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Chou R, Selph SS, Bougatsos C, Nix C, Ahmed A, Griffin J, Schwarz E. Screening, Referral, Behavioral Counseling, and Preventive Interventions for Oral Health in Adults: A Systematic Review for the US Preventive Services Task Force. JAMA 2023; 330:1780-1790. [PMID: 37934490 DOI: 10.1001/jama.2023.20685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Importance Dental caries and periodontal disease are common adult oral health conditions and potentially amenable to primary care screening and prevention. Objective To systematically review the evidence on primary care screening and prevention of dental caries and periodontal disease in adults to inform the US Preventive Services Task Force. Data Sources MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (to October 3, 2022); surveillance through July 21, 2023. Study Selection Diagnostic accuracy studies of primary care screening instruments and oral examination; randomized and nonrandomized trials of screening and preventive interventions; cohort studies on primary care oral health screening and preventive intervention harms. Data Extraction and Synthesis One investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality. Diagnostic accuracy data were pooled using a bivariate mixed-effects binary regression model. Main Outcomes and Measures Dental caries, periodontal disease, morbidity, quality of life, harms; and diagnostic test accuracy. Results Five randomized clinical trials, 5 nonrandomized trials, and 6 observational studies (total 3300 participants) were included. One poor-quality trial (n = 477) found no difference between oral health screening during pregnancy vs no screening in caries, periodontal disease, or birth outcomes. One study (n = 86) found oral health examination by 2 primary care clinicians associated with low sensitivity (0.42 and 0.56) and high specificity (0.84 and 0.87) for periodontal disease and with variable sensitivity (0.33 and 0.83) and high specificity (0.80 and 0.93) for dental caries. Four studies (n = 965) found screening questionnaires associated with a pooled sensitivity of 0.72 (95% CI, 0.57-0.83) and specificity of 0.74 (95% CI, 0.66-0.82) for periodontal disease. For preventive interventions no study evaluated primary care counseling or dental referral, and evidence from 2 poor-quality trials (n = 178) of sealants, and 1 fair-quality and 4 poor-quality trials (n = 971) of topical fluorides, was insufficient. Three fair-quality trials (n = 590) of persons with mean age 72 to 80 years found silver diamine fluoride solution associated with fewer new root caries lesions or fillings vs placebo (mean reduction, -0.33 to -1.3) and decreased likelihood of new root caries lesion (2 trials; adjusted odds ratio, 0.4 [95% CI, 0.3-0.7]). No trial evaluated primary care-administered preventive interventions. Conclusions and Relevance Screening questionnaires were associated with moderate diagnostic accuracy for periodontal disease. Research is needed to determine benefits and harms of oral health primary care screening and preventive interventions.
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Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center, the Department of Medical Informatics and Clinical Epidemiology; Oregon Health & Science University, Portland
- Division of General Internal Medicine; Oregon Health & Science University, Portland
| | - Shelley S Selph
- Pacific Northwest Evidence-based Practice Center, the Department of Medical Informatics and Clinical Epidemiology; Oregon Health & Science University, Portland
| | - Christina Bougatsos
- Pacific Northwest Evidence-based Practice Center, the Department of Medical Informatics and Clinical Epidemiology; Oregon Health & Science University, Portland
| | - Chad Nix
- School of Medicine; Oregon Health & Science University, Portland
| | - Azrah Ahmed
- Pacific Northwest Evidence-based Practice Center, the Department of Medical Informatics and Clinical Epidemiology; Oregon Health & Science University, Portland
| | - Jessica Griffin
- Pacific Northwest Evidence-based Practice Center, the Department of Medical Informatics and Clinical Epidemiology; Oregon Health & Science University, Portland
| | - Eli Schwarz
- School of Dentistry, Division of Dental Public Health, Oregon Health & Science University, Portland
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Machado V, Lyra P, Santos C, Proença L, Mendes JJ, Botelho J. Self-Reported Measures of Periodontitis in a Portuguese Population: A Validation Study. J Pers Med 2022; 12:1315. [PMID: 36013264 PMCID: PMC9410440 DOI: 10.3390/jpm12081315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/25/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Self-reported questionnaires have been developed and validated in multiple populations as useful tools to estimate the prevalence of periodontitis in epidemiological settings. This study aimed to explore the accuracy of self-reporting for predicting the prevalence of periodontitis in a Portuguese population. The questionnaires were given to patients at a university clinic. Thirteen self-reported questions on periodontal health were gathered in a patient-reported questionnaire. Then, self-reporting responses were validated using full-mouth periodontal examination as a comparison. Multivariable logistic regression was used to analyze sensitivity, specificity, accuracy, precision, and area under the curve-receiver operator characteristic (AUC-ROC). Self-reported answers from 103 participants (58 females and 45 males) were included. Self-reported gum health, loose teeth, tooth appearance, and use of dental floss were associated with different definitions of severe periodontitis. The self-reported questions on “having gum disease,” combined with “having gum treatment” and “having lost bone” were the items with higher performance for the 2018 case definition and the 2012 case definition, as well as for each respective severity staging. Categorization of tooth loss was only valuable for the prediction of periodontitis cases according to the 2012 case definition and its severe stage. Multiple self-reporting set-ups showed elevated performance levels for predicting periodontitis in Portuguese patients. These results may pave the way for future epidemiological surveillance programs using self-reporting approaches.
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Yoshioka T, Tabuchi T. Combustible cigarettes, heated tobacco products, combined product use, and periodontal disease: A cross-sectional JASTIS study. PLoS One 2021; 16:e0248989. [PMID: 33784312 PMCID: PMC8009369 DOI: 10.1371/journal.pone.0248989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 03/09/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Combustible cigarettes have detrimental effects on periodontal disease. However, little evidence is available regarding new heated tobacco product (HTP) use and combined product use (both combustible cigarettes and HTPs). This study aimed to examine the association of combustible cigarettes, HTPs, and combined product use with periodontal disease simultaneously. MATERIALS AND METHODS This cross-sectional study was conducted using data from the 2019 arm of the longitudinal Japan "Society and New Tobacco" Internet Survey. Combustible cigarette users, HTP users, combined product users, never-users, and former users' data were separately obtained. In the present study, the primary outcome was self-reported periodontal disease. We estimated adjusted prevalence ratios (PRs) and confidence intervals (CIs) using multivariable modified Poisson regression analysis after adjusting for 12 confounders. RESULTS Of the 10,439 JASTIS respondents, the numbers of users of combustible cigarettes only, HTPs only, and both products were 1,304, 437, and 1,049, respectively. Compared with never-users, HTP use was significantly associated with the prevalence of self-reported periodontal diseases (PR 1.43, 95% CI 1.03-1.62). Moreover, former users, combustible cigarette users, and combined product users also showed significant associations (PR 1.56, 95% CI 1.35-1.80; PR 1.29, 95% CI 1.03-1.62; and PR 1.55, 95% CI 1.20-1.99, respectively). CONCLUSIONS Users of HTPs, combustible cigarettes, and combined products as well as former users were all significantly associated with a higher prevalence of periodontal diseases compared to never-users.
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Affiliation(s)
- Takashi Yoshioka
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima-shi, Fukushima, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Otemae, Chuo-ku, Osaka-shi, Osaka, Japan
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Abstract
Objective Periodontal examinations are time-consuming and potentially uncomfortable for recipients. We modelled if self-reported questions alone, or combined with objective evidence of periodontal bone loss observable from radiographs, are accurate predictors of periodontitis. Methods Self-reported data from the Australian National Survey of Adult Oral Heath 2004-06 were compared with clinical periodontal examinations to assess the validity of 8 periodontitis screening questions in predicting moderate/severe periodontitis. To model alveolar bone loss, a proxy variable simulating radiographic clinical attachment level (rCAL) was created. Three multivariable binary logistic regression models were constructed: responses to 8 screening questions alone (Model 1), screening questions combined with 5 classic periodontitis risk indicators (age, sex, smoking status, country of birth, and diabetes status) (Model 2), and the addition of rCAL (Model 3). Predictive validity was determined via sensitivity (Se) and specificity (Sp) scores and graphically represented using area under the receiver operator characteristic curves (AUROC). Results Data from 3630 participants periodontally examined determined that 32.4% exhibited periodontitis. Periodontitis risk indicators were all significantly associated with periodontitis case status. Six of 8 screening questions (Model 1) were weak periodontitis predictors (Se = 0.28; Sp = 0.89; AUROC = 0.61). Combining 13 variables for (Model 2) improved prediction (Se = 0.55; Sp = 0.81; AUROC = 0.77). The addition of rCAL (Model 3) improved diagnostic capacity considerably (AUROC = 0.86). Conclusions Self-reported questions combined with classic risk indicators are “useful” for periodontitis screening. Addition of radiographs markedly improved diagnostic validity. Based on modelling, nondental health care professionals may provisionally screen for periodontitis with minimal training.
