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Unit of Periodontology, Centre of Oral Health, University of Greifswald, Greifswald, Germany.
Abstract
AIM:
To
examine the associations between factors of socio-economic status
(SES), systemic inflammation and the progression of periodontitis and
incidence of tooth loss.
MATERIAL AND METHODS:
Data of
2566 participants from the Study of Health in Pomerania (SHIP) with a
5-year follow-up were analysed. We evaluated attachment loss and tooth
loss with regard to social variables including education, income,
marital status and related risks such as smoking and obesity.
RESULTS:
Socio-economic
factors were associated with the progression of attachment level and
tooth loss during the follow-up period. Low education and low income
were associated with tooth loss (incidence risk ratio IRR 1.63,
p < 0.001 and 1.25, p < 0.001 respectively) and also progression
of mean clinical attachment level (p < 0.010 and p = 0.046
respectively). SES as well as smoking and obesity were also associated
with increased levels of C-reactive protein (CRP) with effect
modifications between SES factors and CRP, also between gender and
marital status. Tooth loss was associated with disadvantageous SES,
particularly under conditions of high CRP levels (p < 0.001).
CONCLUSIONS:
The
progression of periodontal disease is influenced by socio-economic
factors. Effect modifications of socio-behavioural factors by CRP
indicate that under conditions of systemic inflammation adverse SES
effects may be aggravated.
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