2012 Volume 55 Issue 4 Pages 255-264
Objective: CPI is usually employed for mass-screening for periodontal disease. However, as the examination is time-consuming and causes a large burden on the patients, a simpler method of screening for periodontal disease is desired. In this study, we evaluated the effectiveness of a periodontal screening method combining test paper saliva testing and a symptom-oriented questionnaire survey. Materials and Methods: The subjects were 468 adults (362 males and 106 females, with a mean age of 36.6 years) who underwent a group medical examination by their company and consented to the investigation. The samples used for saliva testing were the fluids discharged after rinsing the mouth with distilled water. The items of saliva testing were hemoglobin, protein, white blood cells, and turbidity. Hemoglobin, protein, and white blood cells were examined using test paper and a special reflectometer. The turbidity was determined as the absorbance at 660 nm. The questionnaire consisted of items related to symptoms (12 items), smoking habit, and age. Screening for periodontal disease was performed using CPI, and the subjects were divided into those with and without periodontal pockets. The relationship of each of the saliva testing items with the presence of periodontal pockets was evaluated by the t-test, and items with high sensitivity were selected by calculating the sensitivity and specificity from the ROC curve. Items of symptoms related to the presence of periodontal pockets were selected by the chi-square test. Moreover, the sensitivity and specificity were calculated by combining the results of saliva testing and answers to the questionnaire, and the optimal combination was evaluated. Results: 1. Of the saliva testing items, hemoglobin, protein, white blood cells, and turbidity were all significantly correlated with the presence of periodontal pockets, and hemoglobin showed the highest sensitivity. 2. Concerning symptoms, a high sensitivity was achieved by combining the 5 items of "The gingiva occasionally bleeds during brushing of teeth", "The gingiva is reddened or darkened", "Food is often caught between teeth", "There are loose teeth", and "Have difficulty in biting hard foods". The sensitivity was further enhanced by adding smoking habit and age. 3. Regarding combinations of the results of saliva testing and answers to the questionnaire, the sensitivity was maximized if periodontal disease was considered positive when hemoglobin was positive or when 4 or more of the 5 items of symptoms, smoking habit, and age were positive. Conclusion: A combination of saliva testing using test paper and a questionnaire primarily regarding symptoms was suggested to be useful as a simple method of screening for periodontal disease applicable to industrial dentistry situations.