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Affiliation(s)
- Kostas Kapellas
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, South Australia, Australia
| | - Anna Ali
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, South Australia, Australia; Robinson Research Institute, University of Adelaide, South Australia, Australia.
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, South Australia, Australia
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Romandini M, Lima C, Pedrinaci I, Araoz A, Costanza Soldini M, Sanz M. Clinical signs, symptoms, perceptions, and impact on quality of life in patients suffering from peri-implant diseases: a university-representative cross-sectional study. Clin Oral Implants Res 2020; 32:100-111. [PMID: 33210787 DOI: 10.1111/clr.13683] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/22/2020] [Accepted: 11/10/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To study the symptoms and perception reported by patients with peri-implant diseases, as well as their signs and their potential impact on the oral health quality of life. MATERIAL AND METHODS Two hundred and forty randomly selected patients were invited to participate. As part of the history assessment, the patient OHIP-14Sp was evaluated together with, for each implant, the patient perception regarding the peri-implant health status and the history of pain, spontaneous discomfort, bleeding, suppuration, swelling, and discomfort during brushing. As part of the clinical examination, the following potential signs of peri-implant diseases were collected: probing pocket depth (PPD), mucosal dehiscence (MD), extent of BoP, presence of SoP, and visual signs of redness and swelling. Those parameters were analyzed in relation to the actual peri-implant health diagnosis. RESULTS Ninety-nine patients with a total of 458 dental implants were studied. Even in case of peri-implantitis, 88.9% of the implants were perceived by the patients as healthy. The total OHIP-14Sp sum score did not differ in relation to the peri-implant health diagnosis. Increased reports of spontaneous discomfort, bleeding, swelling, and discomfort during brushing were observed in presence of disease. However, only a minor proportion of implants with peri-implant diseases presented symptoms. PPD ≥ 6 mm was more frequent in diseased than in healthy implants (p < .01), while PPD ≥ 8 in pre-peri-implantitis/peri-implantitis than in healthy/mucositis implants (p < .01). Implants with peri-implantitis showed higher MD than implants without peri-implantitis (p < .01). CONCLUSION Peri-implant diseases are in most cases asymptomatic and not perceived by the patients. Despite being unable to accurately discriminate between peri-implant mucositis and peri-implantitis, PPD and MD resulted as the only two clinical signs associated with pre-peri-implantitis/peri-implantitis.
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Affiliation(s)
- Mario Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Cristina Lima
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ignacio Pedrinaci
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ana Araoz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | | | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
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Schmidt JC, Vogt S, Imboden M, Schaffner E, Grize L, Zemp E, Probst-Hensch N, Zitzmann NU. Dental and periodontal health in a Swiss population-based sample of older adults: a cross-sectional study. Eur J Oral Sci 2020; 128:508-517. [PMID: 33073429 DOI: 10.1111/eos.12738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 12/18/2022]
Abstract
In this cross-sectional study, the prevalences of tooth loss, prosthetic dental restorations, and probing pocket depths (PPD) ≥4 mm, and their relationship to sociodemographic factors, were investigated in older Swiss adults. There were up to 1,673 participants aged ≥55 yr in the fourth survey of the Swiss Cohort Study on Air Pollution And Lung And Heart Disease In Adults (SAPALDIA4). Missing teeth, prosthetic dental restorations, and PPD ≥4 mm were recorded in clinical examinations conducted by field workers and compared with self-reported information from questionnaires. Examination data showed that participants were missing five teeth on average, 74.8% had a prosthetic dental restoration, and 21.1% had PPD of ≥4 mm. The mean number of missing teeth and the prevalences of tooth loss, fixed dental prostheses, and removable dental prostheses were associated with age, education level, smoking status, and time since last visit to a dentist. Comparison of data obtained by field workers and that from self-reports show a high level of agreement for the number of missing teeth and the prevalence of removable dental prostheses, but a lower level of agreement for self-reports of fixed dental prostheses and periodontitis.
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Affiliation(s)
- Julia C Schmidt
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Sandra Vogt
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Medea Imboden
- Department of Epidemiology & Public Health, Swiss Tropical & Public Health Institute Basel, University of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Emmanuel Schaffner
- Department of Epidemiology & Public Health, Swiss Tropical & Public Health Institute Basel, University of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Leticia Grize
- Department of Epidemiology & Public Health, Swiss Tropical & Public Health Institute Basel, University of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Elisabeth Zemp
- Department of Epidemiology & Public Health, Swiss Tropical & Public Health Institute Basel, University of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Department of Epidemiology & Public Health, Swiss Tropical & Public Health Institute Basel, University of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
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Perdoncini NN, Furquim CP, Bonfim CMS, Soares GMS, Torres-Pereira CC. Self-perception of periodontal health status among individuals with Fanconi anemia. Hematol Transfus Cell Ther 2020; 43:453-458. [PMID: 33023865 PMCID: PMC8573027 DOI: 10.1016/j.htct.2020.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/05/2020] [Accepted: 07/20/2020] [Indexed: 12/05/2022] Open
Abstract
Introduction Fanconi anemia (FA) is a rare genetic disease characterized by congenital malformations and bone marrow failure. One of the most common oral diseases in individuals with FA is periodontitis and adequate self-perception of periodontal status could contribute to its prevention and early detection. Aim To compare oral health self-perception, measured by a questionnaire, with the clinical oral condition of patients with FA. Methods and Results Fifty-six patients with FA, over 11 years of age, answered a questionnaire about dental history and self-reported oral health. Decayed, missing, and filled teeth (DMFT), Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) were measured. The median age of participants was 21 years (min 11, max 44), 31 (55%) were females and 25 (45%) males. Thirty-five (62.5%) participants rated their oral condition as satisfactory and 7 (12.5%) participants reported tooth mobility, 10 (17.9%) exposed roots and 21 (37.5%) gingival bleeding. Clinical examination detected average DMFT = 5.23, VPI = 31.36% and GBI = 33.77%. The gingival bleeding report was more frequent among individuals with higher GBI (p = 0.014). The DMFT was higher in those who had already undergone dental treatments (p = 0.031). There was an association between participants who presented dental caries and who rated their oral health as poor (p = 0.03). The question “Do your gums bleed easily?” had good accuracy in the evaluation of periodontal disease (p = 0.68). Conclusion Oral health self-perception of individuals with FA about gingival inflammation was associated with their gingival bleeding index.
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Ueno M, Shimazu T, Sawada N, Tsugane S, Kawaguchi Y. Validity of Self-Reported Periodontitis in Japanese Adults: The Japan Public Health Center-Based Prospective Study for the Next-Generation Oral Health Study. Asia Pac J Public Health 2020; 32:346-353. [PMID: 32741221 DOI: 10.1177/1010539520944721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study evaluated the validity of self-reported periodontitis measures among 2404 Japanese adults aged 40 to 75 years. A self-administered questionnaire survey and a clinical periodontal examination were conducted from 2013 through 2016. The self-reported periodontitis questions included 3 sociodemographic, 3 health, and 5 periodontal health-related items. Based on the clinical case definition of periodontitis, 26.5% of participants were found to be periodontally healthy, 2.7% had mild periodontitis, 55.2% moderate periodontitis, and 15.6% severe periodontitis. No single self-reported question demonstrated satisfactory validity in predicting the presence or absence of periodontitis. The predictive ability in mild and/or moderate periodontitis was poor even after combining multiple sociodemographic, health, and periodontal health-related questions. In severe periodontitis, the model including age, sex, education level, smoking status, diabetes history, body mass index, informed by a dentist, gingival bleeding, calculus deposit, and tooth mobility, presented moderate predictive performance (C-statistic: 0.676, sensitivity: 65.2%, and specificity: 61.1%). An age-stratified analysis on severe periodontitis showed that sensitivity was higher, and specificity was lower in older age group (60-75 years) than younger age group (40-59 years). Further refinement of questions in the self-report is required to increase the accuracy of the prediction of clinical periodontitis.
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Affiliation(s)
- Masayuki Ueno
- Saitama Prefectural University, Koshigaya, Japan.,Tokyo Medical and Dental University, Tokyo, Japan
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Romano F, Perotto S, Bianco L, Parducci F, Mariani GM, Aimetti M. Self-Perception of Periodontal Health and Associated Factors: A Cross-Sectional Population-Based Study. Int J Environ Res Public Health 2020; 17:E2758. [PMID: 32316219 DOI: 10.3390/ijerph17082758] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Abstract
The aim of this cross-sectional study was to explore sociodemographic, behavioral, and clinical factors associated with self-awareness of periodontal health. Data were collected from a representative sample of 736 adults (25–75 years old) in a city of Northern Italy who self-assessed gingival bleeding, oral malodor, and tooth mobility in a questionnaire and who underwent clinical periodontal examination and organoleptic evaluation. Approximately 50% of the subjects were aware of their actual gingival health status and oral odor. The logistic regression analysis revealed that females presented higher odds of correctly perceiving their gingival conditions and mouth odor, while those who were older and smokers had a greater probability of being less objective in reporting them. Tooth type and position in the dental arches were positively associated with self-perception of tooth mobility. These findings reflected a low level of self-awareness that may influence oral care-seeking behavior. Subjects may be unconcerned about their periodontal health condition or lack enough knowledge to be aware of it. This points to the need for planning strategies to improve education and knowledge about periodontal health, which, by enhancing self-perception of periodontal symptoms, could help everyone to seek treatment in the initial stage of the disease.
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Abstract
The most important development in the epidemiology of periodontitis in the USA during the last decade is the result of improvements in survey methodologies and statistical modeling of periodontitis in adults. Most of these advancements have occurred as the direct outcome of work by the joint initiative known as the Periodontal Disease Surveillance Project by the Centers for Disease Control and Prevention and the American Academy of Periodontology that was established in 2006. This report summarizes some of the key findings of this important initiative and its impact on our knowledge of the epidemiology of periodontitis in US adults. This initiative first suggested new periodontitis case definitions for surveillance in 2007 and revised them slightly in 2012. This classification is now regarded as the global standard for periodontitis surveillance and is used worldwide. First, application of such a standard in reporting finally enables results from different researchers in different countries to be meaningfully compared. Second, this initiative tackled the concern that prior national surveys, which used partial-mouth periodontal examination protocols, grossly underestimated the prevalence of periodontitis of potentially more than 50%. Consequently, because previous national surveys significantly underestimated the true prevalence of periodontitis, it is not possible to extrapolate any trend in periodontitis prevalence in the USA over time. Any difference calculated may not represent any actual change in periodontitis prevalence, but rather is a consequence of using different periodontal examination protocols. Finally, the initiative addressed the gap in the need for state and local data on periodontitis prevalence. Through the direct efforts of the Centers for Disease Control and Prevention and the American Academy of Periodontology initiative, full-mouth periodontal probing at six sites around all nonthird molar teeth was included in the 6 years of National Health and Nutrition Examination Surveys from 2009-2014, yielding complete data for 10 683 dentate community-dwelling US adults aged 30 to 79 years. Applying the 2012 periodontitis case definitions to the 2009-2014 National Health and Nutrition Examination Surveys data, the periodontitis prevalence turned out to be much greater than previously estimated, namely affecting 42.2% of the population with 7.8% of people experiencing severe periodontitis. It was also discovered that only the moderate type of periodontitis is driving the increase in periodontitis prevalence with age, not the mild or the severe types whose prevalence do not increase consistently with age, but remain ~ 10%-15% in all age groups of 40 years and older. The greatest risk for having periodontitis of any type was seen in older people, in males, in minority race/ethnic groups, in poorer and less educated groups, and especially in cigarette smokers. The Centers for Disease Control and Prevention and the American Academy of Periodontology initiative reported, for the first time, the periodontitis prevalence estimated at both local and state levels, in addition to the national level. Also, this initiative developed and validated in field studies a set of eight items for self-reported periodontitis for use in direct survey estimates of periodontitis prevalence in existing state-based surveys. These items were also included in the 2009-2014 National Health and Nutrition Examination Surveys for validation against clinically determined cases of periodontitis. Another novel result of this initiative is that, for the first time, the geographic distribution of practicing periodontists in relation to the geographic distribution of people with severe periodontitis is illustrated. In summary, the precise periodontitis prevalence and distribution among subgroups in the dentate US noninstitutionalized population aged 30-79 years is better understood because of application of valid periodontitis case definitions to full-mouth periodontal examination, in combination with reliable information on demographic and health-related measures. We now can monitor the trend of periodontitis prevalence over time as well as guide public health preventive and intervention initiatives for the betterment of the health of the adult US population.
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Affiliation(s)
- Paul I Eke
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Robert J Genco
- (Formerly) Distinguished Professor of Oral Biology and Microbiology; Director, UB Center for Microbiome Research, State University of New York (SUNY), University at Buffalo, Amherst, New York, USA
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Gufran K, Alasqah M, Almalki S, Alkhaibari Y, Alghamdi Y, Aljulify T. Validation of self-reported periodontal disease status among subjects seeking dental treatment in a dental school. J Pharm Bioallied Sci 2020; 12:S550-S553. [PMID: 33149519 PMCID: PMC7595471 DOI: 10.4103/jpbs.jpbs_157_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 02/14/2020] [Accepted: 03/06/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction: Periodontal disease and its relation with quality of life have made it necessary to know in detail regarding the disease. Hence, the aim of this study was to check the validity of self-reported periodontal status with clinical findings among subjects attending a dental teaching institution. Materials and Methods: A cross-sectional study was conducted on subjects with periodontitis attending a dental teaching institution. A questionnaire was developed after reviewing the relevant literature and participants were asked to complete the questionnaire. Information about signs and symptoms of periodontal disease was included, and subjects were examined for periodontal disease. Data were recorded and analyzed for sensitivity and specificity. Result: A total of 103 subjects answered the study questionnaire and underwent clinical examination. The sensitivity of question varied from 16.6% with need of periodontal or gum treatment to 57.1% in case of gingival swelling. In many questions, more than 90% of specificity was found. There was a difference in self-assessed periodontal status with clinically examined periodontal status. Conclusion: Self-assessed questionnaires were of low value in evaluating oral periodontal disease status. Periodontal perception of subjects was higher but does not reflect with clinical findings; this calls for educational programs to be conducted to improve knowledge and awareness about periodontal diseases.
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Montero E, La Rosa M, Montanya E, Calle‐Pascual AL, Genco RJ, Sanz M, Herrera D. Validation of self‐reported measures of periodontitis in a Spanish Population. J Periodontal Res 2019; 55:400-409. [DOI: 10.1111/jre.12724] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/29/2019] [Accepted: 11/25/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Martina La Rosa
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Eduard Montanya
- Bellvitge Hospital‐IDIBELL Barcelona Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) Barcelona Spain
- Department of Clinical Sciences University of Barcelona Barcelona Spain
| | - Alfonso L. Calle‐Pascual
- Medical School. University Complutense Madrid Spain
- Endocrinology and Nutrition Department Hospital Clínico Universitario San Carlos Madrid Spain
| | | | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
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Chatzopoulos GS, Cisneros A, Sanchez M, Lunos S, Wolff LF. Validity of self-reported periodontal measures, demographic characteristics, and systemic medical conditions. J Periodontol 2019; 89:924-932. [PMID: 29624676 DOI: 10.1002/jper.17-0586] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/20/2017] [Accepted: 01/05/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND The objective of the present study was to assess self-reported periodontal screening questions, demographic characteristics, systemic medical conditions, and tobacco use for predicting periodontal disease among individuals seeking dental therapy in a university dental clinic. METHODS In this retrospective study, a total of 4,890 randomly selected dental charts were evaluated from among patients who had attended the University of Minnesota School of Dentistry clinics for treatment. Radiographic bone loss measurements were used to assess the severity of periodontal disease. Demographic characteristics as well as medical history of the patients were also recorded. Five self-reported periodontal screening questions were included, with answers limited to Yes/No. Generalized logit models were used to assess the association between bone loss and the predictors. RESULTS The sample's mean age was 54.1 years and included 52.6% males and 14.9% smokers, with a mean of 3.5 missing teeth. Self-reported tooth mobility, history of "gum treatment," and the importance of retaining teeth as well as age, tobacco use, and cancer were statistically significant predictors (P < 0.05) of a radiographic diagnosis of moderate and severe periodontal disease. With respect to severe periodontal disease, significant associations (P < 0.05) were also found with "bleeding while brushing," gender, diabetes, anxiety, and arthritis. CONCLUSIONS Self-reported periodontal screening questions as well as demographic characteristics, smoking, and systemic medical conditions were significant predictors of periodontal disease, and they could be used as valid, economic, and practical measures.
