Validity of Self-Reported Periodontal Disease: A Systematic Review and Meta-Analysis

Periodontal disease is shown to be related to other systemic diseases. However in order to assess this relationship, large epidemiological studies are required. Such studies need validated self-report measures. The aim of this systematic review was to assess the validity of self-reported measures in the diagnosis of periodontal disease. The review followed PRISMA guidelines. Medline, Embase and Google Scholar were searched up to January 2016. Two periodontal journals were searched manually. Two reviewers independently made study selection and data extraction. All disagreements were resolved after discussion with a third reviewer. Risk of bias was evaluated using The Quality Assessment tool for Diagnostic Accuracy Studies tool. Sensitivity, specificity, diagnostic odds ratio and 95% confidence interval were calculated. Out of 933 papers found, 11 were selected for the review. All the studies, except two, had acceptable quality. Study size ranged from 114 to 1426 participants. Four comparable studies were selected for meta-analysis. Sensitivity and specificity ranged from 4% to 93% and 58% to 94%, respectively. Diagnostic odds ratio was 1.4 (95% confidence interval 0.9 - 2.2) for question on bleeding gums and 11.7 (95% confidence interval 4.1 - 33.4) for question on tooth mobility. Heterogeneity was low for most of the questions except questions on painful gums and tooth mobility. Self-reported periodontal disease has acceptable validity and can be used for surveillance of periodontal disease in large epidemiological studies. However, there is a need for large well-designed diagnostic studies.