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Bond JC, Casey SM, McDonough R, McLone SG, Velez M, Heaton B. Validity of individual self-report oral health measures in assessing periodontitis for causal research applications. J Periodontol 2024; 95:892-906. [PMID: 38197131 DOI: 10.1002/jper.23-0551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Self-reported measures of periodontitis developed for use in population surveillance are increasingly used in causal research. Numerous studies evaluate the validity of these measures against clinical parameters of periodontitis, yet few include validation parameters outside of multivariable models. Individual item validity is necessary to adequately inform use of these measures in causal research. METHODS We used data from the National Health and Nutrition Examination Survey 2011-2014 in which dentate participants completed full-mouth periodontal examinations (N = 6966). We evaluated six self-report questionnaire items related to periodontal disease status against periodontitis case definitions developed by the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC-AAP). We estimated the sensitivity and specificity of individual items using severe and moderate-to-severe periodontitis classifications. We additionally combined items to evaluate the validity of joint measures. RESULTS Sensitivity was highest when measures were evaluated against severe periodontitis. Self-rated oral health of fair/poor demonstrated the highest sensitivity for severe (0.60) and moderate-to-severe periodontitis (0.48). Specificity was highest when evaluated against moderate-to-severe periodontitis, with self-reported history of tooth mobility as the most specific measure (0.87 for severe disease; 0.92 for moderate-to-severe) followed by a history of bone loss (0.88 for severe; 0.91 for moderate-to-severe). Combining questions generally improved specificity at the expense of sensitivity. CONCLUSIONS Our findings related to item-specific validity and the associated clinical profiles facilitate needed considerations for the use of self-reported measures of periodontitis in causal research. Additionally, item-specific validity can be used to inform assessments of misclassification bias within such investigations.
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Affiliation(s)
- Julia C Bond
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sharon M Casey
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Robert McDonough
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
| | - Suzanne G McLone
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Mabeline Velez
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Brenda Heaton
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
- University of Utah School of Dentistry, Salt Lake City, Utah, USA
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Cassiano LS, Jensen AB, Pajaniaye JB, Leite FRM, Li H, Andersen A, Bitencourt FV, Nascimento GG. Development of a nomogram for identifying periodontitis cases in Denmark. Sci Rep 2024; 14:11280. [PMID: 38760383 PMCID: PMC11101420 DOI: 10.1038/s41598-024-60624-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/25/2024] [Indexed: 05/19/2024] Open
Abstract
Although self-reported health outcomes are of importance, attempts to validate a clinical applicable instrument (e.g., nomogram) combining sociodemographic and self-reported information on periodontitis have yet to be performed to identify periodontitis cases. Clinical and self-reported periodontitis, along with sociodemographic data, were collected from 197 adults. Akaike information criterion models were developed to identify periodontitis, and nomograms developed based on its regression coefficients. The discriminatory capability was evaluated by receiver-operating characteristic curves. Decision curve analysis was performed. Smoking [OR 3.69 (95%CI 1.89, 7.21)], poor/fair self-rated oral health [OR 6.62 (95%CI 3.23, 13.56)], previous periodontal treatment [OR 9.47 (95%CI 4.02, 22.25)], and tooth loss [OR 4.96 (95%CI 2.47, 9.97)], determined higher probability of having "Moderate/Severe Periodontitis". Age [OR 1.08 (95%CI 1.05, 1.12)], low educational level [OR 1.65 (95%CI 1.34, 2.23)], poor/fair self-rated oral health [OR 3.57 (95%CI 1.82, 6.99)], and previous periodontal treatment [OR 6.66 (95%CI 2.83, 15.68)] determined higher probability for "Any Periodontitis". Both nomograms showed excellent discriminatory capability (AUC of 0.83 (95%CI 0.75, 0.91) and 0.81 (95% CI 0.74, 0.88), good calibration, and slight overestimation of high risk and underestimation of low risk. Hence, our nomograms could help identify periodontitis among adults in Denmark.
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Affiliation(s)
- Luisa Schertel Cassiano
- Section for Oral Ecology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus, Denmark.
| | - Anne B Jensen
- Section for Oral Ecology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus, Denmark
| | - Julie B Pajaniaye
- Section for Oral Ecology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus, Denmark
| | - Fábio R M Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Huihua Li
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Anette Andersen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Fernando V Bitencourt
- Section for Oral Ecology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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Zainal Abidin Z, Noor E, Mohd Nor NS, Mohamed Nazari NS, Anuar Zaini A, Azizi NZ, Soelar SA, Shahrizad MM, Abdul Halim R. Type 1 Diabetes Mellitus Patients' Self-perception of Periodontal Diseases. Eur J Dent 2024; 18:534-543. [PMID: 38049120 PMCID: PMC11132774 DOI: 10.1055/s-0043-1772777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVES The study aimed to evaluate type 1 diabetes mellitus (T1DM) patients' self-perceived periodontal health status and to identify the association between periodontal disease (PD) and DM. MATERIALS AND METHODS This cross-sectional study included 113 T1DM children between 3 and 18 years old from the Universiti Teknologi MARA and the University of Malaya. Periodontal health parameters, including plaque index, gingival index, probing pocket depth, simplified basic periodontal examination, and clinical attachment loss, were recorded. Self-perceived periodontal health status was assessed with questionnaires. STATISTICAL ANALYSIS Statistical analysis was performed to evaluate the sensitivity of the questionnaire and the relationship between T1DM and periodontal parameters. RESULTS The median age was 11.4 years. Half of them (50.4%) were females. A total of 83.5% rated their oral condition as good, whereas 27.5% reported a history of gingival bleeding. Clinical examination revealed that 48.7% had healthy gingiva, whereas 47.8% had gingivitis. The question "Do you have bleeding when brushing, flossing, or eating food?" showed good accuracy in the evaluation of PD (p < 0.001). CONCLUSION The questionnaire has a high potential to be used by medical professionals in identifying T1DM patients at risk of PD to guide nondental health care providers in making appropriate referrals to dental services.
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Affiliation(s)
- Zaridah Zainal Abidin
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Erni Noor
- Centre of Studies for Periodontology, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Noor Shafina Mohd Nor
- Department of Paediatrics, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | | | - Azriyanti Anuar Zaini
- Paediatric Department, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nurul Zeety Azizi
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Aiman Soelar
- Clinical Research Centre, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
| | - Marshah Mohamad Shahrizad
- Kuching Division Dental Office, Sarawak State Dental Health Department, Braang Bayur Dental Clinic, Sarawak, Malaysia
| | - Rohaida Abdul Halim
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
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Teza H, Pattanateepapon A, Lertpimonchai A, Vathesatogkit P, J McKay G, Attia J, Thakkinstian A. Development of Risk Prediction Models for Severe Periodontitis in a Thai Population: Statistical and Machine Learning Approaches. JMIR Form Res 2023; 7:e48351. [PMID: 38096008 PMCID: PMC10755655 DOI: 10.2196/48351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Severe periodontitis affects 26% of Thai adults and 11.2% of adults globally and is characterized by the loss of alveolar bone height. Full-mouth examination by periodontal probing is the gold standard for diagnosis but is time- and resource-intensive. A screening model to identify those at high risk of severe periodontitis would offer a targeted approach and aid in reducing the workload for dentists. While statistical modelling by a logistic regression is commonly applied, optimal performance depends on feature selections and engineering. Machine learning has been recently gaining favor given its potential discriminatory power and ability to deal with multiway interactions without the requirements of linear assumptions. OBJECTIVE We aim to compare the performance of screening models developed using statistical and machine learning approaches for the risk prediction of severe periodontitis. METHODS This study used data from the prospective Electricity Generating Authority of Thailand cohort. Dental examinations were performed for the 2008 and 2013 surveys. Oral examinations (ie, number of teeth and oral hygiene index and plaque scores), periodontal pocket depth, and gingival recession were performed by dentists. The outcome of interest was severe periodontitis diagnosed by the Centre for Disease Control-American Academy of Periodontology, defined as 2 or more interproximal sites with a clinical attachment level ≥6 mm (on different teeth) and 1 or more interproximal sites with a periodontal pocket depth ≥5 mm. Risk prediction models were developed using mixed-effects logistic regression (MELR), recurrent neural network, mixed-effects support vector machine, and mixed-effects decision tree models. A total of 21 features were considered as predictive features, including 4 demographic characteristics, 2 physical examinations, 4 underlying diseases, 1 medication, 2 risk behaviors, 2 oral features, and 6 laboratory features. RESULTS A total of 3883 observations from 2086 participants were split into development (n=3112, 80.1%) and validation (n=771, 19.9%) sets with prevalences of periodontitis of 34.4% (n=1070) and 34.1% (n=263), respectively. The final MELR model contained 6 features (gender, education, smoking, diabetes mellitus, number of teeth, and plaque score) with an area under the curve (AUC) of 0.983 (95% CI 0.977-0.989) and positive likelihood ratio (LR+) of 11.9 (95% CI 8.8-16.3). Machine learning yielded lower performance than the MELR model, with AUC (95% CI) and LR+ (95% CI) values of 0.712 (0.669-0.754) and 2.1 (1.8-2.6), respectively, for the recurrent neural network model; 0.698 (0.681-0.734) and 2.1 (1.7-2.6), respectively, for the mixed-effects support vector machine model; and 0.662 (0.621-0.702) and 2.4 (1.9-3.0), respectively, for the mixed-effects decision tree model. CONCLUSIONS The MELR model might be more useful than machine learning for large-scale screening to identify those at high risk of severe periodontitis for periodontal evaluation. External validation using data from other centers is required to evaluate the generalizability of the model.
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Affiliation(s)
- Htun Teza
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Anuchate Pattanateepapon
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Attawood Lertpimonchai
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Gareth J McKay
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - John Attia
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW, Australia
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Martínez-García M, Rodríguez-Hernández AP, Gutiérrez-Esparza GO, Castrejón-Pérez RC, Hernández-Lemus E, Borges-Yáñez SA. Relationship between the Social Development Index and Self-Reported Periodontal Conditions. Healthcare (Basel) 2023; 11:1548. [PMID: 37297688 PMCID: PMC10252225 DOI: 10.3390/healthcare11111548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/12/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Inequalities in oral health are influenced by the social strata of the population. Few studies have focused on the multitude of factors related to social development as indicators of living conditions and periodontal health status. The aim of this study is to evaluate the association between self-reported periodontal conditions and the Social Development Index (SDI). A cross-sectional validated questionnaire was carried out among 1294 Mexican adults. Descriptive statistics and multivariate logistic regression models were used to identify the best predictors of self-reported periodontal conditions. Bone loss reporting was used as a proxy for the presence of periodontal disease. We found that higher global scores on the SDI and quality and available space in the home (QASH) increase the probability of having bone loss. Global SDI (OR = 7.27) and higher QASH (OR = 3.66) were indeed the leading societal factors related to periodontal disease. These results have pointed out how SDI and its indicators, in particular QASH, can be used to further explore inequities related to privileged access to dental care in the context of periodontal diseases.
