New considerations in the prevalence of periodontal disease.

International surveys demonstrate that the prevalence of pocketing of 6 mm or more is between 5% and 20% for much of the world's population. A recently completed national survey of employed adults found the prevalence of gingival bleeding was 44%, the prevalence of pocketing of 4 mm or more was 14%, and the prevalence of attachment loss of 3 mm or more was 44%. Risk indicators for a higher prevalence of periodontal disease include increasing age, poor education, lack of professional dental care, previous periodontal destruction, tobacco use, and diabetes. African-Americans show a higher prevalence of juvenile periodontitis and adult periodontitis than whites. The female-to-male ratio in juvenile periodontitis may be close to 1:1. Another report during the review period suggests that periodontal disease in adults may have a strong genetic component. A doctoral dissertation demonstrated that the sensitivities of methods used in a national survey to detect pocketing and attachment loss range from 0.24 to 0.87 in a high-prevalence population.