title: Factors influencing the effect of race on established periodontitis prevalence.
abstract: OBJECTIVE
  This paper identifies differences in prevalence of established periodontitis and evaluates factors that might explain the differences between non-Hispanic African Americans (n = 232) and whites (n = 199) in the Detroit tricounty area.
  
  
  METHODS
  Subjects from a disproportionate probability sample of community-dwelling adults were interviewed regarding demographic, psychosocial and enabling factors, dental health-related behaviors, and other risk factors, and had comprehensive in-home dental examinations.
  
  
  RESULTS
  The overall prevalence of established periodontitis was 20.8 percent; African Americans exhibited a significantly higher prevalence than whites (29.8% vs 17.7%). The crude association between race and prevalence of established periodontitis was significant (odds ratio [OR] for African Americans = 1.98; 95% confidence interval [CI] = 1.17,3.34). After controlling for other covariates, we found the effect of race may be modified by dental checkup visit frequency: African Americans with dental checkups at least once a year had almost a fourfold higher odds of established periodontitis (OR = 3.64; 95% CI = 1.43, 9.24) than their white counterparts with dental checkups at least once a year (the referent group); while African Americans with a dental checkups once every two years or less often were more than fourfold less likely to have established periodontitis (OR = 0.22; 95% CI = 0.08, 0.59) than their white counterparts in the referent group.
  
  
  CONCLUSIONS
  This analysis supports the disparity in periodontal health as part of the black:white health disparity when taking other factors into account. However, periodontal health disparities may be more complex than previously recognized, requiring greater understanding of factors related to dental care utilization in future studies evaluating this disparity.
authors.affiliation: University of Michigan, Ann Arbor 48109-1076, USA.
authors.forename: Luisa N
authors.initials: LN
authors.lastname: Borrell
authors.forename: George W
authors.initials: GW
authors.lastname: Taylor
authors.forename: Wenche S
authors.initials: WS
authors.lastname: Borgnakke
authors.forename: Linda V
authors.initials: LV
authors.lastname: Nyquist
authors.forename: Marilyn W
authors.initials: MW
authors.lastname: Woolfolk
authors.forename: Doris J
authors.initials: DJ
authors.lastname: Allen
authors.forename: W Paul
authors.initials: WP
authors.lastname: Lang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People; D003729:Dental Care / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D010518:Periodontitis / Q000453:epidemiology / Q000208:ethnology*; D015995:Prevalence; D012959:Socioeconomic Factors; D044465:White People; D001741:Black or African American