Aim To assess the diagnostic performance of self-reported oral health questions and develop a diagnostic model with additional risk factors to predict clinical gingival inflammation in systemically healthy adults in the United Kingdom. Methods Gingival inflammation was measured by trained staff and defined as bleeding on probing (present if bleeding sites >=30%). Sensitivity and specificity of self-reported questions were calculated; a diagnostic model to predict gingival inflammation was developed and its performance (calibration and discrimination) assessed. Results We included 2,853 participants. Self-reported questions about bleeding gums had the best performance: the highest sensitivity was 0.73 (95% CI 0.70, 0.75) for a Likert item and the highest specificity 0.89 (95% CI 0.87, 0.90) for a binary question. The final diagnostic model included selfreported bleeding, oral health behaviour, smoking status, previous scale and polish received. Its area under the curve was 0.65 (95% CI 0.63 to 0.67). Accepted Article This article is protected by copyright. All rights reserved Conclusion This is the largest assessment of diagnostic performance of self-reported oral health questions and the first diagnostic model developed to diagnose gingival inflammation. A self-reported bleeding question or our model could be used to rule in gingival inflammation since they showed good sensitivity, but are limited in identifying healthy individuals and should be externally validated.
We would like to acknowledge all study participants in IQuaD and INTERVAL for contributing with their information, as well as the trial teams involved in planning, conducting and delivering both trials.
IQuaD was funded by the NIHR HTA (project 09/01/45). INTERVAL was funded by the NIHR HTA (project 06/35/99). No additional funding was obtained to conduct the diagnostic accuracy and prediction studies presented in this paper. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.
- gingival inflammation
- prediction modelling