Development of a Periodontal Risk Assessment Tool for Clinical Teaching

Objectives: Over the past two academic years, the School of Dentistry developed a Periodontal Risk Assessment Tool (PRAT) for students to use with each of their patients. The tool was designed to assess patient periodontal disease risk (low, moderate, and high), to help students discuss periodontal risk with their patients, to educate the patient on their risk factors, and to help the patient modify these risk factors. The aim of this project was to evaluate the reliability of the PRAT from its pilot use in the University of Alberta dental hygiene clinical learning environment.
Methods: The electronic patient records (axiUm) were accessed and data extracted on 444 patients who were treated in the dental hygiene clinic between September 1, 2017 and April 10, 2019. Data was collected in two time points. Results were compared between the PRAT and the commonly used Periodontal Risk Assessment (PRA). Weighted Kappa was used to compare consistencies of PRAT and PRA while paired t-test was used to evaluate significant differences across the two time points.
Results: The average PRAT score between the two time points did not change significantly (T1=8.21±3.32, T2=8.51±2.92, p=0.07). For probing depths ≥5mm between the time points, the mean difference was -1.17±6.00. The weighted kappa value for PRA versus PRAT assessments was low (0.136 & 0.082 for the different time points).
Conclusions: The pilot study revealed some issues with the scale and consistency between time points, therefore future studies will re-evaluate metrics and standards used in a revised PRAT. Although some behavioural and clinical changes were found, better emphasis and explanation about risk factors may help patients achieve more significant improvements in those parameters.