Validation of the Oral Health Screening Questionnaire in Predicting Serious Periodontitis Among Adult Filipinos with Type 2 Diabetes Mellitus
Keywords:questionnaire, type 2 diabetes mellitus, periodontitis, Filipino, oral health
Background. Periodontitis affects more than half of patients with diabetes. In resource poor areas in the Philippines, access to routine dental visits may be difficult and thus, a selective approach might be needed to identify those who need dental evaluation and management. An easy-to-administer oral health self-report questionnaire was developed in order to predict serious (moderate to severe) periodontitis.
Objective. The study aims to determine the validity of the Oral Health Screening Questionnaire for Persons with Diabetes (OHSQPD) in estimating the prevalence of serious periodontitis.
Methodology. A cross-sectional criterion-referenced study of 175 participants with T2DM were included in the study. They were asked to answer the questionnaire and then made to undergo a full dental examination to identify the presence and severity of periodontitis. The validity of the questionnaire was assessed by determining the sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver-operating curve (AUROC)with the dental examination as the gold standard.
Results. Using the questionnaire, the prevalence of serious periodontitis was 61% (106) based on an optimal cut-off score of ≥12. At this score, the questionnaire yielded a sensitivity of 80.4% and a specificity of 70.6%, with an AUROC of 0.83.
Conclusion. The OHSQPD is a valid tool in detecting serious periodontitis
International Diabetes Federation. IDF Atlas, seventh edition, 2015. Available from: http://www.diabetesatlas.org/.
FNRI-DOST. Burden of Selected Risk Factors to Non-Communicable Diseases among Filipino Adults. The 8th National Nutrition Survey, 2013. Retrieved from http://obesity.org.ph/v4/wpcontent/uploads/2013/04/8thNNSResultsNCD.pdf.
Yuen HK, Onicescu G, Hill EG, Jenkins C. A survey of oral health education provided by certified diabetes educators. Diabetes Res Clin Pract. 2010; 88(1):48-55. https://doi.org/10.1016/j.diabres.2009. 12.015.
Löe H. Periodontal disease: The sixth complication of diabetes mellitus. Diabetes Care. 1993;16(1):329–34. https://doi.org/10.2337/ diacare.16.1.329.
Wu YY, Xiao E, Graves DT. Diabetes mellitus related bone metabolism and periodontal disease. Int J Oral Sci. 2015;26(7):63-72.
Schmidt AM, Weidman E, Lalla E, et al. Advanced glycation endproducts (AGEs) induce oxidant stress in the gingiva: A potential mechanism underlying accelerated periodontal disease associated with diabetes. J Periodontal Res.1996;31(7):508–15. https://doi.org/ 10.1111/j.1600-0765.1996.tb01417.x.
Preshaw PM, Bissett SM. Periodontitis: Oral complication of diabetes. Endocrinol Metab Clin North Am. 2013;42(4): 849–67. https://doi.org/ 10.1016/j.ecl.2013.05.012.
Apoorva SM, Sridhar N, Suchetha A. Prevalence and severity of periodontal disease in type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus) patients in Bangalore city: An epidemiological study. J Indian Soc Periodontol. 2013;17(1):25-9. https://doi.org/10.4103/0972-124X.107470.
Kowall B, Holtfreter B, Völzke H, et al. Pre-diabetes and well-controlled diabetes are not associated with periodontal disease: The SHIP trend study. J Clin Periodontol. 2015;42(5):422-30. https://doi.org/10.1111/jcpe.12391.
Bitong ED, Jasul GV, Dellosa MAG. Prevalence of periodontitis and its association with glycemic control among patients with type 2 diabetes mellitus seen at St. Luke’s Medical Center. Philipp J Intern Med. 2010; 48(1):9-14.
Lo TE, Lagaya-Estrada MC, Jimeno C, Jasul G. Clinical utility of selfreported oral health measures for predicting periodontitis among adult Filipinos with type 2 diabetes mellitus. J ASEAN Fed Endocr Soc. 2016;31(1):10-17. https://doi.org/10.15605/jafes.031.01.03.
Jimeno CA. Updates on the UNITE for Diabetes Philippine Practice Clinical Practice Guidelines for Diabetes Part 2. PPD Compendium of Philippine Medicine, 2014.
Kiran M, Arpak N, Unsal E, Erdoğan MF. The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. J Clin Periodontol. 2005;32(3):266–72. https://doi.org/10.1111/j.1600- 051X.2005.00658.x.
