An Updated Review of Clinical Risk Assessment Models to Evaluate Periodontal Disease Progression

Contemporary periodontal practice envisages personalised risk assessment so as to identify individual therapeutic targets that may mitigate disease progression. Personalised periodontics may involve identification of genomes/epigenomes and metagenomics, all of which are technically demanding and expensive. Clinically available tools are therefore required for disease surveillance, especially in large populations with huge socioeconomic disparities. This review examines existing clinical tools assessing modifiable risk factors like tobacco smoking, diabetes mellitus, and pathogenic bacteria, and non-modifiable risk factors like genetic factors, host response, age, gender, socioeconomic status, and psychological stress. Ten models are analyzed: Hexagonal Risk Diagram (PRA), Modified PRA (MPRA), UniFe/PerioRisk, SmartRisk, DentoRisk, Periodontal Risk Calculator (PreViser), American Academy of Periodontology (AAP) Self-Assessment Tool, Health Improvement in Dental Practice Model (HIDEP), Cronin/Stassen BEDS CHASM Scale, and Risk Assessment-Based Individualized Treatment Model (RABIT). While these models offer unique advantages in predicting risk, there are some limitations in their ability to predict patient outcomes in real-life clinical settings. Further studies need to done to improve upon existing risk models.