title: Incidence of periodontal attachment loss over 5 years among older South Australians.
abstract: OBJECTIVE
  This study described the 5-year incidence of periodontal attachment loss (ALOSS) among older Australians.
  
  
  METHODS
  Clinical examination data were obtained at baseline and 5 years from participants in a cohort study of South Australians aged 60+. Periodontal measurements (gingival recession, GR; probing depth, PD) were made for each tooth at 3 sites. An incident case of ALOSS was identified as an individual having 2+ sites with 3+ mm ALOSS.
  
  
  RESULTS
  Some 342 (42.7%) of the 801 individuals examined at baseline were re-examined after 5 years, contributing longitudinal data from a total of 15,522 sites (6102 in the maxilla and 9420 in the mandible). Most sites showed no change in either GR or PD. Using a threshold of 3+ mm for change, ALOSS occurred at 2.3% of mesiobuccal sites, 2.5% of buccal sites, and 3.4% of distolingual sites. Distolingual sites on molars showed the highest progression rates. The major component of ALOSS was increased GR. Overall, only 10.1% of the observed ALOSS was contributed by increases in PD. Nearly two-thirds of the sites that experienced ALOSS had <3 mm of ALOSS at baseline. The weighted 5-year incidence estimate for ALOSS was 43.2% (N=145), and was higher among diabetics or those who had lost 1+ teeth since baseline. Smoking was not a significant predictor.
  
  
  CONCLUSIONS
  The rates and patterns of ALOSS among older South Australians are largely similar to those recently reported for North Carolinians. Most ALOSS in older people manifests as increases in GR, rather than PD. Diabetics should be targeted for intensive primary and secondary prevention of periodontal disease.
authors.affiliation: Department of Oral Sciences, University of Otago, Dunedin, New Zealand.
authors.forename: W Murray
authors.initials: WM
authors.lastname: Thomson
authors.forename: Gary D
authors.initials: GD
authors.lastname: Slade
authors.forename: James D
authors.initials: JD
authors.lastname: Beck
authors.forename: John R
authors.initials: JR
authors.lastname: Elter
authors.forename: A John
authors.initials: AJ
authors.lastname: Spencer
authors.forename: Jane M
authors.initials: JM
authors.lastname: Chalmers
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000473:pathology; D017622:Periodontal Attachment Loss / Q000453:epidemiology*; D010514:Periodontal Pocket / Q000453:epidemiology; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology; D013021:South Australia / Q000453:epidemiology; D016388:Tooth Loss / Q000453:epidemiology