Basic Periodontal Examination Research Articles

Evaluation of the Faecal Occult Blood Test as a Screening Tool for Periodontal Disease: A Case-Control Study.

To assess the feasibility of using a faecal occult blood test (FOBT) kit as a screening tool for periodontal disease. Additionally, the study aimed to evaluate the test's sensitivity and specificity while exploring the influence of factors like age, sex and the number of teeth on its performance. A prospective observational case-control study involving 150 participants divided into three groups on the basis of the basic periodontal examination index: healthy (n = 21), gingivitis (n = 52) and periodontitis (n = 77). Salivary occult blood tests were conducted using the Onsite FOB-Hi Rapid Test. Descriptive and analytical statistical analyses were performed using Fisher's exact test and chi-square tests. The FOBT kit demonstrated a sensitivity of 91% and a specificity of 100%. The number of teeth significantly influenced test results (p value = 0.021, chi-square). Age (p value = 0.09, chi-square) and sex (p value = 0.213, chi-square) did not significantly impact the test's performance. The FOBT kit demonstrates high sensitivity (91.3%) and specificity (100%) as a screening tool for periodontal disease. Its affordability and global availability make it suitable for detecting periodontal disease across different age groups, sexes and numbers of teeth.

IMPACT OF AGING AND STRESS ON THE PERIODONTAL HEALTH OF THE GERIATRIC POPULATION BEFORE AND AFTER PERIODONTAL TREATMENT IN OLD HOMES OF KARACHI, PAKISTAN

Age and stress-related periodontal diseases are prevalent in the geriatric population and continue to provide a significant epidemiological concern. Objective: To assess the impact of ageing and stress on the periodontal health of the senior population before and after periodontal treatment Method: A cross-sectional study was conducted between February and October 2023. Twenty-two senior patients aged 55 to 77 were selected through purposeful random sampling, excluding those unwilling or unable to participate. A semi-structured questionnaire, translated into the native language, assessed periodontal health using the Basic Periodontal Examination (BPE). Informed consent was obtained from participants, who were assured confidentiality and the right to withdraw. Data analysis was performed using SPSS version 23, employing mean and standard deviation for continuous data and frequency tables for categorized data. Cross-tabulation and significance testing were utilized to demonstrate associations. Results: The results of the prevailing cross-sectional study reveal that there exists an association between moderate to elevated levels of perceived stress and the manifestation of severe instances of periodontal disease. As per the study findings, periodontitis tends to afflict individuals across older adult age demographics. Conclusion: The study emphasised that stress and ageing are key risk factors for periodontal diseases, underlining the importance of addressing them during therapy. Consistent oral hygiene can prevent periodontitis in older adults.

Impact of Non-surgical Periodontal Therapy on Oral Health-related Quality of Life amongst Primary Dental Care Patients: A Prospective Cohort Study

Abstract Aim: The aim of this study was to determine the impact of non-surgical periodontal therapy (NSPT) on oral health-related quality of life (OHRQoL) of a selected group of the Malaysian population at the primary dental care setting. Participants and Methods: This study was conducted from year 2021 to 2022. Patients attending four government dental clinics in Kinta district were included in the study after basic periodontal examination was conducted. The sample size was calculated using the NCSS PASS 11 power analysis and sample size, and a final sample size of 94 was used. A short version of the Malaysian Oral Health Impact Profile (S-OHIP[M]) questionnaire was given as a baseline before the intervention. NSPT was provided in a single session or by a quadrant approach. Patients were then called for review after 6 weeks during when they were required to complete the S-OHIP(M) questionnaire again. All data were then entered and analysed using SPSS version 26.0. Results: The prevalence of impact decreased significantly post-treatment (n [%] pre vs. post: 91 [96.8%] vs. 70 [74.5%]; P < 0.001). A significant decrease was observed in the severity of impact (additive score) (median [interquartile range (IQR)] pre vs. post: 8.5 [5.0–15.0] vs. 2.0 [0.0–6.0]; P < 0.001) and extend of impact (simple count score) (median [IQR] pre vs. post: 0.5 [0.0–2.0] vs. 0.0 [0.0–0.0]; P < 0.001) post-treatment compared to pre-treatment too. Conclusion: The OHRQoL status amongst gingivitis and mild-to-moderate periodontitis patients in primary care has improved after treatment.