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Affiliation(s)
- Mireya Martínez-García
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
| | - Adriana-Patricia Rodríguez-Hernández
- Laboratory of Molecular Genetics, Graduate Studies and Research Division, School of Dentistry, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
| | - Guadalupe O. Gutiérrez-Esparza
- Cátedras CONACYT Consejo Nacional de Ciencia y Tecnología, Mexico City 08400, Mexico;
- Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
| | - Roberto Carlos Castrejón-Pérez
- Department of Clinical and Epidemiological Geriatric Research, Instituto Nacional de Geriatría, Mexico City 10200, Mexico;
| | - Enrique Hernández-Lemus
- Computational Genomics Division, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico;
- Center for Complexity Sciences, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Socorro Aída Borges-Yáñez
- Dental Public Health Department, Graduate Studies and Research Division, School of Dentistry, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
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Lertpimonchai A, Tuntrakul S, Rattanasiri S, Sutthiboonyapan P, Vathesatogkit P, Udomsak A, Tavedhikul K. Validity of Simple Self-Reported Periodontal Status Questions. Int Dent J 2022; 73:121-127. [PMID: 36460520 PMCID: PMC9875259 DOI: 10.1016/j.identj.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/03/2022] [Accepted: 10/30/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The aim of this research was to evaluate the validity of the questions developed by Thai periodontists on self-reported periodontal status and symptoms in identifying severe periodontitis amongst adults in Thailand. METHODS Registered Electricity Generating Authority of Thailand (EGAT) employees completed medical examinations and full-mouth periodontal examinations. They also were interviewed using a self-reported questionnaire that was developed by Thai periodontists. The questions pertained to their periodontal status and symptoms comprising swollen gums, bad breath, loose teeth, bleeding on brushing, painful gums, and pus or abscesses. The participants were categorised as having nonsevere and severe periodontitis according to the Centers for Disease Control and Prevention in partnership with the American Academy of Periodontology (CDC/AAP) case definitions. Self-reported periodontal status and symptom results were compared with actual periodontal status. The area under the receiver operating characteristic curve (AUROCC), sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. RESULTS A total of 1393 EGAT employees participated in this study. The questions on self-reported periodontal status and all symptoms poorly identified patients with severe periodontitis, with an AUROCC of 0.52 to 0.60. The sensitivity was 5.0% to 40.2%; however, the specificity was good, at 73.2% to 99.1%. The validity of the self-reported questions was comparable amongst the sex, education, and income subgroups. CONCLUSIONS This study demonstrated that self-reported periodontal status and symptoms were inadequate in identifying patients with severe periodontal disease.
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Affiliation(s)
- Attawood Lertpimonchai
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Supang Tuntrakul
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sasivimol Rattanasiri
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pimchanok Sutthiboonyapan
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Artit Udomsak
- Medical and Health Division, Electric Generation Authority of Thailand, Nonthaburi, Thailand
| | - Kanoknadda Tavedhikul
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand,Corresponding author. Kanoknadda Tavedhikul, Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand.
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Antônio Raulino do Nascimento T, Vilton Costa J, Oliveira Guerra R. Periodontal Disease in the Brazilian Population: A Retrospective Analysis on the 2013 National Health Survey to Identifying Risk Profiles. Int J Dent 2022; 2022:5430473. [PMID: 36249730 PMCID: PMC9568304 DOI: 10.1155/2022/5430473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/27/2022] [Indexed: 11/18/2022] Open
Abstract
Periodontal disease (PD) is a global public health problem with prevalence varying according to social and economic contexts; however, few studies have investigated the distribution of PD worldwide. PD is the host response to an infection or progression of a clinical condition, and the identification of modifiable risk factors for adequate clinical management of patients should be a priority in health policies directed to vulnerable population groups. In this context, we investigated the characteristics and risk factors for PD using the Brazilian National Health Survey 2013 (PNS-2013). A cluster analysis using the interdependence technique was applied to explore data on the risk of periodontitis. The presence or absence of a risk factor was analyzed using five variables (ten categories), while ordinal regression assessed risk profiles based on sociodemographic aspects of the Brazilian population. Individuals were classified as low (26.33%), medium (23.34%), or high risk (50.32%) for PD. Age, educational level, ethnicity, and Brazilian regions (except the North region) were significantly associated with risk for PD in the adjusted final regression model. Individual and social contexts were factors related to the high risk of PD in the Brazilian population. Our results highlight the need for public policies on healthy habits to prevent systemic diseases affecting oral health.
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Affiliation(s)
- Thiago Antônio Raulino do Nascimento
- Federal Institute of Education Science and Technology of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Subcoordination of Sanitary Surveillance of State of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - José Vilton Costa
- Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Machado V, Lyra P, Santos C, Proença L, Mendes JJ, Botelho J. Self-Reported Measures of Periodontitis in a Portuguese Population: A Validation Study. J Pers Med 2022; 12:1315. [PMID: 36013264 PMCID: PMC9410440 DOI: 10.3390/jpm12081315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/25/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Self-reported questionnaires have been developed and validated in multiple populations as useful tools to estimate the prevalence of periodontitis in epidemiological settings. This study aimed to explore the accuracy of self-reporting for predicting the prevalence of periodontitis in a Portuguese population. The questionnaires were given to patients at a university clinic. Thirteen self-reported questions on periodontal health were gathered in a patient-reported questionnaire. Then, self-reporting responses were validated using full-mouth periodontal examination as a comparison. Multivariable logistic regression was used to analyze sensitivity, specificity, accuracy, precision, and area under the curve-receiver operator characteristic (AUC-ROC). Self-reported answers from 103 participants (58 females and 45 males) were included. Self-reported gum health, loose teeth, tooth appearance, and use of dental floss were associated with different definitions of severe periodontitis. The self-reported questions on "having gum disease," combined with "having gum treatment" and "having lost bone" were the items with higher performance for the 2018 case definition and the 2012 case definition, as well as for each respective severity staging. Categorization of tooth loss was only valuable for the prediction of periodontitis cases according to the 2012 case definition and its severe stage. Multiple self-reporting set-ups showed elevated performance levels for predicting periodontitis in Portuguese patients. These results may pave the way for future epidemiological surveillance programs using self-reporting approaches.
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Affiliation(s)
- Vanessa Machado
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - Patrícia Lyra
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - Catarina Santos
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - Luís Proença
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
- Quantitative Methods for Health Research, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - José João Mendes
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - João Botelho
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
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Sim CPC, Li H, Peres MA. Who to Be Treated: Nomogram Using Self-Reported Periodontal Screening Instrument among English-Speaking Adults in Multi-Ethnic Singapore. J Pers Med 2022; 12:jpm12060931. [PMID: 35743716 PMCID: PMC9225178 DOI: 10.3390/jpm12060931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
Periodontal disease is a major public health problem. This study aimed to develop a nomogram using a self-reported periodontitis screening instrument in predicting severe periodontitis (SP), defined by the World Workshop on Classification of Periodontal and Peri-Implant Diseases and Conditions, and evaluate its utility in clinical setting. An Akaike information criterion selected multivariable model was developed to predict SP using a self-reported questionnaire, with a nomogram developed based on its regression coefficients. Discriminatory capability was evaluated by Receiver-operating characteristic curve. Ability to predict SP of individual patients was evaluated with bootstrapping. Decision curve analysis (DCA) was performed to evaluate its potential clinical utility by evaluating clinical net benefit at different thresholds. 58.1% of 155 participants were classified with SP. Older males without tertiary education, with ‘loose teeth’, ‘bone loss’ and ‘mouth rinse use’ had higher SP risk. The nomogram showed excellent discriminatory capability with Area under Curve of 0.83 (95% CI = (0.76, 0.89)), good calibration (intercept = 0.026) and slight overestimation of high risk and underestimation of low risk (slope = 0.834). DCA showed consistent clinical net benefit across the range of thresholds relative to assumption of ‘no patient’ or ‘all patient’ with SP. Our nomogram using a self-reported periodontitis instrument is useful in SP screening in English-speaking Singaporean adults.
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Affiliation(s)
- Christina P. C. Sim
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
- Correspondence: ; Tel.: +65-6324-8928; Fax: +65-6324-8900
| | - Huihua Li
- ACP Research Office, National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore;
- Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
| | - Marco A. Peres
- National Dental Centre Singapore, National Dental Research Institute Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore;
- Oral Health Academic Clinical Programme, Health Services and Systems Research Institute Singapore, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
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Pimentel RP, Bittencourt LF, Miller LM, Borges RB, Oppermann RV, Gomes SC. Self-reported questionnaire on periodontal condition validated for use in Brazil. Braz Oral Res 2022; 36:e060. [PMID: 36507747 DOI: 10.1590/1807-3107bor-2022.vol36.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/12/2022] [Indexed: 12/15/2022] Open
Abstract
There is a current expectation of instruments for periodontal condition surveillance worldwide. The present study aimed to validate the Oral Health Questions Set B (OHQB) for the Brazilian Portuguese and evaluate its temporal stability. This is a sequential mixed-method investigation. After the forward-backward translation process to the Brazilian Portuguese, the OHQB Brazil (OHQB-Br) was applied to 156 participants (39.5 ± 14.14 years; 51.9% males). In sequence, through a full-mouth six-sites/teeth examination and in accordance with the original instrument, the periodontal diagnosis was obtained (March 2020). In January 2021, the OHB-BR was reapplied (n = 71). Ordinal alpha and McDonald's omega tested the internal consistency of the OHQB-Br. Temporal stability was investigated [Spearman correlation, intraclass correlation coefficient (ICC), and the Bland-Altman]. The concurrent validity was also verified, considering the periodontal clinical diagnosis (Kruskal Wallis). The ordinal alpha (0.69) and McDonald's omega (0.73) coefficients showed an adequate internal consistency of the OHQB-Br. The OHQB-Br temporal stability was high, as demonstrated by the Spearman coefficient (0.80) and ICC (0.79) and by the Bland-Altman plot. A concurrent validity showed a direct relationship between the OHQB-Br and the clinical condition of no periodontitis, mild, moderate, and severe periodontitis (p < 0.05). Because the OHQB-Br shows internal validity, temporal stability, and adequately identifies periodontal health and moderate/severe periodontitis, the instrument might represent an important tool, at the public level or other settings, for periodontal surveillance in Brazil.