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Affiliation(s)
- Georgios S Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN
| | | | - Miguel Sanchez
- School of Dentistry, University of Minnesota, Minneapolis, MN
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN
| | - Larry F Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN
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Dannewitz B, Sommerer C, Stölzel P, Baid‐Agrawal S, Nadal J, Bärthlein B, Wanner C, Eckardt K, Zeier M, Schlagenhauf U, Krane V, Jockel‐Schneider Y. Status of periodontal health in German patients suffering from chronic kidney disease—Data from the GCKD study. J Clin Periodontol 2019; 47:19-29. [DOI: 10.1111/jcpe.13208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 10/03/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Bettina Dannewitz
- Department of Periodontology Johann Wolfgang Goethe‐University Frankfurt Frankfurt Germany
- Private Dental Practice Weilburg Germany
| | - Claudia Sommerer
- Division of Nephrology Heidelberg University Hospital Heidelberg Germany
| | - Peggy Stölzel
- Division of Periodontology University Hospital of Würzburg Würzburg Germany
| | - Seema Baid‐Agrawal
- Department of Nephrology and Medical Intensive Care University Hospital Charité Berlin Germany
- Department of Nephrology and Transplant Center Sahlgrenska University Hospital University of Gothenburg Gothenburg Sweden
| | - Jennifer Nadal
- Department of Medical Biometry, Informatics, and Epidemiology (IMBIE) University Hospital Bonn Germany
| | - Barbara Bärthlein
- Chair of Medical Informatics University of Erlangen‐Nürnberg Erlangen Germany
| | - Christoph Wanner
- Department of Medicine 1 Division of Nephrology University of Würzburg Würzburg Germany
| | - Kai‐Uwe Eckardt
- Department of Nephrology and Medical Intensive Care University Hospital Charité Berlin Germany
- Department of Nephrology and Hypertension Friedrich‐Alexander‐University Erlangen‐Nürnberg (FAU) University Hospital Erlangen Erlangen Germany
| | - Martin Zeier
- Division of Nephrology Heidelberg University Hospital Heidelberg Germany
| | | | - Vera Krane
- Department of Medicine 1 Division of Nephrology University of Würzburg Würzburg Germany
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Prado MG, Iversen MD, Yu Z, Miller Kroouze R, Triedman NA, Kalia SS, Lu B, Green RC, Karlson EW, Sparks JA. Effectiveness of a Web-Based Personalized Rheumatoid Arthritis Risk Tool With or Without a Health Educator for Knowledge of Rheumatoid Arthritis Risk Factors. Arthritis Care Res (Hoboken) 2019; 70:1421-1430. [PMID: 29316383 DOI: 10.1002/acr.23510] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/02/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To assess knowledge of rheumatoid arthritis (RA) risk factors among unaffected first-degree relatives (FDRs) and to study whether a personalized RA education tool increases risk factor knowledge. METHODS We performed a randomized controlled trial assessing RA educational interventions among 238 FDRs. The web-based Personalized Risk Estimator for RA (PRE-RA) tool displayed personalized RA risk results (genetics, autoantibodies, demographics, and behaviors) and educated about risk factors. Subjects were randomly assigned to a Comparison arm (standard RA education; n = 80), a PRE-RA arm (PRE-RA alone; n = 78), or a PRE-RA Plus arm (PRE-RA and a one-on-one session with a trained health educator; n = 80). The RA Knowledge Score (RAKS), the number of 8 established RA risk factors identified as related to RA, was calculated at baseline and post-education (immediate/6 weeks/6 months/12 months). We compared RAKS and its components at each post-education point by randomization arm. RESULTS At baseline before education, few FDRs identified behavioral RA risk factors (15.6% for dental health, 31.9% for smoking, 47.5% for overweight/obesity, and 54.2% for diet). After education, RAKS increased in all arms, higher in PRE-RA and PRE-RA Plus than Comparison at all post-education points (P < 0.05). PRE-RA subjects were more likely to identify risk factors than those who received standard education (proportion agreeing that smoking is a risk factor at 6 weeks: 83.1% in the PRE-RA Plus arm, 71.8% in the PRE-RA arm, and 43.1% in the Comparison arm; P < 0.05 for PRE-RA versus Comparison). CONCLUSION Despite being both familiar with RA and at increased risk, FDRs had low knowledge about RA risk factors. A web-based personalized RA education tool successfully increased RA risk factor knowledge.
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Affiliation(s)
| | - Maura D Iversen
- Brigham and Women's Hospital, Harvard Medical School, and Northeastern University, Boston, Massachusetts, and Karolinska Institutet, Stockholm, Sweden
| | - Zhi Yu
- Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Sarah S Kalia
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Bing Lu
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Robert C Green
- Harvard Medical School and Brigham and Women's Hospital, Boston, and Broad Institute, Cambridge, Massachusetts
| | - Elizabeth W Karlson
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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16
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von Stein-Lausnitz M, Reissmann DR, Roggendorf MJ, Sterzenbach G, Naumann M. Patients' self-report on post-retained restoration is more valuable than expected! Explorative analysis of an 11-year follow-up. Acta Odontol Scand 2019; 77:33-38. [PMID: 30156134 DOI: 10.1080/00016357.2018.1497804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: Assessment of long-term clinical data regarding post-endodontic restorations is essential for the evaluation of different post-and-core concepts. The aim of the present study was to assess the diagnostic accuracy of patient self-reporting on post-endodontic restorations after 11 years of clinical service.Materials and methods: Twenty-nine patients (61 ± 15 years old) with endodontic glass-fibre and titanium post-endodontic restorations were examined within the 11-year follow-up of a randomized controlled trial. Restorations were assessed by self-reports during a telephone interview (one item), the completion of a four-item questionnaire and clinical and radiographic examination. A gold standard for restoration in situ or 'failure' was defined by clinical and radiographic examination. Diagnostic accuracy of patients' self-reports was evaluated by calculating the sensitivity, specificity, and positive (PPV) and negative predictive values (NPV).Results: After a mean observation time of 137 months (min/max: 125/154 months), 25 (86.2%) restorations were in situ and 4 (13.8%) failures were detected. Self-report during a telephone interview and the four-item questionnaire correctly identified all in situ restorations (specificity = both 100%, NPV = 92.6%/96.2%). Self-report during a telephone interview identified two out of four failures (sensitivity = 50%, PPV = 100%), and self-report on the four-item questionnaire identified three out of four failures (sensitivity = 75%, PPV = 100%).Conclusions: When the clinical examination is not feasible, patients' self-report shows valuable diagnostic potential in the identification of the post-endodontic failure.
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Affiliation(s)
- Manja von Stein-Lausnitz
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
| | - Daniel R. Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias J. Roggendorf
- Department of Operative Dentistry and Endodontics, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Guido Sterzenbach
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
| | - Michael Naumann
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
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Meisel P, Holtfreter B, Völzke H, Kocher T. Self-reported oral health predicts tooth loss after five and ten years in a population-based study. J Clin Periodontol 2018; 45:1164-1172. [DOI: 10.1111/jcpe.12997] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/29/2018] [Accepted: 08/07/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Peter Meisel
- Dental School; University of Greifswald; Greifswald Germany
- Dental Clinics; Department of Periodontology; University Medicine Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Dental School; University of Greifswald; Greifswald Germany
- Dental Clinics; Department of Periodontology; University Medicine Greifswald; Greifswald Germany
| | - Henry Völzke
- Institute for Community Medicine; Ernst Moritz Arndt University Greifswald; Greifswald Germany
| | - Thomas Kocher
- Dental School; University of Greifswald; Greifswald Germany
- Dental Clinics; Department of Periodontology; University Medicine Greifswald; Greifswald Germany
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Carra MC, Gueguen A, Thomas F, Pannier B, Caligiuri G, Steg PG, Zins M, Bouchard P. Self-report assessment of severe periodontitis: Periodontal screening score development. J Clin Periodontol 2018; 45:818-831. [DOI: 10.1111/jcpe.12899] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Maria Clotilde Carra
- Department of Periodontology; Service of Odontology; Rothschild Hospital, AP-HP; Paris France
- U.F.R. of Odontology; Paris 7-Denis Diderot University; Paris France
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Alice Gueguen
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Frédérique Thomas
- Centre d'Investigations Préventives et Cliniques (IPC); Paris France
| | - Bruno Pannier
- Centre d'Investigations Préventives et Cliniques (IPC); Paris France
- Department of Cardiology; Georges Pompidou European Hospital, AP-HP; Paris France
- Medicine Faculty; Paris 5-Descartes University; Paris France
| | | | - Philippe Gabriel Steg
- INSERM-Unité 1148; Paris France
- French Alliance for Cardiovascular Trials (FACT); Département Hospitalo-Universitaire FIRE; Hôpital Bichat; Assistance Publique-Hôpitaux de Paris; Paris France
- Université Paris-Diderot; Sorbonne-Paris Cité; Paris France
- Royal Brompton Hospital; Imperial College; London UK
| | - Marie Zins
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Philippe Bouchard
- Department of Periodontology; Service of Odontology; Rothschild Hospital, AP-HP; Paris France
- U.F.R. of Odontology; Paris 7-Denis Diderot University; Paris France
- EA 2496, Paris 5-Descartes University; Paris France
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19
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Leite FR, Peres KG, Do LG, Demarco FF, Peres MA. Prediction of Periodontitis Occurrence: Influence of Classification and Sociodemographic and General Health Information. J Periodontol 2017; 88:731-743. [DOI: 10.1902/jop.2017.160607] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Fábio R.M. Leite
- Currently, Department of Dentistry and Oral Health, Section of Periodontology, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark; previously, Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Karen G. Peres
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Loc G. Do
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Flávio F. Demarco
- Postgraduate Program in Epidemiology, Federal University of Pelotas
- Postgraduate Program in Dentistry, Federal University of Pelotas
| | - Marco A.A. Peres
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
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20
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Busjan R, Hasenkamp J, Schmalz G, Haak R, Trümper L, Ziebolz D. Oral health status in adult patients with newly diagnosed acute leukemia. Clin Oral Investig 2017; 22:411-418. [PMID: 28536781 DOI: 10.1007/s00784-017-2127-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The aim of this cross-sectional study was to evaluate the oral health of adult patients with newly diagnosed acute leukemia. METHODS Patients with initially diagnosed acute myeloid (AML) or lymphocytic (ALL) leukemia and a matched healthy control (HC) group were included. The oral investigation comprised inspection of the oral mucosa; the decayed (D), missing (M), and filled (F) teeth (DMF-T) index; and a detailed periodontal status. Subgingival biofilm samples were analyzed (polymerase chain reaction) for the presence of selected potentially periodontal pathogenic bacteria. Statistical analysis was performed using Fisher's exact test, chi-squared test, and Mann-Whitney U test (significance level α = 5%). RESULTS Thirty-nine patients with leukemia (AML 26, ALL 13) and 38 HCs were included. Oral mucosal findings were present in 62% of L compared to 0% of HC patients, whereby gingival hyperplasia was the most detected finding. Furthermore, a higher caries prevalence in leukemia patients was shown (D value 3.64 ± 3.98 vs. 0.72 ± 1.72, p < 0.01). The periodontal parameters were poorer in leukemia patients. No substantial differences in microbiological findings of selected bacteria were detected within L group and between L and HC patients. CONCLUSION The high prevalence of oral diseases supports the demand of an early and consequent dental treatment of leukemia patients, especially considering subsequent therapy.
