Screening for periodontitis in pregnant women with salivary enzymes.

AIM: To develop a test for the screening of pregnant women for periodontitis using saliva prior to a dental examination.

METHODS

A cross-sectional research design was employed. Whole unstimulated saliva was collected from 221 pregnant women prior to a dental examination at the Amagasaki Public Health Office and levels of activity of lactate dehydrogenase (LDH) and alkaline phosphatase (ALP), and of occult blood in the saliva were measured. The data were compared with Community Periodontal Index of Treatment Needs (CPITN) scores. The diagnostic performance of LDH, ALP, and occult blood was determined in terms of sensitivity, specificity, and the area under receiver operating characteristics (ROC) curves. The optimal combination of parameters for screening periodontitis was determined at maximum sensitivity and specificity.

RESULTS

Periodontitis (CPITN 3, 4) in 19 women (8.6%) and gingivitis (CPITN 1, 2) in 129 women (58.4%) were observed. The activity levels of LDH and ALP were significantly higher in the pregnant women with periodontitis than those with gingivitis or a healthy periodontium. To distinguish between the pregnant women with periodontitis and the others, a cut-off value of 684 IU/L for LDH and of 75 IU/L for ALP were determined by a ROC analysis. The test combining LDH, ALP, and occult blood showed the highest diagnostic performance; with a sensitivity value of 0.90, specificity value of 0.62, positive predictive value of 0.18, and negative predictive value of 0.98.

CONCLUSIONS

A test combining the parameters salivary LDH, ALP and occult blood is useful for screening pregnant women for periodontitis.