Predictive values of self-reported periodontal need: National Health and Nutrition Examination Survey III.
BACKGROUND
This study assessed predictive values of self-reported periodontal need to identify periodontal conditions using clinical examinations as the gold standard.


METHODS
We identified 12,370 adults > or = 18 years of age in the third National Health and Nutrition Examination Survey. Self-reported periodontal need was based on participants responding that gum treatment and/or cleaning was needed when asked: "What type of dental care do you need now?" Two periodontal conditions were at least two sites with pockets (pockets > or = 3 mm or pockets > or = 4 mm) and at least two sites with calculus. Main outcomes were: 1) positive predictive value (PPV(Clean)): proportion of those who self-reported the need for cleaning who had calculus; and PPV(Gum): proportion who self-reported the need for gum treatment who had pockets; 2) negative predictive value (NPV(Clean)): proportion of those who self-reported no need for cleaning who did not have calculus; and NPV(Gum): proportion who self-reported no need for gum treatment who did not have pockets; 3) association between predictive values and sociodemographic and behavioral characteristics; and 4) proportion of individuals with specific sociodemographic and behavioral characteristics whose self-reported periodontal need predicted periodontal conditions.


RESULTS
The prevalence of periodontal conditions influenced predictive values. Calculus prevalence = 85%: corresponding PPV(Clean) = 88% and NPV(Clean) = 16%. Prevalence of pockets > or = 3 mm = 47%: corresponding PPV(Gum) = 62% and NPV(Gum) = 54%. Prevalence of pockets > or = 4 mm = 11%: corresponding PPV(Gum) = 25% and NPV(Gum) = 90%. Ninety percent of 30- to 44-year-old minority female smokers who did not visit the dentist in the past year and reported the need for gum treatment had pockets > or = 3 mm (PPV(Gum) = 90%).


CONCLUSIONS
Self-reported periodontal need (cleaning/gum treatment) predicted the presence of the prevalent conditions (calculus/pockets > or = 3 mm). Not reporting a need for periodontal treatment predicted the absence of the less common condition (pockets > or = 4 mm) but not the more prevalent condition (calculus).
Department of Orthodontics, Case Western Reserve University, Cleveland, OH 44106-4905, USA. monica.fisher@case.edu
Monica A
MA
Fisher
George W
GW
Taylor
Brent J
BJ
Shelton
Sara M
SM
Debanne
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D003728:Dental Calculus / Q000453:epidemiology; D003777:Dental Prophylaxis / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D005544:Forecasting; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D010510:Periodontal Diseases / Q000453:epidemiology*; D010514:Periodontal Pocket / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data