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Affiliation(s)
- Rilana Busjan
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 10-14, 04103, Leipzig, Germany
| | - Justin Hasenkamp
- Clinic for Hematology and Medical Oncology, University of Goettingen, Goettingen, Germany
| | - Gerhard Schmalz
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 10-14, 04103, Leipzig, Germany
| | - Rainer Haak
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 10-14, 04103, Leipzig, Germany
| | - Lorenz Trümper
- Clinic for Hematology and Medical Oncology, University of Goettingen, Goettingen, Germany
| | - Dirk Ziebolz
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 10-14, 04103, Leipzig, Germany.
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21
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Chatzopoulos GS, Tsalikis L, Konstantinidis A, Kotsakis GA. A Two-Domain Self-Report Measure of Periodontal Disease Has Good Accuracy for Periodontitis Screening in Dental School Outpatients. J Periodontol 2016; 87:1165-73. [DOI: 10.1902/jop.2016.160043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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22
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Laprise C, Shahul HP, Madathil SA, Thekkepurakkal AS, Castonguay G, Varghese I, Shiraz S, Allison P, Schlecht NF, Rousseau MC, Franco EL, Nicolau B. Periodontal diseases and risk of oral cancer in Southern India: Results from the HeNCe Life study. Int J Cancer 2016; 139:1512-9. [PMID: 27215979 DOI: 10.1002/ijc.30201] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 04/27/2016] [Accepted: 05/02/2016] [Indexed: 01/10/2023]
Abstract
Some studies suggest that periodontal diseases increase the risk of oral cancer, but contradictory results also exist. Inadequate control of confounders, including life course exposures, may have influenced prior findings. We estimate the extent to which high levels of periodontal diseases, measured by gingival inflammation and recession, are associated with oral cancer risk using a comprehensive subset of potential confounders and applying a stringent adjustment approach. In a hospital-based case-control study, incident oral cancer cases (N = 350) were recruited from two major referral hospitals in Kerala, South India, from 2008 to 2012. Controls (N = 371), frequency-matched by age and sex, were recruited from clinics at the same hospitals. Structured interviews collected information on several domains of exposure via a detailed life course questionnaire. Periodontal diseases, as measured by gingival inflammation and gingival recession, were evaluated visually by qualified dentists following a detailed protocol. The relationship between periodontal diseases and oral cancer risk was assessed by unconditional logistic regression using a stringent empirical selection of potential confounders corresponding to a 1% change-in-estimates. Generalized gingival recession was significantly associated with oral cancer risk (Odds Ratio = 1.83, 95% Confidence Interval: 1.10-3.04). No significant association was observed between gingival inflammation and oral cancer. Our findings support the hypothesis that high levels of periodontal diseases increase the risk of oral cancer.
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Affiliation(s)
- Claudie Laprise
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | | | - Sreenath Arekunnath Madathil
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | | | - Geneviève Castonguay
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Ipe Varghese
- Kerala University of Health Sciences, Medical College PO, Thrissur, Kerala, India
| | - Shameena Shiraz
- Oral Pathology, Government Dental College, Medical College Campus, Kozhikode 8, Kerala, India
| | - Paul Allison
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, NY
| | - Marie-Claude Rousseau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Eduardo L Franco
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Belinda Nicolau
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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Renatus A, Kottmann T, Schwarzenberger F, Jentsch H. Evaluation of a New Self-Reported Tool for Periodontitis Screening. J Clin Diagn Res 2016; 10:ZC107-12. [PMID: 27504399 PMCID: PMC4963759 DOI: 10.7860/jcdr/2016/19518.8063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/10/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Periodontitis is still highly prevalent in industrial population whereas at the same time appropriate screening programs are missing. AIM To evaluate, a self-reported questionnaire about periodontal risk factors in combination with the Periodontal Screening Index (PSI) to identify an existing need for periodontal treatment combined with the early recognition of high-risk patients. MATERIALS AND METHODS Total 200 patients took part in the questionnaire based study and were examined using the PSI. Thereafter the participants were divided into two groups, subjects with periodontitis (Group 1; PSI 0-2) and subjects without periodontitis (Group 2; PSI 3-4). The answers were evaluated using a point system ranging from 0 to 8, based on known periodontal risk factors and their assumed degree of influence. Receiver-Operating Characteristic (ROC) curve analysis were applied to examine the overall discriminatory power, sensitivity, specificity and corresponding cut-off points of the self-reported periodontal disease scale. RESULTS There was a significant difference between Group 1 and 2 concerning the majority of the inquired items (12 of 16, p<0.05). The distribution of the individual total score exhibited a high statistical significance (p<0.001) of robustness in terms of differing definitions of periodontitis. The Area Under the Curve (AUC) was 0.912 with a sensitivity of 86% and a specificity of 76%. CONCLUSION The questionnaire produced a reliable assessment of the individual risk (total score) and the need for periodontal treatment as well as the differentiation between gingivitis and periodontitis. CLINICAL RELEVANCE Patient-based data (clinical variables and periodontal risk factors of periodontitis) were adequate to make a preliminary assessment of a possible need for periodontal treatment.
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Affiliation(s)
- Antonio Renatus
- Faculty, Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig, Leipzig, Germany
| | | | - Fabian Schwarzenberger
- Professor for Stochastics, Faculty of Informatics/Mathematics at the HTW Dresden, Dresden, Germany
| | - Holger Jentsch
- Professor, Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig, Leipzig, Germany
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Abstract
The objective of the study was to estimate the prevalence of periodontitis at state and local levels across the United States by using a novel, small area estimation (SAE) method. Extended multilevel regression and poststratification analyses were used to estimate the prevalence of periodontitis among adults aged 30 to 79 y at state, county, congressional district, and census tract levels by using periodontal data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012, population counts from the 2010 US census, and smoking status estimates from the Behavioral Risk Factor Surveillance System in 2012. The SAE method used age, race, gender, smoking, and poverty variables to estimate the prevalence of periodontitis as defined by the Centers for Disease Control and Prevention/American Academy of Periodontology case definitions at the census block levels and aggregated to larger administrative and geographic areas of interest. Model-based SAEs were validated against national estimates directly from NHANES 2009-2012. Estimated prevalence of periodontitis ranged from 37.7% in Utah to 52.8% in New Mexico among the states (mean, 45.1%; median, 44.9%) and from 33.7% to 68% among counties (mean, 46.6%; median, 45.9%). Severe periodontitis ranged from 7.27% in New Hampshire to 10.26% in Louisiana among the states (mean, 8.9%; median, 8.8%) and from 5.2% to 17.9% among counties (mean, 9.2%; median, 8.8%). Overall, the predicted prevalence of periodontitis was highest for southeastern and southwestern states and for geographic areas in the Southeast along the Mississippi Delta, as well as along the US and Mexico border. Aggregated model-based SAEs were consistent with national prevalence estimates from NHANES 2009-2012. This study is the first-ever estimation of periodontitis prevalence at state and local levels in the United States, and this modeling approach complements public health surveillance efforts to identify areas with a high burden of periodontitis.
