Risk indicators for periodontal disease among Aboriginal Australian adolescents

Methods: Data were from Wave III of the Aboriginal Birth Cohort Study; a prospective longitudinal investigation of Aboriginal individuals born 1987–1990 at the Royal Darwin Hospital, Northern Territory, Australia. Self-report and clinical data were collected. Moderate and severe periodontal disease was defined by the US Centers for Disease Control and Prevention and the American Academy of Periodontology definitions. Multivariate statistical models predicted odds of periodontal disease using information about socio-demographics, lifestyle, substance use, oral health behaviour and dental service utilisation.

Results: Of 392 participants with complete data (48.5% male, age range 16–20 years), 26.8% had moderate or severe periodontal disease; 3.6 times the prevalence of 15–34-year-olds in Australia's National Survey of Adult Oral Health. Some 78.3% lived in rural/remote locations, 88.4% reported 4+ people staying in their house the previous night, 9.7% sniffed petrol, 40.6% smoked marijuana, 71.7% smoked tobacco, 30.4% did not own a toothbrush, 58.4% were scared of the dentist, 59.3% were 12 years or less when they last visited a dentist, and 22.4% had not always lived in the same community. In multivariate analysis, risk indicators for moderate or sever periodontal disease included being male (OR 2.88, 95% CI 1.75–4.72), petrol sniffing (OR 2.32, 95% CI 1.11–4.85), not owning a toothbrush (OR 2.32, 95% CI 1.25–3.42) and having not always lived in the same community (OR 1.99, 95% CI 1.07–3.71; Nagelkerke R2=15.1).

Conclusions: The prevalence of moderate or severe periodontal disease in this cohort of Aboriginal young adults was high when compared with national estimates. Being male, sniffing petrol, not owning a toothbrush and not having always lived in the same community were significant risk indicators. Experience of periodontal disease may be reduced by initiatives that: address the underlying social determinants that lead to substance abuse and constant movement, particularly among males, in remote Aboriginal communities; target distribution and availability of oral self-care products; and encourage regular oral hygiene practices.