title: Impact of Periodontitis Case Criteria: A Cross-Sectional Study of Lifestyle.
abstract: Associations of risk factors/indicators with periodontitis may depend on the included case criterion. The objective of the current study is to evaluate differences in outcome by applying five periodontitis case definitions for cross-sectional associations with lifestyle factors among participants of the Danish Health Examination Survey (DANHES).
  
  
  
  A total of 4,402 adults aged 18 to 96 years from the general health examination of DANHES had a periodontal examination consisting of half-mouth registration at six sites per tooth including probing depth (PD) and clinical attachment level (CAL). Periodontitis was defined according to severe periodontitis, European Workshop of Periodontology (EWP)-specific, meanCAL ≥2.55 mm, CAL-tertile, and PD-CAL definitions. Multivariable logistic regression models fitted the association of age, sex, smoking status, diabetes mellitus, educational level, alcohol consumption, body mass index, physical activity, body fat percentage, waist circumference, triglycerides, total cholesterol, and C-reactive protein with periodontitis.
  
  
  
  Number of cases captured by the five periodontitis case definitions ranged from 337 (9.2%) to 1,136 (31.0%). A total of 224 participants were defined as periodontitis cases by all five criteria. Analyses on 3,665 participants with complete data revealed statistically significant associations of age and smoking with all periodontitis case definitions and of male sex with severe periodontitis and EWP-specific definitions. Educational level (two lowest groups) was related to three periodontitis criteria. Among obesity and hyperlipidemia measures no factors were related to periodontitis.
  
  
  
  Regression analyses showed little difference in odds ratio across the five periodontitis case definitions; however, the level of significance did show some variation.
authors.affiliation: Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Johanne
authors.initials: J
authors.lastname: Kongstad
authors.affiliation: Department of Infectious Diseases and Rheumatology, Institute for Inflammation Research, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Enevold
authors.affiliation: Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Lisa Bøge
authors.initials: LB
authors.lastname: Christensen
authors.affiliation: Department of International Health, Immunology, and Microbiology; Faculty of Health and Medical Sciences; University of Copenhagen.
authors.forename: Nils-Erik
authors.initials: NE
authors.lastname: Fiehn
authors.affiliation: Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Palle
authors.initials: P
authors.lastname: Holmstrup
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D050218:Body Fat Distribution; D015992:Body Mass Index; D002097:C-Reactive Protein; D002784:Cholesterol; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D003753:Dental Health Surveys; D003920:Diabetes Mellitus / Q000453:epidemiology; D004522:Educational Status; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D010518:Periodontitis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D014280:Triglycerides; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol
keywords: Diagnosis; epidemiology; obesity; periodontitis; risk factors; smoking