Untreated periodontal disease: A follow-up on 30 cases

Background: Many studies have shown that periodontal disease can be successfully treated. However, there is limited documentation as to what happens when periodontal disease is left untreated. This study examined patients in a private practice who were diagnosed with periodontal disease and did not complete any treatment. The goal was to see what happened to this group of untreated patients. Methods: Thirty patients with periodontal disease were included in this study. After a mean period of 2.1 years without periodontal treatment, the patients were re-examined and the changes which occurred evaluated. Results: There was a statistically significant increase in probing depth (3.43 mm to 3.95 mm) and attachment loss (4.19 mm to 4.77 mm) and a statistically significant decrease in the number of teeth present (23.37 to 22.67). Twenty-one teeth were lost, which was 3.0% of the teeth present at the time of initial diagnosis. The rate of tooth loss was 0.32 teeth/patient/year. The teeth that were lost had deeper recession, probing depths, and attachment loss than the teeth that were retained. Patient factors evaluated could not be associated with statistically significant changes in the clinical parameters, except that smokers had a greater number of sites gaining greater than or equal to2 mm of attachment and patients with the poorest oral hygiene had a greater percent of sites breaking down. However, certain site specific variables could be associated with statistically significant changes in the clinical parameters. These included sites: with bleeding on probing, associated with molar furcations, on interproximal surfaces, at posterior teeth, with probing depths greater than or equal to3.43 mm, with probing depths greater than or equal to7 mm, attachment loss greater than or equal to7 mm, and teeth with increased mobility. Conclusions: This group of patients with untreated periodontal disease had greater breakdown and tooth loss than one would expect to see in a group of patients if their periodontal disease was treated.