JKAOH Journal of Korean Academy of Oral Health J Korean Acad Oral Health 1225-388X 2093-7784 Journal of Korean Academy of Oral Health 10.11149/jkaoh.2013.37.2.95 jkaoh-37-95 Original Article Risk indicators of periodontal disease in Korean adults WooDong-Hyeob YouHae-Young KimMin-Ji KimHan-Na KimJin-Bom JeongSeung-Hwa Department of Preventive and Community Dentistry, Pusan National University School of Dentistry, Yangsan, Korea Corresponding Author: Seung-Hwa Jeong Department of Preventive and Community Dentistry, Pusan National University School of Dentistry, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 626-870, Korea Tel: +82-51-510-8222 Fax: +82-51-510-8221 E-mail: jsh0917@pusan.ac.kr 062013 12062013 37 2 95 102 24052013 23062013 24062013 Copyright © 2013 Journal of Korean Academy of Oral Health 2013 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Objectives

The purpose of this study was to evaluate the risk indicators of periodontal disease in a representative sample of Korean adults aged between 18 and 44 years.

 Methods

Data of 6,485 adults were derived from the Fourth Korean National Health and Nutrition Examination Survey, which was conducted from 2007 to 2009. Demographic, socioeconomic, and oral health-related behavioral data were collected as independent variables. The Community Periodontal Index (CPI) was used as a dependent variable. The chi-square test and logistic regression analysis were performed to identify the relationship between the CPI and the other variables.

 Results

Multiple logistic regression analysis revealed that periodontal pocket formation (4 mm or more) was related with sex, age, and income level, irrespective of whether the mother engaged in economic activities in childhood, smoking experience, dental flossing, and use of interdental brushes. The subjects in the lowest-income quartile and those who were current smokers had a higher risk of pocket formation (odds ratios, 1.43 and 1.74, respectively) than those in the highest-income quartile and those who had no smoking experience, respectively.

 Conclusions

This study confirmed various risk indicators of periodontal disease in Korean adults, using Korean national survey data. Smoking cessation, dental flossing, and efforts to decrease socioeconomic inequality should be encouraged to decrease the risk of periodontal disease.

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Summary of relationship between CPI and other variables determined by chi-square test.

Summary of relationship between each variables and periodontal disease.

Relationship between each community periodontal index and other variables analyzed from chi-square test and logistic regression analysis

