Raittio E, Lopez R, Baelum V. Contesting the conventional wisdom of periodontal risk assessment. Community Dent Oral Epidemiol 2024; DOI: 10.1111/cdoe.12942.

Personalised advice should be enough.

Risk expresses the probability that change between two states (eg health to disease) will occur over time. In periodontal risk studies, the concepts of both probability and time are usually overlooked. Here, the authors question both the value and ethics of the use of risk prediction models and assessment tools in periodontal therapy. They argue that:

  • Risk prediction models lack proper development and evaluation and have been commercialised since inception

  • There are no studies of the impact on outcomes of informing the patient of risk prediction

  • Risk prediction gives no information about causation

  • The unethical use of labelling patients as ‘very high risk' as a motivational tool for behaviour change or commercial gain. Motivational communication needs to be personalised, respectful and informative.

The authors conclude that effective periodontal care depends on providing the patient with individual, locally validated, regularly updated predictions of personal risks (age, smoking etc) for which ‘a simple conversation may be sufficient for most clinical encounters.'