title: A new screening method for periodontitis: an alternative to the community periodontal index.
abstract: BACKGROUND
  Periodontal screening plays an important role in the prevention of periodontal disease and promotes an improvement in oral health-related quality of life. The World Health Organization's Community Periodontal Index should be carried out by well-trained dentists. However, the Community Periodontal Index is an invasive technique, and if used for periodontal screening, increases the cost of evaluation. In order to overcome these issues, we developed saliva tests for periodontal screening. The purpose of this study was to calculate the sensitivity and specificity of our method for measuring hemoglobin and lactate dehydrogenase levels in saliva.
  
  
  METHODS
  Inclusion criteria were adults aged over 20 years with at least 20 teeth remaining. The study population comprised 38 men and 54 women with a mean age of 50.03 years. Oral examinations were carried out by dentists, and the number of remaining teeth, presence or absence of calculus, bleeding on probing and pocket depth were recorded. In this study, periodontitis was defined according to the criteria of the Center for Disease Control and Prevention in partnership with the American Academy of Periodontology. In order to examine hemoglobin and lactate dehydrogenase levels in saliva, participants were instructed to chew on a standard-sized tasteless and odorless gum base for 5 min, during which time, stimulated whole saliva was continuously collected.
  
  
  RESULTS
  The sensitivity and specificity for hemoglobin levels were 0.759 and 0.763, respectively, and 0.722 and 0.711, respectively, for lactate dehydrogenase levels. Combining these two tests, when samples tested positive for both hemoglobin and lactate dehydrogenase, the positive predictive value was 91.7 %.
  
  
  CONCLUSIONS
  Measuring hemoglobin and lactate dehydrogenase levels in saliva is a less invasive method than the Community Periodontal Index. Therefore, our saliva tests may be a viable alternative to the Community Periodontal Index for periodontal screening.
authors.affiliation: Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Nomura
authors.affiliation: Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Okada
authors.affiliation: Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
authors.forename: Erika
authors.initials: E
authors.lastname: Kakuta
authors.affiliation: Shimane Dental Association, 141-9 Minamitamachi, Matsue, Shimane, 690-0884, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Gunji
authors.affiliation: Department of Health and Welfare, Shimane Prefectural Government, 1 Tonomachi, Matsue, Shimane, 690-8501, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Kajiura
authors.affiliation: Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan. hanada-n@tsurumi-u.ac.jp.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Hanada
mesh_terms: D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases; D010512:Periodontal Index; D010518:Periodontitis / Q000175:diagnosis*; D011788:Quality of Life; D012463:Saliva / Q000737:chemistry
chemical_list: D006454:Hemoglobins; D007770:L-Lactate Dehydrogenase
keywords: Community Periodontal Index; Periodontitis; Saliva test; Screening