Characteristics of older adults experiencing periodontal attachment loss as gingival recession or probing depth

While attachment loss currently is the best field examination indicator that periodontal disease has progressed, this measure is not disaggregated enough to differentiate between attachment loss that results in deeper pockets and attachment loss that results primarily in recession of the gingiva. If these two conditions have different etiologies, then efforts at predicting who will experience the condition from a single, general risk assessment model will be difficult. The purpose of this paper is to determine whether the characteristics of people who experience attachment loss primarily as increased probing depths are different from those people who experience attachment loss primarily as gingival recession. Baseline and 18‐month follow‐up periodontal measures were gathered on a representative sample of community‐dwelling adults aged 65+. Based on measurement errors obtained one week apart on a reliability subsample, a threshold level of 3+mm was set to define attachment loss. Attachment loss was further characterized as resulting from mostly increased probing depth or from mostly increased gingival recession. In mesio‐buccal sites, 58% of the people had attachment loss mostly due to increased probing depth with 42% having attachment loss mostly due to gingival recession. For buccal sites, the figures were 24% and 76% respectively. The logistic regression models for both sites indicated that people who had their attachment loss in the form of increased probing depths had different characteristics than people who had most of their attachment loss in the form of gingival recession. These epidemiologic data indicate that different processes may be involved in people who experience attachment loss due to deeper probing depths as compared to people whose attachment loss is due more to gingival recession and not separating the two types of attachment loss may be a reason for inacuracies in risk prediction.