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Public Health Implications of Chronic Periodontal Infections in Adults

Historical Progress Report

In collaboration with the American Academy of Periodontology (AAP), CDC has convened a Work Group on Periodontal Disease Surveillance. The purpose of this Work Group is to respond to the need for surveillance measures to assess the prevalence of periodontal disease that can be used more broadly in a population. The purpose of the Work Group is to identify reliable and valid self-reported surveillance measures for periodontal infections, as well as possible sentinel sites, events, providers, and payers.

The Work Group's chairman is Robert Genco, DDS, PhD, Professor in the School of Dental Medicine and Director of the Periodontal Disease Research Center, State University of New York at Buffalo, and editor of the Journal of Periodontology.

The first meeting of this Work Group was held in April 2003 prior to the conference. Public Health Implications of Periodontal Infections in Adults, held in Atlanta, Georgia.

In addition to Dr. Genco, original members of the Work Group were:

  • James Beck, PhD, Department of Dental Ecology, School of Dentistry, University of North Carolina
  • Gordon Douglass, Past President, American Academy of Periodontology
  • Paul I. Eke, PhD, Centers for Disease Control and Prevention
  • Jeff Hyman, National Institute of Dental and Craniofacial Research
  • Roy Page, DDS, PhD, School of Dentistry, University of Washington
  • Gary Slade, BDSc, DDPH, Australian Research Centre for Population Oral Health, University of Adelaide, Australia
  • George W. Taylor, DMD, DrPH, School of Dentistry, University of Michigan
  • Scott Tomar, DDS, DrPH, University of Florida College of Dentistry
  • Kaumudi Joshipura, MS, ScD, Harvard School of Dental Medicine

In addition, Alice DeForest and Kimberly Suda-Blake represent the American Academy of Periodontology (AAP) on the Work Group.

Since its inception, the following individuals also have joined the core Work Group:

  • Wenche Borgnakke, University of Michigan
  • Karen Falkner, PhD, Periodontal Disease Research Center, State University of New York at Buffalo
  • Gregg H. Gilbert, DDS, School of Dentistry, University of Alabama at Birmingham
  • Stuart Gansky, DrPH, School of Dentistry, University of California at San Francisco

Over the past two years, the Work Group has met six times:

  • April 2003, Atlanta, Georgia
  • October 2003, Chicago, Illinois
  • April 2004, Atlanta, Georgia
  • October 2004, San Francisco, California
  • March 2005, Baltimore, Maryland
  • June 2005, San Diego, California

Progress to date on the project includes:

  • Completed a literature review on the validity of self-reported measures for periodontal disease, which will be published in Critical Reviews in Oral Biology & Medicine.

  • Held a symposium at the 2004 meeting of the International Association of Dental Research entitled, Use and Validity of Oral Health Measures in Public Health and Epidemiology.

  • Developed CDC/AAP population-based case definitions of severe and moderate periodontitis.

  • Identified datasets from within and outside the United States that include clinical measures of periodontal disease and a variety of self-reported measures. These included:
    • Florida Dental Care Study (FDCS)
    • Myocardial Infarction–Periodontal Disease (Mi–Perio) Study
    • Erie County Study
    • Predictors of Oral Health of African Americans (AADENT)
    • Nurses Health Study (NHS)
    • Health Professional Follow-up Study (HPFS)
    • German Study of Dental Patients Referred to Endodontist
    • Dental-Atherosclerosis Risk in Community Study (D-ARIC)
    • National Health and Nutrition Examination Survey (NHANES)

  • Conducted extensive bivariate and multivariable analysis to identify potential self-reported measure(s) that may predict the prevalence of periodontal disease in a population.

  • Completed analyses of all datasets that identified self-reported questions for periodontal disease.

  • Conducted a CDC-supported pilot study in the Australian National Adult Oral Health (ASAOH) Survey to validate these self-report questions. This phase of the project is currently being conducted and is scheduled to be completed in 2006.

  • Presented a report on the progress and preliminary findings of the Workgroup to staff of the National Institute for Dental and Craniofacial Research in January 2005.

  • Met with representatives of the National Centers for Health Statistics (NCHS) in March 2005 to discuss validating these questions in the U.S. population using the National Health and Nutrition Examination Survey (NHANES).

  • Submitted Letter of Intent (LOI) to NCHS in March 2005 to pilot study our questions with NHANES.

  • Developing a formal proposal to NCHS to pilot test the self-report questions in the U.S. population using NHANES.

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