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Affiliation(s)
- Roberto Pereira Pimentel
- Universidade Federal do Rio Grande do Sul - UFRGS, School, of Dentistry, Porto Alegre, RS, Brasil
| | - Liana Flores Bittencourt
- Universidade Federal do Rio Grande do Sul - UFRGS, School, of Dentistry, Porto Alegre, RS, Brasil
| | - Luisa Martins Miller
- Universidade Federal do Rio Grande do Sul - UFRGS, School, of Dentistry, Porto Alegre, RS, Brasil
| | - Rogério Boff Borges
- Hospital de Clínicas de Porto Alegre - HCPA, Biostatistics Unit, Porto Alegre, RS, Brasil
| | - Rui Vicente Oppermann
- Universidade Federal do Rio Grande do Sul - UFRGS, School, of Dentistry, Department of Periodontics, Porto Alegre, RS, Brasil
| | - Sabrina Carvalho Gomes
- Universidade Federal do Rio Grande do Sul - UFRGS, School, of Dentistry, Department of Periodontics, Porto Alegre, RS, Brasil
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VALENTIM FB, BARBOSA JSDA, CARNEIRO VC, ARAÚJO AM, ROSETTI EP. Association between periodontitis and type 2 diabetes mellitus: study in a population attended by the Brazilian Health System. REVISTA DE ODONTOLOGIA DA UNESP 2022. [DOI: 10.1590/1807-2577.01022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Periodontitis control helps to prevent and control diabetes mellitus and understanding of this relationship can lead to changes in health policy. Objective The purpose of this study was to investigate the association between periodontitis, knowledge, and glycemic control. Material and method This is a cross-sectional analytical epidemiological survey with 216 Type 2 diabetic patients, non-smokers, who had current blood screenings with glycated hemoglobin (HbA1c). Result Overall, 93.51% of the patients reported brushing their teeth at least twice a day, 62.5% visited the dentist last year, 81.58% have already undergone treatment for periodontal disease, 43.52% reported having periodontitis and 59.72% had controlled diabetes. No significant (p=0.603) association between HbA1c control and the presence of periodontitis was found. Among the patients with periodontitis, no association between HbA1c control and information on the periodontal disease was found (p=0.996), and know/believe in its relationship with diabetes (p=0.659; p=0.973). Conclusion No relationship between periodontitis and diabetes was found in the sample, as well as in patients with periodontitis, those with knowledge on periodontal disease and knowledge/belief in its relationship with diabetes, which could be justified by the care by a multi-professional health team.
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Perdoncini NN, Furquim CP, Bonfim CMS, Soares GMS, Torres-Pereira CC. Self-perception of periodontal health status among individuals with Fanconi anemia. Hematol Transfus Cell Ther 2021; 43:453-458. [PMID: 33023865 PMCID: PMC8573027 DOI: 10.1016/j.htct.2020.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/05/2020] [Accepted: 07/20/2020] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Fanconi anemia (FA) is a rare genetic disease characterized by congenital malformations and bone marrow failure. One of the most common oral diseases in individuals with FA is periodontitis and adequate self-perception of periodontal status could contribute to its prevention and early detection. AIM To compare oral health self-perception, measured by a questionnaire, with the clinical oral condition of patients with FA. METHODS AND RESULTS Fifty-six patients with FA, over 11 years of age, answered a questionnaire about dental history and self-reported oral health. Decayed, missing, and filled teeth (DMFT), Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) were measured. The median age of participants was 21 years (min 11, max 44), 31 (55%) were females and 25 (45%) males. Thirty-five (62.5%) participants rated their oral condition as satisfactory and 7 (12.5%) participants reported tooth mobility, 10 (17.9%) exposed roots and 21 (37.5%) gingival bleeding. Clinical examination detected average DMFT = 5.23, VPI = 31.36% and GBI = 33.77%. The gingival bleeding report was more frequent among individuals with higher GBI (p = 0.014). The DMFT was higher in those who had already undergone dental treatments (p = 0.031). There was an association between participants who presented dental caries and who rated their oral health as poor (p = 0.03). The question "Do your gums bleed easily?" had good accuracy in the evaluation of periodontal disease (p = 0.68). CONCLUSION Oral health self-perception of individuals with FA about gingival inflammation was associated with their gingival bleeding index.
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Oliveira LM, Cerezer DM, Casarin M, Moreira CHC, Zanatta FB. Alcohol use disorders are associated with higher prevalence of periodontitis in a rural area of Brazil. J Periodontal Res 2021; 56:940-950. [PMID: 34057233 DOI: 10.1111/jre.12890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 05/02/2021] [Accepted: 05/05/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The aim of the present cross-sectional study was to determine whether alcohol use disorders (AUD) are independently associated with severe and extent cases of periodontitis in individuals living in a rural area of Brazil. METHODS A representative probability sample (N = 585) was evaluated using six-site full-mouth periodontal examination. AUD was assessed using the alcohol use disorders identification test (AUDIT) and considered in its unidimensional and bidimensional factor structures. The first address hazardous alcohol consumption [HAC (overall scores ≥8)], and the second deals with two distinct constructs, harmful use [HU (items 1-3 scores ≥4 for men or ≥3 for women)], and alcohol-related consequences [ARC (items 4-10 scores ≥1)]. Periodontal outcomes were defined based on the criteria proposed by the CDC-AAP (2012) and an adaptation of the EFP-AAP (2018) definition of generalized stages III or IV periodontitis (GP). Adjusted multilevel multinomial and binary logistic regression analysis were used with a conceptual hierarchical approach to calculate the odds ratios (OR) of periodontal outcomes. RESULTS In the adjusted model, HU (OR = 2.69; 95% CI: 1.29-5.58) and ARC (OR = 3.79; 95% CI: 1.51-9.51) were significantly associated with higher prevalence of severe periodontitis (SP). Higher occurrence of GP was detected in individuals presenting HAC (OR = 1.88; 95% CI: 1.05-3.37) and ARC (OR = 2.90; 95% CI: 1.61-5.24). CONCLUSION AUD was independently associated with higher prevalence of SP and GP in individuals living in a rural area.
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Affiliation(s)
- Leandro Machado Oliveira
- Department of Stomatology, Postgraduate Program in Dentistry, Universidade Federal de Santa Maria (UFSM, Santa Maria, Rio Grande do Sul, Brazil
| | - Débora Martins Cerezer
- Department of Stomatology, Postgraduate Program in Dentistry, Universidade Federal de Santa Maria (UFSM, Santa Maria, Rio Grande do Sul, Brazil
| | - Maísa Casarin
- Department of Semiology and Clinic, Postgraduate Program in Dentistry, Universidade Federal de Pelotas (UFPel, Pelotas, Rio Grande do Sul, Brazil
| | - Carlos Heitor Cunha Moreira
- Department of Stomatology, Postgraduate Program in Dentistry, Universidade Federal de Santa Maria (UFSM, Santa Maria, Rio Grande do Sul, Brazil
| | - Fabrício Batistin Zanatta
- Department of Stomatology, Postgraduate Program in Dentistry, Universidade Federal de Santa Maria (UFSM, Santa Maria, Rio Grande do Sul, Brazil
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Moreno-Drada JA, Silva da Cruz AJ, Soares de Faria ML, Miranda Cota LO, Parreiras Martins MA, Almeida Pordeus I, Nogueira Guimarães de Abreu MH. Oral Health-Related Quality of Life in Anticoagulated Patients with Warfarin Treatment: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3714. [PMID: 33918224 PMCID: PMC8037600 DOI: 10.3390/ijerph18073714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/25/2022]
Abstract
To evaluate factors associated with oral health-related quality of life (OHRQoL) in patients under oral anticoagulant therapy with warfarin, a cross-sectional study was conducted. Validated questionnaires assessed self-reported periodontal disease, demographic variables, and OHRQoL using the short version of the Oral Health Impact Profile (OHIP-14) instrument. After calibration (Kappa > 0.60), an examiner evaluated patients' experience with dental caries and the need for dental prostheses. Statistical analysis involved proportions and measures of central tendency. Negative binomial regression models were used to estimate the rate ratios (RR) and the corresponding 95% confidence interval (CI). The sample consisted of 158 individuals, with a mean age of 58.8 years (SD = 12.1), of which 62.7% of the participants were women. The OHIP-14 mean was 10.62 (SD = 10.92). A higher OHIP-14 total score (worse OHRQoL) was associated with ethnic group, age, periodontal disease self-report, dental caries, and oral health self-report. Demographic and clinical factors can negatively influence the perception of anticoagulated patients on OHRQoL.
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Affiliation(s)
- Johana Alejandra Moreno-Drada
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte CEP 31270-901, Brazil; (A.J.S.d.C.); (M.L.S.d.F.); (L.O.M.C.); (I.A.P.); (M.H.N.G.d.A.)
| | - Alex Junio Silva da Cruz
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte CEP 31270-901, Brazil; (A.J.S.d.C.); (M.L.S.d.F.); (L.O.M.C.); (I.A.P.); (M.H.N.G.d.A.)
| | - Matheus Luis Soares de Faria
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte CEP 31270-901, Brazil; (A.J.S.d.C.); (M.L.S.d.F.); (L.O.M.C.); (I.A.P.); (M.H.N.G.d.A.)
| | - Luís Otávio Miranda Cota
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte CEP 31270-901, Brazil; (A.J.S.d.C.); (M.L.S.d.F.); (L.O.M.C.); (I.A.P.); (M.H.N.G.d.A.)
| | | | - Isabela Almeida Pordeus
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte CEP 31270-901, Brazil; (A.J.S.d.C.); (M.L.S.d.F.); (L.O.M.C.); (I.A.P.); (M.H.N.G.d.A.)
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15
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Wright CD, Heaton B, McNeil DW. Development and validation of a latent, multidimensional, self-report periodontal disease measure. J Periodontol 2021; 92:1554-1563. [PMID: 33651894 DOI: 10.1002/jper.20-0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Self-report measures of periodontal disease have utility for screening, but have not capitalized on a latent variable approach based on psychometric theory to validate such measures. This study aimed to develop a psychometrically valid self-report measure of periodontal disease using latent variable factor analysis and other evidence-based psychometric analyses. METHODS Likert-type items reflecting periodontal disease were administered to a sample of adults (n = 828) in the United States via an online survey. Items were adapted from prior self-report measures or were newly developed based on psychometric item development theory and theoretical knowledge of periodontal disease. Psychometric analyses included exploratory and confirmatory factor analysis, parallel analysis, and a calculation of internal consistency. RESULTS Exploratory factor analysis (EFA) was indicative of the goodness-of-fit with two factors (root mean square error of approximation (RMSEA) = 0.08; comparative fit index (CFI) = 0.97; Tucker Lewis index (TLI) = 0.96; standardized root mean squared residual = 0.06); five of the 22 original survey questions were eliminated based on the results of this EFA. Parallel analysis supported a two-factor model to represent the similarities across items-one factor reflecting physiologic components and another reflecting functional components of periodontal disease. Confirmatory Factor Analysis also indicated adequate model fit (RMSEA = 0.07; CFI = 0.98; TLI = 0.98; and weighted root mean square residual = 1.20). CONCLUSIONS Psychometric analyses of a new 17-item periodontal disease self-report measure provided initial evidence of construct/factor validity. This approach to developing self-report periodontal disease measures may facilitate useful and cost-effective estimates of periodontal disease and provide a testable scale. Future work should include clinical validation.
