A Clinical Validation of Self‐Reported Periodontitis Among Participants in the Black Women’s Health Study

Abstract

Background There is a paucity of data on the validity of self-report of periodontal disease in African Americans. The Black Women’s Health Study (BWHS), a United States national cohort study of 59,000 black women followed via mailed questionnaires since 1995, offered the opportunity to clinically validate self-reported periodontitis among a sample of participants. Methods Oral health questionnaires were sent to study participants residing in Massachusetts. Respondents living in the Boston metro area were invited for clinical examination. Self-reports were compared with clinical data obtained from the 77 women (mean age: 59 years) who were examined. The authors examined the predictive ability of individual and combined questionnaire items with respect to clinical periodontal disease severity. Validation parameters were calculated for each question, and receiver operating characteristic statistics were generated to compare questionnaire items. Results Periodontitis prevalence in the validation sample was 24% for severe periodontitis and 61% for moderate disease. Performance of individual questionnaire items with respect to predicting periodontitis was better for severe compared with moderate disease. Combinations of questionnaire items improved the predictive ability with respect to severe disease beyond that of individual questionnaire items. Conclusions Prevalence of severe periodontitis was similar to other age-comparable populations, without regard for race or sex, whereas prevalence of total periodontitis (moderate and severe) among women of similar age and/or race was much higher. Predictive ability of questionnaire items assessed in the BWHS was similar to that in other studies.

Validity of self‐reported periodontal measures, demographic characteristics, and systemic medical conditions

“…The hypothesis was validated, as all examined self‐reported periodontal screening questions, demographic characteristics such as age and gender, tobacco use, and a number of systemic medical conditions were significantly associated with moderate and severe bone loss. Each individual variable demonstrated generally better predictive ability for severe bone loss compared with moderate bone loss which is in agreement with a previous report . Therefore, this study supports the potential use of these variables in a subjective screening tool for periodontal disease.…”

Predictors of self‐reported oral health in the Black Women's Health Study

“…To our knowledge, this is the largest analysis of self‐reported oral health conducted exclusively in a sample of African American women. Oral health status was assessed at one point in time using previously validated self‐report measures, some of which were validated clinically in a subset of the BWHS population . We found that the predictors of self‐reported oral health in the BWHS are largely consistent with what has been observed in other populations, but we also found different risk factor patterns according to the outcome studied.…”

“…Periodontitis in the NHANES was measured by a dental professional using the CDC case definition . As described above, our validation of self‐reported periodontal disease demonstrated comparable validity . It is possible that in the BWHS, being older and less educated resulted in fewer dental visits and thus fewer opportunities to be diagnosed with periodontal disease.…”

“…In the BWHS, 20 percent of women reported gum disease with bone loss, a self‐report measure with demonstrated clinical validity with severe periodontitis. Clinical validation of self‐reported periodontal disease with bone loss in the BWHS resulted in a 0.71 and 0.65 sensitivity and specificity, respectively …”

“…For the purposes of this investigation, we considered self‐rated oral health (Excellent, Very good, Good vs. Fair, Poor) and self‐reported periodontal disease (Yes vs. No) as the outcomes/dependent variables of interest, both of which have been clinically validated in this study population, while the remaining were examined as independent predictors (see below).…”