Effect of Age on Healing Responses Following Scaling and Root Planing

Objectives: To evaluate healing responses to the nonsurgical periodontal treatment among adults of different age strata and racial/ethnic groups within an academic clinical practice network in rural North Carolina.
Methods: This observational study used de-identified electronic health record data from adult patients (≥18 years) of record (2011-2019) who received a baseline periodontal examination, treatment with scaling and root planning (SRP) and re-evaluation (at 2-3 months versus 4-6 months). Periodontal parameters included pocket depths (PD), clinical attachment levels (CAL) and bleeding on probing (BOP). Changes in probing parameters were expressed as means (SD) and extent scores (%), and then compared after stratifying for sex, age, race/ethnicity and tobacco use.
Results: The study sample consisted of 1,004 patients (50% female) meeting inclusion criteria. The population was diverse: 28% Non-Hispanic Black versus 56% Non-Hispanic White, and 7% reported Hispanic/Latino for race/ethnicity. The sample was also broad in ages: 7% 18-34 years, 18% 35-49 years, 37% 50-64 years and 38% ≥ 65 years. All mean and extent probing scores improved significantly with SRP. Overall, patient age at baseline showed significant correlations with most PD, CAL and BOP responses (range, p=0.04-≤0.001). Accordingly, advanced age was correlated with smaller improvements in mean and extent probing scores. A multiple regression analysis indicated that age at baseline showed significant relationships for CAL responses and that tobacco use showed significant relationships with the observed clinical changes (p<0.05).
Conclusions: These data indicate that older adults and smokers exhibit decreased improvements in probing parameters following SRP relative to younger patients and nonsmokers. The data also suggest the need to develop “personalized” periodontal interventions that take into account patient age, immuno-inflammatory responses and/or the oral microbiome and health behaviors.