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Affiliation(s)
- Casey D Wright
- Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV
| | - Brenda Heaton
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | - Daniel W McNeil
- Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV.,Department of Dental and Rural Practice, School of Dentistry, West Virginia University, Morgantown, WV
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16
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Sekundo C, Bölk T, Kalmus O, Listl S. Accuracy of a 7-Item Patient-Reported Stand-Alone Tool for Periodontitis Screening. J Clin Med 2021; 10:E287. [PMID: 33466797 PMCID: PMC7830157 DOI: 10.3390/jcm10020287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 02/06/2023] Open
Abstract
Periodontitis is interrelated with various other chronic diseases. Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment. So far, however, screening for periodontitis in non-dental settings has been complicated by a lack of easily applicable and reliable screening tools which can be applied by non-dental professionals. The purpose of this study was to assess the diagnostic accuracy of a short seven-item tool developed by the German Society for Periodontology (DG PARO) to screen for periodontitis by means of patient-reported information. A total of 88 adult patients filled in the patient-reported Periodontitis Risk Score (pPRS; range: 0 points = lowest periodontitis risk; 20 points = very high periodontitis risk) questionnaire before dental check-up at Heidelberg University Hospital. Subsequent clinical assessments according to Periodontal Screening and Recording (PSR®) were compared with pPRS scores. The diagnostic accuracy of pPRS at different cutoff values was assessed according to sensitivity, specificity, positive, and negative predictive values, as well as Receiver-Operator-Characteristic curves, Area Under the Curve (AUC), and logistic regression analysis. According to combined specificity and sensitivity (AUC = 0.86; 95%-CI: 0.76-0.95), the diagnostic accuracy of the pPRS for detecting periodontal inflammation (PSR® ≥ 3) was highest for a pPRS cutoff distinguishing between pPRS scores < 7 vs. ≥ 7. Patients with pPRS scores ≥ 7 had a 36.09 (95%-CI: 9.82-132.61) times higher chance of having a PSR® ≥ 3 than patients with scores < 7. In conclusion, the pPRS may be considered an appropriately accurate stand-alone tool for the screening for periodontitis.
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Affiliation(s)
- Caroline Sekundo
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Tobias Bölk
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Olivier Kalmus
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Stefan Listl
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
- Department of Dentistry—Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, 6525 Nijmegen, The Netherlands
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Eke PI, Borgnakke WS, Thornton-Evans G. Public Health Aspects of Periodontitis: Recent Advances and Contributions by Dr. Robert J. Genco. CURRENT ORAL HEALTH REPORTS 2021; 8:1-8. [PMID: 39184312 PMCID: PMC11342794 DOI: 10.1007/s40496-020-00290-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 08/27/2024]
Abstract
Purpose of review This review provides an overview of the objectives, activities and accomplishments of the CDC-AAP collaboration on public health aspects of periodontitis focusing mostly on surveillance. Dr. Robert Genco was co-chair of this effort. Recent findings This initiative developed new standard periodontitis case definitions for surveillance and implemented for the first time a full-mouth periodontal examination protocol for NHANES 2009 -2014. Measurements from this survey resulted in significantly greater estimate for the national prevalence of periodontitis in US adults and our understanding of population risk factors associations with periodontitis. Notably, this initiative also developed, and validated field-testing a battery of eight questions for multivariable modeling of self-report measures for predicting periodontitis in populations. Summary This Initiative resulted in significant improvements of surveillance of periodontitis and produced unique findings with important implications for advancing our understanding of population aspects of periodontitis in US adults at the national, state, and local levels.
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Affiliation(s)
- Paul I. Eke
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Wenche S. Borgnakke
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Gina Thornton-Evans
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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Micu IC, Bolboacă SD, Caracostea GV, Gligor D, Ciurea A, Iozon S, Soancă A, Mureșan D, Roman A. Self-reported and clinical periodontal conditions in a group of Eastern European postpartum women. PLoS One 2020; 15:e0237510. [PMID: 32810155 PMCID: PMC7433868 DOI: 10.1371/journal.pone.0237510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 07/28/2020] [Indexed: 12/02/2022] Open
Abstract
Periodontitis is a highly prevalent condition leading to a continuous destruction of tooth-supporting tissues. It increases the risk for various systemic diseases and adverse pregnancy outcomes. Therefore, screening for periodontitis is important. Screening measures can range from self-reported symptoms to clinical full-mouth periodontal examination. The hypothesis of our study was that self-reported parameters and clinical definition perform equally well in identifying periodontitis patients. The aim of this study was to develop, validate its internal consistency, and evaluate a self-reported instrument against periodontal clinical evaluation for diagnosis of periodontitis in a group of postpartum women, as well as to describe their periodontal status and the risk factors associated with periodontal disease. A cross-sectional study on postpartum women was conducted in a tertiary university hospital, from April 2018 to March 2019. Sociodemographic and behavioral data, periodontal clinical parameters, and self-reported periodontal perception were collected. A 16-item questionnaire was developed to obtain information about perceived periodontal alterations and oral hygiene habits. The utility of the questionnaire was tested against a periodontal diagnosis based on a full-mouth periodontal examination. The questionnaire was applied in 215 postpartum women aged 29.16±5.54 years (mean age (y) ± standard deviation) having the following periodontal status: 16 individuals without periodontal disease (7.44%), 32 individuals with gingivitis (14.88%), 19 individuals with mild periodontitis (8.84%), 132 individuals with moderate periodontitis (61.39%), and 16 individuals with severe periodontitis (7.44%). A significant association was observed between oral hygiene score, smoking status, and periodontal conditions (p<0.05). A significant association between the self-reported items related to “gum swelling”, “halitosis”, “previous periodontal diagnosis” and “previous periodontal treatment” with clinical periodontitis have been identified (p<0.05). Using self-reported questionnaires for detection of periodontal disease was ineffective in our studied population, since self-reported parameters and clinical definition do not appear to perform equally in identifying periodontitis cases. Clinical periodontal examination remains the gold standard for screening. Periodontitis was frequent in our group and the severity was significantly associated with the oral hygiene score and smoking. These results underline the necessity for periodontal clinical examination during pregnancy.
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Affiliation(s)
- Iulia C. Micu
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
- * E-mail: (SDB); (GVC)
| | - Gabriela V. Caracostea
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
- * E-mail: (SDB); (GVC)
| | - Diana Gligor
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Andreea Ciurea
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sofia Iozon
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Daniel Mureșan
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Alexandra Roman
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
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Ueno M, Shimazu T, Sawada N, Tsugane S, Kawaguchi Y. Validity of Self-Reported Periodontitis in Japanese Adults: The Japan Public Health Center-Based Prospective Study for the Next-Generation Oral Health Study. Asia Pac J Public Health 2020; 32:346-353. [PMID: 32741221 DOI: 10.1177/1010539520944721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study evaluated the validity of self-reported periodontitis measures among 2404 Japanese adults aged 40 to 75 years. A self-administered questionnaire survey and a clinical periodontal examination were conducted from 2013 through 2016. The self-reported periodontitis questions included 3 sociodemographic, 3 health, and 5 periodontal health-related items. Based on the clinical case definition of periodontitis, 26.5% of participants were found to be periodontally healthy, 2.7% had mild periodontitis, 55.2% moderate periodontitis, and 15.6% severe periodontitis. No single self-reported question demonstrated satisfactory validity in predicting the presence or absence of periodontitis. The predictive ability in mild and/or moderate periodontitis was poor even after combining multiple sociodemographic, health, and periodontal health-related questions. In severe periodontitis, the model including age, sex, education level, smoking status, diabetes history, body mass index, informed by a dentist, gingival bleeding, calculus deposit, and tooth mobility, presented moderate predictive performance (C-statistic: 0.676, sensitivity: 65.2%, and specificity: 61.1%). An age-stratified analysis on severe periodontitis showed that sensitivity was higher, and specificity was lower in older age group (60-75 years) than younger age group (40-59 years). Further refinement of questions in the self-report is required to increase the accuracy of the prediction of clinical periodontitis.
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Affiliation(s)
- Masayuki Ueno
- Saitama Prefectural University, Koshigaya, Japan.,Tokyo Medical and Dental University, Tokyo, Japan
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20
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Oliveira LM, de David SC, Ardenghi TM, Moreira CHC, Zanatta FB. Gingival inflammation influences oral health-related quality of life in individuals living in a rural area of southern Brazil. J Clin Periodontol 2020; 47:1028-1039. [PMID: 32558954 DOI: 10.1111/jcpe.13333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 06/01/2020] [Accepted: 06/11/2020] [Indexed: 12/25/2022]
Abstract
AIM The aim of the present cross-sectional study was to evaluate whether the extent levels of gingival inflammation (GI) in whole mouth or restricted to the anterior region are independently associated with oral health-related quality of life (OHRQoL) in individuals living in a rural area of southern Brazil. MATERIALS AND METHODS A probability sample of 688 individuals was submitted to a full-mouth periodontal examination at six sites on each tooth. Extent levels of GI in whole mouth and restricted to anterior region were dichotomously considered when bleeding on probing (BoP) occurred at 20% or more of whole-mouth sites and at 10% or more of anterior region sites, respectively, in individuals with probing depths ≤3 mm, totalling 121 individuals analysed, aged 15-82 years. OHRQoL was assessed using the simplified version of the Oral Health Impact Profile (OHIP14 ) questionnaire. Adjusted multilevel Poisson regression analysis was used with a conceptual hierarchical approach to calculate the rate ratio (RR) of OHIP14 scores. RESULTS In the adjusted model, higher extent levels of full-mouth GI (RR = 1.23; 95% confidence interval [CI]: 1.06-1.44; p = .004) and GI restricted to the anterior region (RR = 1.29; 95% CI: 1.11-1.51; p ≤ .001) were significantly associated with poorer OHRQoL. CONCLUSIONS The extent of GI in whole mouth (≥20% of sites with BoP) and in the anterior region (≥10% of sites with BoP) was independently associated with OHRQoL in individuals living in a rural area.
