Educational Level as a Social Determinant of Health and Its Relationship to Periodontal Disease as a Health Outcome

Periodontal disease is a chronic inflammatory disease that affects the majority of the world's population [1,5,6,14]. It affects the tissues that surround and support the teeth which are compartmentalized into soft tissue, gingiva (gums), and hard tissue (bone) segments. Periodontal disease is usually preceded by gingivitis, which is caused by a buildup of bacteria that is reversible if the bacteria are removed. Periodontal disease is categorized as mild, moderate and severe. Most adult dental evaluations involve periodontal probing, which is the measurement from the top of the gums to the bone. Measurements of 1-3 mm are considered healthy, 4-5 mm are considered mild periodontal disease, and 6 mm are considered moderate periodontal disease. Any measurement greater than 7 is severe periodontal disease [1,5, 6]. At the severe stage, tooth loss can occur either by self-exfoliation (tooth falling out on its own) or the tooth can be deemed not salvageable and extracted by the healthcare professional. Symptoms of periodontal disease may also include many of the following: bleeding while brushing or while eating harder foods, receded gums, teeth that appear to be spreading, causing a change in the way the individual's teeth come together, pus, and persistent bad breath.