Abstract

Objective: This study aimed at evaluating bias in the estimates of prevalence of moderate and severe periodontitis for each of four previously identified partial-mouth periodontal examination protocols (PMPE) compared to the gold standard full-mouth periodontal examination (FMPE). Material and Methods: Full-mouth examination data of 3,248 adults ≥ 30 years old from the National Health and Nutrition Examination Survey (NHANES) dataset 2011-2012 was computed to provide periodontitis prevalence according to the case definition by the Centers of Disease Control and Prevention and American Academy of Periodontology (CDC/AAP). Periodontitis prevalence was also computed for the PMPE protocols according to the CDC/AAP definition. As in the partial-mouth exams, ≤ 50% of sites are examined, the criteria of the definition was adjusted accordingly (reduced by half) when computing periodontitis prevalence for PMPE protocols. Absolute bias, relative bias, sensitivity and inflation factor were calculated for the PMPE protocols. Results: Using the CDC/AAP definition, the ranges of relative bias of moderate and severe periodontitis prevalence were 6.8% to 18.1% and 28.4% to 41% in absolute value for the PMPE protocols, respectively. With half-reduced CDC/AAP definition, half-mouth four-site protocol provided small absolute bias (4.2%) and relative bias (11.4%) for the estimates of moderate periodontitis prevalence; corresponding biases for severe periodontitis were -1.1% and -8.2%. Conclusion: The prevalence of moderate and severe periodontitis could be estimated with limited bias when a half-mouth four-site protocol and a half-reduced CDC/AAP case definition were used in combination not only for the NHANES 2009-2010 but also for the NHANES 2011-2012.

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