Evaluation of Periodontal Status and Serum C-Reactive Protein Levels in Adult Cigarette Smokers

Background: This study aimed to evaluate the periodontal status of adult smokers and assess their serum C-reactive protein (CRP) levels, hypothesizing an association between periodontal inflammation, smoking, and elevated serum CRP, a marker for cardiovascular diseases. The primary objective is to contribute to the assessment and prevention of potential cardiovascular diseases in adult smokers. Methods: This cross-sectional study was conducted at HIT Hospital and Dental Hospital HITEC-IMS Taxila Cantt over five months from October 20, 2021, to March 31, 2022, the study included 60 healthy male adult smokers and 20 healthy male non-smokers as a control. Basic periodontal examination involved the use of a periodontal probe, assessing parameters such as gingival index, bleeding on probing, oral pigmentation, presence of periodontal pockets, and gingival recession. Blood samples were collected to evaluate serum CRP levels. Results: Smokers exhibited higher rates of gingival recession (38.3%), gingival pigmentation (43.3%), and periodontal pocket formation (33.3%) compared to the nonsmokers control group, with significant p-values of 0.040 in gingival recession and 0.035 in the presence of periodontal pockets. Serum CRP levels were significantly elevated in adult smokers, with a significant p-value of 0.024. Conclusion: The study concluded that adult smokers show signs of periodontitis, and their serum CRP levels are elevated. Assessing periodontal status and serum CRP in adult smokers may aid in risk assessment and reducing the likelihood of developing future cardiovascular diseases.

Type 1 Diabetes Mellitus Patients' Self-perception of Periodontal Diseases.

The study aimed to evaluate type 1 diabetes mellitus (T1DM) patients' self-perceived periodontal health status and to identify the association between periodontal disease (PD) and DM. This cross-sectional study included 113 T1DM children between 3 and 18 years old from the Universiti Teknologi MARA and the University of Malaya. Periodontal health parameters, including plaque index, gingival index, probing pocket depth, simplified basic periodontal examination, and clinical attachment loss, were recorded. Self-perceived periodontal health status was assessed with questionnaires. Statistical analysis was performed to evaluate the sensitivity of the questionnaire and the relationship between T1DM and periodontal parameters. The median age was 11.4 years. Half of them (50.4%) were females. A total of 83.5% rated their oral condition as good, whereas 27.5% reported a history of gingival bleeding. Clinical examination revealed that 48.7% had healthy gingiva, whereas 47.8% had gingivitis. The question "Do you have bleeding when brushing, flossing, or eating food?" showed good accuracy in the evaluation of PD (p < 0.001). The questionnaire has a high potential to be used by medical professionals in identifying T1DM patients at risk of PD to guide nondental health care providers in making appropriate referrals to dental services.

Salivary lactate dehydrogenase and salivary total protein as potential biomarkers for screening periodontal disease

BackgroundTimely diagnosis of periodontal disease is crucial for restoring healthy periodontal tissue and improving patients' prognosis. There is a growing interest in using salivary biomarkers as a noninvasive screening tool for periodontal disease. This study aimed to investigate the diagnostic efficacy of two salivary biomarkers, lactate dehydrogenase (LDH) and total protein, for periodontal disease by assessing their sensitivity in relation to clinical periodontal parameters. Furthermore, the study aimed to explore the impact of systemic disease, age, and sex on the accuracy of these biomarkers in the diagnosis of periodontal health. Materials and methodsA total of 145 participants were categorized into three groups based on their basic periodontal examination index, with 20 in the periodontally healthy group, 50 in the gingivitis group, and 75 in the periodontitis group. Salivary LDH was measured using the rate of nicotinamide adenine dinucleotide (NADH) oxidation, to measure the kinetics of LDH activity, while total protein was measured using the Lowry method. Descriptive and analytical statistical analyses were performed to examine the associations between the variables and biomarkers. ResultsThe results of the study demonstrated that salivary LDH was 72% sensitive, while salivary total protein was 78% sensitive in correlation to clinical periodontal parameters. The accuracy of the test was not influenced by sex, but age had a significant effect on both biomarkers, particularly LDH. Systemic disease was another factor that significantly affected the accuracy of the test. ConclusionsAlthough salivary LDH and total protein show promise as biomarkers for screening periodontal disease, their interpretation may be impacted by age and systemic disease. To enhance the accuracy of periodontal disease detection, the study suggests combining these biomarkers with more specific indicators and diagnostic tools.

