A new screening method for periodontitis: an alternative to the community periodontal index

BACKGROUND Periodontal screening plays an important role in the prevention of periodontal disease and promotes an improvement in oral health-related quality of life. The World Health Organization's Community Periodontal Index should be carried out by well-trained dentists. However, the Community Periodontal Index is an invasive technique, and if used for periodontal screening, increases the cost of evaluation. In order to overcome these issues, we developed saliva tests for periodontal screening. The purpose of this study was to calculate the sensitivity and specificity of our method for measuring hemoglobin and lactate dehydrogenase levels in saliva. METHODS Inclusion criteria were adults aged over 20 years with at least 20 teeth remaining. The study population comprised 38 men and 54 women with a mean age of 50.03 years. Oral examinations were carried out by dentists, and the number of remaining teeth, presence or absence of calculus, bleeding on probing and pocket depth were recorded. In this study, periodontitis was defined according to the criteria of the Center for Disease Control and Prevention in partnership with the American Academy of Periodontology. In order to examine hemoglobin and lactate dehydrogenase levels in saliva, participants were instructed to chew on a standard-sized tasteless and odorless gum base for 5 min, during which time, stimulated whole saliva was continuously collected. RESULTS The sensitivity and specificity for hemoglobin levels were 0.759 and 0.763, respectively, and 0.722 and 0.711, respectively, for lactate dehydrogenase levels. Combining these two tests, when samples tested positive for both hemoglobin and lactate dehydrogenase, the positive predictive value was 91.7 %. CONCLUSION Measuring hemoglobin and lactate dehydrogenase levels in saliva is a less invasive method than the Community Periodontal Index. Therefore, our saliva tests may be a viable alternative to the Community Periodontal Index for periodontal screening.