Methods: A hospital-based unmatched case-control study was conducted at the Institute of Dentistry at The Royal London Hospital. Patients were recruited from consecutive patients referred for treatment by their general dental practitioners. All participants were 20-40 years old, had a minimum of 24 teeth and no systemic diseases. Cases (n=80) were defined as patients with a minimum of 4 pocket depths greater than 5.5mm involving at least 4 mouth-sextants. Controls (n=153) had pocket depths not greater than 3.5mm. Self-completed validated questionnaires were used to collect socio-economic, socio-psychological and behavioural variables. Ethical approval and consent were obtained. Data analysis included simple and multiple logistic tests.
Results: There was a statistically significant gradient in GAP from lowest to highest SEP (p=0.010). Adjusted results showed that low SEP [OR=3.4 (1.3-8.6)] and negative life events [OR=2.4 (1.2-4.9)] remained as risk factors to GAP, while positive life events [OR=0.4 (0.2-0.9)], high social support [OR=0.5 (0.2-0.9)] and high optimism [OR=0.4 (0.2-0.9)] remained protective. Smoking [OR=1.6 (0.7-3.3)] did not remain significantly associated to GAP in multivariate analysis. Problem-solving-related variables and dental attendance showed p-value greater than 0.200 when associated with GAP in univariate analysis and were excluded from multivariate analysis. Most participants (97%) reported brushing their teeth at least once a day.
Conclusion: The results suggest that positive life events, high social support and high optimism may balance for the harmful effects of low SEP and negative life events.