Caries levels in patients with juvenile periodontitis

The degree and distribution of tooth decay in a group of juvenile periodontitis ( JP ) patients were compared with tooth decay in an age- and sex-matched periodontally normal control group. The experimental group was comprised of 13 patients of no more than 20 years of age who were designated as localized juvenile periodontitis patients ( LJP ) according to the definition of Baer, and 10 patients of no more than 25 years of age who were designated as generalized juvenile periodontitis patients ( GJP ), as described by Manson and Lehner . Twenty-three age- and sex-matched patients with no periodontal disease served as the control group. Caries was evaluated by standard clinical and radiographic criteria and quantitated by decayed, missing, filled teeth and surfaces (DMFS). Decay was further categorized as active proximal decay and as total proximal decay, which included both active proximal caries and restored proximal surfaces. A Student's t test revealed no statistical differences between the LJP and GJP groups. Moreover, there was no difference in the number of missing or filled teeth in the JP group as compared to the control group. However, 17 of the 23 JP patients had no proximal decay, whereas all but two of the 23 control patients had some proximal decay. Moreover, in the JP group ( LJP and GJP ) the mean values for active proximal decay and total proximal decay were both significantly lower than those in the control group (P less than 0.001). Thus, a low number of proximal carious lesions were found in the presence of juvenile periodontitis.(ABSTRACT TRUNCATED AT 250 WORDS)     

Longitudinal study of dental caries, tooth mortality and interproximal bone loss in adults with intellectual disability

The investigation focused on longitudinal changes of oral health in a group of adults with intellectual disability. A number of 124 individuals, aged 21-40 yr in 1990, were followed during 8.5 yr. The incidence and prevalence of caries, incidence of tooth mortality, and interproximal bone loss were registered from clinical examinations and bite-wing radiographs. The subjects visited the dental clinic for preventive dental care on average every third month during the period. The caries incidence was low, on average 0.51 new lesions per yr. Persons with mild intellectual disability experienced more caries than other subjects. During the 8.5 yr, the subjects had lost on average 1.82 teeth, with periodontitis dominating as the reason for tooth mortality. Individuals who cooperated poorly with dental treatment had lost the most teeth. The average annual bone loss in all subjects was 0.03 mm. Subjects with Down syndrome had a higher bone loss compared to those with other diagnoses of intellectual disability. Thus, the major part of the persons with intellectual disability showed satisfactory oral health. However, subjects with poor ability to cooperate with dental treatment and subjects with Down syndrome showed an increased risk for impaired oral health.     

Early onset periodontitis in the United States of America.

A National Survey of the Oral Health of U.S. children aged 5 to 17 was conducted by the National Institute of Dental Research during the 1986-87 school year. Eleven thousand and seven adolescents aged 14 to 17 years received a periodontal assessment. Their patterns of loss of periodontal attachment as assessed by probing at mesial sites were used to classify adolescents as cases of early onset periodontitis. Approximately 0.53% of adolescents nation-wide were estimated to have localized juvenile periodontitis (LJP), 0.13% to have generalized juvenile periodontitis (GJP), and 1.61% to have incidental loss of attachment (LA) (greater than or equal to 3 mm on 1 or more teeth). The total number of adolescents affected were not trivial. Close to 70,000 adolescents in the U.S. were estimated to have LJP in 1986-87. More destructive GJP affected an estimated 17,000 adolescents. Another 212,000 adolescents were estimated to have incidental LA. Blacks were at much greater risk for all forms of early onset periodontitis than whites. Males were clearly more likely (4.3 to 1) to have GJP than females when other variables were statistically controlled. Gender associations were more complicated for LJP because gender interacted with race. Black males were 2.9 times as likely to have LJP as black females. In contrast, white females were more likely than white males to have the disease by about the same odds. When interactions among demographic variables exist, caution must be taken in comparing results from different studies.     

