Impact of Oral Hygiene Compliance on Periodontal Disease Outcomes

Objectives: For this longitudinal cohort study, a private practice general dentist recorded periodontal measurements on 1319 patients between 1990 and 1999. The study examined the impact of oral hygiene and prophylaxis compliance to clinical signs of periodontitis.
Methods: The study utilized staging criteria based on the 2017 Classification of Periodontal Disease. Chi-square statistics were used to assess associations between categorical variables and the Kruskal-Wallis Test for continuous data.. Post-hoc Bonferroni Adjustments and Wilcoxon Rank Sum Tests were performed. Correlations between variables were quantified using Pearson Coefficients.
Results: Periodontitis Stage 1 and Stage 2 had proportionally equal gender distribution, while Stage 3/4 had greater proportion of men (p = 0.004). Further analysis revealed male patients had significantly (p = 0.028) higher average plaque scores (36%) than women (32%). No statistically significant difference in prophylaxis compliance was seen between genders (p = 0.119). Patients in Periodontitis Stage 3 were significantly older (average age of 50.8 years; p < 0.0001) than Stage 1 or Stage 2 patients (42.6 years and 43.7 years, respectively). However, in patients between the ages of 50-65, disease improvement directly correlated to prophylaxis compliance (p = 0.011), whereas in patients between 19 and 30 years old with Periodontitis Stage 2 or 3, prophylaxis compliance or good oral hygiene was not predictive of disease improvement (p = 0.272).
Conclusions: The results of the study indicate that the prevalence of periodontal disease in men is related to preventive practices. Furthermore, the prevalence of periodontal disease in older adults seems to be related to increased exposure to etiological factors rather than intrinsic to aging alone. Therefore, the results of the study suggest that older patients compliant to periodic recalls should demonstrate minimal attachment loss. However, in younger patients with significant periodontitis, the disease appeared recalcitrant to prophylaxis compliance or low plaque scores.