Predictive Values of Self‐Reported Periodontal Need: National Health and Nutrition Examination Survey III

Background: This study assessed predictive values of self‐reported periodontal need to identify periodontal conditions using clinical examinations as the gold standard. Methods: We identified 12,370 adults ≥18 years of age in the third National Health and Nutrition Examination Survey. Self‐reported periodontal need was based on participants responding that gum treatment and/or cleaning was needed when asked: “What type of dental care do you need now?” Two periodontal conditions were at least two sites with pockets (pockets ≥3 mm or pockets ≥4 mm) and at least two sites with calculus. Main outcomes were: 1) positive predictive value (PPV Clean ): proportion of those who self‐reported the need for cleaning who had calculus; and PPV Gum : proportion who self‐reported the need for gum treatment who had pockets; 2) negative predictive value (NPV Clean ): proportion of those who self‐reported no need for cleaning who did not have calculus; and NPV Gum : proportion who self‐reported no need for gum treatment who did not have pockets; 3) association between predictive values and sociodemographic and behavioral characteristics; and 4) proportion of individuals with specific sociodemographic and behavioral characteristics whose self‐reported periodontal need predicted periodontal conditions. Results: The prevalence of periodontal conditions influenced predictive values. Calculus prevalence = 85%: corresponding PPV Clean = 88% and NPV Clean = 16%. Prevalence of pockets ≥3 mm = 47%: corresponding PPV Gum = 62% and NPV Gum = 54%. Prevalence of pockets ≥4 mm = 11%: corresponding PPV Gum = 25% and NPV Gum = 90%. Ninety percent of 30‐ to 44‐year‐old minority female smokers who did not visit the dentist in the past year and reported the need for gum treatment had pockets ≥3 mm (PPV Gum = 90%). Conclusions: Self‐reported periodontal need (cleaning/gum treatment) predicted the presence of the prevalent conditions (calculus/pockets ≥3 mm). Not reporting a need for periodontal treatment predicted the absence of the less common condition (pockets ≥4 mm) but not the more prevalent condition (calculus).