In summary, between the 1960 to 1962 national health survey and the 1971 to 1974 national health survey, the mean periodontal index scores remained unchanged. However, the classification of adults into broad disease categories showed that those with no evidence of disease increased significantly. This improvement in the nation's experience with the periodontal diseases was restricted to those with gingivitis, and a concomitant improvement was observed in the nation's oral hygiene status; debris scores decreased substantially, whereas little change was observed in calculus scores. Hypotheses have been raised in this paper about the decline in the prevalence of gingivitis and its possible association with variables such as OHI-S scores, socioeconomic status, dental care utilization, cigarette smoking, fluorides, and antibiotics. Also noted between the two surveys was a slight decrease in the prevalence of periodontal pockets in persons younger than age 35, whereas in persons older than 35, there was either no change or a slight increase. During this same period, both total loss of teeth and number of missing teeth per person decreased for all ages. A hypothesis is proposed that links this slight increase in the more severe signs of periodontal disease in older adults to an increase in the number of teeth at risk to the disease. The modest change in the prevalence and severity of advanced periodontal disease may be an early sign of a trend that will become accentuated as a result of a distinct increase in the nation's older population coupled with the increased retention of the natural dentition. Thus, it would seem that a decline in edentulism and an increase in number of teeth per person may well contribute to circumstances that will lead to greater, not lesser, risk of advanced periodontal disease problems in the later decades of life. Although this hypothesis may or may not hold true for today's younger adults as they age, it seems to be the likely occurrence for the nation's older adults, at least for the next several decades. A third national survey, using the same indexes and more current periodontal disease measures, is needed to help to clarify the trends reported here.

This article has been cited by other articles:

				K. L. Cropsey, K. M. Crews, and S. L. Silberman Relationship Between Smoking Status and Oral Health in a Prison Population Journal of Correctional Health Care, October 1, 2006; 12(4): 240 - 248. [Abstract] [PDF]

				L. N. Borrell, J. D. Beck, and G. Heiss Socioeconomic Disadvantage and Periodontal Disease: The Dental Atherosclerosis Risk in Communities Study Am J Public Health, February 1, 2006; 96(2): 332 - 339. [Abstract] [Full Text] [PDF]

				L.N. Borrell, B.A. Burt, and G.W. Taylor Prevalence and Trends in Periodontitis in the USA: from the NHANES III to the NHANES, 1988 to 2000 Journal of Dental Research, October 1, 2005; 84(10): 924 - 930. [Abstract] [Full Text] [PDF]

				P.P. Hujoel, B.G. Leroux, T.A. DeRouen, L.V. Powell, and H.A. Kiyak Evaluating the Validity of Probing Attachment Loss as a Surrogate for Tooth Mortality in a Clinical Trial on the Elderly Journal of Dental Research, April 1, 1997; 76(4): 858 - 866. [Abstract] [PDF]

				J. Ye, F. Nishimura, R. Orman, and V.P. Terranova Isolation, Purification, and Partial Characterization of an Autocrine Periodontal Ligament Cell Chemotactic Factor Journal of Dental Research, June 1, 1995; 74(6): 1303 - 1309. [Abstract] [PDF]

				C.W. Douglass and C.H. Fox Cross-Sectional Studies in Periodontal Disease: Current Status and Implications for Dental Practice Advances in Dental Research, July 1, 1993; 7(1): 25 - 31. [Abstract] [PDF]

				B.A. Burt, J.E. Albino, J.P. Carlos, L.K. Cohen, R. Dubner, J.A. Gershen, and J.C. Greene Advances in the Epidemiological Study of Oral-Facial Diseases Advances in Dental Research, May 1, 1989; 3(1): 30 - 41. [Abstract] [PDF]

				H.M. Abdellatif and B.A. Burt An Epidemiological Investigation into the Relative Importance of Age and Oral Hygiene Status as Determinants of Periodontitis Journal of Dental Research, January 1, 1987; 66(1): 13 - 18. [Abstract] [PDF]