Effect of periodontal therapy on spontaneous lymphocyte response and neutrophil chemotaxis in localized and generalized juvenile periodontitis patients

The etiology and pathogenesis of juvenile periodontitis may involve dysfunctions of the host response. In particular, the neutrophil and the lymphocyte have been implicated in the disease. The purpose of the present study was to examine the in vitro spontaneous lymphocyte response and neutrophil chemotaxis in populations of localized juvenile periodontitis (LJP) and generalized juvenile periodontitis (GJP) patients and age- and sex-matched healthy subjects (HS). These laboratory values were also evaluated immediately following and 1 year after periodontal therapy. The results show that spontaneous lymphocyte responses reflecting the autologous mixed lymphocyte reaction (AMLR) are depressed for GJP patients. The decreased AMLR in the GJP group appears to represent an abnormal T-cell function which may reflect activity of the periodontal lesion. LJP patients have an increased AMLR response, although it was not statistically significant. 1 year following active periodontal therapy, spontaneous lymphocyte responsiveness returned to normal in most GJP patients. The increased spontaneous lymphocyte responsiveness of LJP patients was not changed either immediately following active periodontal therapy or 1 year later. LJP and GJP patients exhibited a neutrophil chemotaxis defect when compared to cells from HS. This neutrophil defect was still observed 1 year following active therapy.     

Predictors of tooth loss over 10 years in adult and elderly Chinese

Abstract This study describes the incidence of tooth loss over a 10–year period in a population of rural Chinese, initially aged between 20 and 80 years. Among the 587 persons who participated in a baseline examination in 1984, 440 persons were available for a follow-up study in 1994. A total of 31 persons, mainly aged 50+ years at baseline, had become completely edentulous. Between 45% and 96% of the persons lost at least one tooth, and the average number of teeth lost ranged between 1.0 and 7.2. The distribution of the number of teeth lost was skew, indicating that a minor group of subjects had a substantially higher risk of tooth loss than the majority. Logistic regression analysis identified six significant predictors of tooth loss among those who remained dentate: age, a high number of teeth with dentinal caries lesions, a high number of teeth with caries lesions of any type, presence of teeth with attachment loss 7 mm, presence of mobile teeth, and a low percentage of sites with subgingival calculus deposits. At the subject level, caries variables and periodontal disease variables seemed equally important predictors of the incidence of tooth loss over 10 years, but at the tooth level caries was a predominant cause of tooth loss in all age groups.     

Occurrence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in juvenile periodontitis

Abstract The occurrence of Actinobacillus actinomycetemcomitans, Porphyromanas gingivalis and Prevotella intermedia in subgingival plaque in 24 juvenile periodontitis patients was determined using DNA probe. 36 samples of subgingival plaque from 36 pockets having ≥6 mm depth, ≥3 mm of loss of attachment, and Weeding on probing anchor suppuration were taken from 18 patients with localized juvenile periodontitis (LJP, age range 12-24 years); and 12 samples from-6 patients with generalized juvenile periodontitis (GJP, age range 23–26 years). As control, an equal numbers of samples from health sites in the same patients were studied. P. gingivalis was found in 17 of 18 LJP patients, and in 31 of 36 diseased sites in those patients. P. intermedia was found in 15 out of the 18 LJP patients and in 28 of the 36 diseased sites. A, actinomycetemcomitans was present in 7 of the 18 LJP patients, and in 9 of the 36 diseased sites, and was not found in any GJP patients. All GJP patients had P. gingivalis 1 out of 12 diseased sites) and P. intermedia (all of the diseased sites). None of the three bacterial species was detected in healthy sites of GJP patients, and were found in healthy sites in only 2 of 18 LJP patients. The high prevalence and high levels of P. gingivalis and P. intermedia found in the LJP and GJP patients studied, suggest that there are populations affected by juvenile periodontitis in which this type of periodontitis is more associated with these species than with A. actinomycetemcomitans.     

Dental caries experience, tooth loss, and factors associated with unmet needs of Haitian immigrants in New York City

OBJECTIVE: The aim of this study was to characterize the dental caries experience, tooth loss, and unmet need of a group of Haitian immigrant residents of New York City. METHODS: A purposive sample of 523 adults was obtained through community outreach activities during 1997-98. Clinical examinations were performed by calibrated examiners, according to NIDCR criteria. A comprehensive survey also was administered to all the participants. RESULTS: For the whole group, the mean number of missing teeth was 2.64 (SD = 4.12), the mean DMFT = 6.05 (SD = 5.26), the mean DMFS = 18.80 (SD = 21.04), and the mean DFS = 5.58 (SD = 6.17). Seventeen percent of the subjects had all their teeth sound, 59 percent had at least one tooth missing, 60 percent had at least one decayed tooth, and only 38 percent had restorations. Multivariate analyses showed that age, sex, education, dental insurance, frequency of dental visits, and dental floss use were predictors of unmet need. CONCLUSIONS: Although results showed a relatively low caries experience among this group of Haitian immigrants, the unmet need was very high. Furthermore, the tooth loss experience was relatively high for all age groups, further denoting a lack of access to preventive and restorative services.     

