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牙周医学(periodontal medicine)是牙周病学的一个新学科分支,于1996年由Offenbacher提出,定义为牙周病与系统疾病的相互关系,包括系统疾病对牙周健康或牙周疾病的影响和牙周病对系统健康或疾病的影响两个方面。关于牙周病与全身疾病关系的提出可追溯到1891年     

Severe Loss of Clinical Attachment Level: An Independent Association With Low Hip Bone Mineral Density in Postmenopausal Females

Background: Bone loss is a feature of both periodontitis and osteoporosis, and several studies have analyzed whether the periodontal destruction could have been influenced by systemic bone loss. The aim of this study is to assess the association between clinical attachment level (CAL) and bone mineral density (BMD) at the lumbar spine and hip, lifestyle, smoking, sociodemographic factors, and dental clinical variables in postmenopausal women. Methods: One hundred forty‐eight women were interviewed using a structured written questionnaire and clinically examined. The periodontal examination, which was performed by calibrated investigators, included CAL, probing depth, gingival recession, bleeding on probing (BOP), visible plaque, supragingival calculus, and mean tooth loss. The sample was stratified into two groups: moderate and severe CAL. The moderate group had all sites with CAL ≤5 mm. The severe group had ≥1 site with CAL >5 mm. BMD, measured using dual‐energy x‐ray absorptiometry, was assessed at the lumbar spine, femoral neck, and total femur (grams per square centimeters). Results: Severe CAL was identified in 86 women (58.1%). The multiple linear regression analysis using CAL (dependent variable), adjusted by menopause, education, and family income, demonstrated an inverse relationship of severe CAL with the BMD of the femoral neck (P = 0.015), as well as a positive association of severe CAL with tooth loss (P = 0.000), BOP (P = 0.004), and heavy smokers (P = 0.001). Conclusions: Our study demonstrated that severe CAL was associated with low BMD of the femoral neck and deleterious clinical dental parameters and smoking. Our findings suggest that, in addition to appropriate oral care, individuals with severe CAL may also require additional attention to their systemic bone health.     

Understanding Diagnostic Testing for Periodontal Diseases

Probability computations are used to characterize new periodontal diagnostic tests and are an integral facet of risk assessment for periodontal diseases. However, misinterpretation of these data can result in confusion and erroneous conclusions regarding the relationship of test results to the presence or absence of disease in a subject, or to episodes of periodontal destruction at specific sites. This paper was written to provide clinicians with a primer to help in understanding calculations used to evaluate diagnostic tests and risk assessment. J Periodontol 1995;66:659–666.     

牙周状况、血清白细胞介素-1β水平与妊娠关系初探

目的探讨牙周状况、血清白细胞介素- 1β（IL- 1β）水平与妊娠间的关系。方法以40例先兆早产孕妇（TPL组）和40例正常孕妇（Non- TPL组）为研究对象，检查全口牙齿的牙周状况，记录菌斑指数（PLI）、探诊深度、临床附着丧失和出血指数（BI），并计算牙周炎位点率。酶联免疫吸附试验检测血清IL- 1β水平。对各项检查指标进行统计分析。结果①TPL组40例孕妇中26例足月产（TPL- TB小组），14例早产（TPL- PB小组）；Non- TPL组40例孕妇皆足月产。TPL组和Non- TPL组、TPL- TB小组和TPL- PB小组的分娩孕周、新生儿出生体重、PLI、牙周炎位点率和血清IL- 1β水平间的差异均有统计学意义（P<0.05）。②分娩孕周和牙周炎位点率、BI、IL- 1β水平呈负相关（P<0.05），IL- 1β水平与牙周炎位点率和BI呈正相关（P<0.05）。结论牙周感染可能是早产的原因之一。     

Chronic Periodontal Disease,Periodontal Pathogen Colonization,and Increased Risk of Precancerous Gastric Lesions

