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Case Definitions for Use in Population-Based Surveillance of Periodontitis.

Roy C Page1, Paul I Eke2

  • 1Regional Clinical Dental Research Center, Schools of Dentistry and Medicine, University of Washington, Seattle, WA.

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|March 15, 2018
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Summary

Standardized definitions for periodontitis are crucial for population studies, as current diagnostic criteria evolve. Accurate measurements of probing depth and clinical attachment level are key for consistent periodontitis prevalence assessments.

Keywords:
Periodontal diseasesurveillance

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Area of Science:

  • Periodontology
  • Epidemiology
  • Dental Public Health

Background:

  • Historically, periodontitis and gingivitis were viewed as a disease continuum.
  • Numerous definitions for periodontitis have been employed in population-based studies, lacking a universally accepted standard.
  • Six national US surveys from 1960 to 2000 show an evolution in periodontitis case definitions and protocols.

Purpose of the Study:

  • To review the evolution of periodontitis case definitions used in national surveys.
  • To highlight the importance of standardized clinical case definitions for accurate periodontitis prevalence estimation.
  • To discuss the role of probing depth (PD) and clinical attachment level (CAL) in defining periodontitis severity.

Main Methods:

  • Review of historical national US surveys on periodontal disease (1960-2000).
  • Analysis of diagnostic criteria, including probing depth (PD), clinical attachment level (CAL), bone loss, and bleeding on probing.
  • Examination of the 1999 International Workshop classification and subsequent efforts for standardized definitions.

Main Results:

  • Clinical diagnosis of periodontitis relies on PD, CAL, bone loss, and bleeding on probing.
  • Accuracy and reproducibility of PD and CAL measurements significantly impact disease prevalence estimates.
  • The 1999 AAP classification, while influential, has been further refined for population studies.

Conclusions:

  • Standardized clinical case definitions for periodontitis are essential for reliable population-based studies.
  • Refined definitions incorporating thresholds of PD, CAL, and affected sites improve the accuracy of periodontitis prevalence determination.
  • Ongoing efforts aim to standardize periodontitis classification for public health surveillance.