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Affiliation(s)
- Leandro M Oliveira
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Silvia C de David
- Department of Conservative Dentistry - Periodontology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Thiago M Ardenghi
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Carlos H Cunha Moreira
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Fabrício B Zanatta
- Department of Stomatology, Postgraduate Program in Dentistry, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
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Self-Perception of Periodontal Health and Associated Factors: A Cross-Sectional Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082758. [PMID: 32316219 PMCID: PMC7215350 DOI: 10.3390/ijerph17082758] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Abstract
The aim of this cross-sectional study was to explore sociodemographic, behavioral, and clinical factors associated with self-awareness of periodontal health. Data were collected from a representative sample of 736 adults (25–75 years old) in a city of Northern Italy who self-assessed gingival bleeding, oral malodor, and tooth mobility in a questionnaire and who underwent clinical periodontal examination and organoleptic evaluation. Approximately 50% of the subjects were aware of their actual gingival health status and oral odor. The logistic regression analysis revealed that females presented higher odds of correctly perceiving their gingival conditions and mouth odor, while those who were older and smokers had a greater probability of being less objective in reporting them. Tooth type and position in the dental arches were positively associated with self-perception of tooth mobility. These findings reflected a low level of self-awareness that may influence oral care-seeking behavior. Subjects may be unconcerned about their periodontal health condition or lack enough knowledge to be aware of it. This points to the need for planning strategies to improve education and knowledge about periodontal health, which, by enhancing self-perception of periodontal symptoms, could help everyone to seek treatment in the initial stage of the disease.
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Eke PI, Borgnakke WS, Genco RJ. Recent epidemiologic trends in periodontitis in the USA. Periodontol 2000 2020; 82:257-267. [PMID: 31850640 DOI: 10.1111/prd.12323] [Citation(s) in RCA: 233] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The most important development in the epidemiology of periodontitis in the USA during the last decade is the result of improvements in survey methodologies and statistical modeling of periodontitis in adults. Most of these advancements have occurred as the direct outcome of work by the joint initiative known as the Periodontal Disease Surveillance Project by the Centers for Disease Control and Prevention and the American Academy of Periodontology that was established in 2006. This report summarizes some of the key findings of this important initiative and its impact on our knowledge of the epidemiology of periodontitis in US adults. This initiative first suggested new periodontitis case definitions for surveillance in 2007 and revised them slightly in 2012. This classification is now regarded as the global standard for periodontitis surveillance and is used worldwide. First, application of such a standard in reporting finally enables results from different researchers in different countries to be meaningfully compared. Second, this initiative tackled the concern that prior national surveys, which used partial-mouth periodontal examination protocols, grossly underestimated the prevalence of periodontitis of potentially more than 50%. Consequently, because previous national surveys significantly underestimated the true prevalence of periodontitis, it is not possible to extrapolate any trend in periodontitis prevalence in the USA over time. Any difference calculated may not represent any actual change in periodontitis prevalence, but rather is a consequence of using different periodontal examination protocols. Finally, the initiative addressed the gap in the need for state and local data on periodontitis prevalence. Through the direct efforts of the Centers for Disease Control and Prevention and the American Academy of Periodontology initiative, full-mouth periodontal probing at six sites around all nonthird molar teeth was included in the 6 years of National Health and Nutrition Examination Surveys from 2009-2014, yielding complete data for 10 683 dentate community-dwelling US adults aged 30 to 79 years. Applying the 2012 periodontitis case definitions to the 2009-2014 National Health and Nutrition Examination Surveys data, the periodontitis prevalence turned out to be much greater than previously estimated, namely affecting 42.2% of the population with 7.8% of people experiencing severe periodontitis. It was also discovered that only the moderate type of periodontitis is driving the increase in periodontitis prevalence with age, not the mild or the severe types whose prevalence do not increase consistently with age, but remain ~ 10%-15% in all age groups of 40 years and older. The greatest risk for having periodontitis of any type was seen in older people, in males, in minority race/ethnic groups, in poorer and less educated groups, and especially in cigarette smokers. The Centers for Disease Control and Prevention and the American Academy of Periodontology initiative reported, for the first time, the periodontitis prevalence estimated at both local and state levels, in addition to the national level. Also, this initiative developed and validated in field studies a set of eight items for self-reported periodontitis for use in direct survey estimates of periodontitis prevalence in existing state-based surveys. These items were also included in the 2009-2014 National Health and Nutrition Examination Surveys for validation against clinically determined cases of periodontitis. Another novel result of this initiative is that, for the first time, the geographic distribution of practicing periodontists in relation to the geographic distribution of people with severe periodontitis is illustrated. In summary, the precise periodontitis prevalence and distribution among subgroups in the dentate US noninstitutionalized population aged 30-79 years is better understood because of application of valid periodontitis case definitions to full-mouth periodontal examination, in combination with reliable information on demographic and health-related measures. We now can monitor the trend of periodontitis prevalence over time as well as guide public health preventive and intervention initiatives for the betterment of the health of the adult US population.
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Affiliation(s)
- Paul I Eke
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Robert J Genco
- (Formerly) Distinguished Professor of Oral Biology and Microbiology; Director, UB Center for Microbiome Research, State University of New York (SUNY), University at Buffalo, Amherst, New York, USA
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Gufran K, Alasqah M, Almalki S, Alkhaibari Y, Alghamdi Y, Aljulify T. Validation of self-reported periodontal disease status among subjects seeking dental treatment in a dental school. J Pharm Bioallied Sci 2020; 12:S550-S553. [PMID: 33149519 PMCID: PMC7595471 DOI: 10.4103/jpbs.jpbs_157_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 02/14/2020] [Accepted: 03/06/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction: Periodontal disease and its relation with quality of life have made it necessary to know in detail regarding the disease. Hence, the aim of this study was to check the validity of self-reported periodontal status with clinical findings among subjects attending a dental teaching institution. Materials and Methods: A cross-sectional study was conducted on subjects with periodontitis attending a dental teaching institution. A questionnaire was developed after reviewing the relevant literature and participants were asked to complete the questionnaire. Information about signs and symptoms of periodontal disease was included, and subjects were examined for periodontal disease. Data were recorded and analyzed for sensitivity and specificity. Result: A total of 103 subjects answered the study questionnaire and underwent clinical examination. The sensitivity of question varied from 16.6% with need of periodontal or gum treatment to 57.1% in case of gingival swelling. In many questions, more than 90% of specificity was found. There was a difference in self-assessed periodontal status with clinically examined periodontal status. Conclusion: Self-assessed questionnaires were of low value in evaluating oral periodontal disease status. Periodontal perception of subjects was higher but does not reflect with clinical findings; this calls for educational programs to be conducted to improve knowledge and awareness about periodontal diseases.
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Montero E, La Rosa M, Montanya E, Calle‐Pascual AL, Genco RJ, Sanz M, Herrera D. Validation of self‐reported measures of periodontitis in a Spanish Population. J Periodontal Res 2019; 55:400-409. [DOI: 10.1111/jre.12724] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/29/2019] [Accepted: 11/25/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Martina La Rosa
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Eduard Montanya
- Bellvitge Hospital‐IDIBELL Barcelona Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) Barcelona Spain
- Department of Clinical Sciences University of Barcelona Barcelona Spain
| | - Alfonso L. Calle‐Pascual
- Medical School. University Complutense Madrid Spain
- Endocrinology and Nutrition Department Hospital Clínico Universitario San Carlos Madrid Spain
| | | | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
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Faria SFS, Costa FO, Silveira JO, Cyrino RM, Cota LOM. Self-reported halitosis in a sample of Brazilians: Prevalence, associated risk predictors and accuracy estimates with clinical diagnosis. J Clin Periodontol 2019; 47:233-246. [PMID: 31782537 DOI: 10.1111/jcpe.13226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/24/2019] [Accepted: 11/24/2019] [Indexed: 01/13/2023]
Abstract
AIMS To evaluate the prevalence of self-reported halitosis and its predictors, and to determine the accuracy estimates of self-reported measures with clinical evaluation of halitosis. MATERIALS AND METHODS This cross-sectional study comprised 5,420 individuals (teaching staff, administrative personnel and ongoing students from Federal University of Minas Gerais), who answered a structured questionnaire containing sociodemographic, medical and dental data, and self-reported halitosis measures. A subsample (n = 159) underwent halitosis assessment through the organoleptic method. Predictors for self-reported halitosis were determined through univariate and multivariate analyses. Accuracy estimates of self-reported measures were evaluated in this subsample. RESULTS Prevalence of self-reported halitosis varied from approximately 4%-35%, depending on the self-reported measure. Self-reported halitosis was mainly associated with socio-economic variables (age, gender, educational level), parameters of oral health (gingival bleeding, gingival infections, tongue coating, general oral health evaluation) and impacts on daily activities (family/social environment and intimate relations). Specificity values for self-reported halitosis measures were determined to be high for clinical (organoleptic score ≥2) and strong (organoleptic score ≥4) halitosis. Combinations of self-reported measures retrieved useful accuracy estimates for strong halitosis. CONCLUSION Prevalence rates of self-reported halitosis may be considered moderate. Accuracy diagnostic estimates were determined to be useful, with good prediction for non-diseased individuals.
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Affiliation(s)
- Sandro Felipe Santos Faria
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Juliana Oliveira Silveira
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Renata Magalhães Cyrino
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Reiniger APP, Londero AB, Ferreira TDGM, da Rocha JM, Moreira CHC, Kantorski KZ. Validity of self‐reported measures for periodontitis surveillance in a rural sample. J Periodontol 2019; 91:617-627. [DOI: 10.1002/jper.19-0292] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Ana Paula Pereira Reiniger
- Graduate Program in Oral SciencePeriodontology UnitSchool of DentistryFederal University of Santa Maria Santa Maria Rio Grande do Sul Brazil
| | - Ananda Barrachini Londero
- Graduate Program in Oral SciencePeriodontology UnitSchool of DentistryFederal University of Santa Maria Santa Maria Rio Grande do Sul Brazil
| | - Ticiane de Góes Mário Ferreira
- Graduate Program in Oral SciencePeriodontology UnitSchool of DentistryFederal University of Santa Maria Santa Maria Rio Grande do Sul Brazil
| | - José Mariano da Rocha
- Graduate Program in Oral SciencePeriodontology UnitSchool of DentistryFederal University of Rio Grande do Sul Porto Alegre Rio Grande do Sul Brazil
| | - Carlos Heitor Cunha Moreira
- Graduate Program in Oral ScienceDepartment of StomatologySchool of DentistryFederal University of Santa Maria Santa Maria Rio Grande do Sul Brazil
| | - Karla Zanini Kantorski
- Graduate Program in Oral ScienceDepartment of StomatologySchool of DentistryFederal University of Santa Maria Santa Maria Rio Grande do Sul Brazil
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Chatzopoulos GS, Cisneros A, Sanchez M, Lunos S, Wolff LF. Validity of self-reported periodontal measures, demographic characteristics, and systemic medical conditions. J Periodontol 2019; 89:924-932. [PMID: 29624676 DOI: 10.1002/jper.17-0586] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/20/2017] [Accepted: 01/05/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND The objective of the present study was to assess self-reported periodontal screening questions, demographic characteristics, systemic medical conditions, and tobacco use for predicting periodontal disease among individuals seeking dental therapy in a university dental clinic. METHODS In this retrospective study, a total of 4,890 randomly selected dental charts were evaluated from among patients who had attended the University of Minnesota School of Dentistry clinics for treatment. Radiographic bone loss measurements were used to assess the severity of periodontal disease. Demographic characteristics as well as medical history of the patients were also recorded. Five self-reported periodontal screening questions were included, with answers limited to Yes/No. Generalized logit models were used to assess the association between bone loss and the predictors. RESULTS The sample's mean age was 54.1 years and included 52.6% males and 14.9% smokers, with a mean of 3.5 missing teeth. Self-reported tooth mobility, history of "gum treatment," and the importance of retaining teeth as well as age, tobacco use, and cancer were statistically significant predictors (P < 0.05) of a radiographic diagnosis of moderate and severe periodontal disease. With respect to severe periodontal disease, significant associations (P < 0.05) were also found with "bleeding while brushing," gender, diabetes, anxiety, and arthritis. CONCLUSIONS Self-reported periodontal screening questions as well as demographic characteristics, smoking, and systemic medical conditions were significant predictors of periodontal disease, and they could be used as valid, economic, and practical measures.
