A full-mouth periodontal examination was performed on NHANES participants aged ≥30 years between 2009 and 2014. All dental examiners were trained and calibrated by the reference examiner for the survey [70 (link)]. Gingival recession and periodontal pocket depths were measured using periodontal probes at six sites on the teeth, and clinical attachment loss was calculated [70 (link)]. NHANES researchers referred to the consensus recommendations of the CDC for epidemiological studies and the American Academy of Periodontology Prevention for the diagnosis of periodontitis in conducting this research [71 (link),72 (link)].
In the present study, we categorized those with moderate and severe periodontitis into the periodontitis category; those with mild or no periodontitis were grouped into a referent category, to mitigate the risk of bias due to a potentially excessive prevalence of mild periodontitis in the population [73 (link)]. Severe/moderate periodontitis was defined as follows:
In the present study, we categorized those with moderate and severe periodontitis into the periodontitis category; those with mild or no periodontitis were grouped into a referent category, to mitigate the risk of bias due to a potentially excessive prevalence of mild periodontitis in the population [73 (link)]. Severe/moderate periodontitis was defined as follows:
≥2 Interproximal sites with a clinical attachment loss (CAL) of ≥4 mm;
≥2 Interproximal sites with a periodontal probing depth of ≥5 mm.
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