Self-Reported Periodontal Symptoms and Clinical Periodontal Status in Older Adults With and Without Dementia: A Population-Based Diagnostic Accuracy Study

Abstract

Aim

To evaluate the diagnostic accuracy of self-reported periodontal symptoms compared to clinical periodontal status among older adults with and without dementia.

Materials and Methods

This cross-sectional study included adults ≥ 75 years of age who underwent public dental checkups in Japan. Self-reported gingival bleeding and tooth mobility were assessed as index tests against conceptually matched clinical reference standards: bleeding on probing (BOP) and clinically evaluated tooth mobility (Miller Grade ≥ II), respectively. Dementia status was obtained from health records. Sensitivity, specificity, positive and negative predictive values and area under the receiver operating characteristic curve (AUC) were calculated overall and stratified by dementia status.

Results

Of the 158,990 participants (3.9% with dementia), 61.2% were BOP-positive and 22.5% had Miller Grade ≥ II tooth mobility. Self-reported gingival bleeding showed poor diagnostic accuracy for BOP-positive status (AUC: 0.54; sensitivity: 0.24; specificity: 0.85). Self-reported tooth mobility showed higher but limited accuracy for Miller Grade ≥ II (AUC: 0.66; sensitivity: 0.43; specificity: 0.90), with lower accuracy in participants with dementia (AUC: 0.61) than in those without dementia (AUC: 0.67).

Conclusions

Self-reported periodontal symptoms showed limited diagnostic accuracy in adults aged ≥ 75 years, with the awareness gap most pronounced for tooth mobility in individuals with dementia.