Background: This study assesses the association between periodontal pathogen colonization and the potential risk of developing precancerous lesions of gastric cancer (PLGC) in a clinical setting. Methods: Included were 35 newly diagnosed patients with PLGC and 70 age‐matched individuals without PLGC. A full‐mouth intraoral examination was performed to assess periodontal conditions. Stimulated whole saliva and pooled plaque samples were collected to evaluate colonization by Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans and to characterize oral microbial diversity in saliva and dental plaque. Results: Compared with the control group, patients with PLGC experienced higher prevalence of bleeding on probing (31.5% versus 22.4%; P <0.05), higher levels of T. denticola (P <0.01) and A. actinomycetemcomitans (P <0.01), and less bacterial diversity in their saliva (P <0.01). The final multivariate logistic regression model consisting of all key sociodemographic characteristics, oral health behavioral factors, and periodontal assessments revealed that elevated colonization with periodontal pathogens, specifically T. forsythia, T. denticola, and A. actinomycetemcomitans, decreased bacterial diversity in dental plaque, and not flossing teeth regularly was a significant predictor of increased risk of PLGC (P = 0.022). Conclusion: Findings of the present study provide new evidence suggesting that periodontal pathogen burdens and bacterial diversity in the oral cavity are important factors contributing to a potentially increased risk of developing precancerous gastric lesions.     

Microbiologic Findings in Relation to Risk Assessment for Periodontal Disease: A Cross‐Sectional Study

Background: In this study, an association between a computerized risk calculator and microbiologic testing is examined in patients with periodontitis. Methods: Seventy‐four patients with moderate and severe periodontitis were selected from patients receiving treatment at Tufts University School of Dental Medicine. Their periodontal risk was analyzed with a periodontitis risk assessment tool, and microbiologic testing was performed. Periodontitis risk assessment and microbiologic testing were examined for a possible association. The data were evaluated by the χ² test at P <0.05 levels. Results: Forty‐six patients scored as having a “very high” risk of periodontitis and 22 patients scored as having a “high” risk of periodontitis by the risk assessment tool. Patients with a risk score of very high risk showed a higher detection of each bacterium except Capnocytophaga species than the rest of the study population. Treponema denticola and Prevotella intermedia (P = 0.01 and P = 0.02, respectively) were two bacteria that showed a statistically significant difference between patients at very high risk and those at high risk. Conclusions: Patients with periodontitis were identified as high risk and very high risk compared with the rest of the risk categories by the risk assessment tool. The study population, categorized mostly as very high risk, showed high detection of putative periodontal bacteria.     

Change of Periodontal Disease Status During and After Pregnancy

Background: This study explored whether there is any change of periodontal disease status during and after pregnancy. We also examined whether the change is different between females with a history of gestational diabetes mellitus (GDM) and females without GDM during pregnancy. Methods: A follow‐up study was conducted at Woman's Hospital, Baton Rouge, Louisiana. Thirty‐nine females who were previously enrolled in a case‐control study during pregnancy were followed an average of 22 months postpartum. Periodontal status was assessed through dental examinations performed both during and after pregnancy. Clinical periodontal parameters included bleeding on probing (BOP), mean probing depth (PD), and mean clinical attachment level (CAL). Periodontitis was defined as the presence of ≥1 sites exhibiting PD ≥4 mm or CAL ≥4 mm. We used generalized estimating equation analysis to examine the change of periodontal status. Results: Mean number and percentage of sites with BOP decreased from 10.7 ± 11.6 (mean ± SD) and 6.5% ± 7.0% during pregnancy to 7.1 ± 8.8 and 4.3% ± 5.3% at 22 months postpartum (P <0.05), respectively. Mean levels of PD and CAL decreased from 1.8 ± 0.4 mm and 1.9 ± 0.3 mm to 1.6 ± 0.3 mm and 1.6 ± 0.3 mm (P <0.01), respectively. The prevalence of periodontitis decreased from 66.7% to 33.3% (P <0.01, adjusted risk ratio = 2.1, 95% confidence interval = 1.3 to 3.4). There was no difference in the change of periodontal status between females with GDM and females without GDM during pregnancy. Conclusions: Pregnancy may be associated with an increased risk of periodontal disease. The association is not different between females with GDM and females without GDM during pregnancy.     

