Contesting the conventional wisdom of periodontal risk assessment

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dc.contributor.authorRaittio, Eero
dc.contributor.authorLopez, Rodrigo
dc.contributor.authorBaelum, Vibeke
dc.date.accessioned2025-01-20T17:09:53Z
dc.date.available2025-01-20T17:09:53Z
dc.date.issued2024
dc.description.abstractOver the years, several reviews of periodontal risk assessment tools have been published. However, major misunderstandings still prevail in repeated attempts to use these tools for prognostic risk prediction. Here we review the principles of risk prediction and discuss the value and the challenges of using prediction models in periodontology. Most periodontal risk prediction models have not been properly developed according to guidance given for the risk prediction model development. This shortcoming has led to several problems, including the creation of arbitrary risk scores. These scores are often labelled as 'high risk' without explicit boundaries or thresholds for the underlying continuous risk estimates of patient-important outcomes. Moreover, it is apparent that prediction models are often misinterpreted as causal models by clinicians and researchers although they cannot be used as such. Additional challenges like the critical assessment of transportability and applicability of these prediction models, as well as their impact on clinical practice and patient outcomes, are not considered in the literature. Nevertheless, these instruments are promoted with claims regarding their ability to deliver more individualized and precise periodontitis treatment and prevention, purportedly resulting in improved patient outcomes. However, people with or without periodontitis deserve proper information about their risk of developing patient-important outcomes such as tooth loss or pain. The primary objective of disseminating such information should not be to emphasize assumed treatment efficacy, hype individualization of care, or promote business interests. Instead, the focus should be on providing individuals with locally validated and regularly updated predictions of specific risks based on readily accessible and valid key predictors (e.g. age and smoking).
dc.fuente.origenWOS
dc.identifier.doi10.1111/cdoe.12942
dc.identifier.eissn1600-0528
dc.identifier.issn0301-5661
dc.identifier.urihttps://doi.org/10.1111/cdoe.12942
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/91073
dc.identifier.wosidWOS:001145318100001
dc.issue.numero4
dc.language.isoen
dc.pagina.final498
dc.pagina.inicio487
dc.revistaCommunity dentistry and oral epidemiology
dc.rightsacceso restringido
dc.subjectperiodontal diseases
dc.subjectperiodontics
dc.subjectprognosis
dc.subjectrisk assessment
dc.subjectstatistical model
dc.titleContesting the conventional wisdom of periodontal risk assessment
dc.typeartículo
dc.volumen52
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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