The Validity of Self-reported Gingivitis and Periodontitis: A Systematic Review

Objectives: Self-report is an efficient and accepted means of assessing many population characteristics, risk factors and diseases, but has rarely been used for periodontal disease. The availability of valid self-reported measures of periodontitis would facilitate epidemiologic studies on a much larger scale, allow for integration of new studies of periodontal disease within large ongoing studies, and enable population surveillance of periodontitis. Several studies have been conducted to validate self-reported measures for periodontal disease, but results have been inconsistent. We conducted a systematic review of validation studies of self-report of periodontitis and gingivitis to guide future work in the field.

Methods: A systematic search (Ovid Medline) found sixteen studies that assessed the validity of self-reported periodontitis and/or gingivitis measures against clinical gold standards. Data on self-reported signs, symptoms, perceptions or knowledge of gingivitis of periodontitis or treatment was extracted from these 16 studies.

Results: Three studies provided the patient with a detailed manual for performing a self-exam. The remaining 13 studies asked participants to self-report symptoms, presence of periodontitis itself, or recollection of a dental health professional diagnosing them or providing treatment for periodontitis. Fifteen of 20 self-reported measures for periodontal disease reported appropriate statistics, and 12 of these showed good validity (defined as sum of Sensitivity and Specificity or Positive Predictive Value and Negative Predictive Value >120%). For gingivitis, 7 of 24 self-reported measures reported appropriate statistics, and 2 of these showed good validity.

Conclusion: The review indicates that some measures such as “Has any dentist/hygienist told you that you have deep pockets?”, show promise, but results vary across studies. Validity could be further improved through the inclusion of combinations of several self-reported questions and other predictors of periodontal disease.

Supported by NIH Grant T32-DEO7151 and the Division of Oral Health, at the Centers for Disease Control and Prevention (CDC).