Association between metabolic syndrome and periodontal disease

Background: Metabolic syndrome has been suggested as a potential risk factor for periodontal disease. Data based on NHANES III, with 7431 subjects aged 20 years or older, were analysed to confirm the association between metabolic syndrome and periodontal disease, and identify which components of metabolic syndrome might play a role in this association. Methods: Clinical criteria for metabolic syndrome included: (1) abdominal obesity; (2) increased triglycerides; (3) decreased HDL cholesterol; (4) hypertension or current use of hypertension medication; and (5) high fasting plasma glucose. Periodontal disease was evaluated by probing pocket depth (PPD) and was defined as mean PPD ≥2.5 mm. Results: Women with two or more metabolic components had significantly increased odds of having periodontal disease as compared to those with no component [(two components, OR = 5.6 (95% CI: 2.2–14.4); three or more, OR = 4.7 (2.0–11.2)]. Using the definition of metabolic syndrome as having three to five metabolic components (reference group with <3 components), the adjusted odds ratios were 1.0 (0.7–1.6) for men and 2.1 (1.2–3.7) for women. Abdominal obesity was the largest contributory factor in both genders. Conclusions: While the association between metabolic syndrome and periodontal disease was particularly significant for women, abdominal obesity appeared to be the contributing metabolic factor for both genders.     

Profiles of Dental Caries and Periodontal Disease in Individuals With or Without Psoriasis

Background: Psoriasis is a chronic inflammatory disease that is manifested on the skin. Studies of oral health in psoriasis patients are limited. The aim of this study is to assess the experience and risk of caries and periodontal disease in individuals with and without psoriasis. Methods: The material consisted of 89 individuals with mild‐to‐moderate chronic plaque psoriasis and 54 without psoriasis, recruited at the University Hospital in Gothenburg, Gothenburg, Sweden. Psoriatic arthritis (PsoA) was diagnosed in 25 of the individuals with psoriasis. All participants answered questionnaires and were subjected to saliva sampling and oral radiologic and clinical examinations. Two computer applications were used for illustration of oral disease risk profiles. Results: Individuals with psoriasis had lower salivary pH, fewer remaining teeth, fewer sites with probing depth ≤4 mm, and a lower radiographic alveolar bone level than individuals without psoriasis (P <0.05). Most of the differences remained significant after controlling for confounders. Differences in alveolar bone levels were no longer significant, particularly after introducing the confounder sex into the regression model. Similar numbers of decayed and filled teeth, sites with deep pockets, sites that bled on probing, and risk profiles were observed. Individuals with PsoA exhibited a lower stimulated salivary secretion rate than those without psoriasis (P <0.05). Conclusions: There were no differences in profiles of caries and periodontal disease experience and risk between individuals with and without psoriasis. Fewer remaining teeth were observed in individuals with psoriasis. However, the exact reason for tooth loss could not be identified. Meanwhile, the reduced salivary pH in individuals with psoriasis and salivary secretion in individuals with PsoA may pose some risk for future caries.     