Engebretson S, Kocher T. Evidence that periodontal treatment improves diabetes outcomes: A systematic review and meta-analysis. J Clin Periodontol. 2013;40(Suppl 14):S153–69.
Teeuw WJ, Gerdes VEA, Loos BG. Effect of periodontal treatment on glycemic control of diabetic patients. Diabetes Care. 2010;33(2):421-7. https://doi.org/10.2337/dc09-1378.
Ravindran R, Deepa MG, Sruthi AK, et al. Evaluation of oral health in type 2 diabetes mellitus patients. Oral Maxillofac Pathol J. 2015;6(1):525-31. https://doi.org/10.5005/jp-journals-100037-1030.
Ofilada EJ, Jimeno C. A survey on the barriers to dental care among individuals with type 1 diabetes mellitus. Philipp J Intern Med. 2013;51(2):1-6.
Chaudhari M, Hubbard R, Reid RJ, et al. Evaluating components of dental care utilization among adults with diabetes and matched controls via hurdle models. BMC Oral Health. 2012;12:20. https://doi.org/10.1186/1472-6831-12-20.
Becker W, Berg L, Becker BE. Untreated periodontal disease: A longitudinal study. J Periodontol.1979;50(5):234-44. https://doi.org/ 10.1902/jop.19220.127.116.11.
Matuliene G, Pjetursson BE, Salvi GE, et al. Influence of residual pockets on progression of periodontitis and tooth loss: Results after 11 years of maintenance. J Clin Periodontol. 2008;35(8):685-95. https://doi.org/ 10.1111/j.1600-051X.2008.01245.x.
Lorrentz TCM, Cota LOM, Cortelli JR, Vargas AMD, Costa FO. Tooth loss in individuals under periodontal maintenance therapy: Prospective study. Braz Oral Res. 2010;24(2):231-7. https://doi.org/ 10.1590/S1806-83242010000200017.
Mealey BL, Ocampo GL. Diabetes mellitus and periodontal disease. Periodontol 2000. 2007;44(1):127–53. https://doi.org/10.1111/j.1600- 0757.2006.00193.x.
Eke PI, Genco RJ. CDC periodontal disease surveillance project: Background, objective, and progress report. J Periodontol. 2007;78(7s):1366-71. https://doi.org/10.1902/jop.2007.070134.
Eke PI and Dye B. Assessment of self-report measures for predicting population prevalence of periodontitis. J Periodontol. 2009;80(9):1371- 9. https://doi.org/10.1902/jop.2009.080607.
Miller K, Eke PI, Schoua-Glusberg A. Cognitive evaluation of selfreport questions for surveillance of periodontitis. J Periodontol. 2007;78(7s):1455-62. https://doi.org/10.1902/jop.2007.060384.
American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care. 2015;38(Suppl 1):S1-93.
Dye BA, Barker LK, Selwitz RH, et al. Overview and quality assurance for the National Health and Nutrition Examination survey (NHANES) oral health component, 1999-2002. Community Dent Oral Epidemiol. 2007;35(2):140-51. https://doi.org/10.1111/j.1600- 0528.2007.00310.x.
Albandar JM, Brunelle JA, Kingman A. Destructive periodontal disease in adults 30 years of age and older in the United States, 1988- 1994. J Periodontol. 1999;70(1):13-29. https://doi.org/10.1902/ jop.1918.104.22.168.
Beck JD, Koch GG, Rozier RG, Tudor GE. Prevalence and risk indicators for periodontal attachment loss in a population of older community-dwelling blacks and whites. J Periodontol. 1990;61(8):521- 8. https://doi.org/10.1902/jop.1922.214.171.1241.
Khader Y, Alhabashneh R, Alhersh F. Development and validation of a self-reported periodontal disease measure among Jordanians. Int Dent J. 2015;65(4):203-10. https://doi.org/10.1111/idj.12170.
Zhan Y, Holtfreter B, Meisel P, et al. Prediction of periodontal disease: Modelling and validation in different general German populations. J Clin Periodontol. 2014;41(3):224–31. https://doi.org/ 10.1111/jcpe.12208.
Lai H, Su CW, Chiu SY, et al. A prediction model for periodontal disease: Modelling and validation from a National Survey of 4061 Taiwanese adults. J Clin Periodontol. 2015;42(5):413–21. https://doi.org/10.1111/jcpe.12389.
How to Cite
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to email@example.com or firstname.lastname@example.org.
A written agreement shall be emailed to the requester should permission be granted.