Abstract
BackgroundClinical (normative) and subjective (self-assessment) evaluation of caries and periodontal diseases have been reported to demonstrate a significant disparity. The dental public health team is obligated to recognize and understand this gap. The objectives of the study were to investigate the practical values of using questionnaires (self–perceived assessment) as compared to clinical examinations (normative assessment) and to evaluate the implications of the results in understanding the public's perception of oral health.MethodsThe investigation was performed on 4920, 21 year-old Israeli adults upon release from compulsory military service between 1996 and 1998. Participants were asked to fill in a questionnaire inquiring how they would rate their personal dental and periodontal health levels. Clinical examinations, employing the DMFT and CPITN indices, were performed to determine normative oral health status. Perceived and normative assessments were compared for sensitivity, specificity, positive and negative predictive values and overall proportions using the clinical examinations as a gold standard.ResultsThe sensitivity (disease perception) for dental status was found to be 0.34, while the specificity (health perception) was found to be 0.83. The positive predictive value for perceived dental status was found to be 0.68, whereas the negative predictive value was found to be 0.54. The sensitivity for perceived periodontal status was found to be 0.28, while the specificity was found to be 0.83. The positive predictive value for perceived periodontal status was found to be 0.05, whereas the negative predictive value was found to be 0.97. Regarding the overall proportions, a large discrepancy was found between self–assessment and professional assessment for both dental and periodontal health status.ConclusionsSelf-assessment questionnaires were of low value in evaluating oral health status both in the individual and public levels, though perception levels of health were higher than that of disease. Findings reflects a low level of awareness of the public that may influence care-seeking behavior and highlight the importance of oral health promotion and the crucial need for public health action.
Highlights
Clinical and subjective evaluation of caries and periodontal diseases have been reported to demonstrate a significant disparity
Studies comparing questionnaires and interviews with clinical examinations have demonstrated the efficacy of self–perceived assessment concerning the number of teeth and presence of dentures [4,5,6]
Dental status Four thousand, nine hundred and twenty participants responded to the question about the health status of their teeth
Summary
Clinical (normative) and subjective (self-assessment) evaluation of caries and periodontal diseases have been reported to demonstrate a significant disparity. The objectives of the study were to investigate the practical values of using questionnaires (self–perceived assessment) as compared to clinical examinations (normative assessment) and to evaluate the implications of the results in understanding the public's perception of oral health. In regard to the presence of dental caries, Robinson et al [2], compared questionnaire and clinical assessment, and the results yielded sensitivity and positive predictive values of 58%, and specificity and negative predictive values of 71%. They suggested that the use of questionnaires should be further investigated with reference to community rather than individual aspects
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