Reexamining the Association Between Smoking and Periodontitis in the Dunedin Study With an Enhanced Analytical Approach

Background: Smoking is a major risk factor for periodontal disease. Conventional oral epidemiology approaches have found strong, consistent associations between chronic smoking and periodontal attachment loss (AL) through ages 26, 32, and 38 years, but those statistical methods disregarded the data's hierarchical structure. This study reexamines the association using hierarchical modeling to: 1) overcome the limitations of an earlier approach (trajectory analysis) to the data and 2) determine the robustness of the earlier inferences. Methods: Periodontal examinations were conducted at ages 26, 32, and 38 years in the Dunedin Multidisciplinary Health and Development Study. The number of participants examined at those three ages were 913, 918, and 913, respectively. A generalized linear mixed model with a quasi‐binomial approach was used to examine associations between chronic smoking and periodontal AL. Results: At ages 26, 32, and 38, smokers had 3.5%, 12.8%, and 23.2% greater AL than non‐smokers. Regular cannabis use was associated with greater AL after age 32, but not at age 26. Males had more AL than females. Participants with high plaque scores had consistently greater AL; those who were of persistently low socioeconomic status had higher AL at ages 32 and 38, but not at age 26. The amount of AL in anterior teeth was less than in premolars and molars. Gingival bleeding was associated with higher AL at ages 26, 32, and 38. Conclusion: The smoking–periodontitis association is observable with hierarchical modeling, providing strong evidence that chronic smoking is a risk factor for periodontitis.     

Systemic Inflammatory Biomarkers and Their Association With Periodontal and Diabetes‐Related Factors in the Diabetes and Periodontal Therapy Trial,A Randomized Controlled Trial

Background: The present study evaluates effects of non‐surgical periodontal treatment on serum biomarkers in patients with type 2 diabetes mellitus (t2DM) and chronic periodontitis who participated in the Diabetes and Periodontal Therapy Trial (DPTT); and associations among diabetes markers, serum biomarkers, and periodontal measures in these patients. Methods: DPTT participants randomized to receive immediate or delayed non‐surgical periodontal therapy were evaluated at baseline and 6 months. Serum samples from 475 participants with 6‐month data were analyzed for the following biomarkers: 1) high sensitivity C‐reactive protein; 2) E‐selectin; 3) tumor necrosis factor (TNF)‐α; 4) vascular cell adhesion molecule (VCAM); 5) interleukin (IL)‐6; 6) IL‐8; 7) intercellular adhesion molecule; and 8) IL‐10. Changes in biomarker levels from baseline and correlations among biomarker levels and clinical findings were analyzed. Results: No differences between treatment and control groups were observed for any biomarkers at baseline or 6 months (P >0.05 for all variables). VCAM levels increased by an average (standard deviation) of 17.9 (99.5); ng/mL (P = 0.006) and E‐selectin decreased by 2.33 (16.08) ng/mL (P = 0.03) in the treatment group after 6 months. E‐selectin levels were significantly correlated with DM‐related variables (hemoglobin A1c [HbA1c] and fasting glucose) at baseline and with 6‐month change in both groups; no significant correlations were found among periodontal clinical parameters and serum biomarkers or DM‐related variables. Neither HbA1c or body mass index varied during the study period in either study group. Conclusions: Non‐surgical periodontal therapy and periodontal disease severity were not associated with significant changes in serum biomarkers in DPTT participants during the 6‐month follow‐up. Correlations among changes in E‐selectin, IL‐6, and DM‐related variables suggest that t2DM may be the primary driver of systemic inflammation in these patients.     

Serum Levels of Long‐Chain Polyunsaturated Fatty Acids in Patients With Periodontal Disease

Background: Long‐chain polyunsaturated fatty acids omega‐3 and omega‐6 (LC‐PUFA n‐3 and n‐6) can function as important inflammatory modulators and also have a strong effect in the proresolving inflammatory processes. The aim of the authors is to analyze the serum levels of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and arachidonic acid (AA) in patients with generalized chronic periodontitis (GCP) and compare these results with serum levels of patients with gingivitis only. Methods: Twenty‐one patients with untreated GCP (mean age: 46.0 ± 8.8 years) and 16 patients with gingivitis only (mean age: 31.5 ± 7.5 years) were investigated. The clinical examination included probing depth (PD), clinical attachment level, bleeding on probing, and plaque index. Blood samples were analyzed for the presence of DHA, EPA, DPA, and AA using gas chromatography. Results: Significantly higher levels of DHA, DPA, EPA, and AA were observed in patients with GCP when compared with patients with gingivitis (P = 0.007, P = 0.004, P = 0.033, and P = 0.001, respectively). The differences were still significant even after the adjustments for age and sex. The PD showed a significant positive correlation with DHA (r = 0.5; P = 0.003), DPA (r = 0.6; P <0.001), and AA (r = 0.6; P <0.001). Conclusion: The present findings suggest that serum levels of LC‐PUFA n‐3 and n‐6 may be affected by the severity of periodontal disease.     

