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Comparison Between the 2017 EFP/AAP and CDC/AAP Case Definitions on Periodontal Status and Their Association With
Gro Eirin Holde1,2, Dagmar Fosså Bunæs3, Birgitta Jönsson1,4
1The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway.
Objectives:
To describe the prevalence, extent and severity of periodontitis in an adult Norwegian population, using the 2017 EFP/AAP and CDC/AAP case definitions, and their associations with potential risk factors for periodontitis. A secondary aim was to explore how the stage and grade of periodontitis shifted when complexity and risk factors were added.
Material And Methods:
A subsample of participants (≥ 40 years, n = 21,083) in a cross-sectional health study (Tromsø7, 2015-2016) was invited to an oral health examination (n = 3946). Radiographic bone loss and four site measurements of periodontal probing depth (PPD) and bleeding on probing were recorded for 3701 adults.
Results:
According to EFP/AAP, 89% of participants had periodontitis (21% stage III-IV), while 74% had periodontitis defined by CDC/AAP (12% severe periodontitis). Five percent of stage III/IV cases and 22% of severe cases had generalised disease. Higher age, frequent use of dental care, smoking and higher body mass index were associated with periodontitis for both definitions. PPD contributed to a shift to more severe stages. Smoking contributed the most to the shifting of grade, with 7% of cases shifting to grade C.
Conclusions:
Periodontitis was highly prevalent according to both case definitions. Associations with known risk factors remained relatively consistent between the two case definitions. Complexity and risk factors played a significant role in the shifting of stage and grade of periodontitis.