Variables Level N (%) Community periodontal index Adjusted OR (CI)
CPI 4 CPI 3, 4 CPI 2, 3, 4 CPI 1, 2, 3, 4 CPI 4≤ vs 4> CPI 3≤ vs 3> CPI 2≤ vs 2> CPI 1≤ vs 0
Area Urban (dong) 5,476 (84.4) 159 (2.9) 977 (17.4) 3,452 (63.1) 3,870 (70.4) 1.06 (0.60-1.88) 1.01 (0.76-1.34) 0.93 (0.73-1.19) 0.80 (0.58-1.12)
Rural (eup, myeon) 1,009 (15.6) 37 (3.7) 206 (20.2) 661 (66.5) 767 (76.1) 1 1 1 1
Sex Male 2,767 (42.7) 127 (4.3) 673 (22.5) 1,984 (70.9) 2,157 (77.2) 1.96 (1.28-3.00)§ 1.44 (1.17-1.78)§ 1.42 (1.22-1.66)§ 1.39 (1.18-1.64)§
Female 3,718 (57.3) †69 (1.6) †510 (12.7) †2,129 (55.7) †2,480 (64.7) 1 1 1 1
Age group 18-24 899 (13.9) 1 (0.1) 35 (4.2) 480 (54.5) 562 (63.4) 0.03 (0.00-0.20)§ 0.11 (0.07-0.17)§ 0.41 (0.33-0.51)§ 0.50 (0.39-0.62)§
25-29 1,027 (15.8) 5 (0.4) 97 (9.6) 582 (57.8) 672 (66.5) 0.07 (0.03-0.17)§ 0.26 (0.2-0.34)§ 0.49 (0.40-0.61)§ 0.58 (0.46-0.72)§
30-34 1,373 (21.2) 27 (2.2)† 212 (16.0)† 855 (62.7)† 976 (70.4)† 0.36 (0.22-0.58)§ 0.42 (0.33-0.53§ 0.61 (0.50-0.74)§ 0.68 (0.56-0.84)§
35-39 1,706 (26.3) 63 (4.2) 377 (23.5) 1,131 (67.5) 1,278 (75.6) 0.61 (0.43-0.87)§ 0.66 (0.55-0.8)§ 0.76 (0.64-0.90)§ 0.89 (0.75-1.05)
40-44 1,480 (22.8) 100 (7.2) 462 (32.4) 1,065 (73.3) 1,149 (78.1) 1 1 1 1
Income level Quartile 1 (low) 479 (7.4) 17 (3.6) 95 (18.6) 313 (65.6) 350 (72.8) 2.08 (0.94-4.60) 1.43 (1.02-2.01)‡ 1.14 (0.88-1.46) 1.09 (0.82-1.44)
Quartile 2 1,457 (22.5) 65 (4.2) 309 (19.8) 976 (66.5) 1,083 (72.8) 2.02 (1.24-3.27)§ 1.32 (1.05-1.66)‡ 1.18 (0.99-1.40) 1.07 (0.88-1.29)
Quartile 3 2,247 (34.6) *64 (2.8) *417 (18.4) †1,437 (64.5) 1,610 (71.7) 1.20 (0.83-1.75) 1.13 (0.92-1.37) 1.11 (0.96-1.28) 1.04 (0.89-1.21)
Quartile 4 (high) 2,302 (35.5) 50 (2.2) 362 (15.6) 1,387 (60.3) 1,594 (69.2) 1 1 1 1
Education level Elementary 49 (0.8) 7 (15.1) 17 (36.2) 42 (85.9) 45 (92.1) 3.88 (1.18-12.74)‡ ‡1.47 (0.73-2.94) 2.61 (1.08-6.28)‡ 3.56 (1.19-10.67)‡
Middle 188 (2.9) 17 (9.3) 56 (30.3) 142 (76.5) 152 (81.0) 1.89 (0.96-3.73) 1.15 (0.77-1.71) 1.34 (0.88-2.02) 1.23 (0.78-1.94)
High 3,203 (49.4) †98 (2.8) †597 (17.3) †2,073 (64.5) †2,320 (71.7) 0.96 (0.64-1.44) 0.97 (0.81-1.16) 1.02 (0.89-1.18) 0.98 (0.85-1.14)
University 3,045 (47.0) 74 (2.7) 513 (17.2) 1,856 (61.4) 2,120 (69.7) 1 1 1 1
Nationalhealth insuranceMother's job Non-medical aid 6,375 (98.3) 191 (3.0) 1,154 (17.7) 4,037 (63.5) 4,558 (71.2) 2.27 (0.59-8.69) 0.91 (0.52-1.58) 0.89 (0.55-1.44) 1.20 (0.74-1.94)
Medical aid 110 (1.7) 5 (3.5) 29 (24.2) 76 (68.9) 79 (70.3) 1 1 1 1
Yes 3,687 (56.9) 133 (3.7) 761 (20.6) 2,414 (65.9) 2,697 (73.3) 1.23 (0.84-1.80) 1.21 (1.03-1.43)‡ 1.12 (0.99-1.26) 1.11 (0.98-1.27)
No 2,798 (43.1) †63 (2.1) †422 (14.4) †1,699 (60.8) †1,940 (68.6) 1 1 1 1
Father's education Elementary 2,149 (33.1) 107 (5.4) 526 (25.3) 1,452 (68.7) 1,623 (76.1) 0.92 (0.43-1.97) 1.22 (0.82-1.8) 1.11 (0.87-1.43) 1.16 (0.90-1.50)
Middle 1,402 (21.6) 39 (2.6) 266 (18.3) 900 (63.9) 1,020 (71.6) 0.62 (0.29-1.43) 1.09 (0.75-1.58) 1.05 (0.83-1.34) 1.05 (0.82-1.36)
