Aspirin, a common anti-inflammatory drug, is efficacious in preventing many chronic conditions including cardiovascular disease, dementia and certain cancers. Its effects on periodontal disease in human populations are poorly understood. Objectives: To longitudinally assess the effects of long-term peroral aspirin on periodontitis progression. Methods: The study population consisted of participants in the Piedmont 65+ Study of the Elderly, a random sample of community dwelling people, 65 years or older. At baseline, subjects were interviewed regarding demographics, regular dental visits (≥1/year) and ongoing medications. Complete periodontal exams were also performed, which included measurement of pocket depth (PD), clinical attachment level (CAL) and number of teeth. Interviews and exams were repeated at 5 years. Data were tested using regression models and adjusted for baseline demographics and smoking. Results: 77 subjects were identified who regularly took aspirin versus 86 non-aspirin controls. Although a significant inter-group difference for race was detected (p<0.05) at baseline, groups were comparable for the other characteristics including initial CAL and number of teeth. Significant inter-group differences were detected for changes in CAL and PD over the monitoring period (p<0.05). Whereas aspirin subjects gained a mean 0.09mm of CAL, non-aspirin controls lost 0.11mm. Similarly, aspirin subjects exhibited a mean PD reduction of 0.25mm versus 0.14mm observed for non-aspirin controls. The odds ratio for taking aspirin and not exhibiting periodontitis progression (attachment loss >2mm at >4 sites) was 0.43 (95% CI 0.20-0.92, p<0.05). Non-aspirin subjects lost on average 2.41 teeth over the 5-year period versus 1.49 teeth for aspirin subjects (p=0.22). Conclusions: The data from this longitudinal study indicate that regular aspirin use may improve probing parameters and reduce the incidence of periodontitis progression. (Supported by NIDR R01-09060)

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