Incidence of Periodontal Attachment Loss over 8 to 10 Years among Iowa Elders Aged 71+ at Baseline

Objectives: There has been limited research on the long-term incidence of periodontal attachment loss (ALOSS) among adults aged 70 and older. This study investigated periodontal ALOSS incidence among elderly Iowans aged 71 and older over an 8- to 10-year period. Methods: Clinical examination data were obtained for a cohort of the Iowa 65+ Oral Health Study/Oral Lesion Detection Study in 1988 (baseline) and again in 1996-98. Periodontal measurements, including gingival recession and probing depth, were made by trained examiners at both exams for each retained tooth at buccal (B) and mesiobuccal (MB) sites. Paired-sample t-tests were used to determine whether significant differences existed in ALOSS between the two time points; two-sample t-tests were used to assess the significance between genders and age groups (81 to 85 versus 86 to 93 years at follow-up). Results: Of the 77 individuals examined at baseline, 35 provided longitudinal data for a total of 705 retained teeth. The data revealed that there were significant changes in ALOSS at B, MB, and combined sites during the observation period, but there were no significant differences in ALOSS by gender or age group. The mean differences in ALOSS between the two time periods were 0.57 mm (SD=0.69, Max=2.08) at B sites, and 0.43 mm (SD=0.63, Max=2.00) at MB sites. Over the period of 8 to 10 years, 2+ mm ALOSS incidence occurred at 17.6 percent of B sites and 13.9 percent of MB sites. Also, 68.6, 71.4, and 82.9 percent of the subjects experienced ALOSS incidence of 2+ mm at one or more B, MB, and B or MB sites, respectively, while 20.0, 25.7, and 31.4 percent of the subjects experienced ALOSS incidence of 4+ mm at one or more B, MB, and B or MB sites, respectively. Conclusions: Continuing ALOSS incidence was common in this elderly population. This study suggests that periodontal treatment continues to be important for the elderly.