Immunologic profile of juvenile periodontitis. II. Neutrophil chemotaxis, phagocytosis and spore germination

Patients with juvenile periodontitis (JP) were grouped into one of the two recognized forms of the disease: a localized form affecting incisors and first molars (LJP) and a generalized form affecting more than 14 teeth (GJP). The role of the neutrophil in the etiology and pathogenesis of LJP has recently been recognized. Experiments aimed at confirming previous information related to neutrophil chemotaxis defects in LJP were performed. Additional experiments aimed at demonstrating significant differences in phagocytosis of bacterial spores and inducing spore germination were also completed. Age- and sex-matched healthy subjects were used as "internal" controls (experiments run concomitantly). Peripheral blood neutrophils from 29 LJP, 24 GJP and 24 healthy subjects were assessed for chemotaxis. This assay was performed in a Boyden diffusion chamber using 10(-8) M N-formylmethionylleucylphenylalanine as chemoattractant. A chemotactic defect was defined being 2 standard deviations below the mean of healthy subjects. Twenty-three of 29 LJP (79%) and 14 of 25 GJP (58%) had a neutrophil defect. Peripheral blood neutrophil phagocytosis assays were performed in vitro using radiolabeled bacterial spores [45Ca]Bacillus cereus. Eighteen of 29 LJP (62%) and 7 of 24 GJP (29%) had a phagocytic defect. Neutrophil-induced spore germination assessed in vitro showed that 13 of 20 LJP (65%) and 3 of 8 GJP (38%) had this defect. These observations indicate that patients with JP have abnormalities in neutrophil functions of chemotaxis, phagocytosis and spore germination.     

The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance

BACKGROUND: The biofilm that forms and remains on tooth surfaces is the main etiological factor in caries and periodontal disease. Prevention of caries and periodontal disease must be based on means that counteract this bacterial plaque. OBJECTIVE: To monitor the incidence of tooth loss, caries and attachment loss during a 30-year period in a group of adults who maintained a carefully managed plaque control program. In addition, a comparison was made regarding the oral health status of individuals who, in 1972 and 2002, were 51-65 years old. MATERIAL AND METHODS: In 1971 and 1972, more than 550 subjects were recruited. Three hundred and seventy-five subjects formed a test group and 180 a control group. After 6 years of monitoring, the control group was discontinued but the participants in the test group was maintained in the preventive program and was finally re-examined after 30 years. The following variables were studied at Baseline and after 3, 6, 15 and 30 years: plaque, caries, probing pocket depth, probing attachment level and CPITN. Each patient was given a detailed case presentation and education in self-diagnosis. Once every 2 months during the first 2 years, once every 3-12 months during years 3-30, the participants received, on an individual need basis, additional education in self-diagnosis and self-care focused on proper plaque control measures, including the use of toothbrushes and interdental cleaning devices (brush, dental tape, toothpick). The prophylactic sessions that were handled by a dental hygienist also included (i) plaque disclosure and (ii) professional mechanical tooth cleaning including the use of a fluoride-containing dentifrice/paste. RESULTS: Few teeth were lost during the 30 years of maintenance; 0.4-1.8 in different age cohorts. The main reason for tooth loss was root fracture; only 21 teeth were lost because of progressive periodontitis or caries. The mean number of new caries lesions was 1.2, 1.7 and 2.1 in the three groups. About 80% of the lesions were classified as recurrent caries. Most sites, buccal sites being the exception, exhibited no sign of attachment loss. Further, on approximal surfaces there was some gain of attachment between 1972 and 2002 in all age groups. CONCLUSION: The present study reported on the 30-year outcome of preventive dental treatment in a group of carefully monitored subjects who on a regular basis were encouraged, but also enjoyed and recognized the benefit of, maintaining a high standard of oral hygiene. The incidence of caries and periodontal disease as well as tooth mortality in this subject sample was very small. Since all preventive and treatment efforts during the 30 years were delivered in one private dental office, caution must be exercised when comparisons are made with longitudinal studies that present oral disease data from randomly selected subject samples.     