Knowledge About the Association Between Periodontal Diseases and Diabetes Mellitus: Contrasting Dentists and Physicians

Background: There is a strong body of evidence that supports the relationship between periodontal diseases and diabetes mellitus (DM). Many patients are unaware of the effects of diabetes on oral health. Whether health care providers are applying the information about the link between DM and periodontal diseases in their practices depends on the levels of their knowledge of such valuable information. Therefore, the aims of this study are to evaluate the knowledge of dental and medical practitioners concerning the effects of diabetes on periodontal health and to find out if the practitioners are aware of the bidirectional relationship between periodontal diseases and DM. Methods: This was a cross‐sectional survey of randomly selected general practitioners practicing in Kuwait. Participants were asked about specific periodontal complications that they believed patients diagnosed with diabetes were more susceptible to, and their awareness of the bidirectional relationship between diabetes and periodontal diseases was evaluated. Results: A total of 510 general practitioners (232 physicians and 278 dentists) participated in the study. There were no significant differences between the two groups regarding mean ages, sex distributions, and years in practice. Only 50% of all study participants believed that patients with diabetes were more susceptible to tooth loss because of periodontal diseases than were individuals without diabetes. Dentists were significantly more aware of gingival bleeding, tooth mobility, and alveolar bone resorption than were physicians. Factors significantly associated with having knowledge about the effects of diabetes on periodontal health in logistic regression analyses were older age, female sex, and the dental profession. Conclusion: The knowledge about the association between periodontal diseases and DM should be increased among dental and medical practitioners to effectively prevent, manage, and control diabetes and periodontal diseases.     

Effect of Non‐Surgical Periodontal Treatment on Clinical and Biochemical Risk Markers of Cardiovascular Disease: A Randomized Trial

Background: Various studies have shown periodontal disease is one of the risk factors for coronary heart disease (CHD), and periodontal treatment of patients with CHD has also been correlated with reduction in systemic markers of CHD. The aim of this study is to evaluate the effect of non‐surgical periodontal treatment (NSPT) on the cardiovascular clinical and biochemical status of patients with CHD. Methods: Seventy known patients with CHD were allocated randomly to either a control group (C; no periodontal therapy) (n = 35) or an experimental group (E; NSPT in the form of scaling and root planing [SRP]) (n = 35). Cardiovascular status was assessed using clinical parameters such as pulse, respiratory rate, blood pressure (BP), and biochemical parameters, such as high‐sensitivity C‐reactive protein (hsCRP), lipid profile, and white blood cell (WBC) count, at baseline and 1, 3, and 6 months. Intergroup and intragroup comparisons were performed using Student t test, and P <0.05 was considered statistically significant. Results: The complete data at the end of the study were provided by only 55 patients (group C, n = 25; group E, n = 30). Highly statistically significant reduction was observed in systolic BP (7.1 mm Hg) and very‐low‐density lipoproteins (VLDLs; 5.16 mg/dL) in group E. Changes were also observed in other cardiovascular biochemical and clinical parameters but were not statistically significant. Conclusions: NSPT (in the form of SRP) positively affects limited cardiovascular (clinical and biochemical) status of patients with CHD. Reduction in triglyceride, VLDL, total WBC, lymphocyte, and neutrophil counts and increase in hsCRP, total cholesterol, high‐density lipoprotein, and low‐density lipoprotein levels were observed. Highly significant reduction in VLDL cholesterol levels and systolic BP was observed among the various parameters measured.     

