Association of Treatments With Prevalence and Incidence of Periodontitis

The aim was to evaluate how treatment supplied in public oral health care services is associated with the prevalence and incidence of periodontitis.

The data for this study comprised patients aged 20 years or older who had visited publicly funded oral health care services in the Wellbeing Services County of North Karelia (Siun sote) during the years 2021-2022 (N = 50,469). These patients were retrospectively followed in the patient register starting from 2014. Associations of treatments received during the follow-up period (years 2014-2020) with ICD-10 diagnoses of chronic and acute periodontitis at follow-up (in 2021-2022) were analyzed by logistic regressions.

The prevalence of diagnoses of both chronic and acute periodontitis in 2021-2022 was quite low. The number of years of having received different treatments in 2014-2020 was associated with the odds of being diagnosed with periodontitis in 2021-2022. In the case of chronic periodontitis, an increasing number of years with preventive and restorative treatments was particularly associated with lower prevalence and incidence. Conversely, an increasing number of years with periodontal treatments and tooth extractions, in addition to earlier diagnosis, were associated with higher prevalence and incidence. For acute periodontitis, in contrast, an increasing number of years with preventive care among all participants and periodontal treatment in incident cases appeared to slightly increase the odds, whereas more years of examinations and tooth extractions were associated with reduced odds. In addition, smoking and diagnosis of diabetes mellitus were associated with higher odds of periodontitis diagnosis.

While the association of treatments was similar for prevalence and incidence, it differed between chronic and acute periodontitis, highlighting their distinct pathophysiological profiles. Although preventive care is offered less frequently than other treatments and often for reasons unrelated to periodontal health, it shows a positive impact in reducing the risk of chronic but not acute periodontitis.