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Affiliation(s)
- P I Eke
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - X Zhang
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - H Lu
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - L Wei
- DB Consulting Group, Inc., Atlanta, GA, USA
| | - G Thornton-Evans
- Division of Oral Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - K J Greenlund
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - J B Holt
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - J B Croft
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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25
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Garcia RI, Compton R, Dietrich T. Risk assessment and periodontal prevention in primary care. Periodontol 2000 2016; 71:10-21. [DOI: 10.1111/prd.12124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2015] [Indexed: 11/28/2022]
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26
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García-Pérez Á, Borges-Yáñez SA, Jiménez-Corona A, Jiménez-Corona ME, Ponce-de-León S. Self-report of gingival problems and periodontitis in indigenous and non-indigenous populations in Chiapas, Mexico. Int Dent J 2016; 66:105-12. [PMID: 26800859 DOI: 10.1111/idj.12213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of self-reported gingival and periodontal conditions and their association with smoking, oral hygiene, indigenous origin, diabetes and location (urban or rural) in indigenous and non-indigenous adults in Chiapas, Mexico. METHODS A cross-sectional study of 1,749 persons, ≥20 years of age, living in four rural and four urban marginal localities in Comitán (Chiapas, México). The variables investigated were: age; sex; indigenous origin; oral hygiene; halitosis; chewing ability; gingival conditions; periodontitis; smoking; alcoholism; diabetes; and location. Bivariate analysis and a logistic regression model were used to identify the association of periodontitis with the independent variables. RESULTS In total, 762 (43.6%) indigenous and 987 (56.4%) non-indigenous persons were interviewed. Their mean age was 41 ± 14 years, 66.7% were women and 43.8% lived in rural locations. Gingival problems were reported by 68.5% and periodontitis by 8.7%. In total, 17.9% had used dental services during the previous year, 28.7% wore a removable partial or a complete dental prosthesis, 63.7% had lost at least one tooth, the prevalence of diabetes was 9.2% and the prevalence of smoking was 12.2%. The logistic regression model showed that age, diabetes and the interaction between rural location and indigenous origin were associated with the presence of periodontitis. CONCLUSIONS Indigenous people living in rural areas are more likely to have periodontitis. It is necessary to promote oral health practices in indigenous and marginalised populations with a focus on community-oriented primary care.
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Affiliation(s)
- Álvaro García-Pérez
- Laboratorios de Biológicos y Reactivos de México, S.A. de C.V., BIRMEX, México D.F, México.,Departamento de Epidemiologia Ocular, Instituto de Oftalmología Conde de Valenciana, IAP, México D. F, México
| | - Socorro Aída Borges-Yáñez
- División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, México D. F, México
| | - Aida Jiménez-Corona
- Departamento de Epidemiologia Ocular, Instituto de Oftalmología Conde de Valenciana, IAP, México D. F, México.,Dirección General Adjunta de Epidemiología, Secretaría de Salud, México D. F, México.,Unidad de Diabetes y Riesgo Cardiovascular, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - María Eugenia Jiménez-Corona
- Laboratorios de Biológicos y Reactivos de México, S.A. de C.V., BIRMEX, México D.F, México.,Dirección General Adjunta de Epidemiología, Secretaría de Salud, México D. F, México
| | - Samuel Ponce-de-León
- Laboratorios de Biológicos y Reactivos de México, S.A. de C.V., BIRMEX, México D.F, México.,División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, México D. F, México
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Kim HD, Sukhbaatar M, Shin M, Ahn YB, Yoo WS. Validation of periodontitis screening model using sociodemographic, systemic, and molecular information in a Korean population. J Periodontol 2015; 85:1676-83. [PMID: 24965062 DOI: 10.1902/jop.2014.140061] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This study aims to evaluate and validate a periodontitis screening model that includes sociodemographic, metabolic syndrome (MetS), and molecular information, including gingival crevicular fluid (GCF), matrix metalloproteinase (MMP), and blood cytokines. METHODS The authors selected 506 participants from the Shiwha-Banwol cohort: 322 participants from the 2005 cohort for deriving the screening model and 184 participants from the 2007 cohort for its validation. Periodontitis was assessed by dentists using the community periodontal index. Interleukin (IL)-6, IL-8, and tumor necrosis factor-α in blood and MMP-8, -9, and -13 in GCF were assayed using enzyme-linked immunosorbent assay. MetS was assessed by physicians using physical examination and blood laboratory data. Information about age, sex, income, smoking, and drinking was obtained by interview. Logistic regression analysis was applied to finalize the best-fitting model and validate the model using sensitivity, specificity, and c-statistics. RESULTS The derived model for periodontitis screening had a sensitivity of 0.73, specificity of 0.85, and c-statistic of 0.86 (P <0.001); those of the validated model were 0.64, 0.91, and 0.83 (P <0.001), respectively. CONCLUSIONS The model that included age, sex, income, smoking, drinking, and blood and GCF biomarkers could be useful in screening for periodontitis. A future prospective study is indicated for evaluating this model's ability to predict the occurrence of periodontitis.
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Affiliation(s)
- Hyun-Duck Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
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Abstract
BACKGROUND The development of self-reported measures of periodontal disease would be of great benefit to facilitate epidemiological studies of periodontal disease on a larger scale, and to allow for surveillance of the periodontal condition of populations over time. OBJECTIVES To develop a culturally adapted self-reported measure of periodontal disease, test its predictive and discriminative validity and establish a cut-off value for this measure to diagnose periodontal disease. METHODS A total of 288 Jordanian adults completed the questionnaire assessing self-reported periodontal health (18 questions) and underwent periodontal examination. Of the 18 questions, six were significantly associated with at least one clinical definition of periodontitis and were used to constitute the self-reported periodontal disease measure. Receiver-operating characteristics (ROC) curve analyses were used to examine the overall discriminatory power, sensitivity and specificity, and corresponding cut-off points of the self-reported periodontal disease measure. RESULTS ROC analysis showed that the self-reported periodontal disease measure had an excellent performance to discriminate between those with and without periodontal disease, regardless of the clinical definition used. A score of 2, on a scale of 0 to 6, had the highest sensitivity and specificity to detect periodontal disease when defined by all study criteria. Significant associations were observed between self-reported periodontal disease measures and all clinical definitions in the regression analysis (the odds ratio ranged from 8.31 to 18.96), according to the clinical definition to be predicted. CONCLUSION Self-reported periodontal disease measures have excellent predictive and discriminative validity when tested against clinical definitions, and severity and extent of periodontal disease.
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Affiliation(s)
- Yousef Khader
- Department of Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rola Alhabashneh
- Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Fadi Alhersh
- Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Oluwagbemigun K, Dietrich T, Pischon N, Bergmann M, Boeing H. Association between Number of Teeth and Chronic Systemic Diseases: A Cohort Study Followed for 13 Years. PLoS One 2015; 10:e0123879. [PMID: 25945503 PMCID: PMC4422697 DOI: 10.1371/journal.pone.0123879] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 02/23/2015] [Indexed: 11/19/2022] Open
Abstract
Background There is growing evidence of an association between oral health, specifically dental status, and chronic systemic diseases. However, varying measures of dental status across different populations and low study sample has made comparison of studies and conclusion of findings unclear. Our aim is to examine whether the number of teeth as a measure of dental status is associated with incident chronic diseases in a cohort setting. Methods We conducted a cohort study among 24,313 middle-aged Germans followed up for 13 years. Data on number of teeth as a measure of dental status were obtained through self-reports. Outcomes were clinically–verified incident non–fatal myocardial infarction, stroke, type 2 diabetes mellitus, and cancer. Hazard ratio (HR) and 95% confidence intervals (CI) were obtained from Cox regression models. Results Increasing number of teeth is inversely related to risk of myocardial infarction (HR: 0.97; 95% CI: 0.96, 0.99). The full multivariate model of teeth groups showed a strong linear trend for myocardial infarction, a less strong trend for stroke, and no relation with type 2 diabetes mellitus and cancer in a competing risk model. Participants with 18–23 teeth and those without teeth were at 76% (95%CI: 1.04, 3) and 2.93 times (95%CI: 1.61, 5.18) higher risk of myocardial infarction compared to those with nearly all teeth (28–32 teeth). Conclusions Number of teeth is specifically associated with myocardial infarction and not with other chronic disease indicating that dental status further strengthens the link between oral health and cardiovascular diseases.