Relationship Between Normal Serum Creatinine Concentration and Periodontal Disease in Japanese Middle‐Aged Males

Background: Periodontitis has been shown to be closely related to diabetes, which was recently found to be associated with lower serum creatinine. Conversely, several studies have suggested a positive relationship between periodontitis and abnormally high concentrations of serum creatinine associated with renal dysfunction, seemingly contradicting the above. This study evaluates periodontal status and serum levels of creatinine within the normal range to resolve this apparent contradiction. Methods: A comprehensive health examination of 907 Japanese males, 49 to 59 years old, was performed from 2000 to 2002. A blood sample was collected from the antecubital vein after an overnight fast. The periodontal parameters were periodontal probing depth (PD) and clinical attachment loss (AL). We examined the association between serum creatinine concentration within the normal range and periodontal parameters. Results: Serum creatinine concentration within the normal range was inversely correlated with mean PD and mean AL. In multivariate linear regression analyses, every 0.1‐mg/dL increment in serum creatinine concentration was associated with a 0.064‐mm decrease in both mean PD and mean AL (P <0.05) after adjusting for confounding variables. Conclusion: This study finds a significant inverse association between normal serum creatinine concentration and periodontal disease.     

Low Social Position,Periodontal Disease,and Poor Oral Health‐Related Quality of Life in Adults With Systemic Arterial Hypertension

Background: There is little evidence on the association between periodontal disease and oral health‐related quality of life (OHRQoL) in individuals with chronic diseases, including hypertension. The aim of this study is to identify relationships among sociodemographic characteristics, smoking, tooth loss, dental caries, periodontal status, and OHRQoL in adults with systemic arterial hypertension. Methods: A cross‐sectional study involving 195 adults (mean age: 55.7 years) with systemic arterial hypertension used interviews and oral examinations to collect data on sociodemographic characteristics (age, sex, income); use of antihypertensive medication; smoking; tooth loss; dental caries; periodontal status (bleeding on probing, calculus, and attachment loss); and OHRQoL/oral health impact profile. The Wilson and Cleary (Wilson IB, Cleary PD. JAMA 1995;273:59‐65) conceptual model was used to test direct and indirect relationships among variables using structural equation modeling. Results: Lower age, male sex, smoking, and lower income directly predicted worse periodontal status. Tooth loss, dental caries, worse periodontal status, and smoking were directly linked to poor OHRQoL. Age was indirectly linked to worse periodontal status via income. Income and smoking indirectly predicted poor OHRQoL via periodontal status. Conclusions: Findings support an effect of periodontal disease on OHRQoL in people with systemic arterial hypertension. Periodontal status mediated associations of sociodemographic characteristics and smoking with OHRQoL through different pathways.     

Association Between Plasma Levels of Manganese and Periodontal Status: A Study Based on the Fourth Korean National Health and Nutrition Examination Survey

Background: This study aims to evaluate the association between plasma levels of manganese (Mn) and periodontal status in a representative sample of Korean adults. Methods: Plasma levels of Mn and periodontal status were analyzed in 1,679 participants, all of whom were ≥19 years old. Plasma levels of Mn were divided into four quartiles: first (<1.057 μg/dL), second (1.057 to 1.274 μg/dL), third (1.275 to 1.544 μg/dL), and fourth (>1.544 μg/dL). Periodontal status was assessed using the Community Periodontal Index (CPI). Multivariate logistic regression analyses were performed after adjusting for sociodemographic variables, oral and general health behavior, oral health status, and systemic conditions. All analyses took into consideration the complex sampling design, and multivariate analyses were performed in the subgroups. Results: Multivariate logistic regression analyses revealed a significant association between plasma levels of Mn and higher CPI in the total sample. There was a moderate association between first‐quartile plasma levels of Mn and higher CPI in males (odds ratio [OR]: 2.13; 95% confidence interval [CI] 1.25 to 3.63) and current smokers (OR: 2.07; 95% CI 1.04 to 4.11), compared to the fourth quartile. Conclusion: Periodontal status is significantly associated with plasma levels of Mn in Korean adults, especially in men and smokers.     