Prevalence of Gingival Inflammation among Patients Taking Antipsychotic Drugs

Objective: To explore the prevalence and severity of gingival inflammation among the patients taking antipsychotic drugs. Method: This cross-sectional study was conducted in OPD of a psychiatric department of a tertiary care hospital in Lahore, Pakistan. Sample of 1025 patients was taken with the history of antipsychotic drugs. Patients were examined for the prevalence and severity of gingival inflammation and periodontal disease using modified gingival index (MGI) and basic periodontal examination (BPE). Study was conducted from March to August 2022. Data will be entered in SPSS version 25.0. Descriptive statistics, i.e. frequency and percentage were calculated for categorical data. Results: A total number 1025 patients with history of antipsychotic drugs were examined, 873 of them had some degree of gingival inflammation. Out of 873 patients with gingival disease, 536 (61.39%) patients exhibited mild to moderate inflammation whereas periodontal status of 337 (38.60%) patients presented severe inflammation. Basic periodontal examination was performed on individuals exhibiting severe gingival inflammation and patients were guided regarding further treatment that was needed to improve periodontal health. Conclusion: The findings of current study revealed that patients who are on anti-psychotic drugs are at higher risk of developing gingival diseases due to reduced salivary flow and need advanced treatment for their periodontal condition. Keywords: Psychosis, gingival diseases, Dental caries, Self-esteem

Validation of a Simplified Digital Periodontal Health Screening Module for General Dental Practitioners.

As a silent disease, individuals at risk of periodontitis are not easily identified until the disease has become severe. Early detection at the community level is essential, especially for general dental practitioners. The aim of this study was to design a comprehensive, user-friendly tool to screen patients’ periodontal health at community level and to evaluate users’ acceptance of its use. The periodontal health screening module was first developed by an expert panel of periodontists, public health specialists and general dentists. The developed module was tested for content acceptance on 156 graduating dental students from three public schools and later validated by 12 private general dental practitioners (GDPs) for reliability. Most of the students (64.1%) found the new module an easy assessment tool for periodontal health compared to the Basic Periodontal Examination (BPE). Most claimed that they understand the contents (80.8%) and accepted the designs (86.6%) and agreed (82.7%) that the new assessment module would allow them to screen patients anytime in the clinic. The interrater reliability as assessed between the GDPs and the investigators revealed acceptable agreement ranging from 62.5–100.0% (mean 89.6 ± 10.2%). The simplified digital periodontal health screening module showed promising acceptance for application in private general dental clinics.

Prevalence of Periodontitis in Erectile Dysfunction Patients

Erectile dysfunction (ED) and periodontitis have common risk factors, such as diabetes mellitus and tobacco smoking. Multiple reports are available in regard to the association between ED and chronic periodontitis (CP). The study aimed to determine the association of ED and CP in selected Malaysian population. In this study, 74 patients (mean age = 52.4 ± 10.9 years old) diagnosed with ED, from scores via the International Index of Erectile Function (IIEF-5) questionnaire, were included. ED severity was classified as mild, mild to moderate, moderate, and severe. Periodontal condition was recorded using basic periodontal examination (BPE) method, of which scores of 0, 1, 2, and 3 were associated with having no periodontitis while a score of 4 was considered to have periodontitis. There are 40 (54.1%) subjects found to have periodontitis and the association of ED and periodontitis showed a moderate positive degree of correlation, ρ = 0.487 (p &lt; 0.001). The percentage of subjects having periodontitis indicated an increasing trend with the severity of ED; from 19.0% (mild ED), 54.2% (mild to moderate ED), 75.0% (moderate ED), to 84.6% (severe ED). A greater degree of correlation was noted between dental scaling experience and ED, ρ = 0.635 (p &lt; 0.001). Binomial logistic regression had shown no other co-morbidities and factors were affecting this relation. There seemed to be an association between ED and periodontitis existing in these selected Malaysian populations.

The Evidence-based Periodontal Risk Assessment (PRA) Tool for Nonsurgical Periodontal Therapy in a Comprehensive Periodontal Management by Risk Assessment (PEMBRA)

