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

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.

Evaluation of gingival bleeding awareness by comparison of self-reports and clinical measurements of freshman dental students.

OBJECTIVE: The aims of this descriptive, cross-sectional investigation were to evaluate the gingival health awareness of dental students by comparing their clinical gingival bleeding scores and self-reports, and to compare differences in awareness between males and females. METHODS: In total, 100 (51 males, 49 females) freshman dental students were included in the study. Periodontal indices recorded were: Presence of plaque percentage (plaque index [PI], %), percentage of sites of bleeding on probing (BOP, %), probing depth, and community periodontal index (CPI). Percent agreement, kappa agreement, sensitivity, and specificity were calculated by comparing their self-reported gingival bleeding and BOP%. RESULTS: The self-reports of gingival bleeding exhibited statistically significant correlations with BOP% in females (r = 0.42, P = 0.003). Female students showed a higher degree of awareness when kappa agreement, 0.23 (males: 0.16, females: 0.39), sensitivity, 48% (males: 42%, females: 51%), and specificity, 95% (males: 90%, females: 100%) were calculated. Although male dental students had higher PI and CPI scores, there was no significant difference by gender in the clinical measurements. CONCLUSIONS: According to our results, the validity of self-reported gingival bleeding was higher among dental students than in previous population-based studies. Female dental students showed a higher degree of awareness than males of their gingival health. Half of the included dental students could not differentiate whether they had gingival bleeding when there was actual bleeding. More emphasis should be given to the education of dental students regarding the relationship between gingival bleeding and active periodontal disease.