Self-reported periodontal disease: validation in an epidemiological survey.
BACKGROUND
Evidence is accumulating to support poor oral health as a risk factor for systemic conditions, including cardiovascular diseases, diabetes control, adverse pregnancy outcomes, and pneumonia. Prohibitive costs for clinical assessment of periodontal disease limit information to assess the prevalence and trends of periodontal diseases in the United States population. However, self-report is used widely to assess economically the population-based prevalence of various medical conditions and health-related behaviors and characteristics.


METHODS
The goal of this secondary data analysis was to identify self-report items sufficiently correlated with clinical periodontal disease for use via face-to-face or telephone interviews. Data for analysis were collected for a project focused on oral health that included face-to-face interview items regarding oral health-related self-care, professional care, and barriers; knowledge, beliefs, and attitudes; risk behavior; impact on quality of life; and demographic characteristics. Also, participants had complete oral examinations.


RESULTS
Logistic regression analyses identified self-reported items contributing to two sets of models predicting moderate or severe periodontal disease (MODSEV) and severe periodontal disease (SEV). Age, gender, race/ethnicity, smoking, and periodontal health-related self-report items constituted predictive models with maximum sensitivity and specificity of 71% and 83%, respectively, with area under the receiver operating characteristic curve (AUC) of 0.85 (as a measure of accuracy) for MODSEV. For SEV, predictive models' maximum sensitivity and specificity were 92% and 53%, respectively, with a maximum AUC of 0.92.


CONCLUSIONS
These analyses suggest that self-report may be valid for surveillance of periodontal disease burden and trends in the American population, in lieu of more costly clinical periodontal examinations.
Taylor
George W
GW
Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA. gwt@umich.edu
Borgnakke
Wenche S
WS
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003729:Dental Care; D016021:Epidemiologic Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D009910:Oral Hygiene; D010510:Periodontal Diseases / Q000453:epidemiology*; D010808:Physical Examination; D011159:Population Surveillance; D011788:Quality of Life; D012309:Risk-Taking; D012680:Sensitivity and Specificity; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology