Objective

To determine whether parental periodontal disease history is a risk factor for periodontal disease in adult offspring.

Methods

Proband periodontal examination (combined attachment loss (CAL) at age 32, and incidence of CAL from ages 26–32) and interview data were collected during the age-32 assessments in the Dunedin Study. Parental data were also collected. The sample was divided into two familial-risk groups for periodontal disease (high- and low-risk) based on parents’ self-reported periodontal disease.

Results

Periodontal risk analysis involved 625 proband-parent(s) groups. After controlling for confounding factors, the high-familial-risk periodontal group was more likely to have 1+ sites with 4+mm CAL (RR 1.45; 95% CI 1.11–1.88), 2+ sites with 4+mm CAL (RR 1.45; 95% CI 1.03–2.05), 1+ sites with 5+mm CAL (RR 1.60; 95% CI 1.02–2.50) and 1+ sites with 3+mm incident CAL (RR 1.64; 95% CI 1.01–2.66) than the low-familial-risk group. Predictive validity was enhanced when information was available from both parents.

Conclusions

Parents with poor periodontal health tend to have offspring with poor periodontal health. Family/parental history of oral health is a valid representation of the shared genetic and environmental factors that contribute to an individual’s periodontal status, and may help predict patient prognosis and preventive treatment need.

Background

A parental/family history of poor oral health may influence the oral-health-related quality of life (OHRQOL) of adults.

Objectives

To determine whether the oral health of mothers of young children can predict the OHRQOL of those same children when they reach adulthood.

Methods

Oral examination and interview data from the Dunedin Study's age-32 assessment, as well as maternal self-rated oral health data from the age-5 assessment were used. The main outcome measure was study members' short-form Oral Health Impact Profile (OHIP-14) at age 32. Analyses involved 827 individuals (81.5% of the surviving cohort) dentally examined at both ages, who also completed the OHIP-14 questionnaire at age 32, and whose mothers were interviewed at the age-5 assessment.

Results

There was a consistent gradient of relative risk across the categories of maternal self-rated oral health status at the age-5 assessment for having one or more impacts in the overall OHIP-14 scale, whereby risk was greatest among the study members whose mothers rated their oral health as "poor/edentulous", and lowest among those with an "excellent/fairly good" rating. In addition, there was a gradient in the age-32 mean OHIP-14 score, and in the mean number of OHIP-14 impacts at age 32 across the categories of maternal self-rated oral health status. The higher risk of having one or more impacts in the psychological discomfort subscale, when mother rated her oral health as "poor/edentulous", was statistically significant.

Conclusions

These data suggest that maternal self-rated oral health when a child is young has a bearing on that child's OHRQOL almost three decades later. The adult offspring of mothers with poor self-rated oral health had poorer OHRQOL outcomes, particularly in the psychological discomfort subscale.

Context

Tobacco smoking is a recognized behavioral risk factor for periodontal disease (through its systemic effects), and cannabis smoking may contribute in a similar way.

Objective

To determine whether cannabis smoking is a risk factor for periodontal disease.

Design and Setting

Prospective cohort study of the general population, with cannabis use determined at ages 18, 21, 26, and 32 years and dental examinations conducted at ages 26 and 32 years. The most recent data collection (at age 32 years) was completed in June 2005.

Participants

A complete birth cohort born in 1972 and 1973 in Dunedin, New Zealand, and assessed periodically (with a 96% follow-up rate of the 1015 participants who survived to age 32 years). Complete data for this analysis were available from 903 participants (comprising 89.0% of the surviving birth cohort).

Main Outcome Measure

Periodontal disease status at age 32 years (and changes from ages 26 to 32 years) determined from periodontal combined attachment loss (CAL) measured at 3 sites per tooth.

Results

Three cannabis exposure groups were determined: no exposure (293 individuals, or 32.3%), some exposure (428; 47.4%), and high exposure (182; 20.2%). At age 32 years, 265 participants (29.3%) had 1 or more sites with 4 mm or greater CAL, and 111 participants (12.3%) had 1 or more sites with 5 mm or greater CAL. Incident attachment loss between the ages of 26 and 32 years in the none, some, and high cannabis exposure groups was 6.5%, 11.2%, and 23.6%, respectively. After controlling for tobacco smoking (measured in pack-years), sex, irregular use of dental services, and dental plaque, the relative risk estimates for the highest cannabis exposure group were as follows: 1.6 (95% confidence interval [CI], 1.2–2.2) for having 1 or more sites with 4 mm or greater CAL; 3.1 (95% CI, 1.5–6.4) for having 1 or more sites with 5 mm or greater CAL; and 2.2 (95% CI, 1.2–3.9) for having incident attachment loss (in comparison with those who had never smoked cannabis). Tobacco smoking was strongly associated with periodontal disease experience, but there was no interaction between cannabis use and tobacco smoking in predicting the condition’s occurrence.

Conclusion

Cannabis smoking may be a risk factor for periodontal disease that is independent of the use of tobacco.

Objectives

To describe oral health-related quality of life (OHRQoL) among New Zealand adults and assess the relationship between clinical measures of oral health status and a well-established OHRQoL measure, controlling for sex, socioeconomic status (SES) and use of dental services.

Methods

A birth cohort of 924 dentate adults (participants in the Dunedin Multidisciplinary Health and Development Study) was systematically examined for dental caries, tooth loss, and periodontal attachment loss (CAL) at age 32 years. OHRQoL was measured using the 14-item Oral Health Impact Profile questionnaire (OHIP-14). The questionnaire also collected data on each study member’s occupation, self-rated oral health and reasons for seeing a dental care provider. SES was determined from each individual’s occupation at age 32 years.

Results

The mean total OHIP-14 score was 8.0 (SD 8.1); 23.4% of the cohort reported one or more OHIP problems ‘fairly often’ or ‘very often’. When the prevalence of impacts ‘fairly/very often’ was modeled using logistic regression, having untreated caries, two or more sites with CAL of 4+ mm and 1 or more teeth missing by age 32 years remained significantly associated with OHRQoL, after adjusting for sex and ‘episodic’ dental care. Multivariate analysis using Poisson regression determined that being in the low SES group was also associated with the mean number of impacts (extent) and the rated severity of impacts.

Conclusions

OHIP-14 scores were significantly associated with clinical oral health status indicators, independently of sex and socioeconomic inequalities in oral health. The prevalence of impacts (23.4%) in the cohort was significantly greater than age- and sex-standardized estimates from Australia (18.2%) and the UK (15.9%).

Background

Information is lacking on the natural history of periodontitis through the third and fourth decades of life.

Methods

Periodontal examinations were conducted at 26 and 32 years of age in a longstanding prospective study of a birth cohort born in Dunedin, New Zealand, in 1972 and 1973. At each age, gingival recession (GR) and probing depth (PD) were recorded at three sites per tooth using a diagonal half-mouth design (measurements were made in all four quadrants at 32 years of age, but longitudinal comparisons were made using only the half-mouth data).

Results

A total of 882 individuals were examined at both ages. The mean number of measured sites fell between 26 and 32 years of age. The overall prevalence of one or more sites with ≥4 mm combined attachment loss (CAL) rose from 18.6% to 21.8%, whereas there were greater increases in the proportion with two or more sites with ≥4 mm CAL (from 8.0% to 12.6%) and one or more sites with ≥5 mm CAL (from 3.6% to 8.0%). The extent and severity of CAL also increased. A total of 403 individuals (45.7%) had an increase in CAL ≥2 mm at one or more sites, whereas 110 (12.5%) had a CAL increase ≥3 mm at one or more sites. Seen in ~4% of sites, negative GR (i.e., gingival enlargement) had a substantial effect on PD-based estimates. An increase in PD ≥2 mm at one or more sites was experienced by 345 individuals (39.1%), whereas 88 people (10.0%) had an increase in PD ≥3 mm at one or more sites. The greatest mean attachment loss was experienced at disto-lingual sites on molars, and most manifested as PD increases. Notable increases in GR were seen with lower incisors and canines.

Conclusions

Periodontal loss of attachment continues among a sizable proportion of people from the third to the fourth decade of life; however, contrary to patterns in older adults, changes in the PD component are greater than the changes in the recession component. Incident attachment loss is most frequently observed at proximal sites on posterior teeth.

Background

Smoking is recognized as the primary behavioural risk factor for periodontal attachment loss (AL), but confirmatory data from prospective cohort studies are scarce.

Aim

To quantify the association between cigarette smoking patterns and AL by age 32.

Methods

Periodontal examinations were conducted at ages 26 and 32 in a longstanding prospective study of a birth cohort born in Dunedin (New Zealand) in 1972/1973. Longitudinal categorization of smoking exposure was undertaken using data collected at ages 15, 18, 21, 26 and 32.

Results

Complete data were available for 810 individuals of whom 48.9% had ever smoked (31.5% were current smokers). Compared with never-smokers, long-term smokers (and other age-32 smokers) had very high odds ratios (ORs of 7.1 and 5.7, respectively) for having 1 +sites with 5 +mm AL, and were more likely to be incident cases after age 26 (ORs of 5.2 and 3.2, respectively). Two-thirds of new cases after age 26 were attributable to smoking. There were no significant differences in periodontal health between never-smokers and those who had quit smoking after age 26.

Conclusions

Current and long-term smoking in young adults is detrimental to periodontal health, but smoking cessation may be associated with a relatively rapid improvement in the periodontium.

Background

Dental caries and restorations in proximal tooth surfaces often impinge upon the periodontal biological width.

Aim

This study examines whether these factors may contribute to risk for periodontal attachment loss at these sites.

Methods

The study is based upon data from the Dunedin Multidisciplinary Health and Development Study, a long-standing cohort study. Approximal tooth surfaces of 884 study members were evaluated for restorations and caries at age 26 and again at 32 years, and probing depth and gingival recession were recorded in millimetres at age 32. Attachment loss was computed as the sum of pocket depth and gingival recession. Data were analysed using generalized estimating equations.

Results

Where a caries/restorative event had occurred on an inter-proximal tooth surface before age 26, the age-32 attachment loss at the corresponding periodontal site was approximately twice more likely to be ≥3 mm than if the adjacent tooth surface had remained sound to age 32. This was also true where a caries/restorative event had occurred subsequent to age 26. The association remained after controlling for potential confounders, including smoking.

Conclusions

Site-specific periodontal attachment loss due to dental caries or restorative events occurs in adults in their third and fourth decades of life.

Background

Recent research has suggested that chronic dry mouth affects the day-to-day lives of older people living in institutions. The condition has usually been considered to be a feature of old age, but recent work by our team produced the somewhat surprising finding that 10% of people in their early thirties are affected. This raises the issue of whether dry mouth is a trivial condition or a more substantial threat to quality of life among younger people. The objective of this study was to examine the association between xerostomia and oral-health-related quality of life among young adults while controlling for clinical oral health status and other potential confounding factors.

Methods

Cross-sectional analysis of data from a longstanding prospective observational study of a Dunedin (New Zealand) birth cohort: clinical dental examinations and questionnaires were used at age 32. The main measures were xerostomia (the subjective feeling of dry mouth, measured with a single question) and oral-health-related quality of life (OHRQoL) measured using the short-form Oral Health Impact Profile (OHIP-14).

Results

Of the 923 participants (48.9% female), one in ten were categorised as 'xerostomic', with no apparent gender difference. There was a strong association between xerostomia and OHRQoL (across all OHIP-14 domains) which persisted after multivariate analysis to control for clinical characteristics, gender, smoking status and personality characteristics (negative emotionality and positive emotionality).

Conclusion

Xerostomia is not a trivial condition; it appears to have marked and consistent effects on sufferers' day-to-day lives.