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Predicting Periodontitis at State and Local Levels in the United States.

P I Eke1, X Zhang2, H Lu2

  • 1Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA peke@cdc.gov.

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Summary

This study mapped periodontitis prevalence across the US using small area estimation (SAE). Findings reveal significant geographic disparities, highlighting areas needing targeted public health interventions for this common gum disease.

Keywords:
US populationdental health surveysepidemiologyoral healthpopulation surveillancesmall area estimation

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Area of Science:

  • Dental Public Health
  • Epidemiology
  • Biostatistics

Background:

  • Periodontitis is a common oral disease with significant public health implications.
  • Existing national surveillance data lacks granular, state, and local-level prevalence estimates.
  • Accurate geographic distribution data is crucial for targeted public health interventions.

Purpose of the Study:

  • To estimate the prevalence of periodontitis at state and local levels across the United States.
  • To utilize a novel small area estimation (SAE) method for granular prevalence mapping.
  • To identify geographic areas with a high burden of periodontitis for public health surveillance.

Main Methods:

  • Employed extended multilevel regression and poststratification analyses.
  • Integrated data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012, 2010 US census, and 2012 Behavioral Risk Factor Surveillance System.
  • Utilized SAE incorporating age, race, gender, smoking, and poverty variables to estimate prevalence at census block levels, aggregated to larger geographic areas.

Main Results:

  • Estimated periodontitis prevalence varied by state (37.7% Utah to 52.8% New Mexico) and county (33.7% to 68%).
  • Severe periodontitis prevalence also showed geographic variation (7.27% New Hampshire to 10.26% Louisiana among states).
  • Highest predicted prevalence was observed in southeastern and southwestern states, Mississippi Delta, and along the US-Mexico border.

Conclusions:

  • This study provides the first state and local-level periodontitis prevalence estimates in the US using SAE.
  • The modeling approach successfully identified geographic disparities in periodontitis burden.
  • Findings complement public health surveillance and inform targeted interventions for high-prevalence areas.