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Affiliation(s)
- Kolade Oluwagbemigun
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam–Nuthetal, Germany
- * E-mail:
| | - Thomas Dietrich
- Department of Oral Surgery, the School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Nicole Pischon
- Department of Periodontology, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Manuela Bergmann
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam–Nuthetal, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam–Nuthetal, Germany
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Lai H, Su CW, Yen AMF, Chiu SYH, Fann JCY, Wu WYY, Chuang SL, Liu HC, Chen HH, Chen LS. A prediction model for periodontal disease: modelling and validation from a National Survey of 4061 Taiwanese adults. J Clin Periodontol 2015; 42:413-21. [DOI: 10.1111/jcpe.12389] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Hongmin Lai
- QC Dental Clinic; Taipei Taiwan
- Department of Dentistry; National Yang-Ming University; Taipei Taiwan
- School of Dentistry; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
| | - Chiu-Wen Su
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
- Oral Health Care Research Center; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
| | - Sherry Yueh-Hsia Chiu
- Department and Graduate Institute of Health Care Management; College of Management; Chang Gung University; Tao-Yuan Taiwan
| | | | - Wendy Yi-Ying Wu
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Shu-Lin Chuang
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Hsing-Chih Liu
- School of Oral Hygiene; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
| | - Hsiu-Hsi Chen
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Li-Sheng Chen
- School of Oral Hygiene; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
- Oral Health Care Research Center; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
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Sparks JA, Iversen MD, Miller Kroouze R, Mahmoud TG, Triedman NA, Kalia SS, Atkinson ML, Lu B, Deane KD, Costenbader KH, Green RC, Karlson EW. Personalized Risk Estimator for Rheumatoid Arthritis (PRE-RA) Family Study: rationale and design for a randomized controlled trial evaluating rheumatoid arthritis risk education to first-degree relatives. Contemp Clin Trials 2014; 39:145-57. [PMID: 25151341 DOI: 10.1016/j.cct.2014.08.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 08/08/2014] [Accepted: 08/11/2014] [Indexed: 01/05/2023]
Abstract
We present the rationale, design features, and protocol of the Personalized Risk Estimator for Rheumatoid Arthritis (PRE-RA) Family Study (ClinicalTrials.gov NCT02046005). The PRE-RA Family Study is an NIH-funded prospective, randomized controlled trial designed to compare the willingness to change behaviors in first-degree relatives of rheumatoid arthritis (RA) patients without RA after exposure to RA risk educational programs. Consented subjects are randomized to receive education concerning their personalized RA risk based on demographics, RA-associated behaviors, genetics, and biomarkers or to receive standard RA information. Four behavioral factors associated with RA risk were identified from prior studies for inclusion in the risk estimate: cigarette smoking, excess body weight, poor oral health, and low fish intake. Personalized RA risk information is presented through an online tool that collects data on an individual's specific age, gender, family history, and risk-related behaviors; presents genetic and biomarker results; displays relative and absolute risk of RA; and provides personalized feedback and education. The trial outcomes will be changes in willingness to alter behaviors from baseline to 6 weeks, 6 months, and 12 months in the three intervention groups. The design and the execution of this trial that targets a special population at risk for RA, while incorporating varied risk factors into a single risk tool, offer distinct challenges. We provide the theoretical rationale for the PRE-RA Family Study and highlight particular design features of this trial that utilize personalized risk education as an intervention.
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Affiliation(s)
- Jeffrey A Sparks
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, 45 Francis St., Boston, MA 02115, USA.
| | - Maura D Iversen
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, 45 Francis St., Boston, MA 02115, USA; Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, 360 Huntington Ave., Boston, MA 02115, USA; Department of Women's and Children's Health, Karolinska Institutet, Solnavägen 1, Stockholm 171 77, Sweden.
| | - Rachel Miller Kroouze
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, 45 Francis St., Boston, MA 02115, USA.
| | - Taysir G Mahmoud
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, 45 Francis St., Boston, MA 02115, USA.
| | - Nellie A Triedman
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, 45 Francis St., Boston, MA 02115, USA.
| | - Sarah S Kalia
- Division of Genetics, Brigham and Women's Hospital and Harvard Medical School, 41 Avenue Louis Pasteur, Suite 301, Boston, MA 02115, USA.
| | - Michael L Atkinson
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
| | - Bing Lu
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, 45 Francis St., Boston, MA 02115, USA.
| | - Kevin D Deane
- Division of Rheumatology, University of Colorado School of Medicine, 1775 Aurora Court, Aurora, CO 80045, USA.
| | - Karen H Costenbader
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, 45 Francis St., Boston, MA 02115, USA.
| | - Robert C Green
- Division of Genetics, Brigham and Women's Hospital and Harvard Medical School, 41 Avenue Louis Pasteur, Suite 301, Boston, MA 02115, USA.
| | - Elizabeth W Karlson
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, 45 Francis St., Boston, MA 02115, USA.
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Affiliation(s)
- Mark S Litaker
- Associate Professor/Director of Biostatistics, Department of Clinical and Community Sciences, UAB School of Dentistry, SDB Room 111, 1720 2nd Avenue South, Birmingham, AL 35294-0007, USA, Tel.: +1 205 934 1179, fax: +1 205 975 0603.
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Zhan Y, Holtfreter B, Meisel P, Hoffmann T, Micheelis W, Dietrich T, Kocher T. Prediction of periodontal disease: modelling and validation in different general German populations. J Clin Periodontol 2014; 41:224-31. [DOI: 10.1111/jcpe.12208] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Yiqiang Zhan
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Peter Meisel
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Thomas Hoffmann
- Department of Periodontology; Medical Faculty Carl Gustav Carus; Dresden Germany
| | | | - Thomas Dietrich
- Department of Oral Surgery; School of Dentistry; University of Birmingham; Birmingham UK
| | - Thomas Kocher
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
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Eke PI, Dye BA, Wei L, Slade GD, Thornton-Evans GO, Beck JD, Taylor GW, Borgnakke WS, Page RC, Genco RJ. Self-reported measures for surveillance of periodontitis. J Dent Res 2013; 92:1041-7. [PMID: 24065636 DOI: 10.1177/0022034513505621] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to evaluate the performance of self-reported measures in predicting periodontitis in a representative US adult population, based on 2009-2010 National Health and Nutrition Examination Survey (NHANES) data. Self-reported gum health and treatment history, loose teeth, bone loss around teeth, tooth not looking right, and use of dental floss and mouthwash were obtained during in-home interviews and validated against full-mouth clinically assessed periodontitis in 3,743 US adults 30 years and older. All self-reported measures (> 95% item response rates) were associated with periodontitis, and bivariate correlations between responses to these questions were weak, indicating low redundancy. In multivariable logistic regression modeling, the combined effects of demographic measures and responses to 5 self-reported questions in predicting periodontitis of mild or greater severity were 85% sensitive and 58% specific and produced an 'area under the receiver operator characteristic curve' (AUROCC) of 0.81. Four questions were 95% sensitive and 30% specific, with an AUROCC of 0.82 in predicting prevalence of clinical attachment loss ≥ 3 mm at one or more sites. In conclusion, self-reported measures performed well in predicting periodontitis in US adults. Where preferred clinically based surveillance is unattainable, locally adapted variations of these self-reported measures may be a promising alternative for surveillance of periodontitis.
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Affiliation(s)
- P I Eke
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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Ramos RQ, Bastos JL, Peres MA. Diagnostic validity of self-reported oral health outcomes in population surveys: literature review. Rev bras epidemiol 2013; 16:716-28. [DOI: 10.1590/s1415-790x2013000300015] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 01/15/2013] [Indexed: 11/22/2022] Open
Abstract
Population-based health surveys are increasingly including self-reported oral health measures. However, their validity is frequently questioned. This study aimed to review the diagnostic validity of self-reported oral health measures - regarding periodontal conditions, number of remaining teeth and use and need of prostheses - and to present prototypes of oral health items to assess periodontal conditions. Papers published between 1991 and 2011 were identified through PubMed database. The sample profile, the sample size and the methods used in each study were analyzed, as well as the sensitivity, specificity, positive and negative predictive values of the oral health items. Periodontists were contacted, using a standardized text, sent by e-mail, which asked them to provide self-reported items regarding periodontal conditions. We reviewed 19 studies; 13 assessed periodontal conditions; five, the number of remaining teeth and four, the use and need of prosthesis - some studies evaluated two or more conditions simultaneously. Five of the eight periodontists suggested questions to assess periodontal conditions. The maximum and the minimum sensitivity values to assess periodontal conditions, number of remaining teeth and use and need of prosthesis were 100 and 2%; 91 and 21%; 100 and 100%; respectively; the maximum and the minimum specificity values were 100 and 18%; 97 and 96%; 93 and 93%; respectively. In conclusion, there are acceptable sensitivity and specificity values for number of remaining teeth and use and need of prosthesis only. Finally, we consider there is the need for further studies in the national context, in order to assess the impact of the questions about self-reported oral health conditions in epidemiological analyses. Therefore, it will be possible to empirically verify if self-reported questions can be used in such studies.
