Gingivitis susceptibility among men with and without periodontitis

Gingival inflammation may progress to periodontitis in susceptible individuals. However, whether susceptibility to gingivitis is related to periodontitis susceptibility is unknown. Objectives: The objective of this cross-sectional study was to evaluate whether gingivitis susceptibility is associated with periodontitis. Methods: We analyzed data of 462 men aged 47 – 92 years who participated in the VA Dental Longitudinal Study. The sample was restricted to never smokers and former smokers who quit at least 5 years prior to examination. Bleeding on Probing (BoP) was measured at mesiobuccal and distobuccal sites (yes/no) by one examiner. Plaque and calculus were assessed with ordinal scores per tooth. Periodontitis was defined as having at least one site with probing depths and attachment loss (AL) of ≥5 mm. In addition, mean per-subject interproximal AL was calculated. For the following analyses, sites affected by periodontitis (AL>2 mm) were excluded. Multiple logistic regression models with tooth-level BoP at either site as the dependent variable and periodontitis or mean AL as the independent variable were fit. Generalized estimating equations were used to account for clustering of sites within subjects. The models adjusted for plaque, calculus, crown coverage, age, income, education, marital status, BMI, diabetes and vitamin C intake and stratified by age (<65, 65+ years). Results: There was a significant association between BoP (at sites not affected by periodontitis) and periodontitis. The association was stronger in younger subjects. For periodontitis, the Odds-Ratios and 95% CIs were 2.13 (1.46-3.09) and 1.24 (0.94-1.63) for men ≤65 and 65+ years, respectively. For a 1 mm increase in mean AL, the estimates were 1.17 (1.00-1.36) and 1.10 (0.98-1.23) respectively. Conclusions: Our results indicate that susceptibility to gingivitis may be higher among non-smoking subjects with periodontitis compared to non-smoking subjects without periodontitis. Supported by US Dept. of Veterans Affairs and NIH/NIDCR grants K24DE00419, R03DE016357.