Self-Reported Measures of Periodontitis in a Portuguese Population: A Validation Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Self-Reported Questions
2.3. Study Design and Participants
2.4. Periodontal Examination and Periodontitis Case Definition
- Periodontitis case: Interdental CAL at ≥2 non-adjacent teeth, or buccal/oral CAL ≥ 3 mm with pocketing > 3 mm at ≥2 teeth;
- Severe periodontitis: interdental CAL at site of greatest loss of ≥5 mm; or, radiographic bone loss extending to mid-third of root and beyond.
- Periodontitis (using the mild definition as cutoff): ≥2 interproximal sites with CAL ≥ 3 mm, and ≥2 interproximal sites with PPD ≥ 4 mm (not on same tooth) or one site with PD ≥ 5 mm;
- Severe periodontitis: ≥2 interproximal sites with CAL ≥ 6 mm (not on the same tooth) and ≥1 interproximal site with PPD ≥ 5 mm.
2.5. Statistical Analysis
3. Results
3.1. Participants’ Characteristics
3.2. Predictive Ability of the Self-Reported Questions
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Original Question | Translated Question in Portuguese | Question Variable | Reference |
---|---|---|---|
Do you think you might have gum disease? Yes|No|Don’t know|Refused | Acha que pode ter doença das gengivas? Sim|Não|Não Sei|Recuso-me a responder | Gum disease | Eke et al. (2013) [8] |
Overall, how would you rate the health of your teeth and gums? Excellent/Very good/Good/Fair/Poor/Don’t know/Refused | No geral, como classificaria a saúde de seus dentes e gengivas? Excelente|Muito boa|Boa|Razoável|Fraca|Não Sei|Recuso-me a responder | Teeth/gum health | Eke et al. (2013) [8] |
Have you ever had treatment for gum disease, such as scaling and root planning, sometimes called “deep” cleaning? Yes|No|Don’t know|Refused | Alguma vez recebeu tratamento para a doença das gengivas tal como alisamento ou raspagem radicular, por vezes chamada limpeza profunda? Sim|Não|Não Sei|Recuso-me a responder | Had gum treatment | Eke et al. (2013) [8] |
Have you ever had any teeth become loose on their own, without an injury? Yes|No|Don’t know|Refused | Já teve algum dente que começou a abanar por si só, sem nenhum trauma ou lesão? Sim|Não|Não Sei|Recuso-me a responder | Loose tooth | Eke et al. (2013) [8] |
Have you ever been told by a dental professional that you lost bone around your teeth? Yes|No|Don’t know|Refused | Já algum profissional dentário lhe disse que tinha perdido osso ao redor dos dentes? Sim|Não|Não Sei|Recuso-me a responder | Lost bone | Eke et al. (2013) [8] |
During the past 3 months have you noticed a tooth that doesn’t look right? Yes|No|Don’t know|Refused | Nos últimos 3 meses, reparou se algum dente não tenha estado bem? Sim|Não|Não Sei|Recuso-me a responder | Tooth does not look right | Eke et al. (2013) [8] |
Aside from brushing your teeth with a toothbrush, in the last 7 days, how many times did you use dental floss or any other device to clean between your teeth? _______ Number|Refused | Além de escovar os dentes com escova de dentes, nos últimos sete dias, quantas vezes usou fio dentário ou qualquer outro dispositivo para limpar a região entre os dentes? _______ Número|Recuso-me a responder | Floss use | Eke et al. (2013) [8] |
Do your gums usually bleed either when brushing or chewing? Yes|No|Don’t know|Refused | Sangra habitualmente das gengivas sem escovar ou mastigar? Sim|Não|Não Sei|Recuso-me a responder | Gum bleeding | Saka-Herrán et al. (2020) [13] |
During the past three months, have you had bleeding gums? Never|Hardly ever|Sometimes|Fairly often|Very often | Nos últimos 3 meses, sangrou das gengivas? Nunca|Quase nunca|Ás vezes|Com bastante frequência|Muitas vezes | Gum bleeding last 3 months | Iwasaki et al. (2021) [17] |