In the management of periodontitis patients, periodontal risk assessment (PRA) tool is currently being applied during periodontal review (PR). However, an assessment of risk profiles during examination and diagnosis (E&amp;D) may and would effectively assess and diagnose patients’ periodontal conditions, provide personalised treatment planning, and render an enhanced patient care through periodontal management by risk assessment (PEMBRA). From a retrospective study on selected records of 81 patients treated for chronic periodontitis, the PRA profiles of the patients were evaluated during E&amp;D and two to three months after completion of nonsurgical periodontal therapy (NSPT) during PR. The results were analysed using SPSS version 24 for descriptive statistics. On E&amp;D, the patients presented with 25.9% localised and 74.1% generalised chronic periodontitis. Of these, 2.5% of low-risk patients on E&amp;D increased to 21% during PR signifying an improvement after the treatment. However, the medium-risk patients have a slight increase from 32% to 35%, and patients with a high risk of 62% were reduced to 43%. The improvement of the risk profiles for both low and high-risk groups was mostly contributed by the reduction in the plaque score, percentages of bleeding on probing (BOP), and probing pocket depth (PPD) ≥ 5 mm. This evidence-based evaluation of PRA tool during E&amp;D and PR is important for PEMBRA as it encouraged the clinicians to adopt periodontal management through basic periodontal examination, detailed periodontal charting, radiographic interpretation, tooth per tooth prognosis, diagnosis, and targeted NSPT.

Correlation of Salivary Occult Blood with the Plasma Concentration of Branched-Chain Amino Acids: A Cross-Sectional Study.

Background: Plasma branched-chain amino acids (BCAA) levels are predictors of glycometabolic disorders, leading to diabetes. Microbes, including periodontal pathogens, are thought to be associated with elevated plasma BCAA levels. This study aimed to evaluate the relationship between salivary occult blood (SOB) and plasma BCAA levels in middle-aged Japanese individuals. Methods: Sixty-four Japanese individuals aged ≥ 40 years were recruited for this study, which was conducted in Fukuoka Prefecture, Japan, from August to December 2021. Individuals diagnosed with and/or treated for diabetes were excluded from the study. The body mass index (BMI); plasma concentrations of total, high-density, and low-density lipoprotein cholesterol; triglyceride, glucose, and BCAA; and glycosylated hemoglobin ratio were measured. A basic periodontal examination was performed after the SOB test. Results: The median age of participants (men—20; women—44) was 55 (range, 41–78) years. The plasma BCAA concentration in the SOB-positive group (477 [400–658] μmol/L) was higher than that in the SOB-negative group (432 [307–665] μmol/L). Linear regression analysis revealed that SOB remained independently associated with the plasma BCAA level with statistical significance (β = 0.17, p = 0.02) after adjusting for sex, age, and BMI. Conclusions: SOB was positively correlated with plasma BCAA levels in middle-aged Japanese individuals. Thus, SOB may be a predictor of elevated plasma BCAA levels.

Effectiveness and Efficacy of Thermoformed and 3D Printed Aligners in Correcting Malocclusion (Spacing) and Its Impact on Periodontal Oral Health and Oral Microbiome: A Double-Blinded Parallel Randomized Controlled Multicenter Clinical Trial.

Aligners are the common devices used in orthodontics for the correction of malocclusion. Various materials and techniques are employed to fabricate aligners. One of those includes thermoformed and 3D aligners. These aligners can be worn for several days, and their impact on periodontal health is not known. Therefore, the aim of our protocol is to determine the effectiveness of these aligners in correcting malocclusion and their impact on periodontal health and oral microbiome. A double-blinded randomized controlled clinical trial with a total of n = 60 patients will be included with n = 30 in each group (Test: 3D printed aligners and Control: Thermoformed). The evaluation of oral health indices such as basic periodontal examination (BPE), periodontal screening and recording (PSR) that provide the status of periodontal health will be recorded. The oral microbiome assessment will be conducted with polymerase chain reaction (PCR). The primary endpoint will be the correction of malocclusion, and the secondary end point will be the status of periodontal health and oral microbiome. The duration of follow-up for each group will be 7 days for periodontal health and oral microbiome and 6 months for the space closure of 5 mm by 3D and thermoformed aligners.

The Importance of Periodontal Screening in Paediatric Patients

Detecting dental caries may often be at the forefront of the clinician's mind when examining paediatric patients. However, a range of periodontal abnormalities can also present in the paediatric population. It is essential that this cohort is appropriately assessed for periodontal disease during each clinical examination. Detecting such abnormalities early may enable timely access to the appropriate treatment, which could in turn improve clinical outcomes. This article highlights the importance of screening paediatric patients using the simplified Basic Periodontal Examination as per recommended guidelines. CPD/Clinical Relevance: Vigilance is required when screening paediatric patients for periodontal conditions to enable early detection and disease management, which may in turn improve clinical outcomes.

