Pattern and rate of progression of periodontal attachment loss in an urban population of South Brazil: a 5-years population-based prospective study

Aim: The aim of this 5-years longitudinal study was to investigate the pattern and rate of periodontal attachment loss (PAL) progression in an urban population in South Brazil. Methods: In 2001, a multistage probability sampling strategy was used to derive a representative sample of 1,465 dentate individuals from Porto Alegre, Brazil. Five years later, 697 dentate individuals (294M/403F, mean age: 37.9 +/- 13.3) were available for follow-up. PAL was assessed by calibrated examiners using a full-mouth protocol. Estimates of proximal PAL progression and standard errors (SE) are reported. Results: Fifty-six per cent (SE: 1.9) and 36% (SE: 1.8) of subjects showed PAL progression >= 3 mm affecting >= 2 and >= 4 teeth respectively. PAL progression >= 3 mm was mostly localized affecting 3.8 (SE: 0.2) teeth and 5.7 (SE: 0.3) sites. Annual PAL progression was, on average, 0.3 mm (SE: 0.01). Significant differences in PAL progression were observed according to age, gender, race and socioeconomic status. PAL progression increased with age reaching the highest progression rate in the 40-49 years cohort, and then decreased in older age groups. PAL progression was consistently higher among males and non-Whites than females and whites. Conclusion: A large proportion of this urban Brazilian sample was affected by PAL progression underscoring the need for health promotion initiatives aiming at preventing progression of destructive periodontal disease.