Validity of a Simple Periodontal Disease Screening Tool in Thai Patients

Objectives: To develop and evaluate the validity of a self-reporting questionnaire for periodontitis in the Thai population.

Methods: A cross-sectional analytical study was performed in a group of 300 Thais aged 19-85 years old at the Faculty of Dentistry, Chiang Mai University. Each participant took a questionnaire and received a periodontal status evaluation. Participants were classified into three severity groups using the Centers for Disease Control and Prevention, in partnership with the American Academy of Periodontology (CDC-AAP) criteria. Multivariable ordinal logistic regression analysis was used to achieve the final model. The scoring system was also developed.

Results: One hundred patients of each severity group were recruited. Significant predictors in the final model included age, gender, bleeding gums, tooth mobility, dental flossing, dental check-up frequency, diagnosis by a dentist, and individual assessment of periodontitis. The total derived scores identified the severity group of patients into no/mild, moderate, and severe periodontitis. Our model predicted severity groups correctly in 65.7% of patients, while giving an underestimation of 19.3% and an overestimation of 15%. The area under the receiver operating characteristic curves (AuROCs) equal to 0.92 and 0.80 discriminated moderate and severe from no/mild periodontitis, and severe from no/mild and moderate periodontitis, respectively.

Conclusions: Our periodontal disease screening tool demonstrates adequate accuracy. Its validity should be evaluated in other populations.

1. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005;366(9499):180920.

2. Tonetti MS, Jepsen S, Jin L, Otomo‐Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: a call for global action. J Clin Periodontol. 2017;44(5):456-62.

3. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res. 2014;93(11):1045-53.

4. Department of Health, Ministry of Health. The 8th Thailand National Oral Health Survey 2017 (in Thai). Samcharoen Panich Company Limited; 2018. 1-225.

5. Petersen PE, Ogawa H. The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol 2000. 2012;60(1):15-39.

6. Eke PI, Dye BA, Wei L, Slade GD, Thornton-Evans GO, Beck JD, et al. Self-reported measures for surveillance of periodontitis. J Dent Res. 2013;92(11):1041–7.

7. Blicher B, Joshipura K, Eke P. Validation of Self-reported periodontal disease: a systematic review. J Dent Res. 2005;84:881-90.

8. Zhan Y, Holtfreter B, Meisel P, HoffMann T, Micheelis W, Dietrich T, et al. Prediction of periodontal disease: modelling and validation in different general German populations. J Clin Periodontol. 2014;41(3):224-31.

9. Abbood HM, Hinz J, Cherukara G, Macfarlane TV. Validity of self‐reported periodontal disease: a systematic review and meta‐analysis. J Periodontol. 2016;87(12):1474-83.

10. Carra MC, Gueguen A, Thomas F, Pannier B, Caligiuri G, Steg PG, et al. Self-report assessment of severe periodontitis: Periodontal screening score development. J Clin Periodontol. 2018;45(7):818-31.

11. Genco RJ, Falkner KL, Grossi S, Dunford R, Trevisan M. Validity of self‐reported measures for surveillance of periodontal disease in two western New York population‐based studies. J Periodontol. 2007;78:1439-54.

12. Taylor GW, Borgnakke WS. Self‐reported periodontal disease: Validation in an epidemiological survey. J Periodontol. 2007;78:1407-20.

13. Slade GD. Interim analysis of validity of periodontitis screening questions in the Australian population. J Periodontol. 2007;78:1463-70.

14. Eke PI, Dye B. Assessment of self‐report measures for predicting population prevalence of periodontitis. J Periodontol. 2009;80(9):1371-9.

15. Cyrino RM, Miranda Cota LO, Pereira Lages EJ, Bastos Lages EM, Costa FO. Evaluation of self‐reported measures for prediction of periodontitis in a sample of Brazilians. J Periodontol. 2011;82(12):1693-1704.

16. Yamamoto T, Koyama R, Tamaki N, Maruyama T, Tomofuji T, Ekuni D, et al. validity of a questionnaire for periodontitis screening of Japanese employees. J Occup Health. 2009;51(2):137-43.

17. Wu X, Weng H, Lin X. Self‐reported questionnaire for surveillance of periodontitis in Chinese patients from a prosthodontic clinic: a validation study. J Clin Periodontol. 2013;40(6):616-23.

18. Khader Y, Alhabashneh R, Alhersh F. Validity of self reported periodontal disease questionnaire among Jordanians. Dentistry. 2014;4(2):1-6

19. Saka‐Herrán C, Jané‐Salas E, González‐Navarro B, Estrugo‐Devesa A, López‐López J. Validity of a self‐reported questionnaire for periodontitis in Spanish population. J Periodontol. 2020;00:1-12.

