Accuracy of a 7-Item Patient-Reported Stand-Alone Tool for Periodontitis Screening.

Caroline Sekundo,Tobias Bölk,Stefan Listl,Olivier Kalmus

doi:10.3390/jcm10020287

Abstract

Periodontitis is interrelated with various other chronic diseases. Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment. So far, however, screening for periodontitis in non-dental settings has been complicated by a lack of easily applicable and reliable screening tools which can be applied by non-dental professionals. The purpose of this study was to assess the diagnostic accuracy of a short seven-item tool developed by the German Society for Periodontology (DG PARO) to screen for periodontitis by means of patient-reported information. A total of 88 adult patients filled in the patient-reported Periodontitis Risk Score (pPRS; range: 0 points = lowest periodontitis risk; 20 points = very high periodontitis risk) questionnaire before dental check-up at Heidelberg University Hospital. Subsequent clinical assessments according to Periodontal Screening and Recording (PSR®) were compared with pPRS scores. The diagnostic accuracy of pPRS at different cutoff values was assessed according to sensitivity, specificity, positive, and negative predictive values, as well as Receiver-Operator-Characteristic curves, Area Under the Curve (AUC), and logistic regression analysis. According to combined specificity and sensitivity (AUC = 0.86; 95%-CI: 0.76–0.95), the diagnostic accuracy of the pPRS for detecting periodontal inflammation (PSR® ≥ 3) was highest for a pPRS cutoff distinguishing between pPRS scores < 7 vs. ≥7. Patients with pPRS scores ≥ 7 had a 36.09 (95%-CI: 9.82–132.61) times higher chance of having a PSR® ≥ 3 than patients with scores < 7. In conclusion, the pPRS may be considered an appropriately accurate stand-alone tool for the screening for periodontitis.

Highlights

Regular screening for periodontitis is important to delay dental impairments, such as tooth loss, and of particular importance for patients with other chronic diseases that may deteriorate due to the chronic inflammation caused by periodontitis
Periodontitis has been reported to be linked with chronic diseases, diabetes and cardiovascular diseases [1]
Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment [2,3,4,5]

Summary

Introduction

Regular screening for periodontitis is important to delay dental impairments, such as tooth loss, and of particular importance for patients with other chronic diseases that may deteriorate due to the chronic inflammation caused by periodontitis. Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment [2,3,4,5]. Propositions include the continuous activation of proinflammatory cytokines [8], subsequent dysregulation of the lipid metabolism [9], the induction of oxidative stress [10], or an adaptive immune response directed against periodontal pathogens [11]. Despite many efforts to improve preventive strategies, the global-, regional-, and country-level burden of periodontitis remains high [12,13,14]. Periodontitis has been described as a “silent disease” [15], which implies that patients in early stages (including bleeding, swelling, and tooth mobility) may not seek professional care before experiencing pain associated with more advanced stages of periodontitis. Precisely such patients at increased periodontitis risk tend to visit the dentist less frequently than other patients [16,17]

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