Impact of Partial‐Mouth Periodontal Examination Protocols on the Association Between Gingival Bleeding and Oral Health–Related Quality of Life in Adolescents

Abstract

Background: It is not clear how using partial ‐ mouth periodontal examination (PMPE) protocols affects estimates of the association between gingival bleeding (GB) and oral health–related quality of life (OHRQoL). The aim of the present study is to assess impact of different PMPEs on the association between GB and OHRQoL in 12‐year‐old adolescents. Methods: A total of 1,134 adolescents were evaluated for clinical and subjective variables. GB was determined by full‐mouth examination (FME) of six sites (disto‐buccal [DB], mid‐buccal [B], mesio‐buccal [MB], disto‐lingual [DL], mid‐lingual, and mesio‐lingual [ML]) and different PMPEs were calculated using a 15% cut‐off point: 1) full‐mouth (MB‐B‐DB/MB‐B‐DL); 2) two diagonal quadrants (six sites/MB‐B‐DB/MB‐B‐DL); 3) two randomly selected half‐mouth quadrants (six sites/MB‐B‐DB/ MB‐B‐DL/MB‐DB‐ML‐DL); and 4) the community periodontal index. OHRQoL was assessed using the Child Perceptions Questionnaire (CPQ 11‐14 ). Adjusted negative binomial regression models were used to calculate the rate ratio of CPQ 11‐14 scores for each PMPE. Results: Adolescents with GB showed significantly poorer OHRQoL than their counterparts when FME was used. In contrast, more than half of PMPE protocols did not detect significant associations between GB and CPQ 11‐14 scores in the adjusted analysis. Conclusions: Using PMPE to assess GB in adolescents significantly affects associations with OHRQoL outcomes, depending on the protocol used. PMPEs that evaluated MB‐B‐DL sites of randomly selected half‐mouth quadrants (1 or 2 and 3 or 4) achieved results closer to those obtained with FME.