Objectives: The relationship between serum IgG antibody responses to Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans and periodontal disease severity was determined in a nationally representative, stratified, multi-stage probability sample of 6,195 subjects in the United States, aged ³ 17 years old, participating in NHANES III-Phase 2. Methods: An ELISA assay was used to detect species-specific serum IgG antibody titers to P. gingivalis and A. actinomycetemcomitans for each study subject, and half-mouth clinical examination data was used to determine periodontal disease severity as defined by Albandar et al. (1999). Results: Positive serum antibody responses to P. gingivalis alone, or jointly with A. actinomycetemcomitans, exhibited a positive relationship with increasing periodontal disease severity. Multinomial logistic regression analysis of all study subjects revealed a 9.7 odds ratio for positive serum antibody responses to both test organisms as a risk factor for severe vs. no periodontal disease status, as compared to odds ratios of 5.2 for smoking, 2.9 for being non-Hispanic black, and 2.4 for male gender. Similar analysis with subjects ³ 50 years yielded odds ratios of 18.4 for a positive serum response to P. gingivalis alone, and 4.7 for positive serum antibodies to both organisms, in comparison to odds ratios of 4.1 for smoking and 2.3 for being non-Hispanic black. Conclusions: These population-based findings further implicate host exposure to P. gingivalis alone, and in combination with A. actinomycetemcomitans, in the pathogenesis of severe periodontitis in humans.

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