title: Partial-mouth assessment of periodontal disease in an adult population of the United States.
abstract: BACKGROUND
  It has been previously demonstrated, using periodontal data from an untreated population, that half-mouth assessment of six sites/tooth provides an appropriate alternative to whole-mouth assessment of periodontal disease status. Since periodontal destruction exhibits left-right symmetry, it was hypothesized that this would be equally applicable to a population with access to routine dental care.
  
  
  METHODS
  Adult subjects (N = 92) with a range of disease levels participated in the study. Probing depths (PDs) and recession (REC) were measured directly on six sites/tooth, on all teeth (excluding third molars), and clinical attachment levels (CALs) were derived. Partial-mouth assessments, i.e., assessment of limited sites and/or teeth, were compared with whole-mouth assessment as follows. Intraclass correlation coefficients (ICCs) were calculated for mean PD, CAL, and REC, and for percentage of sites with disease above a specified threshold, to determine the agreement between the whole- and partial-mouth assessment. The sensitivity of partial-mouth assessment of disease prevalence also was determined.
  
  
  RESULTS
  For assessment of six sites per tooth in one upper and one lower quadrant, ICCs were consistently >0.80. Assessment of two sites per tooth or only Ramfjord teeth generally underestimated disease extent and severity, and prevalence, compared to half-mouth assessment.
  
  
  CONCLUSIONS
  These results support the use of a half-mouth examination of six sites/tooth, to conserve time, limit cost, and reduce patient and examiner fatigue, while providing maximal clinical information. Assessment of only two sites per tooth or the Ramfjord teeth was not suitable for evaluation of either disease extent and severity or prevalence.
mesh_terms: D000328:Adult; D000368:Aged; D003753:Dental Health Surveys; D003945:Diagnosis, Oral / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010510:Periodontal Diseases / Q000175:diagnosis* / Q000453:epidemiology; D010512:Periodontal Index; D015995:Prevalence; D015203:Reproducibility of Results; D012107:Research Design; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology