Social disparities in periodontitis among United States adults 1999-2004

Objectives: To investigate whether race/ethnicity, income, and education are independently associated with periodontitis; and to investigate the effect of adjusting for income and education on the association between race/ethnicity and periodontitis in the National Health and Examination Nutrition Surveys 1999-2004. Methods: Analyses were limited to records of non-Hispanic black, non-Hispanic white or Mexican-American adults (n = 10 648). SUDAAN was used to estimate the strength of the association of race/ethnicity, education, and income with the prevalence of periodontitis before and after adjusting for selected characteristics and risk factors. Results: The prevalence of periodontitis was 3.6%, with Black people (7.2%) exhibiting significantly higher prevalence than Mexican Americans (4.4%) and White people (3.0%, P < 0.01). After adjusting for selected sociodemographic characteristics, black adults, those with less than a high school education and those with low income were 1.94 (95% CI 1.46-2.58), 2.06 (95% CI 1.47-2.89) and 1.89 (95% CI 1.18-3.04) times more likely to have periodontitis than White people, those with more than a high school diploma and those with high income, respectively. Conclusions: This study indicates that inequalities in periodontitis associated with race/ethnicity, education and income continue to be pervasive in the US over the years.