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Affiliation(s)
- Georgios S Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN
| | | | - Miguel Sanchez
- School of Dentistry, University of Minnesota, Minneapolis, MN
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN
| | - Larry F Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN
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Ferreira TDGM, Rocha JMD, David SCD, Boligon J, Casarin M, Grellmann AP, Marin J, Ardenghi TM, Zanatta FB, Moreira CHC. Sampling strategy of an epidemiological survey using a satellite image program. Rev Saude Publica 2019; 53:47. [PMID: 31066825 PMCID: PMC6536105 DOI: 10.11606/s1518-8787.2019053000834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 07/25/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the sampling strategy of an epidemiological survey with the aid of satellite images, including details of the multistage probability sampling process. METHODS A probability sample of individuals living in the rural area of Rosário do Sul, state of Rio Grande do Sul, Brazil, aged 15 years old or more, was evaluated. Participants answered questionnaires (medical history, sociodemographic characteristics, habits, alcohol use, quality of life, stress, rumination, and self-perceived periodontal diseases), and were subjected to clinical oral examinations as well as anthropometric measurements (blood pressure, height, weight, abdominal and waist circumferences). Oral evaluation comprehended a complete periodontal exam at six sites per tooth, including the following assessments: furcation involvement; dental abrasion; tooth decay, including the indexing of missing and filled surfaces; O'Brien index; gingival abrasion; oral cavity and lip lesions; complete periapical radiographic exam, and use of prostheses. Besides this oral clinical approach, subgingival plaque, crevicular gingival fluid, saliva, and blood samples were collected. Examiners were trained and calibrated during previous evaluations. A pilot study allowed the logistic of the performed exams to be adjusted as needed. RESULTS Among 1,087 eligible individuals, 688 were examined (63.3%). Age, sex, and skin color data were compared to data from the last demographic census (2010) of the Brazilian Institute of Geography and Statistics, which served to validate the sampling strategy. CONCLUSIONS The careful methods used in this study, in which satellite images were used in the delimitation of epidemiological areas, ensure the quality of the estimates obtained and allow for these estimates to be used in oral health surveillance and health policies improvements.
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Affiliation(s)
- Ticiane de Góes Mário Ferreira
- Universidade Federal de Santa Maria . Curso de Odontologia. Programa de Pós-Graduação em Ciências Odontológicas . Santa Maria , RS , Brasil
| | - José Mariano da Rocha
- Universidade Federal de Santa Maria . Curso de Odontologia. Programa de Pós-Graduação em Ciências Odontológicas . Santa Maria , RS , Brasil
| | - Silvia Cardoso de David
- Universidade Federal do Rio Grande do Sul . Faculdade de Odontologia . Departamento de Periodontia . Porto Alegre , RS , Brasil
| | - Jociana Boligon
- Universidade Federal de Santa Maria . Curso de Odontologia. Programa de Pós-Graduação em Ciências Odontológicas . Santa Maria , RS , Brasil
| | - Maísa Casarin
- Universidade Federal de Pelotas . Faculdade de Odontologia . Departamento de Semiologia e Clínica . Pelotas , RS , Brasil
| | - Alessandra Pascotini Grellmann
- Universidade Federal de Santa Maria . Curso de Odontologia. Programa de Pós-Graduação em Ciências Odontológicas . Santa Maria , RS , Brasil
| | - Janice Marin
- Universidade Federal de Santa Maria . Curso de Odontologia. Programa de Pós-Graduação em Ciências Odontológicas . Santa Maria , RS , Brasil
| | - Thiago Machado Ardenghi
- Universidade Federal de Santa Maria . Curso de Odontologia. Departamento de Estomatologia . Santa Maria , RS , Brasil
| | - Fabricio Batistin Zanatta
- Universidade Federal de Santa Maria . Curso de Odontologia. Departamento de Estomatologia . Santa Maria , RS , Brasil
| | - Carlos Heitor Cunha Moreira
- Universidade Federal de Santa Maria . Curso de Odontologia. Departamento de Estomatologia . Santa Maria , RS , Brasil
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FRANCISCATTO GJ, KOPPE BTDF, HOPPE CB, OLIVEIRA JAPD, HAAS AN, GRECCA FS, ROSSI-FEDELE G, GOMES MS. Validation of self-reported history of root canal treatment in a southern Brazilian subpopulation. Braz Oral Res 2019; 33:e007. [DOI: 10.1590/1807-3107bor-2019.vol33.0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 12/17/2018] [Indexed: 12/28/2022] Open
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30
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ALHarthi SS, BinShabaib M, Akram Z, Rahman I, Romanos GE, Javed F. Impact of cigarette smoking and vaping on the outcome of full-mouth ultrasonic scaling among patients with gingival inflammation: a prospective study. Clin Oral Investig 2018; 23:2751-2758. [PMID: 30361795 DOI: 10.1007/s00784-018-2725-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/18/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVES There are no studies that have assessed the oral soft tissue response to full-mouth ultrasonic scaling (FMUS) among cigarette-smokers (CS) (group 1), individuals vaping electronic-cigarettes (E-cigs) (group 2), and never-smokers (NS) (group 3). The aim was to assess the impact of cigarette smoking and vaping on periodontal tissues following FMUS. MATERIALS AND METHODS In a clinical prospective study, 89 male individuals were divided into three groups: CS (group 1), E-cig users (group 2), and NS (group 3). A questionnaire was used to gather demographic data and information regarding duration and daily frequency of CS and vaping. Full-mouth plaque index (PI), bleeding on probing (BOP), clinical attachment loss (AL), and probing depth (PD) were measured at baseline and 3 and 6 months after FMUS (without root surface debridement). Numbers of missing teeth (MT) were also recorded. RESULTS In groups 1, 2, and 3, 30, 28, and 31 individuals, respectively were included. In group 1, there was no statistically significant difference in mean PI and PD and numbers of sites with PD ≥ 4 mm at 6 months' follow-up compared with baseline and 3 months' follow-up. In groups 2 and 3, there was no significant difference in PI, BOP, and PD at 3 months' (P > 0.05) and 6-months' (P > 0.05) follow-up. There were no pockets with PD ≥ 4 mm at 3 and 6 months' follow-up in groups 2 and 3. There was no difference in the numbers of MT and none of the individuals exhibited clinical AL in all groups. CONCLUSION Following FMUS, gingival inflammation is worse in CS compared with individuals vaping E-cigs and NS. CLINICAL RELEVANCE Periodontal inflammatory parameters are worse in cigarette-smokers than individuals vaping electronic cigarettes and never-smokers following FMUS. However, these findings should be interpreted with extreme caution as a number of factors may have influenced the present results.
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Affiliation(s)
- Shatha Subhi ALHarthi
- Department of Periodontics and Community Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Munerah BinShabaib
- Department of Periodontics and Community Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan.
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Georgios E Romanos
- Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe, University of Frankfurt, Frankfurt, Germany.,Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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Al-Hamoudi N, Mokeem S, Jabbar TA, FahimVohra, Akram Z. Self-perceived oral symptoms and periodontal inflammatory conditions in habitual naswar dippers. Pak J Med Sci 2018; 34:1272-1277. [PMID: 30344590 PMCID: PMC6191774 DOI: 10.12669/pjms.345.15418] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objectives: To compare self-perceived oral symptoms and clinical (plaque index [PI], bleeding on probing [BOP], clinical attachment loss [CAL]) and radiographic (marginal bone loss [MBL]) periodontal parameters among naswar (NW) and non-naswar dippers (NNW). Methods: One hundred and forty-two individuals (72 patients consuming naswar and 70 controls) were included. All participants completed a baseline questionnaire that included information regarding demographic characteristics and self-perceived oral symptoms. Clinical periodontal parameters (PI, BOP, PD and CAL) were recorded. MBL was measured on digital panoramic radiographs. Results: Pain in teeth, pain on chewing, bleeding gums and burning sensation in the mouth was significantly worse among NW than NNW (p<0.01). Clinical periodontal parameters and MBL were significantly high in NW than NNW (p<0.001). There was statistically significant influence of daily use and mean duration of naswar consumption on the severity of PI, BOP, PD (4 to 6 and >6 mm) and MBL among NW group. Conclusions: Self-perceived oral symptoms and periodontal parameters were worse among naswar dippers. It is highly recommended that naswar dipping should be considered a potential threat that could have major effects on periodontal tissues.