High 1,943 (30.0) †33 (1.6) †282 (13.8) †1,190 (61.6) †1,347 (69.3) 0.62 (0.31-1.22) 1.08 (0.78-1.51) 1.08 (0.87-1.33) 1.09 (0.87-1.36)
University 991 (15.3) 17 (1.6) 109 (10.5) 571 (57.2) 647 (64.8) 1 1 1 1
Mother's education Elementary 3,090 (47.6) 141 (4.9) 743 (24.7) 2,068 (67.9) 2,316 (75.3) 3.90 (0.71-21.42) 1.63 (0.92-2.91) 0.96 (0.71-1.31) 1.04 (0.75-1.46)
Middle 1,503 (23.2) 34 (2.1) 240 (15.4) 931 (61.7) 1,062 (70.1) 3.31 (0.60-18.31) 1.38 (0.78-2.42) 0.91 (0.68-1.22) 1.00 (0.73-1.38)
High 1,522 (23.5) †19 (1.1) †172 (10.9) †902 (59.8) †1,021 (67.2) 2.48 (0.47-13.17) 1.36 (0.81-2.28) 0.99 (0.77-1.27) 1.02 (0.77-1.34)
University 370 (5.7) 2 (0.5) 28 (7.3) 212 (56.0) 238 (63.4) 1 1 1 1
Smoking experience Present_smoke 1,722 (26.6) 77 (4.2) 449 (24.5) 1,318 (75.8) 1,407 (80.5) 1.61 (0.99-2.62) 1.74 (1.38-2.19)§ 1.86 (1.55-2.25)§ 1.68 (1.37-2.06)§
Quit 955 (14.7) 48 (4.8)† 222 (21.8)† 651 (64.7)† 729 (72.5)† 1.68 (1.03-2.73)‡ 1.41 (1.11-1.79)§ 1.17 (0.98-1.41) 1.17 (0.97-1.42)
Never 3,768 (58.1) 71 (1.6) 512 (12.5) 2,144 (55.9) 2,501 (65.2) 1 1 1 1
Dental checkupsince last 1 year Yes 2,034 (31.4) 56 (3.0) 335 (17.0) 1,116 (54.8) 1,300 (63.3) 0.98 (0.67-1.43) 0.92 (0.77-1.1) 0.59 (0.51-0.67)§ 0.60 (0.52-0.69)§
No 4,451 (68.6) 140 (3.0) 848 (18.1) †2,997 (67.7) †3,337 (74.8) 1 1 1 1
Toothbrushingfrequency Below 1 592 (9.1) 24 (4.2) 138 (22.9) 395 (67.4) 439 (73.9) 1.17 (0.48-2.84) 1.00 (0.72-1.37) 0.80 (0.60-1.06) 0.78 (0.58-1.06)
2 2,364 (36.5) 78 (3.2) 461 (19.2)† 1,580 (66.8)† 1,757 (74.1)† 1.10 (0.65-1.87) 0.96 (0.76-1.21) 0.94 (0.77-1.14) 0.95 (0.79-1.16)
Above 3 3,529 (54.4) 94 (2.6) 584 (15.8) 2,138 (60.6) 2,441 (68.6) 1 1 1 1
Brushing after lunch No 3,222 (49.7) 107 (3.3) 655 (20.0) 2,155 (67.2) 2,397 (74.3) 0.91 (0.50-1.65) 1.21 (0.97-1.5) 1.20 (0.98-1.45) 1.20 (0.99-1.46)
Yes 3,263 (50.3) 89 (2.7) †528 (15.4) †1,958 (59.8) †2,240 (68.0) 1 1 1 1
Brushingbefore sleepingDental floss No 3,212 (49.5) 110 (3.6)* 648 (19.8)† 2,077 (65.1)* 2,343 (72.8)* 1.05 (0.72-1.53) 1.05 (0.9-1.23) 1.03 (0.91-1.17) 1.07 (0.94-1.22)
Yes 3,273 (50.5) *86 (2.4) †535 (15.9) *2,036 (62.1) *2,294 (69.6) 1 1 1 1
No use 5,257 (81.1) 176 (3.2) 1,031 (18.9) 3,452 (65.7) 3,859 (73.1) 1.47 (0.86-2.52) 1.49 (1.18-1.87)§ 1.42 (1.23-1.64)§ 1.42 (1.22-1.64)§
Use 1,228 (18.9) *20 (1.9) †152 (12.5) †661 (53.2) †778 (61.8) 1 1 1 1
Interdental brush No use 5,615 (86.6) 159 (2.7)† 981 (17.0)† 3,592 (64.1)* 4,051 (71.8)† 0.64 (0.43-0.95)‡ 0.68 (0.55-0.84)§ 1.11 (0.94-1.32) 1.20 (1.00-1.44)§
Use 870 (13.4) †37 (4.6) †202 (23.3) *521 (59.8) †586 (66.3) 1 1 1 1
Oral rinse No use 5,741 (88.5) 171 (2.9) 1,058 (18.0) 3,652 (63.8) 4,113 (71.4) 0.48 (0.29-0.78)§ 0.88 (0.68-1.14) 0.92 (0.77-1.09) 0.94 (0.78-1.14)
Use 744 (11.5) 25 (3.9) 125 (16.3) 461 (61.7) 524 (69.0) 1 1 1 1
Total 6,485 (100) 196 1,183 4,113 4,637
Value in the bracket means rate of subjects who have the CPI code among subjects.The CI means 95% confidence interval.*P<0.05, †P<0.01 by determined by chi-square test, ‡P<0.05, §P<0.01 by determined by logistic regression analysis.