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

Abstract

We aimed to assess the validity of the self-report questionnaire for periodontitis in a Japanese population. A Japanese 9-item self-report questionnaire, developed by translating English-version questions that were used to detect periodontitis, was validated against full-mouth clinically-assessed periodontitis in 949 Japanese adults (average age = 43.2 years). Multivariable logistic regression modeling was used to calculate the area under the receiver operating characteristic curve (AUC), wherein the periodontitis case definition of the Centers for Disease Control and Prevention/American Academy of Periodontology was considered the gold standard. Severe, moderate, and mild periodontitis were identified in 6.2%, 30.0%, and 6.7% of the study population, respectively. Self-reported oral health questions combined with socio-demographic and health-related variables had an AUC > 0.70 (range, 0.71–0.87) for any periodontitis category. Four oral health questions (“have gum disease,” “loose tooth,” “lost bone,” and “bleeding gums”) were selected in the parsimonious model for severe periodontitis. The periodontitis screening score generated by the responses to these four questions had an AUC, sensitivity, and specificity of 0.82, 73.1%, and 74.3%, respectively, where the cut-off was set at 2 points. In conclusion, a locally adapted version of the self-report questionnaire had an acceptable diagnostic capacity for the detection of periodontitis in this study population.

Self-Reported Measures of Periodontitis in a Portuguese Population: A Validation Study

“…We tested the performance of this set of questions in predicting cases of both periodontitis and severe periodontitis in two accepted case definitions. This questionnaire included eight items of the original CDC/AAP questionnaire [ 8 ] and five items from other similar studies [ 13 , 17 ]. Our results show that the predictive values of the reduced models were 86% in both the EFP/AAP 2018 and the CDC/AAP 2012 case definitions, while for severe periodontitis the reduced models ranged between 71% and 80% for the EFP/AAP 2018 and the CDC/AAP 2012, respectively.…”

“…The self-report questionnaire for periodontitis not only is a relevant alternative strategy to the clinical diagnosis, with good validity and a reliability to screen individuals with periodontitis, but it also requires fewer resources [ 8 , 11 , 23 ]. This method enables large scale epidemiological studies and facilitates the challenging diagnosis of periodontitis at the populational level [ 17 ]. In fact, self-report as a tool has been previously validated in other medical contexts as well [ 24 , 25 , 26 ].…”

“…Patients were deemed eligible if they met the following inclusion criteria: aged at least 18 years old; being able to read and understand Portuguese; agreeing to participate in the study; completing the questionnaire; and receiving a complete periodontal examination. As exclusion criteria, patients having less than two teeth or who had been pre-diagnosed with a severe or terminal disease (for instance, advanced heart failure, end-stage kidney disease, or advanced-stage cancer) [ 17 ] were not included.…”

“…The questionnaire included a total of thirteen self-reported questions, with eight of them based on the original CDC/AAP [ 8 ]. The remaining five questions were selected from a group of past studies that presented good performance results [ 13 , 17 ] ( Table 1 ).…”

“…This tool is a valid instrument to screen the prevalence of periodontitis in American dentate adults [ 9 , 10 , 11 ]. This CDC/AAP questionnaire has been successfully cross-culturally adapted and validated for Spanish [ 12 , 13 ], French [ 14 ], Brazilian [ 15 ], Dutch [ 16 ] and Japanese [ 17 ] populations, with discriminative capability for detecting individuals with periodontitis. Nonetheless, this epidemiological tool has never been validated in Portugal, a country with high prevalence and burden of periodontitis.…”