Prevalence of Periodontitis and Methodological Aspects of the 2018 EFP/AAP Classification—The Study of Health in Pomerania (SHIP-TREND)

Abstract

Aim: To estimate the prevalence of periodontitis and highlight methodological issues using the Application of the 2018 Periodontal Status Classification to Epidemiological Survey Data (ACES) framework. Materials and Methods: We used data from the population-based Study of Health in Pomerania (SHIP-TREND; age 20–84 years). Periodontal status was recorded using a half-mouth protocol. We estimated the prevalence of periodontitis, evaluated changes in the assignment of stages to combinations of available complexity factors, associated periodontal status with 7-year tooth loss and illustrated agreement with the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) classification. Results: The total prevalence of periodontitis was 78.6%; 18.0% and 17.4% were Stage III and Stage IV, respectively. Grade C was exhibited by 49.1% of Stage III cases and 37.8% of Stage IV cases. Assignment of stage changed only marginally when complexity factors were considered in addition to interdental clinical attachment levels. Three percent of Stage IV cases and 15.2% of non-classified cases became toothless. Adjusted incidence rates for tooth loss were 3.60 for Stage III cases, 6.55 for non-classified cases and 8.69 for Stage IV cases. Severe cases (CDC/AAP) corresponded primarily to Stage III (42.9%) and Stage IV (53.0%) cases. Conclusions: For public health purposes, caution should be exercised when translating the periodontitis prevalence according to the ACES framework into treatment requirements. Furthermore, complex and effective interventions are required for non-classified and Stage IV cases in order to prevent tooth loss and edentulism.