Застосування лікувально-профілактичного комплексу при карієсі та гінгівіті у дітей шкільного віку

Актуальність. Єдність найбільш значущих патогенетичних механізмів розвитку карієсу та захворювань тканин пародонту обґрунтовує сучасну концепцію профілактики цих захворювань, що включає розробку лікувально-профілактичних програм з урахуванням клінічних особливостей поєднаного перебігу карієсу та захворювань пародонту в дітей та основних патогенетичних механізмів розвитку цих захворювань. Мета дослідження: оцінити вплив розробленого лікувально-профілактичного комплексу в дітей шкільного віку при поєднаному перебігу карієсу та хронічного катарального гінгівіту з урахуванням основних патогенетичних механізмів розвитку цих захворювань. Матеріали та методи. Клінічні дослідження проводили за участю 138 дітей віком від 7 до 10 років, у яких визначали індекс кп + КПУ, приріст інтенсивності карієсу зубів, редукцію та карієспрофілактичний ефект, ТЕР-тест, індекс Greenn — Wermillion, спрощений індекс зубного нальоту О’Leary, індекс ефективності гігієни порожнини рота (РНР), індекс РМА, Basic Periodontal Examination-Simplified (BPES) перед проведенням лікувально-профілактичного комплексу (ЛПК) та через 18 місяців після його триразового застосування. Результати. Результати клінічного дослідження показали, що при позитивній динаміці клінічних показників у дітей всіх досліджуваних груп, у підгрупах, де ми застосовували розроблений і запропонований ЛПК, ми визначили добрий стан гігієни порожнини рота (0,37 ± 0,03; 0,46 ± 0,04) та добру ефективність проведення гігієнічних заходів (0,58 ± 0,05; 0,60 ± 0,03); низький рівень приросту інтенсивності карієсу (0,11–0,18) із редукцією 67,27–80,70 % при карієспрофілактичній ефективності 66,53–76,79 % на відміну від контрольних груп дітей, в яких рівень приросту інтенсивності карієсу становив 0,35–0,57, гігієнічний стан порожнини рота залишився на задовільному рівні. Серед дітей із хронічним катаральним гінгівітом повне усунення основних клінічних ознак запалення з подальшою довготривалою ремісією при застосуванні ЛПК ми спостерігали в більшому відсотку випадків на відміну від дітей, при лікуванні яких використовували стандартні підходи. Висновки. Отримані результати клінічних досліджень, а саме запобігання подальшому розвитку карієсу та усунення основних клінічних проявів запалення ясен із тривалою ремісією, свідчать про позитивний вплив та ефективність розробленого ЛПК.

The importance of the Basic Periodontal Examination for paediatric orthodontic patients.

Periodontal disease is considered to increase in prevalence around adolescence, owing to pubertal hormonal changes, early presentation in at-risk individuals and the challenges in maintaining patient motivation at this age. Adolescence provides the ideal stage of dental development for orthodontic assessment. Active periodontal disease can increase tooth mobility during orthodontic treatment. Therefore, it is essential that children and adolescents have appropriate and timely periodontal screening before commencing orthodontic treatment. The British Society of Periodontology and the British Society of Paediatric Dentistry recommend a modified Basic Periodontal Examination (BPE) assessing index teeth for paediatric patients.This paper will summarise the recommended paediatric periodontal assessment and review a case which highlights the need for routine periodontal examination of orthodontic patients, by both general dental practitioners and orthodontists, to identify patients at risk for periodontal disease. The modified BPE for this younger cohort is simple and allows for rapid screening of periodontal disease. Where it is needed, further detailed examination and treatment can then be initiated to prevent exacerbation of an existing problem.

Gestational Diabetes and Periodontal Disease in Trinidad – A pilot study

Objective To determine the prevalence of periodontitis in patients with and without gestational diabetes in Trinidad. Methods A convenience sample was obtained from antenatal clinic collaborating sites; patients were invited to undergo oral examinations at the School of Dentistry. The basic periodontal examination (BPE) assessed the periodontal disease status in all patients, the examiner was blinded to the GD status. Results There were 65 women who participated in the study, of which 13 had gestational diabetes and 52 did not. The mean age was 34.32 years and 43.1% and 35.4% of participants were Afro-Trinidadian and Indo-Trinidadian respectively. Reversible stages of periodontal disease were present in most participants (63.1%). Signs of severe periodontal disease (BPE scores 3 and 4) were more prevalent in the non-GD group and the Afro-Trinidadian group. Conclusion These data provide the first insight into the periodontal status of patients with and without gestational diabetes. The non-GD group showed a higher prevalence of severe periodontal disease compared to the group with GD.

