title: Risk factors for the progression of periodontal attachment loss: a 5-year population-based study in South Brazil.
abstract: OBJECTIVE
  To assess sociodemographic and behavioural risk factors for periodontal attachment loss (PAL) progression after 5 years in an urban sample from south Brazil.
  
  
  METHODS
  At baseline, 1586 subjects, 14 years and older, were derived using a multistage probabilistic sample strategy. At follow-up, 653 of 755 subjects had ≥6 teeth and were included in this analysis. A modified multiple Poisson regression was used to calculate adjusted relative risks (RR) and 95% confidence intervals (CI).
  
  
  RESULTS
  Overall, 247 (37.8%) subjects exhibited PAL progression ≥3 mm in ≥4 teeth. Subjects older than 30 years had approximately two times higher risk of having PAL progression than younger subjects. Subjects with low education had 53% higher risk (RR = 1.53; 95% CI:1.06-2.22) of PAL progression compared to those with high education. A significant interaction between gender and smoking was observed. Among never-smokers, males were 33% more likely (RR = 1.33; 95% CI:1.06-1.66) to experience PAL progression than females. Among smokers, there was 8% increased risk of PAL progression (RR = 1.08; 95% CI:1.01-1.14) for males and 21% (RR = 1.21; 95% CI:1.11-1.33) for females per 10 packyears. Skin colour, socioeconomy, dental care and diabetes were not significantly associated with PAL progression after statistical adjustment.
  
  
  CONCLUSIONS
  Sociodemographic factors and smoking are independent risk factors for PAL progression in this Brazilian population.
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Alex Nogueira
authors.initials: AN
authors.lastname: Haas
authors.forename: Marcius Comparsi
authors.initials: MC
authors.lastname: Wagner
authors.forename: Rui Vicente
authors.initials: RV
authors.lastname: Oppermann
authors.forename: Cassiano Kuchenbecker
authors.initials: CK
authors.lastname: Rösing
authors.forename: Jasim M
authors.initials: JM
authors.lastname: Albandar
authors.forename: Cristiano
authors.initials: C
authors.lastname: Susin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009910:Oral Hygiene / Q000706:statistics & numerical data; D017622:Periodontal Attachment Loss / Q000453:epidemiology*; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D014504:Urban Health / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Brazil; cohort; epidemiology; longitudinal studies; periodontal attachment loss; periodontal diseases; risk factors; smoking