Community-based Screening and Prevention Model for Periodontal Disease

Periodontal disease continues to be a significant health problem and is one of the major causes of tooth loss in adults in Taiwan and throughout the world. American Dental Association (ADA) with the endorsement of the American Academy of Peridontology (AAP) introduced the Periodontal Screen and Recording IndexTM(PSR) as the system recommended for the early detection of patients with periodontal disease. The clinical burden of diagnosis and confirmatory should be taken into account even though applying PSR in community. In this circumstance, one needs to screen general population on the basis of predictive model to ascertain high-risk subjects that in turn receive confirmatory diagnosis at second stage. However, application of periodontal screen modality to population-based periodontal disease screening with one-stage or two-stage design in community has been hardly addressed. In this project, we aim to construct a risk predicting model for periodontal pocketing based on community periodontal screening data by using hierarchical model. The evidence will be translated into clinical weights for further developing the risk score for periodontal disease accordingly. In the present study, we would like to construct a multi-state Markov model to depict periodontal disease nature history. Accordingly, the proposed model will be used to apply to different scenarios considering risk-score based screening, conventional screening, and pass care by using computer simulation. Cost-effectiveness analysis is further assessed. Accordingly, we proposed a two-year project. The objectives are stated below: Year 1 (Aug 2012 to July, 2013) (1) Systematical review for literatures regarding risk factor on periodontal disease. The hierarchical random effect model is applied to assess the risk factors for periodontal disease based on community periodontal disease screening data. (2) To build risk-score based predict model for periodontal disease. Year 2 (Aug 2013 to July, 2014) (1) To construct a Markov model to depict periodontal disease nature history. Using the above developed model to simulate a hypothetical cohort with characteristics mimicked from a cohort for a Taiwanese community. (2) To perform the cost-effective analysis on the hypothetical cohort which is randomized into different scenarios: risk-score based screening, conventional screening, and pass care.