Attachment loss trends over 3 years in community-dwelling older adults
The purpose of this paper was to present the trends in attachment loss over a three-year period in a population of community-dwelling elderly. Also the paper addressed the following issues: whether attachment loss during one period in time makes a person at higher risk for attachment loss, whether sites with deeper periodontal pockets at baseline are more likely to experience future attachment loss, and whether teeth that experience attachment loss during one time period are more likely to be lost at the next time period. A sample taken from the Piedmont 65+ study of the elderly was taken (stratified on race to assure equal numbers of blacks and whites) for a total of 818 dentate and 200 edentulous people. The subjects used in these analyses were 169 blacks and 169 whites. Respondents were interviewed and examined in their homes using five teams consisting of a dentist and a recorder (a total of five dentists). Ramfjord measures for gingival recession and probing depth for two sites were recorded (buccal and M-B).The threshold was set for a change in attachment level at 3 mm or more (over an 18-month period).
Researchers found that whites were less likely to experience attachment loss (63% experienced no loss over three years compared to 45% of blacks). Blacks were more likely to experience attachment loss during both 18-month periods. People who experienced attachment loss during the first 18-month period were more likely to experience attachment loss during the second period (i.e., 57 blacks had attachment loss the first period and 27 of them went on to experience attachment loss the second period). At both examinations, whites were half as likely to have attachment loss at a site. There was a nonsignificant trend indicating that sites with attachment loss at 18 months were less likely to have further loss. For blacks, greater baseline probing depths were associated with a higher percentage of sites with attachment loss at 18 and 36 months. (For whites it was similar.) The vast majority of sites that did break down had probing depths of 3 mm or less (80% for blacks and 95% for whites).
In conclusion, attachment loss and probing depths are related to future breakdown in individual sites measured in this study. Also, baseline probing depth and attachment levels by themselves will not be good predictors of future attachment loss as the majority of events occurred in sites with normal levels of attachment and probing depths. [c.c.]
Beck, J.D., G.G. Koch, and S. Offenbacher, J. Periodont, 65:737, 1994