Serum Antibody Responses to Periodontal Microbiota in Chronic and Aggressive Periodontitis: A Postulate Revisited

Background: The authors revisited the 1999 International Workshop postulate of robust serum antibody responses to infecting agents in localized aggressive periodontitis (LAgP) and weak responses in generalized aggressive periodontitis (GAgP). Antibody responses were further examined in localized and generalized chronic periodontitis (LCP and GCP). Methods: The study includes 119 patients (60 males and 59 females, aged 11 to 76 years), 18 with LAgP, 37 with GAgP, 37 with LCP, and 27 with GCP. Multiple subgingival plaque samples/patient (1,057 in total) were analyzed with respect to 11 bacterial species using checkerboard DNA‐DNA hybridizations, and serum immunoglobulin (Ig)G levels were measured against the same bacteria using checkerboard immunoblotting. Further, infection ratios (antibody level over the average bacterial colonization by the homologous species) were computed for each patient. Comparisons of bacterial colonization, serum IgG levels, and infection ratios were made across the diagnostic categories using multivariable linear regression models adjusting for age and race/ethnicity. Results: There were no statistically significant differences in serum IgG levels to Aggregatibacter actinomycetemcomitans among the four diagnostic categories. IgG levels to several species, including Porphyromonas gingivalis, Treponema denticola, and Campylobacter rectus, were highest in patients with GAgP and significantly different from LCP and GCP, but not from LAgP. Comparisons based on infection ratios showed no statistically significant differences for any species between GAgP and LAgP. Conclusion: This study provides evidence against the 1999 Workshop's postulate of weak serum antibody responses in patients with GAgP and shows that serum IgG responses in GAgP are comparable to those in LAgP, but higher than in GCP or LCP for several species.     

Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study

Background: Chronic kidney disease (CKD) remains a prevalent public health problem that disproportionately affects African Americans, despite intense efforts targeting traditional risk factors. Periodontal disease, a chronic bacterial infection of the oral cavity, is both common and modifiable and has been implicated as a novel potential CKD risk factor. The authors seek to examine to what extent periodontal disease is associated with kidney function decline. Methods: This retrospective cohort study examines 699 African American participants with preserved kidney function (defined by estimated glomerular filtration rate (eGFR) >60 mL/minute/1.73m² at baseline) who underwent complete dental examinations as part of the Dental‐Atherosclerosis Risk in Communities study (1996 to 1998) and subsequently enrolled in the Jackson Heart Study (2000 to 2004). Using multivariable Poisson regression, the authors examined the association of periodontal disease (severe versus non‐severe) with incident CKD, defined as incident eGFR <60 mL/minute/1.73m² and rapid (5% annualized) eGFR decline at follow‐up among those with preserved eGFR at baseline. Results: Mean (± SD) age at baseline was 65.4 (± 5.2) years, and 16.3% (n = 114) had severe periodontal disease. There were 21 cases (3.0%) of incident CKD after a mean follow‐up of 4.8 (± 0.6) years. Compared with participants with non‐severe periodontal disease, those with severe periodontal disease had a four‐fold greater rate of incident CKD (adjusted incidence rate ratio 4.18 [95% confidence interval 1.68 to 10.39], P = 0.002). Conclusions: Severe periodontal disease is prevalent among a population at high risk for CKD and is associated with clinically significant kidney function decline. Further research is needed to determine if periodontal disease treatment alters the trajectory of renal deterioration.