Validity of periodontitis screening questions in a Brazilian adult population-based study

Abstract

Population-based studies assessing self-reported periodontal questions in low-income countries are lacking, and therefore we aimed to assess the accuracy of self-reported periodontal items in Brazil. One thousand one hundred and forty adults from Florianópolis, Brazil, had their periodontium clinically examined, and responded to the following self-reported items on periodontal conditions: Question (Q)1, Do you have any wobbly teeth?; Q2, Do your gums usually bleed?; and Q3, Has your dentist ever told you that you have gum disease? Periodontitis was defined as: a. ≥ 6.0 mm periodontal pocket and ≥ 4.0 mm clinical attachment loss in the same tooth, in at least one tooth (PD1); or b. ≥ 6.0 mm periodontal pocket and ≥ 4.0 mm clinical attachment loss, not necessarily in the same tooth (PD2). Sensitivity (SN) and specificity (SP) were calculated, and analyses were stratified by socioeconomic status and time since last dental visit. Scores were generated in order to determine the accuracy of the whole set of items. Receiver operating characteristic (ROC) curves were plotted. Prevalence of clinically diagnosed periodontitis was 2.6% (95%CI = 1.7-4.0%) for PD1 and 3.8% (95%CI = 2.7-5.3%) for PD2. Prevalence of self-reported periodontitis varied between 2.7 (Q2) and 22.0% (Q3). SN and SP ranged between 0.0-60.0% and 73.3-98.6%, respectively; Q1 showed the highest accuracy (140.8%) followed by Q3 (140.0%). The combined score of the three self-reported items did not improve accuracy estimates; the areas under the ROC curves were 0.70 and 0.68 for PD1 and PD2, respectively. The accuracy of self-reported items was low, and further studies are needed in order to develop valid and reliable periodontitis screening questions for population-based studies.

Validity of self‐reported measures for periodontitis surveillance in a rural sample

“…Studies that evaluated self‐reported oral health measures to predict periodontitis have shown that a single question is not appropriate to determine periodontitis . However, self‐reported gum/teeth health, loose teeth and lost teeth presented herein individually combined values of sensitivity plus specificity that ranged from approximately 1.30 and 1.40.…”

Self-perception of periodontal health status among individuals with Fanconi anemia

“…Furthermore, self-reports are an alternative to estimate the prevalence of periodontal disease when a complete clinical examination is not possible 20 and efforts have been made to validate this model in Brazil. 17 , 21 In the context of the National Fanconi Anemia Meeting (many individuals, no dental chair and short time) this represents a great opportunity to evaluate the oral condition of a representative sample of FA patients. Considering that in the present study the majority of participants presented unsatisfactory clinical conditions related to gingival inflammation, it is important to know if it is compatible with their self-perception to adopt strategies of oral hygiene support and dental care.…”

High prevalence of periodontitis in blood donors and the possibility of questionnaire‐based screening – results of a cross‐sectional study

“…However, the clinical relevance of the presence of periodontitis is questionable because no associations with common blood parameters were found in the current study. In recent literature, inhomogeneous findings regarding similar screening methods for periodontitis exist (Ng & Leung, ; Eke et al, ; Foster Page et al, ; Ramos et al, ). In principle, a clinical periodontal examination remains undesirable for exact periodontitis diagnosis (Foster Page et al, , Ramos et al, ).…”

“…In recent literature, inhomogeneous findings regarding similar screening methods for periodontitis exist (Ng & Leung, ; Eke et al, ; Foster Page et al, ; Ramos et al, ). In principle, a clinical periodontal examination remains undesirable for exact periodontitis diagnosis (Foster Page et al, , Ramos et al, ). However, standardised questionnaires are able to predict periodontal conspicuities well and are a promising approach, especially if clinical diagnostics are not available (Eke et al, ).…”