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Evaluation of accuracy and variability of scoring-area-based plaque indices. A laboratory model
Background:
Plaque scoring, using a variety of indices and methods, is widely used in clinical dentistry. There is limited information on inter- and intra-examiner variability and almost no data on examiner accuracy.
Aims:
The aim of this study, was to determine the inter- and intra-examiner variability and accuracy of 15 examiners, of differing plaque-scoring experience, in recording and judging plaque areas from simulated plaque on tooth charts.
Methods:
Plaque, shaded red, was drawn onto tooth charts of 8 simulated "patients" and measured by planimetry by 1 investigator. For each tooth for each "patient", examiners subjectively copied the plaque onto blank charts and scored plaque in 5% increments for the global plaque index. This was repeated on 2 occasions. Drawn plaque areas were determine by the investigator and comparisons made with the actual areas and % scores of plaque.
Results:
For both plaque recording methods, intra-examiner variability was low and slightly better than inter-examiner variability. Reproducing plaque areas showed a high level of accuracy in most examiners, as was judging areas in 5% increments, albeit slightly less accurate than area drawing. Overall examiner experience had little influence on judging plaque areas.
Conclusion:
The data suggest that area-based plaque indices can be scored or recorded accurately and with minimal variability within or between examiners. The laboratory model could be used to train and assess examiners.
