I read Dr. Chester Douglass’ November JADA supplement article, "Risk Assessment and Management of Periodontal Disease," (
JADA 2006;137[supplement 3]:27S–32S[Abstract/Free Full Text]
), with great interest. The assessment of risk caused by periodontal disease is an essential factor during treatment and maintenance phases.
In trying to make a comprehensive assessment of risk caused by periodontal diseases, several factors need to be considered and analyzed, leading to a great degree of variation in the assessment of risk between general dentists and periodontists and among periodontists themselves.1 Manually summarizing and analyzing these factors could be a complex process, and a computer-generated risk assessment model becomes a necessity to assess the risk caused by various forms of periodontal disease.
Various risk assessment models for periodontal disease are in vogue, such as the Oral Health Information Suite (OHIS)2 and the Periodontal Risk Calculator (PRC).1 However, the biggest drawback of these models is that different patient-based factors are considered that might, or might not, contribute to the predictive ability of these risk assessment models. In addition, these models have been used prospectively or retrospectively to assess risk, thus confounding periodontists both in the selection, as well as in the interpretation, of data from a risk assessment model.3
In an era when there is a transition occurring in periodontics from a normal health care delivery model to a complete wellness model,4 there is an attempt to create and develop tools that can aid a general dentist, periodontist or even a patient to assess his or her oral hygiene and periodontal status. From simple questionnaire-based risk assessment models ("www.perio.org/consumer/-4a.html#") to slightly more complex periodontal risk calculators ("www.geocities.com/viswa_chandra/Risk_assessment_model.xls"), there is a surge in the variety of tools a clinician has at his or her disposal.
Thus, the use of computer-generated risk assessment tools, over time, may be expected to result in more accurate periodontal clinical decision making, improved treatment protocols and, indirectly, the reduction of complex therapies. These tools also may help prevent the effects of periodontal disease, such as bone and tooth loss.
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