Socio-Demographic and Oral Health Related Risk Factors for Periodontal Disease in Inner North East London (INEL) Adults: A Secondary Analysis of the INEL Data

Introduction: Periodontal disease is a serious collection of diseases which can lead to chronic inflammation, the destruction of tooth supporting structures and ultimately; tooth loss. It is also one of the most common diseases of the oral cavity and the major cause of tooth loss in adults and may have a major impact on the quality of life off those who suffer with the condition. Objectives: To determine the socio-demographic and oral-health-related risk factors for periodontal disease in a sample of adults living in Inner North East London (INEL), UK. Methods: A secondary analysis was conducted on data from the 2008 survey on ‘The Oral Health of Adults in INEL.' Data were entered into the Statistical Package for Social Sciences (SPSS v19, IBM UK Ltd, Portsmouth, UK) and analysed using descriptive analysis, chi-squared tests (P ≤ 0.05), together with multivariate regression analysis. The original survey employed a multi-stage sampling procedure and the final sample size was 361. All of the participants were selected from the London Boroughs of Tower Hamlets, City and Hackney and Newham. Periodontal disease indicators, such as the loss of clinical attachment and periodontal pocket depths were cross-matched with socio-demographic and oral health-related behaviours. Associations between the two were ascertained using chi-squared statistics and multivariate regression analysis. The case-definition adopted to indicate the presence of periodontal disease was “a clinical loss of attachment and periodontal pocketing of four millimetres or more, in at-least one tooth respectively”. Results: The prevalence of periodontal disease in the original INEL sample was 39.3%. Age and gender were the variables most commonly associated with periodontal disease. The prevalence of disease demonstrated an increase with age, and in terms of gender, 48.7% of males were observed to have periodontal disease compared to 32.2% of females. Ethnicity (p=0.005) and area of residence (p=0.005) were more directly associated with periodontal pocket depth ≥ 4 mm. Dental attendance (p=0.04) and education (p=0.02) were more directly associated with clinical loss of attachment. When assessing the combined outcomes, multivariate regression analysis showed that after controlling for age and gender, subjects without a work-related qualification were more likely to have periodontal disease (OR=1.780, 95% C.I. 1.066-2.973). Dental attendance was identified as another significant predictor of periodontal disease for example subjects who never visited a dentist were at more risk than the regular attenders (OR=3.700, 95% C.I. 1.448-9.458). Conclusion: The overall prevalence of periodontal disease in an Inner North East London sample was observed to be slightly higher but generally comparable with respect to the national average, as determined by the UK Adult Dental Health Survey (1998). Of the various sociodemographic and oral-health-related risk factors analysed in the present study, age, gender, work-related qualification and dental attendance were observed to increase the likelihood of periodontal disease. Furthermore, epidemiological studies should be implemented in order to develop prevention strategies which should focus on improving access to dental services in the local community in order to reduce periodontal disease rates.