Effect of Immigration and Race/Ethnicity on Periodontal Disease

Objectives: We conducted a large cross-sectional study of 1,508 Haitian, Chinese, Asian Indian, West Indian, Dominican, Puerto Rican, and Other Hispanic immigrants in New York City to examine the association between immigrant status and periodontal disease. Methods: Subjects aged 18-65 were recruited through community-based organizations. Comprehensive oral examinations utilizing NIDCR criteria were conducted. Subjects completed a self-administered questionnaire. Multiple regression models were performed to assess differences in periodontal disease experience among ethnic groups. Proportional odds models were conducted to compute odds ratios for having a higher level of disease in relation to length of stay in the U.S. and age at immigration. Results: We observed significant differences (p<0.01) among the six racial/ethnic subgroups for percent of sites with pocket depth > 4mm, with age- and gender- adjusted values ranging from 7.89% (SD=1.09) in Other Hispanics to 12.17% (SD=0.84) in Haitians; and in mean pocket depth, ranging from 2.28 mm (SD= 0.05) in other Hispanics to 2.47 mm (SD= 0.04) in Haitians. These differences remained significant (p<.01) after adjusting for demographic, socioeconomic, knowledge, attitudes, practices, smoking status and self-reported diabetes as well as length of stay in the US and age at immigration. There were no apparent associations between these indices and length of stay in the US. On the other hand, age at immigration was positively related to all four indices of periodontal disease (p-value for trend tests in ORs all <0.01). Conclusions: Race/ethnic differences exist in levels of periodontal disease after controlling for established predictors of periodontal disease with Haitians exhibiting highest levels of disease. Further research is needed to investigate the factors associated with these differences. Supported by NIH/NIDCR grant no. R03-DE-016864.