Am J Epidemiol 2004; 159:499-506.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Birth Order, Sibship Size, and Housing Density in Relation to Tooth Loss and Periodontal Disease: A Cohort Study among Swedish Twins
1 Department of Epidemiology, Harvard School of Public Health, Boston, MA.
2 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
3 Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA.
4 Department of Biostatistics, Harvard School of Public Health, Boston, MA.
5 Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
6 Adverse Reaction Unit, Dental Biomaterials, University of Bergen/UNIFOB, Bergen, Norway.
7 Department of Psychology, University of Southern California, Los Angeles, Los Angeles, CA.
For diseases with an infectious etiology, birth order may dictate the age of exposure to childhood infection, while sibship size may be a proxy for the probability of exposure. The authors examined whether birth order, sibship size, and childhood housing density affect risk of tooth loss and periodontal disease. The study included 28,690 adults aged 
42 years who were participating in a 1998–2002 follow-up of persons listed in the Swedish Twin Registry. Logistic regression was used to calculate odds ratios and 95% confidence intervals, with adjustment for age, sex, education, and smoking and mutual adjustment for family composition (sibship size and/or birth order). Tooth loss and periodontal disease affected 8% and 19% of the twins, respectively. Each additional sibling increased the odds of tooth loss by 10% (95% confidence interval (CI): 1.06, 1.15) and the odds of periodontal disease by 5% (95% CI: 1.02, 1.08). Later birth order was associated with lower odds of periodontal disease. Each additional person per room in the childhood home increased the odds of tooth loss (odds ratio = 1.28, 95% CI: 1.03, 1.60) but lowered the odds of periodontal disease (odds ratio = 0.65, 95% CI: 0.48, 0.89). These findings are compatible with the hypotheses that adult oral diseases are associated with the probability of exposure in childhood and that earlier age at exposure lowers risk.
birth order; communicable diseases; family characteristics; oral health; periodontal diseases; siblings; tooth loss; twins
Abbreviations: Abbreviations: CI, confidence interval; SALT, Screening Across the Lifespan of Twins.
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