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Affiliation(s)
- Nawwaf Al-Hamoudi
- Nawwaf Al-Hamoudi, Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sameer Mokeem
- Sameer Mokeem, Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Tariq Abdul Jabbar
- Tariq Abdul Jabbar, Professor, Department of Prosthetic Dental Science, College of Dentistry, King Saud University; Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, College of Dentistry, Riyadh 11545, Saudi Arabia
| | - FahimVohra
- Fahim Vohra, Professor, Department of Prosthetic Dental Science, College of Dentistry, King Saud University; Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, College of Dentistry, Riyadh 11545, Saudi Arabia
| | - Zohaib Akram
- Zohaib Akram Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
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Meisel P, Holtfreter B, Völzke H, Kocher T. Self-reported oral health predicts tooth loss after five and ten years in a population-based study. J Clin Periodontol 2018; 45:1164-1172. [DOI: 10.1111/jcpe.12997] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/29/2018] [Accepted: 08/07/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Peter Meisel
- Dental School; University of Greifswald; Greifswald Germany
- Dental Clinics; Department of Periodontology; University Medicine Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Dental School; University of Greifswald; Greifswald Germany
- Dental Clinics; Department of Periodontology; University Medicine Greifswald; Greifswald Germany
| | - Henry Völzke
- Institute for Community Medicine; Ernst Moritz Arndt University Greifswald; Greifswald Germany
| | - Thomas Kocher
- Dental School; University of Greifswald; Greifswald Germany
- Dental Clinics; Department of Periodontology; University Medicine Greifswald; Greifswald Germany
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Carra MC, Gueguen A, Thomas F, Pannier B, Caligiuri G, Steg PG, Zins M, Bouchard P. Self-report assessment of severe periodontitis: Periodontal screening score development. J Clin Periodontol 2018; 45:818-831. [DOI: 10.1111/jcpe.12899] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Maria Clotilde Carra
- Department of Periodontology; Service of Odontology; Rothschild Hospital, AP-HP; Paris France
- U.F.R. of Odontology; Paris 7-Denis Diderot University; Paris France
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Alice Gueguen
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Frédérique Thomas
- Centre d'Investigations Préventives et Cliniques (IPC); Paris France
| | - Bruno Pannier
- Centre d'Investigations Préventives et Cliniques (IPC); Paris France
- Department of Cardiology; Georges Pompidou European Hospital, AP-HP; Paris France
- Medicine Faculty; Paris 5-Descartes University; Paris France
| | | | - Philippe Gabriel Steg
- INSERM-Unité 1148; Paris France
- French Alliance for Cardiovascular Trials (FACT); Département Hospitalo-Universitaire FIRE; Hôpital Bichat; Assistance Publique-Hôpitaux de Paris; Paris France
- Université Paris-Diderot; Sorbonne-Paris Cité; Paris France
- Royal Brompton Hospital; Imperial College; London UK
| | - Marie Zins
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Philippe Bouchard
- Department of Periodontology; Service of Odontology; Rothschild Hospital, AP-HP; Paris France
- U.F.R. of Odontology; Paris 7-Denis Diderot University; Paris France
- EA 2496, Paris 5-Descartes University; Paris France
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Quiroz V, Reinero D, Hernández P, Contreras J, Vernal R, Carvajal P. Development of a self-report questionnaire designed for population-based surveillance of gingivitis in adolescents: assessment of content validity and reliability. J Appl Oral Sci 2017; 25:404-411. [PMID: 28877279 PMCID: PMC5595113 DOI: 10.1590/1678-7757-2016-0511] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/12/2017] [Indexed: 12/12/2022] Open
Abstract
The major infectious diseases in Chile encompass the periodontal diseases, with a combined prevalence that rises up to 90% of the population. Thus, the population-based surveillance of periodontal diseases plays a central role for assessing their prevalence and for planning, implementing, and evaluating preventive and control programs. Self-report questionnaires have been proposed for the surveillance of periodontal diseases in adult populations world-wide.
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Affiliation(s)
- Viviana Quiroz
- Universidad de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Santiago, Chile
| | - Daniela Reinero
- Universidad de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Santiago, Chile
| | - Patricia Hernández
- Universidad de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Santiago, Chile
| | - Johanna Contreras
- Universidad de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Santiago, Chile
| | - Rolando Vernal
- Universidad de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Santiago, Chile.,Universidad de Chile, Facultad de Odontología, Laboratorio de Biología Periodontal, Santiago, Chile
| | - Paola Carvajal
- Universidad de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Santiago, Chile
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Heaton B, Gordon NB, Garcia RI, Rosenberg L, Rich S, Fox MP, Cozier YC. A Clinical Validation of Self-Reported Periodontitis Among Participants in the Black Women's Health Study. J Periodontol 2017; 88:582-592. [PMID: 28088874 PMCID: PMC5556388 DOI: 10.1902/jop.2017.160678] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND There is a paucity of data on the validity of self-report of periodontal disease in African Americans. The Black Women's Health Study (BWHS), a United States national cohort study of 59,000 black women followed via mailed questionnaires since 1995, offered the opportunity to clinically validate self-reported periodontitis among a sample of participants. METHODS Oral health questionnaires were sent to study participants residing in Massachusetts. Respondents living in the Boston metro area were invited for clinical examination. Self-reports were compared with clinical data obtained from the 77 women (mean age: 59 years) who were examined. The authors examined the predictive ability of individual and combined questionnaire items with respect to clinical periodontal disease severity. Validation parameters were calculated for each question, and receiver operating characteristic statistics were generated to compare questionnaire items. RESULTS Periodontitis prevalence in the validation sample was 24% for severe periodontitis and 61% for moderate disease. Performance of individual questionnaire items with respect to predicting periodontitis was better for severe compared with moderate disease. Combinations of questionnaire items improved the predictive ability with respect to severe disease beyond that of individual questionnaire items. CONCLUSIONS Prevalence of severe periodontitis was similar to other age-comparable populations, without regard for race or sex, whereas prevalence of total periodontitis (moderate and severe) among women of similar age and/or race was much higher. Predictive ability of questionnaire items assessed in the BWHS was similar to that in other studies.
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Affiliation(s)
- Brenda Heaton
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | - Nicholas B. Gordon
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | - Raul I. Garcia
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | | | - Sharron Rich
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | - Matthew P. Fox
- Department of Epidemiology, School of Public Health, Boston University
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Abbood HM, Hinz J, Cherukara G, Macfarlane TV. Validity of Self-Reported Periodontal Disease: A Systematic Review and Meta-Analysis. J Periodontol 2016; 87:1474-1483. [DOI: 10.1902/jop.2016.160196] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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37
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Chatzopoulos GS, Tsalikis L, Konstantinidis A, Kotsakis GA. A Two-Domain Self-Report Measure of Periodontal Disease Has Good Accuracy for Periodontitis Screening in Dental School Outpatients. J Periodontol 2016; 87:1165-73. [DOI: 10.1902/jop.2016.160043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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38
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Cyrino RM, Costa FO, Cortelli JR, Cortelli SC, Cota LOM. Sense of coherence and periodontal health outcomes. Acta Odontol Scand 2016; 74:368-73. [PMID: 27244670 DOI: 10.3109/00016357.2016.1154601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Sense of Coherence (SOC) has been associated with perceived oral health measures, but the contribution of SOC to clinical measures is still unclear. The aim of the present cross-sectional study was to evaluate the potential association between periodontal health outcomes, such as periodontal clinical parameters and perceived periodontal health, and SOC. MATERIALS AND METHODS The study sample comprised 276 individuals, aged 18-60 years, from Belo Horizonte, Brazil. Participants answered questionnaires covering sociodemographic variables, self-perceived periodontal health and SOC. Full-mouth periodontal examinations were performed. The sample was divided into three groups according to SOC score: (a) SOC1 = weak (24-46); (b) SOC2 = moderate (47-51); (c) SOC3 = strong (52-65). Multivariate analyses including appropriate logistic or linear regression models were performed to evaluate the association between periodontal health outcomes and biological, sociodemographic and behavioural variables. RESULTS Perceived general oral health was associated with family income bracket (p = 0.010), smoking (p = 0.004), dental flossing (p = 0.017) and SOC (weak SOC: p = 0.005). Perceived gum disease and perceived periodontal disease were associated with SOC (weak SOC: p = 0.001 and p = 0.015, respectively). CONCLUSIONS Overall, perceived periodontal health outcomes were associated with SOC. However, no association between clinical periodontal health outcomes and SOC were observed.
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Affiliation(s)
- Renata Magalhães Cyrino
- Department of Periodontology School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fernando Oliveira Costa
- Department of Periodontology School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Luís Otávio Miranda Cota
- Department of Periodontology School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Nomura Y, Okada A, Kakuta E, Gunji T, Kajiura S, Hanada N. A new screening method for periodontitis: an alternative to the community periodontal index. BMC Oral Health 2016; 16:64. [PMID: 27388493 PMCID: PMC4937556 DOI: 10.1186/s12903-016-0216-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 05/18/2016] [Indexed: 11/26/2022] Open
Abstract
Background Periodontal screening plays an important role in the prevention of periodontal disease and promotes an improvement in oral health-related quality of life. The World Health Organization’s Community Periodontal Index should be carried out by well-trained dentists. However, the Community Periodontal Index is an invasive technique, and if used for periodontal screening, increases the cost of evaluation. In order to overcome these issues, we developed saliva tests for periodontal screening. The purpose of this study was to calculate the sensitivity and specificity of our method for measuring hemoglobin and lactate dehydrogenase levels in saliva. Methods Inclusion criteria were adults aged over 20 years with at least 20 teeth remaining. The study population comprised 38 men and 54 women with a mean age of 50.03 years. Oral examinations were carried out by dentists, and the number of remaining teeth, presence or absence of calculus, bleeding on probing and pocket depth were recorded. In this study, periodontitis was defined according to the criteria of the Center for Disease Control and Prevention in partnership with the American Academy of Periodontology. In order to examine hemoglobin and lactate dehydrogenase levels in saliva, participants were instructed to chew on a standard-sized tasteless and odorless gum base for 5 min, during which time, stimulated whole saliva was continuously collected. Results The sensitivity and specificity for hemoglobin levels were 0.759 and 0.763, respectively, and 0.722 and 0.711, respectively, for lactate dehydrogenase levels. Combining these two tests, when samples tested positive for both hemoglobin and lactate dehydrogenase, the positive predictive value was 91.7 %. Conclusion Measuring hemoglobin and lactate dehydrogenase levels in saliva is a less invasive method than the Community Periodontal Index. Therefore, our saliva tests may be a viable alternative to the Community Periodontal Index for periodontal screening.
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Affiliation(s)
- Yoshiaki Nomura
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Ayako Okada
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Erika Kakuta
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Takahide Gunji
- Shimane Dental Association, 141-9 Minamitamachi, Matsue, Shimane, 690-0884, Japan
| | - Seiji Kajiura
- Department of Health and Welfare, Shimane Prefectural Government, 1 Tonomachi, Matsue, Shimane, 690-8501, Japan
| | - Nobuhiro Hanada
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
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40
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García-Pérez Á, Borges-Yáñez SA, Jiménez-Corona A, Jiménez-Corona ME, Ponce-de-León S. Self-report of gingival problems and periodontitis in indigenous and non-indigenous populations in Chiapas, Mexico. Int Dent J 2016; 66:105-12. [PMID: 26800859 DOI: 10.1111/idj.12213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of self-reported gingival and periodontal conditions and their association with smoking, oral hygiene, indigenous origin, diabetes and location (urban or rural) in indigenous and non-indigenous adults in Chiapas, Mexico. METHODS A cross-sectional study of 1,749 persons, ≥20 years of age, living in four rural and four urban marginal localities in Comitán (Chiapas, México). The variables investigated were: age; sex; indigenous origin; oral hygiene; halitosis; chewing ability; gingival conditions; periodontitis; smoking; alcoholism; diabetes; and location. Bivariate analysis and a logistic regression model were used to identify the association of periodontitis with the independent variables. RESULTS In total, 762 (43.6%) indigenous and 987 (56.4%) non-indigenous persons were interviewed. Their mean age was 41 ± 14 years, 66.7% were women and 43.8% lived in rural locations. Gingival problems were reported by 68.5% and periodontitis by 8.7%. In total, 17.9% had used dental services during the previous year, 28.7% wore a removable partial or a complete dental prosthesis, 63.7% had lost at least one tooth, the prevalence of diabetes was 9.2% and the prevalence of smoking was 12.2%. The logistic regression model showed that age, diabetes and the interaction between rural location and indigenous origin were associated with the presence of periodontitis. CONCLUSIONS Indigenous people living in rural areas are more likely to have periodontitis. It is necessary to promote oral health practices in indigenous and marginalised populations with a focus on community-oriented primary care.
