Low reproducibility between oral radiologists and general dentists with regards to radiographic diagnosis of caries

Abstract

Aim: Early clinical and radiological diagnosis of dental caries is one of the fundamental objectives of clinical dentistry because of the high frequency of the disease and severe complications if caries remains untreated, especially among the elderly and patients with immunodeficiency. Dental panoramic tomography (DPT) is a common radiographic method for evaluating dentition when indicated, especially in an adult population. The aim of this study was to assess the reproducibility of diagnosis between specialists in oral radiology and general dentists with regards to caries lesions based on DPTs of adults.

Material and methods: One-hundred DPTs taken from adult patients (average age 35) and then analyzed and reported on by 42 general dentists were then analyzed independently by two specialists in oral radiology with respect to caries lesions in the premolar and molar areas using radiographic criteria established for caries diagnosis. The general dentists versus oral radiologists were not calibrated before. Level of agreement between specialists and general dentists was measured using Cohen’s kappa.

Results: Comparison between observations of general dentists and specialists in oral radiology showed that 61% of the caries lesions on proximal surfaces of premolars and molars observed by specialists went unobserved by general dentists. Cohen’s kappa value for specialists was 0.85 (p < .001) and for each specialist and general dentists 0.48 (p < .001) and 0.44 (p < .001).

Conclusions: The reproducibility between specialists in oral radiology and general dentists for detecting caries in DPTs was low.

Keywords:

• Caries detection
• diagnosis
• general dentists
• image analysis
• panoramic tomography

Acknowledgements

We are grateful to Tuomo Maisala D.D.S. at the Department of Social Services and Health Care of the City of Helsinki for automatic computer randomization of the data.

Disclosure statement

No potential conflict of interest was reported by the authors.