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Affiliation(s)
- Renato Quirino Ramos
- Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil
| | - João Luiz Bastos
- Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil
| | - Marco Aurélio Peres
- Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil; The University of Adelaide, Australia
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Wu X, Weng H, Lin X. Self-reported questionnaire for surveillance of periodontitis in Chinese patients from a prosthodontic clinic: a validation study. J Clin Periodontol 2013; 40:616-23. [PMID: 23557490 DOI: 10.1111/jcpe.12103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 01/18/2013] [Accepted: 02/27/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Xiayi Wu
- Guanghua School and Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Haiyan Weng
- Guanghua School and Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Xuefeng Lin
- Guanghua School and Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
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Eke PI, Thornton-Evans G, Dye B, Genco R. Advances in surveillance of periodontitis: the Centers for Disease Control and Prevention periodontal disease surveillance project. J Periodontol 2012; 83:1337-42. [PMID: 22324489 PMCID: PMC6004792 DOI: 10.1902/jop.2012.110676] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The Centers for Disease Control and Prevention (CDC) has as one of its strategic goals to support and improve surveillance of periodontal disease. In 2003, the CDC initiated the CDC Periodontal Disease Surveillance Project in collaboration with the American Academy of Periodontology to address population-based surveillance of periodontal disease at the local, state, and national levels. This initiative has made significant advancements toward the goal of improved surveillance, including developing valid self-reported measures that can be obtained from interview-based surveys to predict prevalence of periodontitis in populations. This will allow surveillance of periodontitis at the state and local levels and in countries where clinical resources for surveillance are scarce. This work has produced standard case definitions for surveillance of periodontitis that are now widely recognized and applied in population studies and research. At the national level, this initiative has evaluated the validity of previous clinical examination protocols and tested new protocols on the National Health and Nutrition Examination Survey (NHANES), recommending and supporting funding for the gold-standard full-mouth periodontal examination in NHANES 2009 to 2012. These examinations will generate accurate estimates of the prevalence of periodontitis in the US adult population and provide a superior dataset for surveillance and research. Also, this data will be used to generate the necessary coefficients for our self-report questions for use in subsets of the total US population. The impact of these findings on population-based surveillance of periodontitis and future directions of the project are discussed along with plans for dissemination and translation efforts for broader public health use.
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Affiliation(s)
- Paul I Eke
- Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
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Spangler L, Chaudhari M, Barlow WE, Newton KM, Inge R, Hujoel P, Genco RJ, Reid RJ. Using administrative data for epidemiological research: case study to identify persons with periodontitis. Periodontol 2000 2012; 58:143-52. [PMID: 22133373 DOI: 10.1111/j.1600-0757.2011.00422.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Naumann M, Koelpin M, Beuer F, Meyer-lueckel H. 10-year Survival Evaluation for Glass-fiber–supported Postendodontic Restoration: A Prospective Observational Clinical Study. J Endod 2012; 38:432-5. [DOI: 10.1016/j.joen.2012.01.003] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 01/06/2012] [Accepted: 01/08/2012] [Indexed: 11/17/2022]
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Gomes MS, Hugo FN, Hilgert JB, Padilha DM, Simonsick EM, Ferrucci L, Reynolds MA. Validity of self-reported history of endodontic treatment in the Baltimore Longitudinal Study of Aging. J Endod 2012; 38:589-93. [PMID: 22515884 DOI: 10.1016/j.joen.2012.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 02/07/2012] [Accepted: 02/09/2012] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Self-reported history of endodontic treatment (SRHET) has been used as a simplified method to estimate the history of endodontic disease and treatment. This study aimed to quantify the validity of SRHET, as reported in the Baltimore Longitudinal Study of Aging (BLSA), as a method to identify individuals who experienced endodontic treatment (ET) and to identify individuals who present with apical periodontitis (AP). METHODS SRHET was collected through the BLSA questionnaire in 247 participants. Data on ET and AP were determined from panoramic radiographs. The total number of ET, AP, and missing teeth were recorded for each individual. The validity of SRHET was determined based on ET and AP separately. Accuracy, efficiency, sensitivity, specificity, positive and negative predictive values (+PV and -PV), and positive and negative likelihood ratios (+LR and -LR) were calculated according to standard methods. RESULTS After exclusions, 229 participants were available for ET analysis and 129 for AP analysis. The SRHET validity values were sensitivity (ET = 0.915, AP = 0.782), specificity (ET = 0.891, AP = 0.689), +PV (ET = 0.824, AP = 0.353), -PV (ET = 0.949, AP = 0.936), +LR (ET = 8.394, AP = 2.514), and -LR (ET = 0.095, AP = 0.316). CONCLUSIONS SRHET was found to be a highly accurate method to predict ET but a weak predictor of the presence of AP among participants in the BLSA.
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Cyrino RM, Miranda Cota LO, Pereira Lages EJ, Bastos Lages EM, Costa FO. Evaluation of self-reported measures for prediction of periodontitis in a sample of Brazilians. J Periodontol 2011; 82:1693-704. [PMID: 21563951 DOI: 10.1902/jop.2011.110015] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Questionnaires including self-reported measures have become effective as a means of accessing many diseases. The aim of the present study is to evaluate the performance of a set of self-reported periodontal measures on estimating the prevalence of periodontitis. METHODS The sample comprised 284 individuals, aged 18 to 60 years, from Belo Horizonte, Brazil. Full-mouth periodontal examinations were performed and periodontal parameters were recorded. Periodontitis was categorized as no or mild, moderate, and severe. Each participant answered 18 questions covering sociodemographic variables, known risk factors, and self-reported periodontal measures. Questions were globally tested through logistic regression analysis. RESULTS The complete final model for moderate periodontitis included age, dental flossing, and gum disease (sensitivity = 23.1%; specificity = 98%; area under the receiver operating characteristic curve = 75.4%). The complete final model for severe periodontitis included all previously cited variables in addition to the number of teeth (sensitivity = 36.4%; specificity = 96.9%; area under the receiver operating characteristic curve = 85.3%). CONCLUSIONS Self-reported periodontal measures showed a moderate predictive value for periodontitis prevalence. The use of these measures could be a good strategy in investigating prevalence of periodontal disease.
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Affiliation(s)
- Renata Magalhães Cyrino
- Department of Periodontology, Dentistry School, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Dietrich T, Kaiser W, Naumann M, Stosch U, Schwahn C, Biffar R, Dietrich D, Kocher T. Validation of a multivariate prediction rule for history of periodontitis in a separate population. J Clin Periodontol 2009; 36:493-7. [DOI: 10.1111/j.1600-051x.2009.01400.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yamamoto T, Koyama R, Tamaki N, Maruyama T, Tomofuji T, Ekuni D, Yamanaka R, Azuma T, Morita M. Validity of a Questionnaire for Periodontitis Screening of Japanese Employees. J Occup Health 2009; 51:137-43. [DOI: 10.1539/joh.l8108] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Tatsuo Yamamoto
- Department of Preventive DentistryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJapan
| | - Reiko Koyama
- Department of Preventive DentistryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJapan
| | - Naofumi Tamaki
- Department of Preventive DentistryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJapan
| | - Takayuki Maruyama
- Department of Preventive DentistryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJapan
| | - Takaaki Tomofuji
- Department of Preventive DentistryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJapan
| | - Daisuke Ekuni
- Department of Preventive DentistryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJapan
| | - Reiko Yamanaka
- Department of Preventive DentistryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJapan
| | - Tetsuji Azuma
- Department of Preventive DentistryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJapan
| | - Manabu Morita
- Department of Preventive DentistryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJapan
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Abstract
This supplement contains papers presented at the 2006 International Association of Dental Research (IADR) symposium entitled "Development of Self-Reported Measures for Population-Based Surveillance of Periodontitis." These papers highlight activities of an independent periodontal disease surveillance workgroup convened by the Division of Oral Health (DOH), Centers for Disease Control and Prevention (CDC), in collaboration with the American Academy of Periodontology, to examine the feasibility of using self-reported measures for population-based surveillance of periodontal disease in the United States. This workgroup was convened in 2003 as part of a CDC periodontal disease surveillance project.
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Affiliation(s)
- Paul I Eke
- Division of Oral Health, Surveillance, Investigations and Research Team, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
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