Black people with household incomes exceeding $20,000 a year were more likely than both lower-income blacks and high-income whites to have periodontitis, according to Luisa N. Borrell, D.D.S., Ph.D., of the Mailman School of Public Health and School of Dental and Oral Surgery, Columbia University and colleagues of the University of Michigan. The findings are published in the American Journal of Public Health.
Previous studies suggested that periodontitis was more prevalent among people with lower incomes and low levels of education. Borrell and colleagues say the equation is more complicated.
"Our study, although somewhat consistent with previous studies, shows that the relationship between the prevalence of periodontitis and income and education is different across racial/ethnic groups," Borrell says.
Periodontitis is a dental disease that follows advanced gum inflammation, where the ligaments and bone holding teeth in their sockets start to deteriorate.
Using data from 3,407 dental exams performed as part of a nationwide health survey, the researchers examined periodontitis among white, black and Mexican-American survey participants ages 50 and older.
Borrell and colleagues classified the participants by income depending on whether their annual household income fell above or below $20,000. The researchers also divided the people into higher and lower education groups based on whether they had attended more or less than 12 years of school.
Periodontitis levels were highest among men, people without health insurance and those who had not visited a dentist in the past six months, people with a history of diabetes and smokers, the researchers found.
Income and education seemed to reduce the odds of periodontitis among white people, but the same was not true for blacks.
"In fact, blacks in the higher education group exhibited prevalences of periodontitis that were 2.3 and 4.9 times higher than their white or Mexican-American counterparts, respectively," Borrell and colleagues say.
"Mexican Americans exhibited the lowest prevalence of periodontitis regardless of their income or education," they add.
The researchers suggest a number of factors, from stress to the "historical implications of unequal opportunities for blacks in our society," might help explain the high levels of dental disease among older black people.
The study was supported by The Columbia Center for the Active Life on Minority Elders and The National Institute for Dental and Craniofacial Research.
By Becky Ham, Science Writer
Health Behavior News Service
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American Journal of Public Health