Dental status of adults with and without periodontitis

All 30- to 59-year old subjects (N = 757) from a representative sample of adult Finns (total sample = 1,105), showing advanced periodontitis (marginal bone loss more than 30%, n = 125), were compared with their age- and sex-matched pairs showing no marginal bone loss (n = 291) with respect to the number of intact teeth (no caries experience) present. Both male (n = 83) and female (n = 42) subjects with advanced periodontitis had more intact teeth and intact molars than their matched pairs (113 men and 178 women) (P less than or equal to 0.01 for intact teeth and P less than or equal to 0.05 for intact molars in both groups). The total number of teeth present did not differ significantly between the compared groups. Contrary to earlier hypotheses, our results suggest that periodontitis and dental caries do not necessarily share a common etiology.     

Flow cytometric evaluation of phagocytosis by peripheral blood polymorphonuclear leucocytes in human periodontal diseases.

The complement-dependent phagocytic functions of polymorphonuclear leucocytes (PMNL) in peripheral blood from 15 patients with localized juvenile periodontitis (LJP), 13 with generalized juvenile periodontitis (GJP) and 52 with adult periodontitis (AP), and from 30 normal subjects as controls were measured by flow cytometry. Heparinized blood was collected and incubated with fluorescent microspheres, and erythrocytes were removed. By means of single-cell analysis the percentage of phagocytosing cells (% phagocytosis) and the mean number of microspheres phagocytosed by one PMNL (degree of phagocytosis; d-phagocytosis) were measured. Some but not all patients with LJP (53%) and GJP (46%) showed consistently low % phagocytosis and d-phagocytosis. On the other hand, only 6% of AP patients and no healthy subjects showed a reduction of PMNL phagocytosis. Phagocytosis was unchanged after initial periodontal treatment in all subjects, suggesting the depression of PMNL phagocytosis may not be a transient phenomenon associated with periodontal status. Furthermore, PMNLs from the LJP patients that showed depressed phagocytic function exhibited depressed phagocytic responses with either autologous or normal plasma, while control PMNLs with either normal or the patients' plasma showed normal responses. These results suggested that the depressed phagocytic responses in LJP patients could be due to cell-associated defect(s) on the PMNL.     

Increased oxidative product formation by peripheral blood polymorphonuclear leukocytes in human periodontal diseases

We examined the oxidative burst (hydrogen peroxide-dependent oxidative product formation) of polymorphonuclear leukocytes (PMNL) in the peripheral blood from the patients with various types of periodontal diseases including localized juvenile (LJP), generalized juvenile (GJP) and adult periodontitis (AP). Heparinized peripheral blood was obtained from 15 LJP. 13 GJP and 52 AP patients and from 30 healthy control subjects. The oxidative product (2', 7'-dichlorofluorescein: DCF) formation of PMNL by stimulation with phorbol myristate acetate was evalauted by a rapid quantitative assay using flow cytometry. The results indicated that all patient groups contained variable populations with normal or increased DCF formation, while the control subjects exhibited DCF formation as a single population. No significant differences in average DCF formation were found among the three patient groups. Although individual patients gave various values, the average DCF formation of the three patient groups was much higher than that of the control group. Statistical analysis revealed a significant positive correlation between DCF formation and the clinical periodontal parameters on an individual basis. Futhermore, after intial periodontal treatment, DCF formation decreased to normal levels. These results suggest that the capacity of peripheral blood PMNL to mount oxidative burst reactions might reflect the inflammotory status of periodontal disease.     