Have you lost teeth in recent years because of mobility? Yes|No|Don’t know|Refused | Perdeu algum dente nos últimos anos por ter começado a abanar? Sim|Não|Não Sei|Recuso-me a responder | Loose teeth loss | Saka-Herrán et al. (2020) [13] |
Have you felt pain in your gums during the last months? Yes|No|Don’t know|Refused | Nos últimos meses, doeram-lhe as suas gengivas? Sim|Não|Não Sei|Recuso-me a responder | Gum pain | Saka-Herrán et al. (2020) [13] |
In the past years have you noticed that your teeth are longer or that you have receding gums? Yes|No|Don’t know|Refused | Nos últimos meses, notou que os seus dentes estão maiores e as gengivas mais retraídas do que o normal? Sim|Não|Não Sei|Recuso-me a responder | Gum retraction | Saka-Herrán et al. (2020) [13] |
In the last years have you noticed that you see the roots of several of your teeth? Yes|No|Don’t know|Refused | Nos últimos meses, notou que se vêem as raízes dos seus dentes? Sim|Não|Não Sei|Recuso-me a responder | Roots visible | Saka-Herrán et al. (2020) [13] |
Variable | Total (n = 103) | EFP/AAP 2018 Periodontitis (n = 63) | EFP/AAP 2018 Severe Periodontitis (n = 39) | CDC/AAP 2012 Periodontitis (n = 71) | CDC/AAP 2012 Severe Periodontitis (n = 56) |
---|---|---|---|---|---|
Age | 50.6 (16.0) | 56.3 (13.2) | 59.2 (11.5) | 54.7 (13.9) | 58.3 (11.7) |
Sex | |||||
Female | 58 (56.3) | 31 (49.2) | 17 (43.6) | 38 (53.5) | 25 (44.6) |
Male | 45 (43.7) | 32 (50.8) | 22 (56.4) | 33 (46.5) | 31 (55.4) |
Education level | |||||
Elementary | 32 (31.1) | 27 (42.9) | 16 (41.0) | 27 (38.0) | 24 (42.9) |
Middle | 39 (37.9) | 20 (31.7) | 12 (30.8) | 25 (35.2) | 18 (32.1) |
Higher | 32 (31.1) | 16 (25.4) | 11 (28.2) | 19 (26.8) | 14 (25.0) |
Smoking habits | |||||
Non-smoker | 63 (61.2) | 33 (52.4) | 20 (51.3) | 38 (53.5) | 27 (48.2) |
Former smoker | 13 (12.6) | 11 (17.5) | 7 (17.9) | 12 (16.9) | 11 (19.6) |
Current smoker | 27 (26.2) | 19 (30.2) | 12 (30.8) | 21 (29.6) | 18 (32.1) |
Tooth loss | |||||
0 | 21 (20.4) | 4 (6.3.0) | 0 (0.0) | 5 (7.0) | 2 (3.6) |
1–5 | 36 (35.0) | 19 (30.2) | 12 (30.8) | 24 (33.8) | 16 (28.6) |
≥6 | 46 (44.7) | 40 (63.5) | 27 (69.2) | 42 (59.2) | 38 (67.9) |
Toothbrushing per day | |||||
1 | 14 (13.6) | 12 (19.0) | 5 (12.8) | 12 (16.9) | 11 (19.6) |
2 | 57 (55.3) | 34 (54.0) | 20 (51.3) | 38 (53.5) | 30 (53.6) |
3 or more | 32 (31.1) | 17 (27.0) | 14 (35.9) | 21 (29.6) | 15 (26.8) |
Question | Adjusted OR (Standard Error) a | |||
---|---|---|---|---|
EFP/AAP 2018 Periodontitis (n = 63) | EFP/AAP 2018 Severe Periodontitis (n = 39) | CDC/AAP 2012 Periodontitis (n = 71) | CDC/AAP 2012 Severe Periodontitis (n = 56) | |
Gum disease | 53.0 (8.5–330.9) *** | 4.3 (1.8–10.1) *** | 30.0 (5.8–156.0) *** | 14.7 (3.7–58.1) *** |
Teeth/gum health | 7.7 (0.1–508.0) | - | 109.8 (10.7–1126.8) *** | - |
Had gum treatment | 12.4 (2.4–63.2) ** | 1.9 (0.8–4.5) ** | 20.3 (2.4–171.8) ** | 6.2 (1.8–21.6) ** |
Loose tooth | 13.6 (2.7–69.2) ** | 6.9 (2.8–17.1) *** | 8.4 (2.4–30.1) * | 5.6 (1.7–18.0) ** |
Lost bone | 12.4 (2.9–54.1) *** | 7.1 (2.9–17.4) *** | - | 18.3 (4.3–77.9) *** |
Tooth does not look right | 4.4 (1.4–13.8) ** | 5.2 (2.1–12.8) | 0.7 (0.3–1.7) * | 2.9 (1.0–8.2) * |
Floss use | 1.3 (0.4–3.7) | 0.7 (0.3–1.5) | 1.8 (1.1–3.1) | 1.9 (0.6–5.7) |
Gum bleeding | 6.2 (1.8–21.4) ** | 1.5 (0.7–3.3) | 2.7 (0.9–7.7) | 2.7 (0.9–8.1) |
Gum bleeding last 3 months | 6.0 (0.3–107.9) | 2.9 (1.0–8.3) | - | 2.6 (0.6–11.8) |
Loose tooth loss | 31.5 (1.8–561.8) * | 3.9 (1.5–10.5) ** | 11.0 (1.1–111.9) * | 7.3 (1.2–44.6) * |
Gum pain | 6.3 (1.4–27.9) * | 1.2 (0.5–3.1) | 2.8 (0.8–9.5) | 2.3 (0.7–7.9) |
Gum retraction | 3.0 (0.9–9.9) | 4.6 (1.9–11.0) *** | 12.5 (2.5–63.3) ** | 3.7 (1.1–11.9) * |
