Validity of a self-reported questionnaire for periodontal status in a Thai population

A self-reported questionnaire developed by the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC/AAP) has demonstrated adequate reliability for evaluating periodontal status in national surveillance surveys--which has been translated and validated in multiple languages--but has not yet been tested in Thai. Therefore, this cross-sectional study evaluated the validity of the CDC/AAP self‑report questionnaire for periodontitis in a Thai population.

The Thai version of CDC/AAP self-reported questionnaire was developed. Full-mouth periodontal examinations were performed, and periodontitis was diagnosed using CDC/AAP 2012 or European Federation of Periodontology (EFP)/AAP 2018 case definition. Association between questionnaire responses and a periodontitis diagnosis was assessed using multiple regression modeling. Several predictive models were constructed and their validity assessed using receiver operating characteristic curves.

The study included 250 participants resided in Chiang Mai, Thailand, aged 20-82 years, with 83.6% and 84.4% diagnosed with periodontitis based on CDC/AAP 2012 and EFP/AAP 2018 case definitions, respectively. CDC/AAP questions revealed a satisfactory performance in predicting CDC/AAP-defined severe periodontitis and EFP/AAP-defined stage III/IV periodontitis. Additional questions regarding demographic data and periodontal risk factors improved the performance. Reduced model constructed using stepwise regression yielded sensitivity versus specificity of 57.8% versus 84.0% and 79.4% versus 81.4% for predicting CDC/AAP-defined severe periodontitis and EFP/AAP-defined stage III/IV periodontitis, respectively.

The questionnaire in Thai version demonstrated better performance in predicting advanced stages of periodontitis when combined with demographic variables and periodontal risk factors. Our findings highlight the potential utility of this tool in diverse populations.

Despite being one of the most common diseases in humans, periodontal disease diagnosis is not easy at the individual and surveillance levels. Efforts have been made to assemble tools to ease the process, and questionnaires are an auspicious tool. This study aimed to validate the self-reported questionnaire developed by the US Centers for Disease Control and Prevention in collaboration with the American Academy of Periodontology for predicting periodontal disease in the Thai population. The validity of the questionnaires was assessed by comparing the self-reported responses to the data collected through a full-mouth examination by a third-year resident from the Periodontology Residency Training Program. In our study, questions related to signs of the disease showed promising validity as a predictive variable for periodontitis, especially its severe form, and the questionnaires performed better when used together with other questions, such as age and education level.