title: Epidemiologic risk factors for periodontal attachment loss among adults in the United States.
abstract: OBJECTIVE
  The objective of this study was to identify variables related to periodontal loss of attachment (LOA).
  
  
  METHODS
  The study population consisted of a nationally representative sample of 12,325 US adults who participated in the National Health and Nutrition Examination Survey III. The analyses used survey multinomial logistic regression to account for the complex survey design.
  
  
  RESULTS
  The adjusted odds ratio for a mean LOA of 3 mm or more associated with current smoking was 18.55 (95% CI 9.44-36.45) among 20-49-year olds. Among those aged 50 years or more, the odds ratio for a mean LOA of 4 mm or more was 25.64 (13.04-50.40). Prior smoking, untreated decayed surfaces (on both person and site levels), and male gender were also associated with LOA. There was no excess risk observed among non-Hispanic blacks or Mexican-Americans. The adjusted population attributable fractions due to current smoking were 60% for persons aged 20-49 with the worst 10% of LOA (1.58 mm or more), and 47% for those aged 50 plus (LOA of 3.39 mm or more).
  
  
  CONCLUSIONS
  These results support earlier findings regarding the central role of cigarette smoking in the etiology of periodontal loss of attachment, a role due in large part to the substantial relationship between smoking and severe periodontal disease.
authors.affiliation: National Institute of Dental and Craniofacial Research, Bethesda, MD 20892-6401, USA. jh393y@nih.gov
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Hyman
authors.forename: Britt C
authors.initials: BC
authors.lastname: Reid
mesh_terms: D000328:Adult; D000367:Age Factors; D044383:Black People; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology; D016021:Epidemiologic Studies; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008875:Middle Aged; D016017:Odds Ratio; D017622:Periodontal Attachment Loss / Q000453:epidemiology*; D010512:Periodontal Index; D010518:Periodontitis / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American