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Affiliation(s)
- Álvaro García-Pérez
- Laboratorios de Biológicos y Reactivos de México, S.A. de C.V., BIRMEX, México D.F, México.,Departamento de Epidemiologia Ocular, Instituto de Oftalmología Conde de Valenciana, IAP, México D. F, México
| | - Socorro Aída Borges-Yáñez
- División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, México D. F, México
| | - Aida Jiménez-Corona
- Departamento de Epidemiologia Ocular, Instituto de Oftalmología Conde de Valenciana, IAP, México D. F, México.,Dirección General Adjunta de Epidemiología, Secretaría de Salud, México D. F, México.,Unidad de Diabetes y Riesgo Cardiovascular, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - María Eugenia Jiménez-Corona
- Laboratorios de Biológicos y Reactivos de México, S.A. de C.V., BIRMEX, México D.F, México.,Dirección General Adjunta de Epidemiología, Secretaría de Salud, México D. F, México
| | - Samuel Ponce-de-León
- Laboratorios de Biológicos y Reactivos de México, S.A. de C.V., BIRMEX, México D.F, México.,División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, México D. F, México
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Zhan Y, Holtfreter B, Meisel P, Hoffmann T, Micheelis W, Dietrich T, Kocher T. Prediction of periodontal disease: modelling and validation in different general German populations. J Clin Periodontol 2014; 41:224-31. [DOI: 10.1111/jcpe.12208] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Yiqiang Zhan
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Peter Meisel
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Thomas Hoffmann
- Department of Periodontology; Medical Faculty Carl Gustav Carus; Dresden Germany
| | | | - Thomas Dietrich
- Department of Oral Surgery; School of Dentistry; University of Birmingham; Birmingham UK
| | - Thomas Kocher
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
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Jin HJ, Bae KH, Kim JB, Park DY, Jeong SH, Kim BI, Jeong SH, Im SU, Choi YH. Validity and reliability of a questionnaire for evaluating periodontal disease. ACTA ACUST UNITED AC 2014. [DOI: 10.11149/jkaoh.2014.38.3.170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Hye-Jung Jin
- Department of Dental Hygiene, Dong-Eui University, Busan, Korea
| | - Kwang-Hak Bae
- Department of Preventive & Public Health Dentistry, Seoul National University School of Dentistry, Seoul, Korea
| | - Jin-Bom Kim
- Department of Preventive & Community Dentistry, Pusan National University School of Dentistry, Yangsan, Korea
| | - Deok-Young Park
- Department of of Preventive and Public Health Dentistry, College of Dentistry, Gangneung-Wonju National University & Research Institute of Oral Science, Gangneung, Korea
| | - Seong-Hwa Jeong
- Faculty of Health Science, Daegu Haany University, Gyeongsan, Korea
| | - Beak-Il Kim
- Department of Preventive Dentistry & Public Oral Helath, Yonsei University College of Dentistry, Seoul, Korea
| | - Seung-Hwa Jeong
- Department of Preventive & Community Dentistry, Pusan National University School of Dentistry, Yangsan, Korea
| | - Sang-Uk Im
- Department of Preventive Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Youn-Hee Choi
- Department of Preventive Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea
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Eke PI, Dye BA, Wei L, Slade GD, Thornton-Evans GO, Beck JD, Taylor GW, Borgnakke WS, Page RC, Genco RJ. Self-reported measures for surveillance of periodontitis. J Dent Res 2013; 92:1041-7. [PMID: 24065636 DOI: 10.1177/0022034513505621] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to evaluate the performance of self-reported measures in predicting periodontitis in a representative US adult population, based on 2009-2010 National Health and Nutrition Examination Survey (NHANES) data. Self-reported gum health and treatment history, loose teeth, bone loss around teeth, tooth not looking right, and use of dental floss and mouthwash were obtained during in-home interviews and validated against full-mouth clinically assessed periodontitis in 3,743 US adults 30 years and older. All self-reported measures (> 95% item response rates) were associated with periodontitis, and bivariate correlations between responses to these questions were weak, indicating low redundancy. In multivariable logistic regression modeling, the combined effects of demographic measures and responses to 5 self-reported questions in predicting periodontitis of mild or greater severity were 85% sensitive and 58% specific and produced an 'area under the receiver operator characteristic curve' (AUROCC) of 0.81. Four questions were 95% sensitive and 30% specific, with an AUROCC of 0.82 in predicting prevalence of clinical attachment loss ≥ 3 mm at one or more sites. In conclusion, self-reported measures performed well in predicting periodontitis in US adults. Where preferred clinically based surveillance is unattainable, locally adapted variations of these self-reported measures may be a promising alternative for surveillance of periodontitis.
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Affiliation(s)
- P I Eke
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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Ramos RQ, Bastos JL, Peres MA. Diagnostic validity of self-reported oral health outcomes in population surveys: literature review. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2013; 16:716-28. [DOI: 10.1590/s1415-790x2013000300015] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 01/15/2013] [Indexed: 11/22/2022] Open
Abstract
Population-based health surveys are increasingly including self-reported oral health measures. However, their validity is frequently questioned. This study aimed to review the diagnostic validity of self-reported oral health measures - regarding periodontal conditions, number of remaining teeth and use and need of prostheses - and to present prototypes of oral health items to assess periodontal conditions. Papers published between 1991 and 2011 were identified through PubMed database. The sample profile, the sample size and the methods used in each study were analyzed, as well as the sensitivity, specificity, positive and negative predictive values of the oral health items. Periodontists were contacted, using a standardized text, sent by e-mail, which asked them to provide self-reported items regarding periodontal conditions. We reviewed 19 studies; 13 assessed periodontal conditions; five, the number of remaining teeth and four, the use and need of prosthesis - some studies evaluated two or more conditions simultaneously. Five of the eight periodontists suggested questions to assess periodontal conditions. The maximum and the minimum sensitivity values to assess periodontal conditions, number of remaining teeth and use and need of prosthesis were 100 and 2%; 91 and 21%; 100 and 100%; respectively; the maximum and the minimum specificity values were 100 and 18%; 97 and 96%; 93 and 93%; respectively. In conclusion, there are acceptable sensitivity and specificity values for number of remaining teeth and use and need of prosthesis only. Finally, we consider there is the need for further studies in the national context, in order to assess the impact of the questions about self-reported oral health conditions in epidemiological analyses. Therefore, it will be possible to empirically verify if self-reported questions can be used in such studies.
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Affiliation(s)
- Renato Quirino Ramos
- Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil
| | - João Luiz Bastos
- Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil
| | - Marco Aurélio Peres
- Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil; The University of Adelaide, Australia
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Wu X, Weng H, Lin X. Self-reported questionnaire for surveillance of periodontitis in Chinese patients from a prosthodontic clinic: a validation study. J Clin Periodontol 2013; 40:616-23. [PMID: 23557490 DOI: 10.1111/jcpe.12103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 01/18/2013] [Accepted: 02/27/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Xiayi Wu
- Guanghua School and Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Haiyan Weng
- Guanghua School and Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Xuefeng Lin
- Guanghua School and Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
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Eke PI, Thornton-Evans G, Dye B, Genco R. Advances in surveillance of periodontitis: the Centers for Disease Control and Prevention periodontal disease surveillance project. J Periodontol 2012; 83:1337-42. [PMID: 22324489 PMCID: PMC6004792 DOI: 10.1902/jop.2012.110676] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The Centers for Disease Control and Prevention (CDC) has as one of its strategic goals to support and improve surveillance of periodontal disease. In 2003, the CDC initiated the CDC Periodontal Disease Surveillance Project in collaboration with the American Academy of Periodontology to address population-based surveillance of periodontal disease at the local, state, and national levels. This initiative has made significant advancements toward the goal of improved surveillance, including developing valid self-reported measures that can be obtained from interview-based surveys to predict prevalence of periodontitis in populations. This will allow surveillance of periodontitis at the state and local levels and in countries where clinical resources for surveillance are scarce. This work has produced standard case definitions for surveillance of periodontitis that are now widely recognized and applied in population studies and research. At the national level, this initiative has evaluated the validity of previous clinical examination protocols and tested new protocols on the National Health and Nutrition Examination Survey (NHANES), recommending and supporting funding for the gold-standard full-mouth periodontal examination in NHANES 2009 to 2012. These examinations will generate accurate estimates of the prevalence of periodontitis in the US adult population and provide a superior dataset for surveillance and research. Also, this data will be used to generate the necessary coefficients for our self-report questions for use in subsets of the total US population. The impact of these findings on population-based surveillance of periodontitis and future directions of the project are discussed along with plans for dissemination and translation efforts for broader public health use.
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Affiliation(s)
- Paul I Eke
- Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
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Bernardo CDO, Boing AF, Vasconcelos FDAGD, Peres KG, Peres MA. Association between tooth loss and obesity in Brazilian adults: a population-based study. Rev Saude Publica 2012; 46:834-42. [DOI: 10.1590/s0034-89102012000500010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 01/04/2012] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: To examine the association between tooth loss and general and central obesity among adults. METHODS: Population-based cross-sectional study with 1,720 adults aged 20 to 59 years from Florianópolis, Southern Brazil. Home interviews were performed and anthropometric measures were taken. Information on sociodemographic data, self-reported diabetes, self-reported number of teeth, central obesity (waist circumference [WC] > 88 cm in women and > 102 cm in men) and general obesity (body mass index [BMI] ≥ 30 kg/m²) was collected. We used multivariable Poisson regression models to assess the association between general and central obesity and tooth loss after controlling for confounders. We also performed simple and multiple linear regressions by using BMI and WC as continuous variables. Interaction between age and tooth loss was also assessed. RESULTS: The mean BMI was 25.9 kg/m² (95%CI 25.6;26.2) in men and 25.4 kg/m2 (95%CI 25.0;25.7) in women. The mean WC was 79.3 cm (95%CI 78.4;80.1) in men and 88.4 cm (95%CI 87.6;89.2) in women. A positive association was found between the presence of less than 10 teeth in at least one arch and increased mean BMI and WC after adjusting for education level, self-reported diabetes, gender and monthly per capita income. However, this association was lost when the variable age was included in the model. The prevalence of general obesity was 50% higher in those with less than 10 teeth in at least one arch when compared with those with 10 or more teeth in both arches after adjusting for education level, self-reported diabetes and monthly per capita family income. However, the statistical significance was lost after controlling for age. CONCLUSIONS: Obesity was associated with number of teeth, though it depended on the participants' age groups.
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