Pattern of tooth loss in recipients of free dental treatment at the University Hospital of Amman, Jordan

The aim of this study is to document reasons for tooth loss in disadvantaged Jordanians who seek free dental care at the University Hospital/Dental Clinics. A 4-year (1998-2001) prospective study was undertaken involving 2200 randomly selected patients from this subpopulation. Of their 3069 lost teeth, 46.9% were lost due to caries and its sequel; 18% were lost because of periodontal disease; 8% were lost for a combination of caries and periodontal disease; 19.4% for pre-prosthetic reasons; 4% for orthodontic reasons; 2.8% for eruption problems and 0.7% due to trauma. Logistic regression analysis for reasons of tooth loss in this sector revealed that caries and its sequel was the predominant cause of tooth loss in patients 相似文献   

Ten-year incidence of tooth loss and dental caries in elderly Swedish individuals

There has been a significant reduction in edentulism and the elderly retain more teeth into old age. The 10-year incidence of tooth loss, coronal and root caries was studied in a random sample of inhabitants of G?teborg, who were 55, 65 and 75 years old at baseline. Of the 208 persons examined at baseline, 102 (49%) participated in the follow-up examination: 56, 37 and 9, respectively, in the different age groups of 65, 75 and 85 years. In addition, for the purpose of time-trend comparisons, a new random sample of 98 individuals aged 55 years was examined. The mean numbers of remaining teeth were 24, 23, 17 and 14, respectively, in the age groups of 55, 65, 75 and 85. The corresponding mean numbers at baseline were 23, 19 and 17, respectively, in those subjects who were then 55, 65 and 75 years old. Forty-eight percent had lost no teeth during the 10-year period, while 13% had lost more than 2 teeth. The major reason for tooth extraction was dental caries and it was found in 60% of all cases. The incidence of coronal caries decreased, while that of root caries increased with age (p < 0.01). Comparing the same age groups, the frequency of root caries had decreased during the 10-year period. It could be concluded from this study that elderly people were determined to retain their teeth for as long as possible, but dental caries may be a problem among the very old.     

Immunologic profile of juvenile periodontitis. I. Lymphocyte blastogenesis and the autologous mixed lymphocyte response

Studies of blastogenesis of lymphocytes in culture from juvenile periodontitis (JP) patients have been inconclusive. Experiments demonstrating differences in lymphocyte blastogenesis to preparations of putative periodontopathogens in JP and phytohaemagglutinin (PHA) were performed. Variables in the blastogenesis assay system recently reported were controlled which included using a range of cell and activator concentrations, incubation times of 3, 5 and 7 days, conical-bottomed microtest wells and chemical inhibitors during labeling of DNA which permits accurate assessment of lymphocyte blastogenesis. Using these modified culture conditions, stimulated lymphocytes of localized (LJP) and generalized (GJP) forms of JP patients did not differ significantly from stimulated lymphocytes of healthy subjects in counts incorporated, stimulation index, incubation time, cell concentration or activator dose required for maximal blastogenesis to bacterial preparations of Actinobacillus actinomycetemcomitans (Y-4), Bacteroides gingivalis, Capnocytophaga ochraceus, Fusobacterium nucleatum, Streptococcus sanguis and Treponema denticola. Unstimulated lymphocyte cultures reflecting the autologous mixed lymphocyte response (AMLR) were increased for LJP compared to healthy subjects although not statistically significant. Unstimulated lymphocyte cultures of GJP were decreased compared to healthy subjects and LJP (P less than 0.05). These observations indicate that GJP patients may have abnormalities in T- and B-lymphocyte regulatory mechanisms.     

Tooth loss in a young population from south Brazil

OBJECTIVES: To assess the prevalence, extent, and risk indicators of tooth loss in a representative young urban population from south Brazil. METHODS: A representative sample was drawn using a multi-stage probability cluster sampling strategy, and consisted of 612 subjects 14-29 years of age in the metropolitan area of Porto Alegre, Brazil. A clinical examination was carried out by 4 calibrated examiners in a mobile examination center. RESULTS: The prevalence of tooth loss was 44.8%, 26%, and 60%, and the mean tooth loss was 1.4, 0.6, and 2.4 teeth in the age groups 14-29, 14-19 and 25-29 years, respectively. First molars were the most frequently missing teeth, and the mandibular incisors and canines were the least missing teeth. Tooth loss increased sharply with age, and was similar in males and females. Having > or =4 missing teeth was significantly associated with low socioeconomic status and heavy smoking, and was significantly more likely in persons who had > or =2 teeth with caries/fillings and/or > or =5 mm attachment loss. CONCLUSION: Tooth loss is a dental health concern in this young Brazilian population. Community-based oral diseases prevention programs targeting groups having these risk factors should be implemented to reduce tooth loss.     