20. Page RC, Eke PI. Case Definitions for Use in Population-Based Surveillance of Periodontitis. J Periodontol. 2007;78(7S):1387-99.

21. Renatus A, Kottmann T, Schwarzenberger F, Jentsch H. Evaluation of a new self-reported tool for periodontitis screening. J Clin diagnostic Res. 2016;10(6):107-12.

22. National Statistical Office, Ministry of Digital Economy and Society. Statistical Yearbook Thailand 2019 (In Thai). Available at: http://service.nso.go.th/nso/nsopublish/pubs/e-book/SYB-2562/files/assets/basic-html/page1.html.

23. Dietrich T, Stosch U, Dietrich D, Schamberger D, Bernimoulin J, Joshipura K. The accuracy of individual self‐reported items to determine periodontal disease history. Eur J Oral Sci 2005;113(2):135-40.

24. Gilbert GH, Litaker MS. Validity of self‐reported periodontal status in the Florida dental care study. J Periodontol 2007;78:1429-38.

25. Torrungruang K, Tamsailom S, Rojanasomsith K, Sutdhibhisal S, Nisapakultorn K, Vanichjakvong O, et al. Risk Indicators of periodontal disease in older Thai adults. J Periodontol. 2005;76(4):558-65.

26. Glavind L, Attström R. Periodontal self‐examination A motivational tool in periodontics. J Clin Periodontol. 1979;6(4):238-51.

27. Pihlstrom BL. Periodontal risk assessment, diagnosis and treatment planning. Periodontol 2000. 2001;25(1):37-58.

28. Cepeda MS, Weinstein R, Blacketer C, Lynch MC. Association of flossing/inter‐dental cleaning and periodontitis in adults. J Clin Periodontol. 2017;44(9):866-71.

29. Bolin A, Eklund G, Frithiof L, Lavstedt S. The effect of changed smoking habits on marginal alveolar bone loss. a longitudinal study. Swed Dent J. 1993;17(5):211-16.

30. Nelson RG, Shlossman M, Budding LM, Pettitt DJ, Saad MF, Genco RJ, et al. Periodontal disease and NIDDM in Pima Indians. Diabetes Care. 1990;13(8):836-40.

31. Shlossman M, Knowler WC, Pettitt DJ, Genco RJ. Type 2 diabetes mellitus and periodontal disease. J Am Dent Assoc. 1990;121(4):532-6.

32. Amarasena N, Ekanayaka ANI, Herath L, Miyazaki H. Tobacco use and oral hygiene as risk indicators for periodontitis. Community Dent Oral Epidemiol. 2002;30(2):115-23.

33. Nelson D, Holtzman D, Bolen J, Stanwyck CA, Mack K. Reliability and validity of measures from the behavioral risk factor surveillance system (BRFSS). Soz Praventivmed. 2001;46 Suppl 1:S3-42.

34. Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988;240(4857):1285-93.

35. Holtfreter B, Albandar JM, Dietrich T, Dye BA, Eaton KA, Eke PI, et al. Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies. J Clin Periodontol. 2015;42(5):407-12.


Bureesri T, Ruengorn C, Sang-in S, Bandhaya P. Validity of a Simple Periodontal Disease Screening Tool in Thai Patients : Original articles. CM Dent J [Internet]. 2023 Jan 26 [cited 2024 May 14];44(1):53-64. Available from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=197

Bureesri, T., Ruengorn, C., Sang-in, S. & Bandhaya, P. (2023). Validity of a Simple Periodontal Disease Screening Tool in Thai Patients . CM Dent J, 44(1), 53-64. Retrieved from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=197

Bureesri, T., Ruengorn Chidchanok,Sang-in Supatra and Bandhaya Panwadee. 2023. "Validity of a Simple Periodontal Disease Screening Tool in Thai Patients ." CM Dent J, 44(1), 53-64. https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=197

Bureesri, T. et al. 2023. 'Validity of a Simple Periodontal Disease Screening Tool in Thai Patients ', CM Dent J, 44(1), 53-64. Retrieved from https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=197

Bureesri, T., Ruengorn, C., Sang-in, S. and Bandhaya, P. "Validity of a Simple Periodontal Disease Screening Tool in Thai Patients ", CM Dent J, vol.44, no. 1, pp. 53-64, Jan. 2023.

Bureesri, T., Ruengorn, C., Sang-in, S., et al. "Validity of a Simple Periodontal Disease Screening Tool in Thai Patients ." CM Dent J, vol.44, no. 1, Jan. 2023, pp. 53-64, https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=197