Risk Indicators for Tooth Loss Due to Periodontal Disease

Objectives: Several risk indicators for periodontal disease severity have been identified. The association of these factors with tooth loss for periodontal reasons was investigated in this cross-sectional comparative study. Methods: All extractions performed in 21 general dental practice clinics (25% of all such clinics in Kuwait) over a 30-day period were recorded. Documented information included patient age and gender, medical history findings, dental maintenance history, toothbrushing frequency, types and numbers of the extracted teeth, and reason for the extraction. Reasons were divided into periodontal disease vs. other reasons in univariate and binary logistic regression analyses. Results: A total of 1,775 patients had 3,694 teeth extracted. More teeth per patient were lost due to periodontal disease than for other reasons (2.8 ± 0.2 vs. 1.8 ± 0.1; p< 0.001). Factors significantly associated with tooth loss due to periodontal reasons in logistic regression analysis were age > 35 years (OR 3.45; 95% C.I. 2.79-4.26), Male gender (OR 1.42; 95% C.I. 1.17-1.73), never having periodontal maintenance (OR 1.48; 95% C.I. 1.23-1.78), never using the toothbrush (OR 1.81; 95% C.I. 1.49-2.20), current or past smoking (OR 1.56; 95% C.I. 1.28-1.91), anterior tooth type (OR 3.23; 95% C.I. 2.57-4.05), and the presence of either of the following medical conditions: diabetes mellitus (OR 2.64; 95% C.I. 2.19-3.18), hypertension (OR 1.73; 95% C.I. 1.41-2.13), or rheumatoid arthritis (OR 4.19; 95% C.I. 2.17-8.11). Conclusion: Tooth loss due to periodontal disease is associated with the risk indicators of age, male gender, smoking, lack of professional maintenance, inadequate oral hygiene, diabetes mellitus, hypertension, rheumatoid arthritis, and anterior tooth type.