Periodontitis Prevalence, Severity, and Risk Factors: A Comparison of the AAP/CDC Case Definition and the EFP/AAP Classification.

Meliha Germen,Erhan Fıratlı,Cagdas Caglar Lacin,Ulku Baser,Funda Yalcin,Halim İşsever

doi:10.3390/ijerph18073459

Meliha Germen, Erhan Fıratlı + Show 4 more

Open Access

https://doi.org/10.3390/ijerph18073459

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Abstract

Background: This cross-sectional study evaluated the utility of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classifications of epidemiological studies in terms of periodontitis severity, prevalence and associated risk factors and the 2012 American Academy of Periodontology/Centers for Disease Control and Prevention (AAP/CDC) case definitions. Methods: We included 488 participants aged 35–74 years. Measurements were recorded at six sites per tooth by two qualified examiners. The evaluated parameters included pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP). Periodontitis prevalence and severity were reported using the 2018 EFP/AAP classification and the AAP/CDC case definitions. The data were stratified by recognized risk factors (age, diabetes and smoking status). Results: The 2018 EFP/AAP classification indicated that all patients suffered from periodontitis. When CAL served as the main criterion, the frequency of patients with severe (Stages III–IV) periodontitis was 54%. When the AAP/CDC case definitions were applied, the prevalence of periodontitis was 61.9% and that of severe periodontitis 16.8%. Age was the most significant risk factor, regardless of the chosen case definition. Conclusion: It is essential to employ a globalized standard case definition when monitoring periodontitis and associated risk factors.

Highlights

The European Association of Dental Public Health (2010) recommends the combined use of the Clinical Attachment Loss (CAL), Probing Depth (PD) and Bleeding on Probing (BOP) tests; these three key variables should be assessed in all future epidemiological studies on periodontal diseases [17]
Periodontitis Prevalence and Severity According to the AAP/CDC Case Definition
The prevalence of severe periodontitis was significantly lower in adults aged 35–44 years than in those aged 45–64 and

Summary

Introduction

A risk factor may be an environmental exposure, a behavioral trait or an inherent characteristic associated with a disease [2]. Risk factors play roles in both the initiation and progression of periodontal disease [7]. A rigorous analysis of evidence supposedly supporting the roles of various risk factors in terms of periodontitis prevalence and severity is very important when diagnosing and treating periodontal disease. The historical lack of a standard periodontitis definition facilitating surveillance precludes any meaningful comparisons of findings in terms of variations in socioeconomic status, ethnicity or exposure to risk factors. The lack of consistency in terms of both case definitions and clinical examination protocols, and differences in sample demographics, limit comparisons between our present findings and the literature data [15,16].

Results

Discussion

Conclusion