Epidemiology of periodontal diseases.

This review summarizes findings from 46 reports selected from over 130 epidemiologic studies published in 1993 and 1994. Recent findings from longitudinal studies are consistent with the concept that periodontal destruction proceeds in random bursts at specific sites and demonstrate that some individuals have an elevated risk of attachment loss. These and other studies provide further evidence that cigarette smoking is a significant risk factor. New studies have quantified the risk of tooth loss due to periodontal disease, and there is better knowledge about HIV-associated periodontal diseases. Familial studies suggest that both environmental and genetic factors contribute to individual variations in etiologic factors (such as plaque) and periodontal diseases. Several studies propose an intriguing link between periodontal diseases and coronary heart disease, which may be mediated through risk factors common to both diseases, and as a direct consequence of the contribution of periodontal bacteria and their products to atherosclerosis.