Risk indicators of periodontal disease in Korean adults

Dong-Hyeob Woo; Hae-Young You; Min-Ji Kim; Han-Na Kim; Jin-Bom Kim; Seung-Hwa Jeong

doi:10.11149/jkaoh.2013.37.2.95

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Woo, You, Kim, Kim, Kim, and Jeong: Risk indicators of periodontal disease in Korean adults

Original Article

J Korean Acad Oral Health 2013;37(2):95-102.

Published online: 12 June 2013

DOI: https://doi.org/10.11149/jkaoh.2013.37.2.95

Risk indicators of periodontal disease in Korean adults

Dong-Hyeob Woo, Hae-Young You, Min-Ji Kim, Han-Na Kim, Jin-Bom Kim, Seung-Hwa Jeong

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

Received 24 May 2013 Revised 23 June 2013 Accepted 24 June 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.

Keywords: Flossing, Korean adults, Periodontal disease, Risk indicator, Smoking, Socio-economic inequality

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Fig. 1.

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

Fig. 2.

Summary of relationship between each variables and periodontal disease.

Table 1.

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)
Variables	Level	N (%)	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)
Area	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)^§
Sex	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)^§
Dental checkupsince last 1 year	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)
Brushing after lunch	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)^§
Interdental brush	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)
Oral rinse	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.

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