Periodontitis in the United States: beyond black and white.
OBJECTIVE
This paper examines whether historical disparities in periodontal status between African Americans and whites in the United States have increased, decreased, or remained the same over the 15-year period between the First National Health and Nutrition Examination Survey (NHANES I, 1971-74) and the Third National Health and Nutrition Examination Survey (NHANES III, 1988-94).


METHODS
This study compared the magnitude of the relative and absolute differences in the periodontal status of African-American and white adults in NHANES I and again in NHANES III.


RESULTS
The prevalence of periodontitis in the US adult population in NHANES I was 31.6 percent, with African Americans exhibiting higher prevalence than whites. In NHANES III, using a different case-definition for periodontitis, the overall prevalence was 11.9 percent, with African Americans again exhibiting higher prevalence than whites. The magnitude of the intrasurvey relative and absolute differences between African Americans and whites increased between NHANES I and NHANES III. This finding remained after adjustment in the logistic regression analyses. After adjustment for all covariates in the model, African Americans were more likely to exhibit periodontitis than whites in both NHANES I (odds ratio [OR] = 1.31; 95% confidence intervals [CI] = .78, 2.19) and NHANES III (OR = 2.09; 95% CI = 1.68, 2.60). However, the CI included 1.00 in NHANES I.


CONCLUSIONS
Disparities in periodontitis between African Americans and whites are pervasive and have increased over time. This increase appears to be driven by social, cultural, and behavioral factors.
Borrell
Luisa N
LN
Department of Epidemiology, Mailman School of Public Health, Columbia University, 600 West 168th Street, PH-18, New York, NY 10032, USA. lnb2@columbia.edu
Burt
Brian A
BA
Gillespie
Brenda W
BW
Lynch
John
J
Neighbors
Harold
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010510:Periodontal Diseases / Q000453:epidemiology*; D010512:Periodontal Index; D015995:Prevalence; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American