Progression of dental caries and tooth loss between the third and fourth decades of life: a birth cohort study

The majority of what is known of the experience of dental caries among adults is from cross-sectional studies, and there are surprisingly few population-level longitudinal studies of dental caries among adults. Dental examinations were conducted at age 26 and again at age 32 among participants in a longstanding prospective study of a birth cohort born in Dunedin (New Zealand) in 1972/1973. Some 901 individuals (88.8%) were dentally examined at both ages. The mean number of remaining teeth and tooth surfaces fell between 26 and 32, reflecting ongoing tooth loss. The overall prevalence of caries rose from 94.9 to 96.8%, while there were greater increases in the proportion with caries-associated tooth loss (from 10.8 to 22.8%). Caries experience was greatest in the molar teeth and upper premolars, and was lowest in the lower anterior teeth. The mean crude caries increment (CCI) was 5.0 surfaces (SD 6.6); 681 (75.5%) experienced 1+ CCI, and the mean CCI among those individuals was 6.6 surfaces (SD 6.9). Substantial dental caries and tooth loss experience occur as people move from the third into the fourth decade of life.     

Proportions of Streptococcus mutans, lactobacilli and Actinomyces spp in root surface plaque

Abstract – The incidence of Streptococcus mutans, lactobacilli and Actinomyces was examined in root surface dental plaque from 24 subjects with root surface caries and in 24 subjects with exposed root surfaces as a consequence of periodontitis but without root surface caries. Plaque was collected from the most posterior teeth in each quadrant: in the caries group from carious lesions and in the periodontitis group from buccal root surfaces. There were significantly higher proportions of S. mutans and lactobacilli in dental plaque samples taken from subjects suffering from root surface caries than in samples from subjects without root surface caries. The level of the group A. viscosus/naeslundii in the periodontitis group was higher than that found in the root surface caries group, but the difference was not statistically significant.     

Occurrence of periodontitis in an urban adolescent population

The presence of periodontitis in 307 black, Hispanic, and Asian students age 12 to 15 years was evaluated by calibrated examiners in a Los Angeles inner city junior high school. The periodontal status of maxillary and mandibular incisors and permanent first molars was evaluated using the Plaque Index, probing depth, attachment loss, bleeding on probing, tooth mobility, presence of calculus, and caries. Thirty-nine (12.7%) of 307 students had 5 mm or deeper probing depths and associated attachment loss of at least 2 mm and were considered to have periodontitis (PD). The PD group had significantly more bleeding, calculus, and missing teeth than the non-PD group, but both groups had moderate to severe plaque accumulation. The distribution and severity of disease increased with age. Deeper probing depths were associated with the molar teeth and six (15.4%) of the 39 subjects in the PD group had furcation involvement. Clinical screening alone was not sufficient to determine if the periodontitis seen was localized juvenile periodontitis; however, the program detected a high occurrence of periodontitis in this population group.     

Tooth loss and associated risk indicators in an adult urban population from south Brazil

The aim of the present study was to assess the prevalence, extent, and risk indicators of tooth loss in a representative adult, urban population in the Brazilian state of Rio Grande do Sul. A sample of 974 subjects (ages 30 to 103 years, mean 48.7, SD 13.4) representative of the metropolitan area of Porto Alegre, Brazil was selected by a multi-stage probability cluster sampling strategy. In all, 94% of the subjects had experienced tooth loss. The mean tooth loss was 11.2 teeth, and varied between 5.5 and 20.2 teeth in the 30-39 and 60 + years age groups, respectively. The multivariable analysis, adjusted for age, showed that subjects who had lost 7-13 or > or = 14 teeth were more likely to be females (odds ratio (OR) = 1.4, 2.4), of low (OR = 2.8, 5.1) or middle socio-economic status (OR = 2.3, 3.4), and heavy smokers (OR= 2.0, 2.3) than those with 6 or fewer missing teeth. Furthermore, loss of > or = 14 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR= 5.7), and loss of 7-13 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR = 2.4) and having 15-30% or > 30% decayed-filled teeth (OR = 2.7 and 4.1). In conclusion, tooth loss is highly prevalent in this urban Brazilian population. Gender, socio-economic status, cigarette smoking, caries experience, and attachment loss are important risk indicators. A reduction in the population's tooth loss may be achieved by the implementation of community programs for the prevention and treatment of dental caries and periodontal diseases.