Self-Perception of Periodontal Health and Associated Factors: A Cross-Sectional Population-Based Study

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. population and individual level [8]. In larger populations, a combination of demographic measures and self-reported oral health questions (self-perceived assessment) has demonstrated promising validity in predicting periodontitis for planning public health programs, especially when clinical assessment is unattainable [9][10][11][12]. In individuals, clinical and self-reported measures of periodontal disease have been reported to demonstrate significant disparity [13,14].A recent contribution provided evidence of low sensitivity (disease perception), but high specificity (health perception) values for self-reported bleeding gums [13,14] and low to moderate sensitivity and specificity for oral malodor [15][16][17][18], while little is known about self-perceived tooth mobility [15,16,19,20]. In contrast, people demonstrated the ability to refer to their own dental history, number of remaining teeth, previous experience of restorations, presence of prostheses, and screening of urgent dental care [6,9,[21][22][23][24].Several studies have shown that self-perception of oral health varies among social groups and age cohorts [13,25,26], although these findings have not been corroborated in other studies [27,28]. Most of the available information is derived from older participants, especially community dwelling or institutionalized individuals [29][30][31], while representative samples of adult populations were seldom involved, and none of them assessed predictors of gingival health and oral odor self-awareness [5,10,32]. Self-awareness of periodontal health status influences oral health-seeking behavior and is related to the utilization of dental services for early detection and prevention...

Prevalence and Associated Factors of Self-Reported Gingival Bleeding: A Multicenter Study in France

“…Previous epidemiological studies have demonstrated the age dependence and gender differences of gingival bleeding data [ 8 , 9 , 28 , 30 ]. Our results found a higher prevalence of GB among females and are in line with those of other studies [ 8 , 28 , 31 ]. The higher SRGB prevalence observed in females could be attributed to the facts that (i) women are more aware of their oral health and (ii) women are more susceptible to gingival inflammation exacerbations due to hormonal fluctuations [ 32 , 33 ].…”

“…By contrast, Buhlin et al observed an inverse association of SRGB according to age [ 34 ]. Elderly people have a higher number of missing teeth than those younger, but most importantly, they seem to be less aware of their gingival bleeding, as shown in the study of Romano et al [ 31 ]. Ebersole et al demonstrated the presence of age-associated alterations in innate immune function within the periodontium, which could affect not only the initiation but also the resolution of inflammation [ 35 ].…”

Validation of a self-report questionnaire for periodontitis in a Japanese population

“…Gingival bleeding is an indicator of the presence of an inflammatory lesion. Gingival bleeding is objective 35 , and therefore, may be less confusing than other items, such…”

“…In our study, the predictive ability varied with the definition used for periodontitis. Generally, periodontitis progresses silently, and the pathological changes take a long time before pain, discomfort, and functional disability occur 35 . This poor self-perception of periodontitis progression can partly explain the lower predictive ability of the self-report in milder cases of periodontitis in our study.…”

“…Gingival bleeding is an indicator of the presence of an inflammatory lesion. Gingival bleeding is objective 35 , and therefore, may be less confusing than other items, such as teeth/gum health, for our study participants. One study 25 demonstrated the usefulness of using responses to both oral health questions and smoking status to screen for severe periodontitis in Japanese workers.…”