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Multiple issues| refimprove|date=September 2010}} Epidemiology of periodontal disease is the study of patterns, causes, and effects of periodontal diseases. Periodontal disease is a disease affecting the tissue surrounding the teeth. This causes the gums and the teeth to separate making spaces that become infected. The immune system tries to fight the toxins breaking down the bone and tissue connecting to the teeth to the gums. The teeth will have to be removed. This is an advance stage of gum disease that has multiple definitions. Adult periodontitis affects less than 10 to 15% of the population in industrialized countries, mainly adults around the ages of 50 to 60. The disease is now declining world-wide. ==Prevalence of Periodontal Diseases in Adults== Many studies look at the prevalence of “advanced periodontitis”, but have differing definitions of this term. Generally though, severe forms of periodontitis do not seem to affect more than 15% of the population of industrialized countries. The proportion of such subjects increases with age and seems to peak between 50 and 60 years. A later decline in prevalence may be due to tooth loss. There are a number of methodological concerns with prevalence studies, particularly 1) the ability of partial recording to reflect full-mouth conditions and 2) the use of the Community periodontal index of treatment needs (CPITN) recording system. The performance of a partial recording system is affected by the actual prevalence of periodontal disease in the population in question. The less frequent the disease, the more difficult it becomes for a partial recording system to detect it and thus may lead to greater underestimation of the disease prevalence. A full-mouth examination remains the best method of accurately assessing the prevalence and severity of periodontal disease in a population. The use of the CPITN system for Epidemiology/B>Many studies look at the prevalence of “advanced periodontitis”, but have differing definitions of this term. Generally though, severe forms of periodontitis do not seem to affect more than 15% of the population of industrialized countries. The proportion of such subjects increases with age and seems to peak between 50 and 60 years. A later decline in prevalence may be due to tooth loss. There are a number of methodological concerns with prevalence studies, particularly 1) the ability of partial recording to reflect full-mouth conditions and 2) the use of the Community periodontal index of treatment needs (CPITN) recording system. The performance of a partial recording system is affected by the actual prevalence of periodontal disease in the population in question. The less frequent the disease, the more difficult it becomes for a partial recording system to detect it and thus may lead to greater underestimation of the disease prevalence. A full-mouth examination remains the best method of accurately assessing the prevalence and severity of periodontal disease in a population. The use of the CPITN system for epidemiological purposes has flaws, which are grounded in a number of historical truths. At the time the system was designed, the initiation of periodontal disease was thought to develop from a continuum from an inflammation-free state to gingivitis, to calculus deposition and pocket formation and then to progressive disease. Treatment concepts were based on the concept of pocket depths being the most critical criterion for surgical versus non-surgical treatments. This index was also designed to screen large populations to determine treatment needs and formulate preventive strategies, not to describe the prevalence and severity of periodontal diseases. Albandar (1999) reported on data from the Third National Health and Nutrition Examination Survey (NHANES III). This was derived from a large nationally representative, stratified, multistage probability sample in the USA comprising 9689 subjects. Pockets > 5mm were found in 7.6% of non-Hispanic white subjects, 18.4% of non-Hispanic black subjects and 14.4% in Mexican Americans; a total of 8.9% of all subjects had pockets > 5mm. Attachment loss > 5mm was found in 19.9% of non-Hispanic white subjects, 27.9% of non-Hispanic black subjects and 28.3% of Mexican Americans; a total of 19.9% of all subjects had attachment loss > 5mm. This suggests that severe periodontitis in not uniformly distributed among various races, ethnicities and socioeconomic groups. Hugoson (1998) examined three random samples of 600, 597 and 584 subjects in 1973, 1983 and 1993 respectively. These subjects were aged 20–70 years. The severity of disease was divided into five groups, with group 5 having the most severe disease. There was an apparent increase from 1% to 2% to 3% over the three study periods, which may have been due to an increase of dentate subjects in the older age groups. Susin 2004 examined a representative sample of 853 dentate individuals in Brazil who were selected by a multistage probability sampling method. They had a full-mouth clinical examination of six sites per tooth and answered a structured written questionnaire. Seventy-nine percent (79%) and 52% of the subjects and 36% and 16% of the teeth per subject had CAL >5 and >7mm, respectively. Oliver 1998 Bourgeois 2007 found that the prevalence of deep pockets (> 5mm) is low (10.21%) in a cross-sectional study. Baelum 1996 recalculated their previous data from Kenyan and Chinese populations to conform to the methods of examination and data presentation utilized in six other surveys. They did not find that the data supported the traditional generalization that prevalence and severity of periodontitis is markedly increased in African and Asian populations. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Epidemiology of periodontal diseases」の詳細全文を読む スポンサード リンク
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