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

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.