The importance of periodontal screening in children. A case report

The British Society of Periodontology, in collaboration with the British Society of Paediatric Dentistry, published guidelines in 2012 for the periodontal screening of children and adolescents. The guidelines recommended a simplified Basic Periodontal Examination (BPE) of six teeth for children aged 7–17 years. This is further modified for ages 7–11, using codes 0–2 from the 0–4 BPE adult chart. An unusual case of an 11-year-old boy who attended his general dental practitioner for a check-up is reported. Periodontal screening led to the detection of 13-mm pockets associated with the two mandibular first permanent molars that required surgical intervention and multidisciplinary care. CPD/Clinical Relevance: This case report highlights the importance of paediatric periodontal screening in both primary and secondary care.

Oral Diseases and Quality of Life between Obese and Normal Weight Adolescents: A Two-Year Observational Study.

This study aimed to investigate the association between oral disease burden and oral health related quality of life (OHRQoL) among overweight/obese (OW/OB) and normal weight (NW) Malaysian adolescents. A total of 397 adolescents were involved in the two-year prospective observational cohort study. OHRQOL was measured through a self-administered questionnaire containing the short version of the Malaysian Oral Health Impact Profile (OHIP[M]). Body mass index (BMI) was used for anthropometric measurement. Whilst, decayed, missing, and filled teeth (DMFT) index, Significant Caries Index (SiC), simplified basic periodontal examination (S-BPE), and gingival bleeding index (GBI) were used for clinical assessment tools. Higher dental caries prevalence was observed in the NW group while higher SiC was reported in the OW/OB group. Regardless of the obesity status, the prevalence of gingivitis (BPE code 1 and 2) was high in this study. A reduction of GBI prevalence was observed in the two-year follow-up results with an increased prevalence of OHRQoL impact in the OW/OB group compared to the NW group (p > 0.05). The findings from this study suggested that obesity status did not have influence over the burden of oral diseases and OHRQoL. It offers insights referring to the changes in adolescents’ oral diseases burden and OHRQoL.

Use of the sociodental approach in estimating orthodontic treatment needs in adolescent patients.

The sociodental model integrates clinical assessment, perceived impacts of malocclusion on quality of life, and behavioural propensity when prioritising orthodontic treatment. This study compares the effect of using different instruments to measure impact-related need on the assessment of orthodontic treatment need based on the sociodental framework. In this cross-sectional study, 206 Malaysian adolescents (age: 11-18 years) were screened in orthodontic clinics to identify those with normative need, oral impacts due to malocclusion, and having high and medium-to-high behavioural propensities. The Index of Orthodontic Treatment Need classified normative need. The Psychosocial Impact of Dental Aesthetics (PIDA) questionnaire and the Condition-Specific Child-Oral Impacts on Daily Performances (CS-OIDP) index measured oral impacts. Subjects' behavioural propensities for successful treatment outcome were based on the Basic Periodontal Examination and International Caries Detection and Assessment System. Data were analysed using the McNemar test. The response rate was 99.0%. Estimates of normative need (89.7%) were significantly reduced under the sociodental model by 65.7% (p < 0.0001) when impact-related need was measured using PIDA, and by 41.7% (p < 0.0001) when measured using CS-OIDP. The difference between the results of the two instruments in proportions of identified need for orthodontic treatment was 24.0% (p < 0.0001). For Malaysian adolescents, estimates of need for orthodontic treatment when assessed with the sociodental approach were substantially lower than normative clinical assessment and depended highly on the tools selected to assess the patient's impact-related need. Health policy makers should understand the implication of adopting one instrument or the other when estimating orthodontic treatment need.

Standard of periodontal examination and evaluation during oral diagnosis and treatment

Report of the fourth national oral health survey showed that the prevalence of gingivitis and periodontitis stayed at a high level in Chinese population and the periodontitis was the most common cause of tooth loss in Chinese adults. Therefore, the examination of periodontal health status, disease condition and risk assessment are particularly important. The Society of Periodontology of the Chinese Stomatological Association organized experts of related disciplines to formulate the standard of basic periodontal examination and evaluation during oral diagnosis and treatment, aiming to emphasize the necessity and importance of periodontal health and to improve dental clinicians' abilities in understanding, diagnosis and treatment planning of periodontal disease. As a national and professional standard, it will play an important and practically significant role in conservation of natural teeth and improvement of people's oral health in China.