Roots visible | 2.7 (0.8–9.2) | 4.1 (1.7–10.0) ** | 9.3 (1.8–47.7) ** | 2.6 (0.8–8.4) |
EFP/AAP 2018 Periodontitis (Models) | EFP/AAP 2018 Severe Periodontitis (Models) | |||||||
---|---|---|---|---|---|---|---|---|
Question | 1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 |
Gum disease | X | X | X | X | X | X | ||
Teeth/gum health | X | X | X | X | ||||
Had gum treatment | X | X | X | X | X | |||
Loose tooth | X | X | X | X | ||||
Lost bone | X | X | X | X | X | X | ||
Tooth does not look right | X | X | X | X | ||||
Floss use | X | X | X | X | ||||
Gum bleeding | X | X | X | X | ||||
Gum bleeding last 3 months | X | X | X | X | ||||
Loose tooth loss | X | X | X | X | ||||
Gum pain | X | X | X | X | ||||
Gum retraction | X | X | X | X | ||||
Roots visible | X | X | X | X | ||||
Age | X | X | X | X | ||||
Sex | X | X | X | X | ||||
Education | X | X | X | X | ||||
Employment status | X | X | X | X | ||||
Smoking habits | X | X | X | X | ||||
AUC | 0.58 | 0.49 | 0.50 | 0.86 | 0.55 | 0.50 | 0.50 | 0.71 |
Sensitivity (%) | 100.0 | 0.98 | 100.0 | 88.9 | 100.0 | 100.0 | 100.0 | 79.5 |
Specificity (%) | 15.4 | 0.0 | 0.0 | 82.5 | 9.4 | 0.0 | 0.0 | 62.5 |
Accuracy (%) | 67.6 | 61.2 | 60.2 | 86.4 | 43.7 | 37.9 | 37.9 | 68.9 |
Precision (%) | 65.6 | 61.2 | 60.8 | 88.9 | 40.2 | 37.9 | 37.9 | 66.0 |
AIC | 78.3 | 113.1 | 75.8 | 87.0 | 116.2 | 119.8 | 130.1 | 117.8 |
EFP/AAP 2018 Periodontitis (Models) | EFP/AAP 2018 Severe Periodontitis (Models) | |||||||
---|---|---|---|---|---|---|---|---|
Question | 1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 |
Gum disease | X | X | X | X | X | X | ||
Teeth/gum health | X | X | X | X | ||||
Had gum treatment | X | X | X | X | X | X | ||
Loose tooth | X | X | X | X | ||||
Lost bone | X | X | X | X | ||||
Tooth does not look right | X | X | X | X | ||||
Floss use | X | X | X | X | ||||
Gum bleeding | X | X | X | X | ||||
Gum bleeding last 3 months | X | X | X | X | ||||
Loose tooth loss | X | X | X | X | ||||
Gum pain | X | X | X | X | ||||
Gum retraction | X | X | X | X | ||||
Roots visible | X | X | X | X | ||||
Age | X | X | X | X | ||||
Sex | X | X | X | X | ||||
Education | X | X | X | X | ||||
Employment status | X | X | X | X | ||||
Smoking habits | X | X | X | X | ||||
Tooth Loss | X | X | X | X | ||||
AUC | 0.57 | 0.49 | 0.50 | 0.86 | 0.56 | 0.50 | 0.49 | 0.80 |
Sensitivity (%) | 98.6 | 98.4 | 100.0 | 96.8 | 100.0 | 100.0 | 98.2 | 96.8 |
Specificity (%) | 15.6 | 0.0 | 0.0 | 75.0 | 12.8 | 0.0 | 0.0 | 75.0 |
Accuracy (%) | 72.8 | 60.2 | 68.9 | 88.3 | 60.2 | 54.4 | 53.4 | 88.3 |
Precision (%) | 72.2 | 60.8 | 68.9 | 85.9 | 57.7 | 54.4 | 53.9 | 85.9 |
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Machado, V.; Lyra, P.; Santos, C.; Proença, L.; Mendes, J.J.; Botelho, J. Self-Reported Measures of Periodontitis in a Portuguese Population: A Validation Study. J. Pers. Med. 2022, 12, 1315. https://doi.org/10.3390/jpm12081315
Machado V, Lyra P, Santos C, Proença L, Mendes JJ, Botelho J. Self-Reported Measures of Periodontitis in a Portuguese Population: A Validation Study. Journal of Personalized Medicine. 2022; 12(8):1315. https://doi.org/10.3390/jpm12081315
Chicago/Turabian StyleMachado, Vanessa, Patrícia Lyra, Catarina Santos, Luís Proença, José João Mendes, and João Botelho. 2022. "Self-Reported Measures of Periodontitis in a Portuguese Population: A Validation Study" Journal of Personalized Medicine 12, no. 8: 1315. https://doi.org/10.3390/jpm12081315
APA StyleMachado, V., Lyra, P., Santos, C., Proença, L., Mendes, J. J., & Botelho, J. (2022). Self-Reported Measures of Periodontitis in a Portuguese Population: A Validation Study. Journal of Personalized Medicine, 12(8), 1315. https://doi.org/10.3390/jpm12081315