The "gold standard" outcome measure for periodontal diseases is clinical loss of attachment measured with a periodontal probe. All risk factors for periodontal diseases must be estimated against this standard, which provides post hoc evidence of past disease activity. Measurement of clinical attachment level is crude; therefore, rather large changes must be recorded for specificity to be ensured. This apparently results in rather poor sensitivity, masking good predictors that could prove valuable on a population, individual, and site basis. If risk assessment for periodontal diseases is to advance, this problem must be solved.
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