. Over a mean observational period of 3.4 years, 91% of subjects received at least one oral prophylaxis; over 60% received two to four prophylaxes. Subjects with severe periodontal conditions received as many as 22 appointments for prophylaxis or periodontal therapy. From initial to final examination, periodontal status improved for 29.2% of subjects, deteriorated for 31.3%, and remained unchanged for 39.5%. Subjects presenting initially with healthy periodontia, or gingivitis without periodontitis, tended to deteriorate or remain unchanged, while those exhibiting periodontitis tended to improve with periodontal therapy. Over 75% of subjects who exhibited a change in status only changed by one grade (69% improved and 83% worsened). Race (non-white) and greater age at entry were significantly associated with increased risk for poorer periodontal health at initial and final examination. Conclusion: Although periodontal conditions respond favorably with active therapy, patients who receive sporadic care may deteriorate over time. To maintain periodontal health in this population, appropriate preventive and periodontal therapies should be provided soon after entry, and repeated at intervals specific to individual patient need.