Development and Design of A Risk Calculator for Future Periodontal Disease

Objectives: The medical or wellness model of periodontal care requires accurate and valid assessment of risk. A computer-based risk assessment tool, the Periodontal Risk Calculator (PRC) has been developed to meet this need. Methods: The design parameters used in developing the PRC are: (1) A risk factor was defined as a factor that is part of the causal chain of disease, or exposes the patient to the causal chain, which if present directly increases the probability of disease occurring and if absent reduces the probability; (2) A risk factor must have a scientific basis that is supported by publications in refereed scientific journals; (3) All information needed for the PRC must be obtained during a traditional periodontal examination; (4) The time required for data collection and input must fit within the usual time allocated for a traditional periodontal examination. Only 22 data points are used. 12 are measurements of periodontal pocket depth and radiographic alveolar bone height reported by sextant using a 3-point scale and others include periodontal bone defects, bleeding on probing, calculus, smoking, and diabetes. Risk scores are calculated and expressed on a 5-point scale. Results: Risk scores calculated by PRC have been shown to be highly accurate and valid (p < 0.0001). The variation between dentist- and PRC-assigned risk scores has been reported. Conclusions: Risk scores can be used to guide treatment urgency and aggressiveness and to develop risk-based treatment suggestions, and changes in status can be used to measure treatment effectiveness. Use of the PRC and suggested risk-based treatment options over time may be expected to result in more uniform clinical periodontal decision making, a reduction in disease incidence, improved oral health, a significant reduction in the need for complex periodontal treatment and reduction in the cost of care. Supported by Dental Medicine International, Inc.