Associated factors for mid‐buccal gingival recessions: Findings from the National Health and Nutrition Examination Survey

BACKGROUND: Population-level evidence on associated factors for mid-buccal gingival recession (GR) severity stratified by periodontitis status remains limited. This study assessed the prevalence and severity of GR in United States (US) adults and identified associated factors. METHODS: Data from 5891 dentate adults (≥30 years) from the National Health and Nutrition Examination 2011-2014, representing 129.6 million US adults, were analyzed. GR prevalence and severity were defined using mm-based cutoffs (no GR, <3, <5, ≥5 mm) and the Cairo et al. classification (no GR, recession type [RT] 1/RT2, RT3). Survey-weighted ordinal logistic regression models were stratified by periodontitis status (American Academy of Periodontology case definition) for the mm-based outcome (p < 0.05). RESULTS: Weighted GR prevalence was 91.1% (≥1 mm), 37.2% (≥3 mm), and 6.0% (≥5 mm), and RT1/RT2/RT3 prevalence was 7.3%, 88.2%, and 58.7%, respectively. Age was associated with GR across models, with the largest effect in participants with periodontitis (≥65 years: odds ratio [OR] = 5.0, 95% confidence interval [CI]: 3.4-7.4). Male s predicted higher GR severity across all models (OR = 1.1-1.7). Within the periodontitis stratum, current smoking (OR = 2.1; 95% CI: 1.5-2.9) and lower educational level were associated with GR. In the Cairo et al.-based model, periodontitis (OR = 3.3; 95% CI: 2.7-3.9) and current smoking (OR = 1.6; 95% CI: 1.3-1.9) predicted more severe recession types (all p < 0.001). CONCLUSIONS: Mid-buccal GR severity in US adults shows distinct risk patterns by periodontitis status, with age and se as associated factors in both groups and current smoking as an associated factor in participants with periodontitis. Targeted prevention and risk-based management strategies may help reduce the burden of severe GR.