Validation of Self-reported Periodontal Disease: A Systematic Review

Department of Oral Health Policy and Epidemiology, Harvard University, Cambridge, Massachusetts, United States
Journal of Dental Research (Impact Factor: 4.14). 11/2005; 84(10):881-90. DOI: 10.1177/154405910508401003
Source: PubMed


Self-report is an efficient and accepted means of assessing many population characteristics, risk factors, and diseases, but has rarely been used for periodontal disease (chronic periodontitis). The availability of valid self-reported measures of periodontal disease would facilitate epidemiologic studies on a much larger scale, allow for integration of new studies of periodontal disease within large ongoing studies, and facilitate lower-cost population surveillance of periodontitis. Several studies have been conducted to validate self-reported measures for periodontal disease, but results have been inconsistent. In this report, we conducted a systematic review of the validation studies. We reviewed the 16 studies that assessed the validity of self-reported periodontal and gingivitis measures against clinical gold standards. Seven of the studies included self-reported measures specific to gingivitis, four included measures only for periodontitis, and five included both gingivitis and periodontal measures. Three of the studies used a self-assessment method where they provided the patient with a detailed manual for performing a self-exam. The remaining 13 studies asked participants to self-report symptoms, presence of periodontal disease itself, or their recollection of a dental health professional diagnosing them or providing treatment for periodontal disease. The review indicates that some measures showed promise, but results varied across populations and self-reported measures. One example of a good measure is, "Has any dentist/hygienist told you that you have deep pockets?", which had a sensitivity of 55%, a specificity of 90%, positive predictive value of 77%, and negative predictive value of 75% against clinical pocket depth. Higher validity could be potentially obtained by the use of combinations of several self-reported questions and other predictors of periodontal disease.

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Available from: Kaumudi J Joshipura, Aug 20, 2014
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    • "They could be rather an overestimation of a participant's self-reported oral health status and oral health behavior. Some have found that self-reported oral health measures, however, can serve as a valuable tool in epidemiological studies by reducing resources and costs [30] [31]. This measure has proven useful in evaluating dental conditions and periodontal diseases [32] or in detecting students with healthy oral status; it is more specific than sensitive [33] "
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    ABSTRACT: Objective. To evaluate oral health literacy, independent of other oral health determinants, as a risk indicator for self-reported oral health. Methods. A cross-sectional population-based survey conducted in Tehran, Iran. Multiple logistic regression analysis served to estimate the predictive effect of oral health literacy on self-reported oral health status (good versus poor) controlling for socioeconomic and demographic factors and tooth-brushing behavior. Results. In all, among 1031 participants (mean age 36.3 (SD 12.9); 51% female), women reported brushing their teeth more frequently (P < 0.001) and scored higher for oral health literacy (mean 10.9 versus 10.2, P < 0.001). In the adjusted model, high age (OR = 1.01, 95% CI 1.003-1.034), low education (OR = 1.88, 95% CI 1.23-2.87), small living area in square meters per person (OR = 1.85, 95% CI 1.003-3.423), poor tooth brushing behavior (OR = 3.35, 95% CI 2.02-5.57), and low oral health literacy scores (OR = 1.58, 95% CI 1.02-2.45) were significant risk indicators for poor self-reported oral health. Conclusions. Low oral health literacy level, independent of education and other socioeconomic determinants, was a predictor for poor self-reported oral health and should be considered a vital determinant of oral health in countries with developing health care systems.
    Full-text · Article · Mar 2013
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    • "One of the main limitations of our study is that our dental measures were not validated in our population. Past literature on the validity of self-reported dental measures reveal mixed results [35] [36] [37] [38]. Fortunately, there are a few validity studies on questions that specifically inquire about periodontal bone loss. "
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    ABSTRACT: Objective: Periodontal disease has been associated with systemic inflammation and may be a risk factor for autoimmune diseases. This study evaluated the association between periodontal disease and the risk of incident psoriasis in a large prospective cohort study. Material and methods: Self-reported history of periodontal bone loss, from 1998-2008, was evaluated as a risk factor for incident psoriasis among 60,457 women in the Nurses' Health Study. Secondary analyses examined associations between history of tooth loss and number of natural teeth and psoriasis risk. Cox proportional hazards models were used to assess multivariate estimates, adjusting for age, cigarette smoking, body mass index, alcohol intake and physical activity. Results: An increased multivariate risk of psoriasis was observed for those with mild periodontal bone loss (RR = 1.35, 95% CI = 1.03-1.75) and moderate-to-severe periodontal bone loss (RR = 1.49, 95% CI = 1.08-2.05), as compared to those without periodontal bone loss, after adjusting for age, cigarette smoking, body mass index, alcohol intake, physical activity and tooth loss. Number of natural teeth and tooth loss were not associated with risk of psoriasis in this study. Conclusion: This study shows that a history of periodontal bone loss may increase risk of subsequent psoriasis. A limitation of this study is that it is based on self-reported measures.
    Full-text · Article · Feb 2013 · Acta odontologica Scandinavica
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    • "We relied on parental self-report data to categorise the proband into familial-risk groups and on proband self-report data on tobacco use, and use of dental services. The issue of the reliability and validity of self-report data has been addressed by others (Blicher et al. 2005, Gilbert & Litaker 2007). Interview/examiner-based assessments, as used in the family health history study, are more likely to yield valid data than " self-completed " data. "
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    ABSTRACT: To determine whether parental periodontal disease history is a risk factor for periodontal disease in adult offspring. Proband periodontal examination [combined attachment loss (CAL) at age 32, and incidence of CAL from ages 26 to 32] and interview data were collected during the age-32 assessments in the Dunedin Study. Parental data were also collected. The sample was divided into two familial-risk groups for periodontal disease (high- and low-risk) based on parents' self-reported periodontal disease. Periodontal risk analysis involved 625 proband-parent(s) groups. After controlling for confounding factors, the high-familial-risk periodontal group was more likely to have 1+ sites with 4+mm CAL [relative risk (RR) 1.45; 95% confidence interval (CI) 1.11-1.88], 2+ sites with 4+mm CAL (RR 1.45; 95% CI 1.03-2.05), 1+ sites with 5+mm CAL (RR 1.60; 95% CI 1.02-2.50), and 1+ sites with 3+mm incident CAL (RR 1.64; 95% CI 1.01-2.66) than the low-familial-risk group. Predictive validity was enhanced when information was available from both parents. Parents with poor periodontal health tend to have offspring with poor periodontal health. Family/parental history of oral health is a valid representation of the shared genetic and environmental factors that contribute to an individual's periodontal status, and may help to predict patient prognosis and preventive treatment need.
    Full-text · Article · Apr 2011 · Journal Of Clinical Periodontology
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