Periodontal disease progression in the second half of life and following a single episode of scaling and root planing: A clinical study in the Sri Lankan tea plantation cohort with documented clinical parameters for more than 40 years

J Periodontol. 2022 Jan;93(1):45-56. doi: 10.1002/JPER.20-0480. Epub 2021 Sep 23.


Background: To evaluate periodontal disease progression (PDP) and potentially detectable effects of a single episode of scaling and root planing (se-SRP) in subjects lacking professional dental care and oral hygiene practices for >40 years.

Methods: In 2013, se-SRP was offered to all available subjects from the original cohort of 480 males initially established in 1970. From a total of 75 attending the previous examination in 2010 (baseline), 27 consented to receive the intervention while 18 declined and served as controls. Clinical data were recorded again in 2014 (follow-up) similarly to the previous surveys (1970 to 2010).

Results: Subjects' mean age in 2010 was 62.5 (± 3.6, test) and 61.9 (± 3.8, control) years. At follow-up, both groups presented with elevated tooth loss of 1.2 (from 15.5 ± 9.0, test) and 1.5 (from 17.9 ± 6.6, control) resulting in 1,392 (test) and 1,061 (control) sites available for further analysis. In both groups, clinical attachment level (CAL) loss and probing depths (PD) deteriorated. PD increase of 0.22 mm (± 1.70) in the test group was significantly higher compared with the control group (0.08 mm ± 1.30) (P <0.0001) demonstrating unaffected PDP. Computed estimates of further PDP revealed CAL and PD reductions in subjects aged ≥40 years. Specifically, the latter was positively correlated with tooth loss in subjects aged ≥40 years (P = 0.69, P = 0.0012) and ≥50 years (r = 0.62, P <0.0001).

Conclusion: se-SRP in previously untreated periodontitis subjects aged ≥50 years may be ineffective in reducing PDP thus demanding advanced preventive measures, treatment in the first half of life, and sustained access to supportive care.

Keywords: periodontal disease progression; periodontal therapy; periodontitis; periodontitis in the elderly; scaling and root planing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Dental Scaling* / methods
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Periodontal Attachment Loss / drug therapy
  • Periodontal Pocket / drug therapy
  • Root Planing / methods
  • Sri Lanka
  • Tea
  • Tooth Loss* / therapy


  • Tea